The government's Advisory Council on the Misuse of Drugs has been a focus for media attention in recent weeks. With the dismissal of its Chairman David Nutt and resignation of a further five members, the group faces a difficult few months - but remains as important as ever.
We are gravely concerned about the rapid rise of new and potentially harmful drugs often coined "legal highs", many of which are inexpensive and readily available to young people. In this field of emerging risks, the ACMD can greatly assist the government in formulating a timely and proportionate response.
For example, before much of the recent press coverage of its dangers, the ACMD recognised the growing trend in abuse of the anaesthetic drug ketamine. The ACMD's advice subsequently led to the recommendation that ketamine be made illegal -- which the Home Secretary and parliament accepted and acted upon. In the current parliamentary session there is a proposal to classify a further five drugs or drug classes, including GBL, BZP and various forms of synthetic cannabis often sold under the name "spice". All were recommended for classification by the ACMD as a result of a careful analysis of the scientific evidence for physical and social harms.
The Council also has serious concerns about the increasing use of other synthetic drugs such as mephedrone, and is proposing a more rapid system of appraising such drugs before they get a foothold on our streets.
In keeping the wider picture of substance misuse under review, the Council periodically publishes in-depth thematic reports. These generally receive less media attention than classification decisions; though often have a more profound impact. As a historical benchmark, the ACMD report in 1988 on AIDS and Substance Misuse led directly to a public health response that today leaves us with one of the lowest rates of HIV amongst injecting drug users in Europe. In recent years, the Council has published reports on the impact on children of drug using parents; the patterns of tobacco, alcohol and illicit drug use by young people; and a proposed strategy to tackle the epidemic of Hepatitis C amongst injecting drug-users. If any of these reports has even a fraction of the long-term impact of the 1988 AIDS and Substance misuse report, the Council will be continuing to prove its worth over and above its input on classification.
Much of the recent comment and news coverage has misunderstood the composition of the Council. Of the total ACMD membership of thirty (prior to the recent resignations), eight are research scientists, covering the fields of pharmacology, chemistry, epidemiology, psychology and social sciences. The majority of members are physicians, psychiatrists and other professionals who deal directly with drug-users and the problems that drugs cause in society. These members have expertise spanning mental health and addiction; drug policy, criminology, forensic medicine, and drug treatment. In addition there are two senior police officers, a judge and a member of the Serious Organised Crime Agency. This diverse group, contributing its time without compensation, is well-placed to offer advice to government on all aspects of illicit drug use.
After recent problems, the Council will have to embark on a period of reconstruction. However, it is important to note the quality of work carried out by the ACMD and the positive impact if has made to drugs policy in this country. Over the 38 years since inception, the vast majority of recommendations made by the group have been accepted by government. This also is true of the present government, notwithstanding the problematic handling of the reports on Cannabis and Ecstasy.
The ACMD and government are working to revise working practices. Part of the approach will focus on the Principles for the Treatment of Independent Scientific Advice put forward by the Royal Society, and currently under review by the Chief Scientist, John Beddington. This should help clarify existing guidelines and allow for the distinction between advice and decision making - but treat the evidence and advisors with the respect and transparency they deserve.
We sincerely believe that the relationship between the Council and government can and must be repaired. It is in the wider interests of society that this process be supported and encouraged.
Leslie Iversen and Richard Phillips
December 7, 2009
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