The reaction to my report shows how sterile our drugs debate has become. But there's still a chance we can reach consensus.
Since pointing out this week that alcohol is more harmful than any other drug, I have been painted as an alcohol prohibitionist or, conversely, as someone who wants to legalise all drugs. Neither is true, and this misrepresentation is testament to how sterile this debate has become. We must get beyond this.
My interest has always been to develop a rational scale of drug harm to enable policymakers to get to grips with a significant social problem, irrespective of legal status. If alcohol was discovered today it would be controlled as an illegal drug alongside similar sedatives such as GHB and GBL. Certainly it is far more dangerous than any other legally available substance. Of course, many people are social drinkers, apparently unharmed by this pleasure. But if only 10% of the 40 million UK drinkers are significantly harmed, this total is still 10 times that of the next most harmful drug, heroin. Many social drinkers also imbibe at well above the safe levels, their health silently damaged.
Historically alcohol has been treated differently from other drugs. For most of the past millennium beers were the only safe liquid to drink, as river water was so polluted. Small – that is, weak – beer was drunk throughout the day.
Even then the effects of alcohol intoxication and dependence were well recognised and a global temperance movement developed. This led in the 1920s to prohibition in some countries, most notably the US. Most observers suggest this was a disaster.
Since the second world war the alcohol industry has become one of the most powerful and successful in the UK. Intake has grown steadily, each person on average drinking more than twice that consumed in 1945. Successive governments have often made decisions that increase sales, the most significant being the opening up of alcohol sales in supermarkets; increasing the daily hours that alcohol can be purchased, usually at discounted prices; and the extension of pub drinking hours.
The alcohol industry has successfully grown its market into under-age drinking groups by making available innocent-tasting alcopops; advertising alcohol in a glamorous and cool way with "psychedelic" or stimulant overtones; and increasing the availability of high-strength drinks, the most dangerous of which are the 8-9% ciders and lagers, providing the cheapest way to get drunk.
The alcohol industry, naturally, is denying its role in creating this problem and is making no serious attempt to moderate its contribution to the enormous harms caused. One step that could be taken is for parliament to hold an inquiry into the impact of the alcohol lobby on the legislative process over the past generation.
Disease levels caused by alcohol are at record highs and still growing, with ever younger people entering hospital with cirrhosis of the liver. By 2020 liver disease is set to overtake heart disease as the leading cause of death in the UK.
A cross-departmental review of the causes of and solutions to harmful alcohol consumption, by a coalition that has had radically different approaches to drug consumption, may offer a once-in-a-generation opportunity to build a consensus on the regulation of alcohol.
To identify the problem is not, of course, to find the solution. But a coherent policy response does need to be informed by a dispassionate, evidence-based analysis. The Independent Scientific Committee on Drugs has an important role to play. An evidence-based debate may help to overcome the alcohol blindness suffered by so many policymakers and commentators.
Friday 5 November 2010 20.30 GMT
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