That one disgruntled vet can scupper government plans to outlaw an "evil" chemical is evidence of a clash of philosophies on the role of the state in dealing with risk. It will also be cited as support for the view that the Misuse of Drugs Act is not fit for purpose. View attachment 13948
The system of drug classification and penalties goes back almost 40 years and, it is argued, is too clunky to cope with a modern world in which a new and dangerous drug can move from a Far-Eastern lab to become the drug of choice in British nightclubs in a matter of a few months.
The current structure moves at a stately pace: from considered scientific assessment to ministerial judgement and through the legislative process of both Houses of Parliament. It also contains, as the home secretary discovered this morning, statutory traps which can frustrate ministers wishing to act promptly.
Under the act, Dr Polly Taylor's resignation means the Advisory Council on the Misuse of Drugs (ACMD) is not constituted properly. The 1971 legislation states that the council must include someone with "wide and recent experience of... veterinary medicine" and, at the moment, she is the only vet they've got. Until such time as the committee finds a suitable replacement, the home secretary cannot act (though see update below).
For those who believe delay puts lives at risk, Dr Taylor's action must seem the height of irresponsibility. But for her, it is a matter of profound principle.
The resignation is further fall-out from the home secretary's decision to sack the former chairman of the ACMD, Professor David Nutt, last November. The professor was dismissed after giving an academic lecture in which he criticised the government policy on classifying cannabis and ecstasy, but his departure prompted five members of the Advisory Council to resign, furious at what they saw as an attack on the independence of scientific advisers.
In an attempt to cool matters, the government has published principles on which its relationship with scientific advisers will be founded. The final version was released five days ago. But before the ink is barely dry, Dr Polly Taylor has resigned from the council, saying the code won't stop advice being "subjected to a desire to please ministers or the mood of the day's press".
Dr Taylor is particularly dismayed by a line in the code which says that "Government and its scientific advisers should not act to undermine mutual trust". In her resignation letter [154Kb PDF], she View attachment 13949 says this is "highly unsatisfactory and appeared to justify ministers appointing and dismissing independent scientific advisers according to 'trust' which is an arbitrary and subjective matter".
The affair is evidence of a philosophical divide between a political community which wants to respond swiftly to public anxiety and a scientific community which wants hard evidence before coming to any conclusion.
As a result, there are two distinct views on how government should respond to the arrival of new drugs which pose a potential harm to users.
The first, favoured by politicians, is the so-called precautionary principle: "we don't know how dangerous this substance is, so we will ban it until such time as it can be proved to be safe".
The second is supported by some scientists and academics: "we should not move hastily towards a ban without evidence of the physical harm from a drug because prohibition itself causes harms".
The UK Drugs Policy Commission, an independent academic think-tank, has urged "much caution" before rushing to outlaw mephedrone. "The result would be to potentially create criminal sanctions against users (and hence possible imprisonment) for a drug whose real harms have not even been assessed," says commission Chief Executive Roger Howard. "If the harms were later to be found less than anticipated, then it would be extremely unlikely that any government would 'un-classify' it or downgrade it," he tells me.
Prohibition, it is argued, tends to push price up and purity down, increasing the health risks and prompting more acquisitive crime. A ban also moves production and supply from an observable and potentially controllable legal environment to the underworld. But the counter-argument is that it is the very legality of mephedrone which has increased its popularity. There is evidence that it has now overtaken ecstasy among clubbers, some of whom may believe that because it is legal, it is safe.
Professor David Nutt and Dr Les King, who set up the Independent Scientific Committee on Drugs following their departure from the View attachment 13950 ACMD, have also written to the home secretary [86Kb PDF] urging him to wait before taking action against mephedrone.
They write that: "it is imperative to avoid, particularly in the pre-election period, a knee-jerk reaction to press coverage of deaths that may or may not have been caused by mephedrone".
Their view is that ministers would do better to wait until the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has completed its evaluation of 'legal highs', including mephedrone. A formal risk-assessment is expected to be submitted in early July.
It is self-evident that, with any new drug, it takes time to assemble the hard science on which to judge its relative harm. Despite all the press stories, there is actually no confirmed case in Britain of mephedrone having contributed to any death in any way. That's not to say that it isn't dangerous: today the ACMD is reported to have identified at least 18 deaths in England and a possible seven in Scotland where cathinones, of which mephedrone is one, have been implicated. In seven cases, there was evidence of mephedrone at post-mortem. But, as yet, no inquest has concluded that mephedrone killed someone.
For politicians, though, especially in the febrile atmosphere of an impending election campaign, this is not the time for considered debates about the role of independent scientific advice and risk assessment. As the prime minister told the country at Question Time last week, he is "determined to act to prevent this evil hurting the young people of this country".
Update 1254: Home Office lawyers have been poring over the Misuse of Drugs Act and believe that, even without the requisite vet, the Advisory Council can report and the government can legislate for a ban. A spokesperson has said:
"Based on its current formation, the ACMD is still able to fulfil its statutory role and provide advice on mephedrone today on which we can act. We have said we intend to act immediately on receipt of the ACMD's advice and this is still our intention."
Mark Easton Monday, 29 March 2010
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