Will the mephedrone ban cause more drug deaths?
Fascinating analysis on the Straight Statistics blog suggests that the now-banned drug mephedrone may have saved lives when it was legal.
Professor Sheila Bird, a statistician with the Medical Research Council at Cambridge, has been trying to understand why, after steady rises, there was an unexpected but significant fall in cocaine-related deaths in the first half of 2009.
"One possible explanation," she writes, "might be that cocaine- and ecstasy- users were switching to a less dangerous drug, mephedrone, in and before this period":
"[T]he decision to make mephedrone illegal may have curtailed a notable decrease in deaths. And so closed off a pragmatic harm-reduction strategy - that of switching from illegal cocaine with its documented lethality to a legal high which avoided criminality and the criminals who deal drugs, and which might (or might not) have lower lethality than cocaine."
An article in the Lancet a couple of weeks ago also looked at the mephedrone ban and concluded that "classification of mephedrone has had a limited effect on controlling its availability and use":
"Before the introduction of the legislation, users generally obtained mephedrone via the internet. Now they buy it from street dealers, on average at double the price. We suspect that, in time, there are likely to be reductions in purity, and increases in health harms."
The findings echo warnings from the European Monitoring Centre for Drugs and Drug Addiction [190Kb PDF] over the summer.
Reviewing how the mephedrone ban might play out, a report said "control measures could create an illegal market in mephedrone with the increased risk of associated criminal activity, including organised crime".
The paper accepted that prohibition could be expected to limit the availability of mephedrone but also suggested that the ban "could impact on both the quality/purity and price".
- A health consequence that can be foreseen as a result of control measures are benefits brought about by the presumed reduction in use.
- However, if a significant number of young users continue to use the drug, costs may be incurred by bringing them into contact with the criminal justice system.
- New control measures would imply additional costs related to law enforcement, criminal justice, forensic analysis, testing, etc.
- This control could lead to replacement with other (established or new) psychoactive substances which may in themselves have public health consequences.
- It is not possible to predict whether there will be health or social consequences from any substance that might come to be used as an alternative.
When it comes to drug prohibition, arguments are being increasingly made around the risks of unintended consequences which make matters worse.
Mephedrone was classified as a Class B drug last April, a move with broad political support in the House of Commons. The decision to prohibit its sale and possession followed a report from the Advisory Council for the Misuse of Drugs which said mephedrone has similar effects to amphetamines and can cause temperature changes, heart palpitations and paranoia.
Chair of the council Professor Les Iversen said at the time: "This is not a simple, harmless party drug. Just because it is legal doesn't mean it is safe."
However, an editorial in the Lancet following the decision said the ACMD "did not have sufficient evidence to judge the harms caused by this drug class", adding that "politics has been allowed to contaminate scientific processes and the advice that underpins policy".
Mark Easton, BBC News Online
Tuesday, 23 November 2010
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