Ten years after Professor David Nutt was sacked as chair of the Advisory Council on the Misuse of Drugs (ACMD), I resigned from it.
How far have we come in those ten years in achieving an evidence-informed drug policy, and in protecting the independence of scientific advice?
The short answer is: not very far at all. Drugs are still classed illogically, according to David’s (and others’) work on a scientifically based scale of harms. MDMA and LSD are in class A of the Misuse of Drugs Act, even though they are associated with much lower levels of harm than alcohol and tobacco. Successive governments have not followed the ACMD’s advice to put MDMA in class B, and cannabis back in class C. Last year, over 1,500 children were prosecuted for cannabis possession.
The ACMD has done valuable work in the time since David was sacked. Its 2012 report on naloxone enabled the wider provision of this life-saving antidote to opioid overdose. Its 2016 recommendation to invest in heroin-assisted treatment for people for whom methadone does not work are finally being followed by action in Glasgow and Middlesborough.
But there are many other recommendations that remain unimplemented. Perhaps the most important was the ACMD’s 2016 advice to maintain investment in opioid substitution therapy in order to limit the record levels of drug-related deaths. Despite formally accepting this recommendation, the government has overseen substantial cuts to drug treatment funding, and drug deaths continue to climb.
A huge gap in the use of evidence in drug policy is the continuation of law enforcement as the primary tool. The government’s own evaluation of the 2010 drug strategy acknowledged the lack of evidence to support the costs and harms imposed by this approach. But the Home Office continues to offer increased law enforcement as its knee-jerk response to drug problems.
Apart from a brief mention of diversion from criminalisaton in its responses to the 2010 and 2017 drug strategy consultations (and an unpublished report on how the Misuse of Drugs Act is affected by the Psychoactive Substances Act), the ACMD has steered clear of comment on the overall legal framework for drug control. It is empowered, even obliged, to make such comments by section 1.2 of the Misuse of Drugs Act. But it has rarely done so, perhaps for fear of being seen to be ‘campaigning’ on drug laws.
My resignation in early October 2019 was not because ministers were ignoring ACMD advice. They have the democratic and legal right to do so, even if this does lead to unnecessary, preventable deaths. It was because ministers were not abiding by the ‘working protocol between the Home Secretary and the ACMD’. This was put in place after David’s sacking. It acknowledges the independence of the ACMD.
When it came to light that appointment of suitably qualified experts to the ACMD had been blocked after vetting of their statements on Twitter – and not just on drug policy, but on Brexit and Windrush – it raised concerns that this protocol was being ignored. When ministers refused to provide information or assurances on the vetting process, these concerns were confirmed. As it is now apparent that ministers have been deciding who can join the ACMD on the basis of whether they already agree with them, the independence of the ACMD has been undermined once more. This is yet another backward step in the move towards a drug policy that respected the evidence more than political ideology.
Alex Stevens is Professor in Criminal Justice, University of Kent and will be speaking at the public talk being given by David Nutt later later this month that the Centre is organising with Drug Science.