Tuesday, 26 April 2016

Drugs Without the Hot Air

This book, by David Nutt (one of Britain's leading guru of hard-science verdicts on psychoactive drug usage and their harms - he also used to be* a top policy advisor on the topic), is one of those rare kind of non-fiction book, the exquisite and almost impenetrable presentation of brute fact. I love reading these kinds of book about complex and controversial topics - like whether gender is psychologically innate or what the value of socioeconomic equality is - it takes a certain breed of author to systematically pen down logical overviews of enormous depths of evidence, organised into coherent explanatory frameworks, remaining a robust case without descending to polemics, and still somehow being pretty easy to read.
   The core point of the book is that drug use, being essentially a personal health risk, should be treated as such by policymakers. Obviously this entails extensive analysis of said personal health risks, which are surprisingly high for legal drugs** like alcohol and tobacco and public-perception-defyingly low for certain heavily stigmatised drugs like LSD or MDMA. (I've just written a huge fat chunk of fact, in summary from the book, in the second asterisk bit below, so read that now if you didn't at the **). I've clearly had a fair bit of fun embellishing that last lump of argument with colourful detail, but the crux of the point is in the statistics and the science and the policy results, all of which you should check out for yourself - but you'll struggle to find a more reputable source on the matter than David Nutt, so I'd wager. These aggregations of fact force one to question the norms surrounding drug use, both legal and illegal - prohibition of alcohol failed spectacularly in Depression-era America, and the modern-day 'War on Drugs' has failed on a multitude of fronts (which I can't be bothered to go into detail about but is basically a huge waste of money that has among other things: overlapped systemic racism to fuel mass-incarceration of black African-American men on a horrific scale for minor crimes such as possession of weed; consolidated huge power in criminal gangs in the global South; prevented pharmacological access to substances that have shown enormous benefits in treating certain psychological problems; perpetuated societal trends of wasteful decay through the 'greenlighting' of alcohol and tobacco as legal and thus endorsed for irresponsible use; and so on). The community of socio-medical experts on the matter is almost unanimous in calling for policy-making emphasis on drug use to shift from criminality to public health.
   A government's job (imho) is to strike a balance between protecting liberties and protecting wellbeing - the 'War on Drugs' has quite blatantly failed to do this: the harms of highly-problematic substances like alcohol and tobacco are not minimised (the same can be said of crack cocaine and heroin, as the state more instinctively treats such crippling addictions as moral failures rather than behavioural health problems in desparate need of rehabilitation); the liberties to experience certain states of mind is stripped back to ones unlikely to shake up social norms (imagine if social weed-smoking was as prevalent as pint-drinking - how many more interesting conversations and thoughts would we have instead of just-another-night-down-pub, going for a wee every half-hour past about eleven p.m. and feeling unnatural urges for doner kebabs?); I feel like throughout the spread of this post I've already fleshed out some of my key points in support here; to regather - the policy structures in place are nowhere near adequate or accurate to the reality of risks of harms and benefits for these kinds of activity, being as they are governed by the normative dregs of late-20th-century scaremongering rather than by rational presentations or interpretations of fact.
   Anyway. If you feel strongly opposed to everything I'm saying - good, at least you've read this far through the post, now if you want to be reasonable instead of reactionary, I'd recommend you read the whole of David Nutt's book. And if you're really skeptical, check out his scientific and statistical sources.**** On the flipside, if you're a heartily critical liberal like me, you'll probably enjoy this book and find it massively enrich your opinions and informedness about an interesting yet generally poorly-publicly-debated issues facing British/world society today.
   To cap off this post a bit I'd like to offer a bit of personal reflection on the issue of using illegal substances for recreational purposes. For me the clincher here is their [il]legality - I absolutely do not condone such activities, not because their being legislatively prohibited renders them immoral, but because the risks of prosecution are massive, and hippies like me probably wouldn't cope well in the criminal justice system, even just brushing up against it slightly. Also, as a Christian, I must cite the biblical exhortation to in clear conscience obey worldly rulers' laws, as these are people God has put in authority over us, whether I find their exercise of such authority agreeable or not (this is why I'm such a keeno for getting Christians into counter-hegemonic activism, as resignation to political order is often lived out as acceptance of preventable injustice) - since recreational drug use is, in my view, in and of itself a morally neutral activity, I feel abstinence is probably best practice in societies where it's illegal. Despite this, given the weight of evidence about these policies' failures (discussed literally everywhere in this post) in promoting liberties and minimising harms, I do strongly advocate for the decriminalisation of many***** currently illegal psychoactive substances, and for such drugs' availability to be couched in heavy regulation and education for public health. From the sounds of it, there is much communal-emotional and artistic and transcendental-experiential benefit to be had from responsible use of some of these substances, particularly several for which the associated risks of harms are astoundingly low. (See final asterisk bit below.) Needlessly restricting well-informed responsible individuals' access to potentially good things is, in my view, a plain abuse of legislative power - especially when done so through a campaign that fuels and perpetuates so much injustice, not to mention comprehensively failing to minimise harms, or even reduce usage by notable figures.
   This was meant to be a relatively short post. Ah well. I always find it's better to run into fullish explanations of one's own perspective when writing about controversial issues, as putting forth your case with more detail and structure helps prevent angry confused commenters arguing against a straw man of your own creation because you couldn't be arsed to do a proper man. Or it would, if I ever got angry confused commenters. I don't tend to get any commenters at all, because nobody reads this blog, which is fine by me.



* As in, isn't anymore, because in a stunningly ironic demonstration of some of this book's key points, the government 'disagreed' with his scientifically and statistically sound findings and sacked him in 2009.

** Take issue with this phrasing? Think referring to alcohol and tobacco, or even things like caffeine and paracetamol, in the same category as powerful hallucinogenics and the likes of meth, ket, and crack, is ridiculous? It's probably because your definitions of what a 'drug' is have been shaped by a mixture of extreme cultural examples of drug use and public information programmes exaggerating probable harms of drug use to encourage abstinence, rather than the scientific definition of 'drug', which is basically a chemical taken into the body to produce an effect (other than sustenance - we call that 'food'). These effects can be but are not always psychoactive - magic mushrooms, whiskey, and cannabis are examples of drugs that alter one's mental state. Drugs can be used medically (e.g. aspirin, morphine) or recreationally (e.g. most psychoactive drugs, as are the focus of drug policy and this book), and of these psychoactive substances there is no clear or consistent pattern of correlation between their potential harmfulness, experiential intensity, and legal availability.
   For example, let's briefly compare ecstasy to alcohol. The former is linked to between ten and fifty deaths in the UK per year (though looking closer at case-by-case almost all of these result from combinations of poor provision of public education about how to rave responsibly and the risk of dealers fobbing people off with sometimes-dangerously impure substances, which would be an entirely avoidable problem in a legally regulated market) while the latter is linked to the deaths of around 40,000 Brits annually (also linked to 7,000 traffic incidents and 1,200,000 violent incidents per year, not to mention that it has 3,500,000 British addicts (alcoholism being a drug addiction so common to the UK that it seems to have been co-opted and justified as a reasonably widespread sociocultural quirk), is a significant contributing factor in 40% of domestic abuse and 50% of child protection cases, and overall is estimated to cause between £30 and £55 billion [yep] of damage to global societies and economies worldwide every year). Ecstasy is also almost universally described as a more intrinsically pleasant subjective experience than alcohol when taken responsibly (given that rather than slowing down your whole physiology and merely lowering inhibitions, it gives one's brain a bath in seratonin, leading to an energy spurt, also functioning effectively as a chemical flood of happiness and love***). More - whereas booze has been indisputably linked to depression and similar mental health issues on a major scale, experimental treatments using ecstasy have yielded incredibly promising results for otherwise extremely difficult-to-treat disorders (such as PTSD). 
   And yet in the UK, being as it is Class A under the 1971 Misuse of Drugs Act, possession of ecstasy for personal use can (if you're unlucky and get caught by lairy police officers on your way to a warehouse full of banging techno and well-hydrated and surprisingly huggy strangers who automatically feel like friends) slap you in for a seven year sentence, while anyone over the age of 18 can waltz into the nearest Wetherspoons and sit quaffing an enormous range of well-regulated and high-tax-generating and generally-quite-nice-in-moderation [and legal] products until they get into an aggressive stumbling argument with someone because they shouted "BREXIT" ironically and were misinterpreted by that local regular who's an avid xenophobe (perhaps because decades of alcoholism has made it hard to take in any cohesive opinions about the contemporary world more cosmopolitan than, say, those of Nigel Farage).

*** If you have video proof of people on MDMA being anywhere near as aggressive as a standard drunken Englishman, I will buy you a pint. And then fight you.

**** Of course it's fully and extensively referenced! We're not barbarians, are we?

***** Based on David Nutt's book, my own research through reputable portals, and having had some good insightful conversations with friends and acquaintances about their experiences with drugs (one does not simply [do a philosophy degree & be part of an environmental activist group & whatever else - student life is rife with these people and they're largely lovely] without meeting some pretty 'open-minded' folk), I have settled on a short list of some of the most common and widely-known illegal psychoactive substances that I feel should probably be largely legal, at least to the same extent as alcohol, based on their effects and health risks.
   So, in no particular order: common-or-garden weed/hash, LSD, magic mushrooms, nitrous oxide; also skunk and MDMA though possibly in a more highly-regulated category, and ketamine and cocaine in a yet higher one.
   Obviously, given the health and wellbeing foundations of my opinion here, I would only condone the use of such substances if legalised and properly regulated, and with users being fully aware of the physiological risks they're putting themselves at by taking a given drug, including systems for working out and sticking to responsible dosages to avoid social dysfunctionality and physical risk. Acting based upon the best available scientific and statistical information is crucial - you can't be responsible without being aware. I envisage such an endpoint to resemble current markets for alcohol and tobacco: you might buy a gram of coke in branded packaging decorated only by perfunctory information about safe usage and a big cigarette-packet-style picture of some coke-diseased organ or something accompanied by words to the effect of "LOOK AT THIS DISEASE THAT COKE OFTEN CAUSES": you might buy a pre-rolled spliff (if Netherlands-type coffee-shop culture were to filter over as an alternative to English pub culture) that must legally disclose at the point of sale what strength it is, in units, or some kind of measure of tetrahydrocannabinol-(the active chemical in marijuana)-per-joint, much like alcoholic beverages divulge their alcohol-per-drink as a percentage: you might buy a flap of LSD-soaked paper in a well-packaged envelope also containing a small but detailed booklet explaining how to arrange your environment and circumstances optimally.
   Who knows what the future holds?

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