In February of this year, my supervisor at the time circulated to the members of his group Professor David Nutt’s article (*pdf*) Equasy – An overlooked addiction with implications for the current debate on drug harms [1].
At the time, the Equasy article made us chuckle!
Commentary on the article’s publication made it into the press and I followed the story for a time, including the carefully worded apology given by Nutt in response to the (then) Home Secretary’s demands.
I was surprised by the news, which I first read last night but which is in today’s papers, that Professor Nutt has been asked to resign from his position as Chair of the Advisory Council on the Misuse of Drugs (ACMD).
The ACMD is an “independent expert body that advises government on drug related issues in the UK”. It seems to me that the government did not like the advice. The call to resign is prompted by the publication of Estimating drug harms: a risky business (*pdf*) [2] by the Centre for Crime and Justice Studies at King’s College London.
The article is an edited transcript of a lecture given by Nutt, which I suspect contributes to its narrative clarity. In the article, Nutt introduces the many factors influencing legislation concerning drugs, acknowledging that the advice of the ACMD is but one voice in a debate subject to media influence, public perception and political opinion. Findings relating public perception and media influence are presented, and the interrelationship between these, and their affect on policy decisions, is discussed. Nutt also presents the scale published (*pdf*) in The Lancet in 2007 [3] in which he and his colleagues attempted to parametrize and summarize the risk associated with use of drugs both legal and illegal, resulting in a table that seemed at odds with current drug classification.
Nutt acknowledges
In recent years the whole process of determining drug classification has become quite complex and highly politicised.
What I suspect prompted the call for Knutt’s resignation is his criticism of the government’s approach to drugs legislation that is not based on an assessment of harms. He summarises
A fully scientifically-based Misuse of Drugs Act where drug classification accurately reflects harms would be a powerful educational tool. Using the Act in a political way to give messages other than those relating to relative harms undermines the Act and does great damage to the educational message.
It is a shame that, given his acknowledgment that the scientific voice was unlikely to be the deciding one in legislation, his attempt to offer a more rigorous and honest perspective has been squashed, and that what his findings have to offer was are not acknowledged for what they are – information that could be used to usefully inform decision-making in a tricky and emotive legislative area.
1 Nutt DJ (2009). Equasy– an overlooked addiction with implications for the current debate on drug harms. Journal of psychopharmacology (Oxford, England), 23 (1), 3-5 PMID: 19158127
2 Nutt D (2009). Estimating drug harms: a risky business? Centre for Crime and Justice Studies
3 Nutt D, King LA, Saulsbury W, & Blakemore C (2007). Development of a rational scale to assess the harm of drugs of potential misuse. Lancet, 369 (9566), 1047-53 PMID: 17382831
I was going to blog about this, but wasn’t sure I was on top of the issues, so I am glad you’ve done this. I think it’s shocking that Professor Nutt has been sacked for telling the truth, and shows just how
muchlittle the political classes respect science. My consolation is that this appalling shower will be voted out soon, so perhaps the next government will be able to start with a clean slate. Here’s hoping, anyway.My opinion, for what it’s worth, is that Nutt is right – alcohol and tobacco do far more damage, individually and collectively, than cannabis and ecstasy. Again, in my view, all drugs should be legalized immediately and then taxed.
Interesting stuff, Erika and clearly in a very important area for scientists. I’ve not yet digested all the ins and outs of this but at least this incident is likely to give the issue a good airing.
I did hear Nutt and Sir David King (former Chief Scientific Adviser to the UK govt) discuss this on Radio4’s Today programme this morning (listen to the interview here) and my impression was that King had a slightly clearer perception of the fine line that independent advisers have to walk. I don’t think in his day he was any less outspoken than Nutt, but his criticism was perhaps more implicit than explicit.
Not that I am defending Johnson’s decision to sack him which seems ill-considered.
By-the-bye via Twitter I have learned that, science minister Lord Paul Drayson (@LordDrayson) has picked up on this matter and is ‘looking into it’.
@Henry
I was nervous about this blog post – I do not make a claim to be “on top of the issues” and am terrified of reporting something inaccurate. I did make a point of reading the publication (which, as I said, is very readable) and the press release, and not just the newspaper articles, before posting.
The news report on Nutt’s resignation caught my attention because I had followed the Equasy story, and the controversy surrounding this publication earlier this week. I normally steer clear of political issues – I am more interested in doing science than doing politics. I did my best to keep my blog post neutral because it is so easy to get misunderstood when blogging.
That said, I was shocked by this explicit rejection of scientific advice.
@Stephen, agreed about the difference between King and Nutt on Today. When I was reading Nutt’s article, I was nodding along until I got to the second quotation in my blog post, the one that criticises the MDA as it stands, then I took a sharp intake of breath. To claim that the MDA could be used as a powerful educational tool seemed pointed to me because of Labour’s “Education, Education, Education” mantra – I wasn’t sure if this connection was intentional.
I like the tracking of Drayton on Twitter! It crossed my mind to wonder how Nutt’s successor will be appointed. As yet the ACMD website doesn’t seem to have been updated.
@Henry My consolation is that this appalling shower will be voted out soon, so perhaps the next government will be able to start with a clean slate. Here’s hoping, anyway.
I’m afraid, on this issue at least, you may be disappointed since the shadow home secretary applauded Nutt’s sacking.
Perhaps the BCA or the Society of Homeopaths could provide a new chair for the ACMD.
It is particularly disappointing, being instigated by Alan Johnson, formerly of the DfES. However, that an adviser, scientist or otherwise, has been dumped for not giving politicians the ‘facts’ they want to hear at a particular time is hardly new. Thatcher, a scientist by degree, was apparently very good at ignoring expert opinion. Don’t let’s kid ourselves that the government-in-waiting will be any different.
Several other members of Nutt’s committee have resigned – “http://news.bbc.co.uk/1/hi/uk_politics/8336884.stm”.
It was good to see Elizabeth Blackburn get the Nobel Prize; recalling how she was bumped of Bush’s Council on Bioethics – now, why was that…?
Nutt compared risk of ecstasy with horse riding. Alan Johnson said that the remark was political, given that people in his constituency were unlikely to have ridden a horse. What a stupid thing to say about an assessment of risk, but no more than one might expect from some chippy socialist peasant whose idea of science owes more to Lysenko than to the facts.
@Frank – Hah!
@Henry
I thought this part of Johnson’s response particularly curious. The Equasy paper is a touch tongue-in-cheek but it is not really about horseriding, it is about the assessment and perception of risk. Nutt calls for debate on how harmful activities are tolerated by society. I would like to think that such a debate would be welcomed by politicians, even if they conclude that current drug classification should remain as it is for whatever reason. I think it is clear from this debate that public and political opinion are unlikely to be disentangled from drugs policy.
I remember reading the Equasy article soon after it came out, and I, like Erika, thought it was an amusing twist on risk assessment and perception. I can definitely see the humor and irony in the piece, as well as its more serious message, even though (or perhaps because) I regularly engage in the equasy habit. Horseriding is an undeniably risky and dangerous activity, and I have physician friends and colleagues who think that it is completely insane and reckless to participate in any sort of equestrian activity.
With few exceptions, horseriding is an activity of (relative) socioeconomic privilege. There is no denying that, and it’s true in both the US and the UK. But having been on the receiving end of thinly-veiled and (IMO) unprovoked criticism from this angle many times, I think I recognize the smug self-righteousness behind Alan Johnson’s comment. He’s painting himself as the voice of the socioeconomically underprivileged – as Henry writes, a “chippy socialist peasant” – and we’re meant to ignore the obvious hypocrisy of this position. I call horse-puckey on it.
Dr Grumble seems to be of the same view.
Johnson’s comment smacks of desperation to me. He knows his position is indefensible but has found some spurious justifications through an appeal to populism.
He reminds me a bit of that other chippy socialist peasant, George Bush.
The hypocrisy is that, in an appeal to populism, Johnson has taken a conservative stance, as backed by the haughty tory toff who shadows him. So when the next government assumes office, shall we assume that Nutt will be reinstated?
Nutt won’t be reinstated, but that’s the least of our worries as scientists. The whole issue shows that the political class, whether chippy socialist peasants, or haughty Tory toffs, knows nothing at all about science and affects disdain towards it, as if presentation of the evidence was just one opinion to be counted among many, as literary theorists might recommend. The only political party to come out for Nutt is the Lib Dems – but they can afford to say what they like, as they’re unlikely to be the next party of government.
I agree Henry, in general the politics class it ruins everything.
Ditto. (Blimey!)
Seems like a good sum-up to me 🙂
If Lee Turnpenny and I agree on anything, ever, it means that
(1) It is completely right;
(2) It is catastrophically wrong;
(3) we have suddenly entered an alternate universe in which unspecified hostile powers are capable of launching missiles at Britain with 45 minutes’ notice;
(4) The lady asking whether the bus goes to trhe station has been abducted by aliens;
(5) Other.
(6) No opinion.
The chippy socialist peasant is now being grilled by MPs. I wouldn’t eat him, not even with chips and mushy peas.
Go on, knock yerself out.
We speak different things. In my case the politician in my country enjoy a very good life, good salaries and health but they don’t solve many problems.
¡I hope this clear now!
And now I go to lunch late after so much work.
Then I help them with their dramas.Ok!
Congratulations on so swiftly blogging about this, Erika 🙂
(Apologies in advance to cat lovers)
This issue is partially reminiscent of the BSE Inquiry in the late 90’s in terms of a number of key Scientific Advisors to the Govt. being ignored, “moved on”, or sacked.
I vividly recall watching the Parliament debate/discussion when the UK Govt. responded to the recommendations made by The Members of the Committee of the Inquiry.
During the discussion, an MP from Tyne & Wear highlighted the fact that in 1990, a Scientific Advisor to the Government had submitted significant findings in the form of feline spongiform encephalopathy (FSE):-
Later, between August 1990 and January 1991, transmissions were set up with MAFF funding, in collaboration with Dr Geoff Pearson (Bristol University), from three domestic cats with feline spongiform encephalopathy (FSE) (publication 42). The patterns of disease produced in mice injected with tissues from all five sources closely resembled those in the BSE transmissions, showing that the cats, kudu and nyala had been infected with the BSE strain of agent. This was very important as it was the first direct evidence that a TSE had spread accidentally between species.
SOURCE
Can’t recall word for word what the Tyne & Wear MP said about this, but this is pretty close:- “The ramifications of this research was not what the Government wanted to hear, so what did they do?. They sacked him…… Why??”
That if it is a great drama, Graham. Something is wrong
Quite, Alejandro. You had nice lunch??
“I take my vegetables seriously, and my politicians with a pinch of salt”.
More under the fold on this NN thread.
—
The “drama” continues on Twitter via #nuttsack and the latest here on BBC News.
Spliffing stuff !!
Graham: Listen me, my lunch consist in vegetables; broccoli, cauliflower and roasted chicken, very good tasted made by a English Chef.
The Cheaf leave in Crawley (South of London)and came to Chile and he talk to me of politics of London. He told me that belonged at the politic class Chippy socialist peasants intolerant but now is Haughty Tory toffs small tolerant in England. And I said amicably:
– I care an cucumber.-
bq. Congratulations on so swiftly blogging about this, Erika 🙂
Thank you Graham!
–
I cannot help but wonder if comments are not open on this article for a reason.
Erika – Your blog is good, thank you for the las article.
I think the alcohol (in very much quantity) cause damage.
The drugs, heroin, ecstasy, cocaine,THC etc., cause psychosis and damage. Maybe
Mr. Nutt is no explain very good. The same step below the horses.
Mr. Nutt is very wrong may not be comparing the riding and other risk sports with drug. Is how giving the reason at the drug traffickers. The drug dealers be due very happy with this article. Meanwhile them unhappy addicted are die slowly.
That pain for drug addicts who are consumed very slowly, to death.
That is all.
Poor Mr. Nutt, the same step below the foot of horses. Did not think in Darwin.
The Daily Nimbyist Bungaloid Curtain Twitcher is at it again. Following yesterday’s article from Melanie Phillips, here is A. N. Wilson who refers to scientists such as Nutt as self-appointed ‘Gods Of Certainty’ and then compares scientists with Nazis.
I don’t think I should say more in case I libel anyone.
Henry: I read the articles, were reasonable. In any case human beings make mistakes (myself included).
Hmm. He’s a bit of a confused fellow, isn’t he? There’s a lot of screaming goes on, which is often according to which side of the drug argument people place themselves, and less to do with the issue of disregarding the advice of appointed expert advisers. Those who prefer downgrade to Class C berate the politician who decides not. Those who want to see retention of Class B status, label the scientist who says otherwise a fool. (Personally, I don’t know where I am on the issue of drug classification/legalisation; but I sure as heck get tits-ed off with science being picked up or dropped depending on whether it accords or not with some political or ideological position.) It’s irritating when these paid columnists take the opportunity to ladle up a dollop of Appleyard-ish anti-science, as is evident in Wilson’s article: the ‘gods of certainty’ line is surely more apt for the politician who doesn’t want to be seen to be wrong, as it is likely he/she who then has to resign.
John Beddington, Government Chief Science Adviser, support’s Nutt’s evidence on dangers of cannabis.
Intersting to read Erica! I had no idea about this although it isn’t that uncommon having a clash between the scientist and then turning it into politics imho. It seems to be that way when people like scientists when we {they} have opinions in agreement with “political agendas and perceptions” but when scientists point out that there are no “significant links between A and B or logic to back the reasoning of law C” that’s when the political agenda cuts the science off.
I mean, there is no other explanation if you ask an “independent expert body that advises government on drug related issues in the UK” to form an opinion and then proceed to dissolve the committee. (close to what ‘people’ assume Pharma does with scientist who don’t agree with their agenda, isn’t it?)
In recent years the whole process of determining drug classification has become quite complex and highly politicised I would think that the classification has a slight point in “usage and numbers” correlated to “danger and risk of public health”.
(my disclaimer; this despite I am not a supporter of legal drugs but I would rather have an honest debate than some kind of “hoyty toyty” talk with strange and wrong argumentation)
I lost the last part of my comment…
In recent years the whole process of determining drug classification has become quite complex and highly politicised I would think that the classification has a slight point in “usage and numbers” correlated to “danger and risk of public health”. Although, mainly it is pointing towards “who are using which drugs” and how that influences the perception of what the drug is worth. US and crack vs cocaine comes to mind, as well as pot.
Maybe if Nutts have done a study with more weight something like with severe mental brain damage index and distortion in perception on individuals, would have been better.
and tobacco.
Ah! Forgot, suicide a very important parameter (in my Table).
Finally! this is the table.
I hope it helps someone.
Åsa: How about an investigation into drug related psychoses and mental disorders. I think it would be as close to reality, which is measured by the degree of psychosis and illnesses of the mind and indirectly to the social harm they cause such diseases. I get the impression that this is social risk that politicians wanting to evaluate.
Ah!! Forgot, delinquency a very important parameter (in my Table).
Nutt’s editorial in New Scientist
This government has a very poor record with its expert advisers. Anyone remember David Kelly ?
For anyone following the Nutt story and not on, er, Twitter (where it goes by the hilarious tag #nuttsack), worth checking out David Colquhoun’s take on it at the British Medical Journal. A small masterpiece of understated scorn.
And in the latest twist, Nutt vows to set up new drug body
The tobacco and alcohol stimulants, classified as risk (Nutts, 2009)
Excellent post Erika, and a good discussion.
Thank you Ian 🙂
As Graham said, you can follow developments on Twitter but in the latest, Evan Harris MP has written to Alan Johnson.
I did not see the debate in the House of Commons , although Davis summarises the problems he had with Johnson’s responses in his letter above.
Johnson’s reply is here.
This one didn’t make it into the #nuttsack yet as far as I can tell – it’s Harris’ reponse to Johnson’s response. What people will go to, to not admit they are wrong.
I must admit to following this with a smirk on my face. After years of watching GWB make a complete & humiliating balls-up of handling science policy its refreshing to note that everyone else’s pollies are just as bad.
Hot off
the pressTwitter (followed shortly afterwards by the BBC)Three more
drug baronsdrugs advisers resign“Dr John Marsden, Dr Ian Ragan and Dr Simon Campbell have quit the Advisory Council for the Misuse of Drugs after two others left earlier this month.”
Another interesting commentary on all this can be found here, which also takes a look at the comments of the expert Alan Johnson seems to prefer, Prof Robin Murray.
The only conclusion from all this, as far as I can see, is that Govts are only interested in expert advisers who will publicly agree with them, come what may, and who will not do inconvenient things like discuss the evidence. Politicians seemingly do not understand the concept of “independent”. Funny, that.
Wowzer. Great post.
Note that the latest three to quit the ACMD seem to have quit after their meeting with Johnson today, where apparently they were seeking reassurance that it was recognised at, er, Ministerial level that the ACMD was supposed to provide independent advice.
I am tempted to paraphrase that last sentence as
The fact that they have now quit might lead one to conclude they didn’t get an explanation they found satisfactory – see e.g. Evan Harris’ blog that Heather just linked to.
By jove – whatever next…
#ballssack ??
Another view on today’s meeting between Johnson and the ACMD from BBC journalist Mark Easton.
Lee was quite right to draw parallels with Elizabeth Blackburn’s situation. Politicians really do manage to hear only what they want to. I can only imagine how furious she was to have been led to believe she could make a difference and to find out she was only there to lend some credibility to views that were diametrically opposite to a scientist’s thinking perspective:
“…we feel that some facts that would help the public and scientists better assess the content of the report were not brought out clearly or were omitted entirely.”