30 Dec What The ACMD Doesn’t Know And Can’t Define

We all know that under the Misuse of Drugs Act 1971 (MoDA) possession, production or supply of any drug on the arbitrary ‘hit list’ results in draconian punishment (if you get caught). What some might not know is the role that the Advisory Council on the Misuse of Drugs (ACMD) play. The MoDA is actually an excellent act, allowing safe and sensible regulation of any known drug with a licence (except the Home Office issues next to no licences), but its creators saw the potential furore that combined drugs and politicians and mandated that an independent body, the ACMD, be set up to advise the government with science and evidence. The government didn’t have to listen but they would be flying in the face of evidence which doesn’t bode well long term. So, the ACMD was set up with the following remit – Section 1(2):

“It shall be the duty of the Advisory Council to keep under review the situation in the United Kingdom with respect to drugs which are being or appear to them likely to be misused and of which the misuse is having or appears to them capable of having harmful effects sufficient to constitute a social problem, and to give to any one or more of the Ministers, where either the Council consider it expedient to do so or they are consulted by the Minister or Ministers in question, advice on measures (whether or not involving alteration of the law) which in the opinion of the Council ought to be taken for preventing the misuse of such drugs or dealing with social problems connected with their misuse, and in particular on measures which in the opinion of the Council ought to be taken”

It suddenly occurred to me, what is this term ‘misuse’? Is misuse of a drug getting out of your face and doing something stupid, is it addiction or is something as simple as literally just using the drug in any way, even if said use is done safely and within the comfort of one’s own home? I searched through the MoDA and found nothing so I decided to submit a Freedom of Information Act (FOI) request to get to the bottom of this mysterious term ‘misuse‘.

I eventually got the following reply “The ACMD do not hold the classes of information regarding your request” and that it is “couched” in Section 1(2). That’s strange, how can they justify taking away our civil liberties if they don’t define what constitutes misuse in the first place? I requested an internal review which is still being progressed.

However, whilst that was progressing I re-read their original mandate. It seemed that all their efforts are directed towards the drugs themselves causing a “social problem“. This seemed to be where all the other elements of the law ended in Section 1(2). So, I submitted another FOI to this effect regarding the definition of a ‘social problem’. Guess what… the exact same answer – they “do not hold the classes of information”. So, another internal review to progress.

Lastly, I wanted to know the definition of that other phrase, ‘harmful effects’. We all know that drugs can be harmful (and their harms are greatly increased by prohibition), but what exactly is a harmful effect. If someone defines the euphoria that Cannabis produces as a harmful effect, then fair enough, at least we know, at least there are some goalposts to work within. So, the response to this FOI was probably one of the most interesting. Again, they gave the same initial response about it being couched in Section 1(2), but also linked me to several ACMD publications that I had not yet delved into, but more about that in a minute.

So, three freedom of information requests later and we are still no further along in getting a definition for several key points of the act by which, literally, millions of your fellow citizens are considered criminals. Not sure if I was overreacting I decided to research another topic with parallels – dangerous driving (in that it is also a criminal offense and the term is very broad). I found this from the CPS, where it gives examples of what constitutes dangerous driving (such as “ignoring traffic lights, road signs or warnings from passengers”[1]), but nothing on definitions of misuse or social problems [2]. So, why in one area of the law does the body who classifies drugs not have the information available by which to class these drugs? How can you say someone is misusing a drug if you don’t have a definition of what misuse is? Is it using Heroin? What if it’s using pharmaceutical Heroin (Diamorphine) for pain? Is that different to someone self-medicating without a prescription? The list of rhetorical questions goes on. The fact of the matter is that I think it was deliberately left vague so that any non-sanctioned-non-medical use would constitute misuse, but it is still hard to see how this then leads inexorably and immediately to a social problem.

Nutt Harm Scale

Which leads back to the ‘harmful effects’ FOI response. I understand that there are a number of scientists in the ACMD who have a very tough job and simultaneously a very tough line to follow between doing thorough, evidence-based work or ending up like Prof. David Nutt. So, with ‘harmful effects’ they had used a multi-criteria analysis [3] that divided harm into that to users and others, such as drug-related mortality and loss of tangibles. There is actually some good work here and it goes into relative detail (pages 7-8). This is the (familiar) result of such an analysis – notice Cannabis causes less harm and dependence than Alcohol.

The next document was the infamous ‘Cannabis: Classification and Public Health‘[4] in which Jacqui Smith more or less demanded that the ACMD validate her aim to class Cannabis as ‘B’ in order to send a message, even though messages per-se are not part of the ACMD remit. One of their conclusions were “The Council hopes that the government, parliament and the public appreciate that the use of cannabis is, ultimately, a public health problem; and that it requires a public health response if current use and the associated harms are to be substantially reduced.”[emphasis mine]. Jacqui ignored all their advice.

But the most interesting was the ‘Pathways to Problems‘[5] report in which the ACMD made some interesting comments (all page 18):

  • “Psychoactive drugs are used worldwide in the pursuit of pleasure, solace and acceptance. Young people may also be attracted to use them for other, sometimes contradictory reasons curiosity, rebellion or a desire to belong or escape”
  • “The mechanisms of action of psychoactive drugs cannot in themselves explain the huge worldwide increase in their use over the past 40 years. Attitudinal, cultural and economic changes may provide at least a partial explanation “
  • “The current system for classifying and controlling drugs in the UK has a number of shortcomings and should be reviewed. “
  • “There is an on-going responsibility for adults to provide children and young people with accurate and credible information about drugs, their effects and the possible consequences of their use.” [emphasis mine]

The last of these probably the most important – why do parents feel that they should abdicate such responsibility to the government and let them criminalise millions because drugs are a ‘hard topic’ to talk about? Also, what has changed regarding drugs in the last 40 years (clue, prohibition). Another interesting recommendation was “As their actions are similar and their harmfulness to individuals and society is no less than that of other psychoactive drugs, we recommend that tobacco and alcohol should be explicitly included within the terms of reference of the Advisory Council on the Misuse of Drugs.” (page 23). The ACMD recognise they have a flawed system, they tacitly recognise that the system is not listened to and fairly regularly ask for policies that are more akin to decriminalisation than prohibition. They still have to toe the line with government policy although they are meant to be an independent body.

Back to the original question of what don’t the ACMD know and what can’t they define. I would be hard pressed to declare that they don’t know much about the misuse of drugs, the social problems that the misuse can cause and the harmful effects associated with this. They certainly talk about the three issues with great knowledge and give descriptions of them when related to specific drugs. Maybe it is just a question of what they can’t, or are not allowed, to define. When I originally submitted these requests I was hoping to get some data/information to which I could say ‘ah ha gotcha! Alcohol and Tobacco do that too!’, but alas, they had beaten me to it in the ‘Pathways to Problems’ report, at least concerning the harms aspect.

By every metric of undefined harm, misuse and social problem, Alcohol and Tobacco should be included in the ACMDs terms of reference, but having an actual legal definition of the terms in Section1(2) would mandate, or at least leave next to no credible wiggle room, to not including the nations ‘favourite’ drugs. The ACMD daren’t try legally define some vague terms such as “misuse” or “social problem” as the government would surely come down on them like a ton of bricks when they realised the implications. Use the negative effects of drugs (including misuse such as addiction, social problems such as drunken violence and harms such as blood-borne diseases) sure, but never actually define them. I will wait for the internal reviews but will not hold my breath – the ACMD don’t have the definitions and I very much doubt the Home Office, or any other government body would be willing to provide them as it would expose yet another huge flaw in the logic of prohibition. Thankfully, these flaws are becoming more and more obvious to the public – soon the politicians won’t be able to hide behind their hypocrisy, doublespeak and straw man arguments.

[1] What is ‘Dangerous driving’? http://www.cps.gov.uk/news/fact_sheets/dangerous_driving/
[2] Drug Offences, incorporating the Charging Standard – http://www.cps.gov.uk/legal/d_to_g/drug_offences/
[3] Consideration of the use of Multi-Criteria Decision Analysis in drug harm decision making – http://www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/acmd1/ACMD-multi-criteria-report?view=Binary
[4] Cannabis: Classification and Public Health – http://www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/acmd1/acmd-cannabis-report-2008?view=Binary
[5] Pathways to Problems – http://www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/acmd1/pathways-to-problems/Pathwaystoproblems.pdf?view=Binary