October 31, 2009: Home Secretary Sacks ACMD Chair

The government has sacked Professor David Nutt, head 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 was established under the Misuse of Drugs Act 1971 and its current chair is Professor David Nutt. The AMCD makes recommendations to government on the control of dangerous or otherwise harmful drugs, including classification and scheduling under the Misuse of Drugs Act 1971 and its regulations.

It considers any substance which is being or appears to be misused and of which is having or appears to be capable of having harmful effects sufficient to cause a social problem. The legal status of cannabis was reclassified from Class B to Class C on the advice of the ACMD some five years ago, only for the decision to be subsequently reversed. The government reclassified cannabis from Class C to Class B in January 2009. The upgrading to Class B follows a review of cannabis classification which was carried out by the ACMD at the request of the Prime Minister.

Home Secretary Alan Johnson said Nutt had overstepped his advisory role and strayed into politics. The Home Secretary said that he had lost confidence in Professor Nutt. The government came to this view after Professor Nutt suggested that the scientific evidence indicated that ecstasy, cannabis and LSD were less harmful than alcohol.

Nutt has suggested that the government has ignored the scientific evidence. According to the Home Office, (Nutt's) "clear role...is to provide independent scientific advice and not to lobby for changes in policy As chair of the council his actions undermine its role and scientific independence."

Nutt had previously told the BBC, "You are more likely to die riding a horse than you are by taking cannabis or ecstasy...I am not prepared to mislead the public about the harms of drugs like cannabis and ecstasy just to give messages."

The professor was quoted in the Telegraph as stating:

 “I’m not prepared to mislead the public about the harmfulness of drugs like cannabis and ecstasy. I think most scientists will see this as a further example of the Luddite attitude of this government, and possible future governments, towards science.”

According to a briefing from the Centre for Crime and Justice Studies (CCJS), alcohol probably poses the biggest drugs harm challenge today,  In `Estimating drug harms: a risky business', Professor Nutt argues that the relative harms of legal drugs such as alcohol and tobacco are greater than those of a number of illegal drugs, including cannabis, LSD and ecstasy.

Nutt proposes a `drug harm ranking', which compares the harms caused by legal as well as illegal drugs. Alcohol ranks as the fifth most harmful drug after heroin, cocaine, barbiturates and methadone. Tobacco is ranked ninth. Cannabis, LSD and ecstasy, while harmful, are ranked lower at 11, 14 and 18 respectively. He argues that simply focussing on the harms caused by illegal drugs, without assessing them against those of drugs such as alcohol and tobacco, results in an `isolated and arbitrary' debate about relative drug harms.

Nutt argues in favour of an evidence-based approach to drugs classification policy and criticises the `precautionary principle', used by the former Home Secretary Jackie Smith to justify her decision to reclassify cannabis from a class C to a class B drug. By erring on the side of caution, Nutt argues, politicians `distort' and `devalue' research evidence. `This leads us to a position where people really don't know what the evidence is', he writes.

On cannabis, Nutt makes clear that it is `a harmful drug' and argues for a `concerted public health response... to drastically reduce its use'. However, he points out that cannabis usage fell when it was reclassified from class B to class C. He points out that there is `a relatively small risk' of psychotic illness following cannabis use. To prevent one episode of schizophrenia, he argues, it would be necessary `to stop 5,000 men aged 20 to 25 from ever using' cannabis.

On recent debates about the classification of ecstasy, in which the ACDM recommended it be classified as a class B drug, Nutt writes that the ACDM:

`won the intellectual argument, but we obviously didn't win the decision in terms of classification'.

Nutt also criticises the quality of some research evidence on drug harms. There are, he writes, `some horrific examples where some of the so-called "top" scientific journals have published poor quality research about the harms of drugs such as cannabis and ecstasy, sometimes having to retract the articles'.

Among Nutt's recommendations are:

• Stopping the `artificial separation of alcohol and tobacco as non-drugs'. It will only be possible to assess the real harms of illicit drugs when set alongside the harms of other drugs `that people know and use', he writes.
• Improving the public's general understanding of relative harms. He had previously compared the risks of taking ecstasy over the risks of horse-riding, he writes, because media reporting `gives the impression that ecstasy is a much more dangerous drug than it is'.
• The provision of `more accurate and credible' information on drugs and the harms they cause. Drug classification based on the best research evidence would `be a powerful educational tool'. Basing classification on the desire `to give messages other than those relating to relative harms... does great damager to the educational message', he argues.

Nutt commented:

`No one is suggesting that drugs are not harmful. The critical question is one of scale and degree. We need a full and open discussion of the evidence and a mature debate about what the drug laws are for - and whether they doing their job?'

Commenting on Nutt's paper, Centre for Crime and Justice Studies director Richard Garside said:

`Professor Nutt's briefing gives us an insight into what drugs policy might look like if it was based on the research evidence, rather than political posturing and moralistic positioning. The Centre for Crime and Justice Studies is a strong advocate of research evidence informing policy making and it is delighted to be publishing this very timely and important contribution by one of the country's top drugs experts.'

This is the first time in 40 years that an ACMD chair has been sacked. Following his sacking, Nutt told the BBC that the sacking of an advisor for reasons which considered to include political expediency represented "a very bleak day for science"

Professor David Nutt is the Edmond J. Safra Chair of Neuropsychopharmacology at Imperial College London and heads the Psychopharmacology Unit at the University of Bristol. He is no longer chair of the Advisory Council on the Misuse of Drugs.