29 May 2010

Press, police, politicians and the public

It was no great surprise to Grumble when he learned earlier this week that the two young men who died, apparently after taking mephedrone, had not actually taken mephedrone at all. It was clear at the time that the evidence that mephedrone had caused their deaths was just not there. Now there is no doubt whatsoever that mephedrone could not even have been involved.

Armed with this information, Dr Grumble was all set to point out what had led to the extraordinarily precipitous banning of mephedrone. He would have said something like:

1. That the police should not make pronouncements and certainly not hold press conferences on mere conjecture.

2. The media should wait for evidence and allow the scientific process to take place before claiming harms of new legal highs.

3. The government and their advisers should have the courage to face down media hysteria and let the truth evidence drive decision making.

4. Proper investment in the science of new drugs is required - we at the Independent Scientific Committee on Drugs are currently developing guidelines on the minimum data set that will be made public and should be acquired for any new drug before a decision to ban it is made.

5. There is a real need for a new approach to the drug laws; the 1971 Misuse of Drugs Act is forty years old, fatally flawed in its current classification system and not fit for purpose in this new internet-based environment in which it must be used; it needs fundamental revision or better still, a completely new approach should be taken.

6. The message must be conveyed to anyone who drinks and takes drugs that alcohol itself is very toxic (killing by acute poisoning, hundreds of young people each year through stopping breathing) and these actions are magnified when in combination with other drugs that lower breathing. If you do consider taking drugs whilst drunk then avoid at all costs other sedative drugs such as opioids and GHB/GBL.

But there is no need for Dr Grumble to tell you any of this because David Nutt now has his own blog. The words above are just a cut and paste job. Professor Nutt is absolutely right but the reality is that the press, police, politicians and the public are never going to be any different. Odd people the lot of them. The oddest thing of all is how accepting the four Ps are of the risks of alcohol and how hostile they are to much more harmless substances.

The press, the police, politicians and the public make a dangerous cocktail.


Prisoner of Hope said...

As a (very) "old school" health manager I also used to speak of the 4 P's - albeit over 25 years ago. For me however they represented the different pressures that needed to be responded to in preparing plans for service development and included "Professionals" (which was short hand for clinicians and hands on service deliverers such as yourself) instead of the Police. In those days the dialogue required to understand and respond to the concerns of these 4 P's required differentiating between 3 political viewpoints summarised as: (1) Supporters of Corporate/Socialised Medicine; (2) Those with Absolute Faith in Markets and ...(3) The Well Meaning But Confused.

Most clinicians that I taught years ago owned up to being in the 3rd group. I wonder to what extent this still applies - after the demonstrable failure of voodoo economics and market mechanisms to allocate scarce resoures?

As someone with a high need for achievement allied to a low threshold for wasting time it was important to me to always bear in mind not only all of the 4 P's but also the extent to which individuals, staff and patient groups themselves subscribed to one or other of the 3 political viewpoints.

Dr Grumble said...

It is interesting, Prisoner of Hope, that you describe the second political viewpoint as those with "absolute faith" in markets in contrast to those favouring corporate/socialised medicine whom you describe as "supporters". I think you are right that those favouring markets do, in general, have an absolute, some might say blind, faith in markets. In contrast those in favour of socialised medicine are mostly less fervent and more cognisant of the problems of the system they favour.

Worship of markets is common. The market concept is very seductive. You might have expected the recent failures of unfettered markets in the world of finance to have caused those who believe that markets will sort out the problems of healthcare to doubt their faith but there is little sign of that. It's this blind faith that I find most worrying about the marketeers.

English Pensioner said...

I can understand people taking drugs, as indeed I drink alcohol. What I can't understand is anyone who would take a drug from an unknown source.
To my mind, the best solution would be to make some of the so-called recreational drugs available through approved sources so that the user is at least aware that they are what they claimed to be. If they include a description leaflet like that which comes with my prescription drugs, there is a fair chance that anyone reading this will be put off from taking them!
Such drugs could also be taxed, the government reasonably could argue that the other drugs, cigarettes and alcohol, are taxed, and that the money could be needed for drug rehabilitation.
The present policy seems merely to encourage criminals in the form of importers and pushers, and result in deaths from impure substances.

Dr Grumble said...

I am not sure that the four Ps would agree, English Pensioner. But there is evidence of the benefits of decriminalization. On every metric in Portugal it was a success. But politicians, as we know, are not very good at looking at the evidence.

Marjorie said...

other potential advantages of decriminalising (say) cannabis would be that the risk of it being a 'gateway' drug* to 'harder' drugs, as those who use it would no longer be involved, even of the fringes, of criminal groups, andpossibly the fact that it was legal and easy to buy might make it appear much less alluring - a packet of fags isn't very romantic, after all!

I have yet to hear a good argument for cannabis being illegal which would not apply eqaully or to a greater extent if applied to tabacco and alcohol.

I gather that the Portugese model merely decriminalised possession for personal use; I guess full legalisation, including legalising, taxing etc the supply would also have additional benefits including significant drop in crime rates, baring in mind how much crime, especially theft, is drug-related.

(*I am not sure to what extent cannabis *is* a gateway drug; my experience is that most people who use other drugs such as heroin report starting with cannabis, but of course not eveyone who uses cannabis goes on to other drugs, and most ofthose who use heroin etc also use alcohol, and smoke..)