01 November 2010

David Nutt on alcohol


Anonymous said...

Watching this reminds me why I gavw up on the BBC years ago. The cretinous interjections from their pretty boys and bimbos who seem to know nothing of science, logic or even intelligent listening skills make me want to scream. All they want are ludicrous soundbites and headlines that frighten or enrage people. Enough, already.


the a&e charge nurse said...

Couldn't agree more Ray - why try to reduce an important debate to the sort of tosh the Daily Fail has been churning out for years.

At one point one of the GMTV presenter snorts "so heroin is not dangerous" - christ on a bike, how is it possible to engage in any meaningful debate when such context free, and scare mongering questions are being asked?

Dr No said...

The media coverage of this important question has generally been dreadful (and the BBC can't even put the right clip on the Today website!) but let us not forget that Nutt is using cod science, and that doesn't help one little bit. Yesterday's Lancet paper was all based on our old friends modelling and interactive workshops. And Nutt may - or may not - be commercially driven. At the very least, he has a potential conflict of interest. Hardly the best way to go about an important debate...

ADDY said...
This comment has been removed by the author.
ADDY said...

Sorry I deleted the previous post as it contained so many typos.I'll try again.....

Alcohol addiction has just killed my husband. It is probably not more dangerous than heroin but is certainly more readily available and probably cheaper to buy. It is often underestimated by medics and other profesionals (at least the ones who were treating my husband). Incidentally I know for a fact that the journalists often play dumb to get the interviewee to spill the beans more. I would hope that is what they were trying to do here.

English Pensioner said...

His argument seems to be based on the rather strange logic that because more people suffer harm from alcohol than heroin, it must be far more dangerous. He totally ignores the fact that there are many times more people who use alcohol.

Following his convoluted logic, it could be argued that drunk driving is twice as safe as sober driving because only about a third of serious accidents involve drunk drivers, whilst two thirds involve sober drivers!

Dr No said...

English Patient - you are on the money here. The numbers thing is crucial. X kills one in ten people, but only ten people use it. Y kills one in a hundred, but a thousand people use it.

Which is more dangerous? Which is more harmful? Which matters more - dangerousness, or harmfulness? What happens if you pay greater heed to harm than danger? Or the other way round?

These questions, it seems to Dr No, are all important parts of the debate, which Prof Nutt conveniently sweeps under the table.

Dr No said...

EP - whoops - being a doctor, Dr No has turned you from a pensioner into a patient! Many apologies.

If Dr G feels able to make the appropriate correction, Dr No would be obliged - and the pensioner no doubt glad to be free of Dr No's medical clutches!

Dr Grumble said...

Sorry, Dr No, I can delete but not edit.

I have to say that I think you are both being a bit harsh on my friend David. Sometimes I get the impression that people don't want to understand him.

Dr No said...

DN's mistake will have to stand then, with further and better apologies to the EP.

Perhaps DN is being harsh on your pal David, but in his own way YPD is doing a similar thing to Donaldson and Gilmore - relying on spun and/or selective science. In YPD's case, it is - as suggested above and elsewhere - a subjective judgement on his part on which figures to present, and how to present them (his latest Lancet paper, recall, was based on 'interactive workshops' and modelling; and the results of modelling depend crucially on the assumptions (which is what they are) that you feed in). YPD's subjective view (and its actual and perceived conclusions) then of course feeds into the media frenzy - and we get more silly debate - and to that extent he is not helping.

On the other hand, he is to be applauded for bringing up the matter, so at least we are having a debate on something that we appear to all agree is important!

Sam said...

I think Professor Nutt's search findings are being misinterpreted. What he says is that out of 100, Alcohol was the most harmful overall with a score of 72. He goes on to say;

" Heroin, crack, and crystal meth were the most harmful drugs to the individual, whereas alcohol, heroin, and crack were the most harmful to others."

... and then lists the scores here:


Better read at source than media releases, me thinks, because as you will find in there has scientific logic and is hence above board, for sure.

Dr No said...

As Sam's comment notes, it all depends which way you choose to look (from an individual? societal? point of view) at the assessment of harm.

Nutt's newest idea was to use so called 'MCDA', a technology borrowed from the nuclear waste (stroof! - talk about lateral thinking!) industry (following quote comes from the link Sam provides):

"To rectify these drawbacks, the authors undertook a review of drug harms with the multicriteria decision analysis (MCDA) approach. MCDA technology has been used successfully to lend support to decision makers facing complex issues characterised by many, conflicting objectives, such as policies for disposal of nuclear waste."

And then a bit later we have:

"The criteria are weighted according to a judgement of their relative importance. "The issue of the weightings is crucial since they affect the overall scores,” the authors say. “The weighting process is necessarily based on judgement, so it is best done by a group of experts working to consensus.""

Well - self-appointed experts would say that, wouldn't they? But Dr No's point remains - the assessment is based on judgement, and judgement is subjective. It is opinion, not fact.

And crucially, the result that you get depends on the judgement you apply.

Dr No has no problem with opinion. It may even be that Nutt's and Co's opinions are right. What he objects to is Nutt and Co presenting opinion as fact. It is disingenuous, gives proper science a bad name, and - as we know only too well - confuses the hacks no end.