Monday, 1 November 2010

Professor Nutt wants to control alcohol not liberalise drugs.


There are various ways in which we might look at Professor Nutt’s pronouncements on the UK’s drugs policies and, in particular, that part of the policy framework concerned with the classification of drugs. And we should note, of course, that Professor Nutt is an “expert” in such matters having chaired the Government’s (name of drugs advisory board). Plus of a course a hero of “evidence-based policy-making” because he resigned from said advisory panel during the heated debate about miaow-miaow or some other such ‘legal high’.

Looking at Professor Nutt’s comments brings one of two responses:

1. Our drugs classification system – indeed the entirety of our drugs policy – is based on prejudice, ignorance and misunderstanding rather than on “the science”. The good professor is saying to public authorities that the system needs reform amd, of course, reform means liberalisation

2. The problem with our drugs policy – and its medicalisation – is that some drugs are outside of its remit. And alcohol is by far the more significant of those drugs (although nicotine, caffeine and other ‘legal’ highs are also partly outside the influence of the medical/pharmaceutical industry’s control).

To understand which of these positions most typifies Professor Nutt, we need to look at what he has said – both in this instance – and on other occasions.

Prof Nutt had sparked the controversy earlier this week by attacking what he called the "artificial" separation of alcohol and tobacco from other, illegal, drugs. He also repeated his claim that the risks of taking ecstasy are no worse than riding a horse.

Firstly, Professor Nutt is very clear that he wants any reform to be about bringing alcohol (and tobacco but not caffeine) within the remit of the drugs control system. The intention of prohibitionists like Professor Nutt is not to prevent people having access to drugs but to ensure that any access is moderated through the aegis of the medical profession.

Thus the moral jeopardy here is not the ancient jeopardy – the sin of drinking – but a modern jeopardy - the sin of ill-health. In the view of people like Professor Nutt, behaviour that threatens our health is itself a pathology – an illness. People who smoke, who drink more than an extremely modest amount, who eat too much or the wrong food and who fail to exercise enough are all in need of treatment and support.

In many ways this is a less threatening attack on lifestyle choices than the classic prohibitionist attack. Who, after all, can argue with the good doctors and their friends in the drugs companies when they say they just want to help us to be healthier? Even when the medicalisation of behaviour results in a further extension of treatments within the health industry – each of which carry a cost. And, of course, Professor Nutt – by distancing himself from the Government’s drugs policy – appears to be on the side of the liberal view. This makes his views still more dangerous.

Others will – I’m sure – remind us of the poor science involved here. The conflating of individual and social “harms”, the selective list of these “harms” and the careful choice of data on which to adjudge the “harms”.

I merely want to point out the moral hazards implicit in Professor Nutt’s position including the way in which the ‘New Puritan’ controls create a new criminal opportunity, further marginalise drug use thereby increasing abuse and increase the pressure on health resources by creating new “illnesses” where there were no illnesses before. Our behaviour – including seemingly irrational behaviour such as drug use – is not in most cases a pathology to be managed through the medical profession but a set of choices that we make freely as individuals.

There is a debate to be had about the degree to which “society” (however we choose to define it) can act to limit and control behaviours that damage that “society”. In making this assessment we have to judge between proximate problems such as the drink driver running down a child or the junkie mugging an old lady and ultimate problems (in the aggregate) derived from the estimation of ‘costs’ – be they healthcare, crime or other costs – and the identification of moral hazards such as the ‘corruption’ of children or transferable (‘second-hand’ or even ‘third-hand’) health concerns. Put simply the illness must be contagious – or at least appear that way.

It seems to me very difficult to justify – in a liberal society – measures to control behaviour founded not on the risks to another individual but on the basis of ill-defined “costs” to society in general. Yet this is the basis on which people such as Professor Nutt proceed – the justification for their controls and for the medicalisation of lifestyle choices. That and a wholly rational (and possibly selfish) view that the medical profession and its outriders know better and should be allowed to exercise such controls in the “interests of society”.

There is more moral hazard in Professor Nutt's proposals than you think. He is a very dangerous man.


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