Pure Pedantry

Are we dividing drugs into illegal and legal based on a rational classification system based on risk?
A British government committee says no:

The committee’s report recommends that drugs be ordered on “a more scientific scale, to give the public a better sense of the relative harms involved”. But Michael Gossop of King’s College London, UK, who studies drug use, is not sure that drugs can be easily ranked by the harm they cause. “There are lots of different aspects to ‘harm’,” he says. “It’s not clear that when you add them together you get a simple rating.”

In seeking to compile a league table of harm, the parliamentary committee took evidence from a previous report by the ACMD. As David Nutt, a psychopharmacologist at the University of Bristol, UK, who helped to compile that report, explains, a drug’s potential for harm was divided into three factors: physical harm to the individual drug-taker, the tendency of the drug to create dependence, and the social impact of the drug’s use.

Twenty drugs were rated in this system by psychiatrists, chemists and other experts. At the top came the class-A drugs heroin and cocaine. But ecstasy came near the bottom of the list. “We just have to accept that some drugs seen as class A, such as ecstasy and LSD, are not as dangerous as we thought,” says Nutt. Meanwhile, alcohol was placed fifth, and tobacco ninth. (Emphasis mine.)

I must admit that the present system choosing drug legality is not particularly rational. Cannabis is not physically addictive and has not been shown to have any greater lasting consequences than cigarettes or alcohol. Why is it illegal? Still, drugs like heroin — which from both personal experience with patients and considerable experimental evidence remove one’s capacity for to give informed consent — are illegal and should be.

What we need to get to is a system like this one — one that fully evaluates the long-term and short-term risks of drug use with experimental evidence. Then we can give people the freedom to use those drugs for which recreational use is reasonable and possible and prohibit them from using those drugs for which it is not. Systems like this would not deny that all drug use has lasting consequences, but it would still allow the loophole of personal freedom when personal freedom can reasonably be exercised without inevitable self-harm or harm to others.

UPDATE: Nick has a great deal of analysis and facts over at The Scientific Activist.

Comments

  1. #1 douglass truth
    August 1, 2006

    even tho heroin and cocain are dangerous, it makes no sense for them to be criminalized. they, like alcohol and cigarettes, and many other dangerous or harmful things, ought to be medical problems, not criminal issues. this is particularly true from a societal point of view. Criminalization only helps the outlaws who profit so enormously (enough to be able to subvert police and justice systems, and even buy entire governments) from the trade. Alcohol prohibition was a disaster – the “war on drugs” is much, much worse.

  2. #2 adamsj
    August 1, 2006

    There’s a difference, douglass, between decriminalization–making simple possession not a crime–and legalization, which would appropriate for the not-very-harmful ones.

  3. #3 Nick Anthis
    August 1, 2006

    Clearly, the UK system has a lot of problems to sort out, but I think that if more scientific evidence is taken into account they’ll have a pretty comprehensive system. At least they’re getting pot right. In contrast, take a look at the US system, where marijuana is lumped right in with heroin and other hard drugs in Schedule I. Yikes.

  4. #4 daksya
    August 1, 2006

    This new ordering, while not as arbitrary as the current system, is still malformed. They seem to take into account the current footprint of physical harm, dependence and its nature, social harms and on that basis, estimate the ‘harm potential’ of each drug for an user. Neglected is the fact that many destructive lifestyle patterns develop and are sustained DUE TO prohibition. Note the drop in relative consumption of beer to spirits during Prohibition (1920-1933) and the gradual subsequent restoration after repeal. Also, the same drug can be very harmful or hardly, depending on certain variables i.e. difference between smoking crack and ingesting 10 mg of cocaine unextracted within a coca leaf. The same’s true of heroin. I’ll point you to a recent study: ‘Occasional and controlled heroin use: Not a problem?’*.

    Instead of assigning a single harm metric to a drug i.e. heroin is very harmful but cannabis isn’t, the better & more accurate method is to assign harm levels to drug-taking behavior i.e. mainlining heroin/diamorphine 3 times a day using shared needles is very bad, but having low-concentration opium tea is nowhere as problematic. See this post** at the DWR forum for information.

    *http://www.jrf.org.uk/bookshop/details.asp?pubID=747
    **http://www.drugwarrant.net/forum/viewtopic.php?p=1253#1253

  5. #5 Nick Anthis
    August 1, 2006

    The study did break down the “harm” of the various drugs into different categories and with a few exceptions, most of the drugs had a similar level of harm in multiple categories, so the combination of various paramenters into one measure appears pretty valid.

  6. #6 daksya
    August 1, 2006

    Nick Anthis – “The study did break down the “harm” of the various drugs into different categories and with a few exceptions, most of the drugs had a similar level of harm in multiple categories, so the combination of various paramenters into one measure appears pretty valid.

    The various parameters include different aspects of use, i.e. physical harm, intoxication, social harm..etc, NOT different drug-using behaviors viz. oral heroin vs. IV heroin.

    From Ev 116 –

    The participants in this study were asked to assess the harm of drugs in the form that they are normally used. In a few cases, it was clear that the harms caused by a particular drug could not be completely isolated
    from interfering factors associated with the particular style of use. For example, cannabis is commonly
    smoked mixed with tobacco, which might have elevated its scores for physical harm, dependence, etc.

    and

    Crack cocaine is generally considered to be more dangerous than powdered cocaine, but here they were considered together.

    They have this comment on Ev 115 -

    Drugs that can be administered by the iv route were ranked relatively high, and this was not caused solely
    by exceptionally high scores for parameter three (propensity for iv use) and nine (healthcare costs). Even if the scores for these two parameters were excluded from the analysis, the high ranking for such drugs persisted. In other words, drugs that can be administered intravenously were also judged to be substantially
    harmful in many other respects.
    “,

    which is not the same thing as considering other behaviors i.e. the social harm due to oral heroin use may not equal social harm due to IV heroin use, so all measures need to be recalibrated. What they mean is that if one excludes ‘propensity for IV use’, the average stays close to the same, but that’s just a measure of prevailing norms, which are dictated by existing use culture, typical drug purity & self-selection of thrill-seeking/risk-ready heroin users, considering the very low prevalence of heroin use. The study I linked to in an above post is a real-world field study of users of various drugs. Among heroin users, the contact group had Severity of Dependence scores of 12.6/15 vs. 5.9/15. 81.2% of the former injected, compared to 31.2% among the latter, which is still a pretty high percentage. Even then, many in the latter still smoked or snorted the drug.

    This new evaluation is better, but it’s not sufficiently nuanced or thorough.

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