Phil's Diary November 9, 2009

The Nutt-Brown-ale conjunction

Professor David Nutt seems to have followed a similar career trajectory to the late (twice) Jesus Christ. In the space of a week. He starts out honourably standing up for truth against state authority, is punished for it, and then rather immodestly showboats the whole episode.

Interviewed in The Times he tosses aside a liberal approach to drugs to demonise drink. “If alcohol was discovered tomorrow,” he says, “it would definitely be illegal.”

This is hypothetical in the extreme. Alcohol is legal precisely because it’s been manufactured into tasty drinks for a very long time and massive industries have been built around its production and distribution.

Prof Nutt appears to miss the point his own case exemplifies so sharply. That alcohol and drugs policy is based not on evidence of harm but on political and economic considerations.

This is, of course, wrong, and undermines efforts at harm reduction. But what would an evidence-based policy look like? And how are we defining harm?

Shocking figures on alcohol harm partly result from the fact that so many people drink. Here’s an amazing chart that shows what happens when you adjust for numbers of users) - scroll down to ‘Deadliest Drugs II’.

Alcohol is mid-table and, as Prof Nutt says, deadlier than ecstasy and cannabis. Yet still less than one in 10,000 drinkers die of it. I wouldn’t want to play down that one, but isn’t this a lot less than you would have thought from reading the newspapers?

The chart also shows that individual alcohol-related deaths are under-reported. But the media makes up for that in its coverage of total deaths.

Mind you, you can’t read off alcohol and drugs policy from simple evidence like this either. One of the best things I’ve read on the NuttSack affair came from the drugs agency Release (()) which explores Nutt’s much-ridiculed suggestion that horse riding is more dangerous than ecstasy.

The dangers of horse riding are clearly not reducible to the horse. For one thing the rider’s skill comes into it. And it’s the same with drink and drugs. Possessing skills and knowledge makes their use safer.

“The harmfulness of a drug, like its effects, does not just reside in the molecular structure of its chemical constituents or their impact on the body’s neurological and physiological systems,” says Release. “The emotional and psychological frame of reference of the consumer plays an important part, as does the social setting and its associated expectations, myths and fantasies.

“The notion of a purely scientific system of drug classification is itself something of an illusion, built on the reductive model of drug-effects as matters of chemistry and biology. Of course, they are matters of chemistry and biology, but they are also much, much more.”

This is not an excuse to excludes scientists from making a vital contribution to policy, but it is an argument to broaden the evidence base.

Ruff justice

The distortions around the alcohol debate can throw up some real weirdness. Following the furore around BrewDog’s 18.2 per cent ABV beer Tokyo The Portman Group has banned it, based on a complaint from a “member of the public”.

And who was that? It was BrewDog itself, as it proudly admits.

Does The Portman Group really need any help to make daft decisions?

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