The Sunday Times, Uncategorized

January 8th, 2006

They should tell the truth about drugs

Poor Charles Kennedy is not alone in his unhappy struggle with the demon drink; Britons lead the way in drinking themselves to death, according to the headlines on Friday. In more sober language, figures published in The Lancet last week showed a steep recent rise in Britain in deaths from cirrhosis of the liver (commonly caused by drinking too much), whereas the rate is falling fast in most other European countries.

In the 1950s England and Wales had by far the lowest rates of liver cirrhosis deaths in western Europe and Scotland’s rate, although higher, was still relatively low. That has changed completely; in the 1980s the death rate went up fast and in the 1990s it rose by two-thirds in England and Wales and doubled in Scotland. These alarming increases affect both men and women across all age groups and are accelerating.

Writing in The Lancet, Professor Robin Room blamed the UK government for turning “a determined blind eye to the problem” and for failing “to make the reduction of the population’s alcohol intake a policy goal. Through the new alcohol licensing law, and the new official guidance on it, the national government has also done its best to tie the hands of local government on this issue”.

It would be unfair to blame the government for whatever it is that makes people drink so much. But it is certainly fair to blame Labour for making it so much easier to drink, regardless of the explosion in underage drinking. It is fair to blame it for the extraordinary licence that it seems determined to legislate, for reasons which remain obscure. Not only does it seem to wish us to drink night and day; it has also tried to press us to gamble more and to relax about cannabis.

Now, not surprisingly, ministers are being driven to backtrack. Tessa Jowell was making recantatory noises about gambling and its dangers last week and Charles Clarke felt obliged on Friday to hint at a humiliating U-turn on cannabis; he appears to be thinking of turning it back into a class B drug — David Blunkett had downgraded it in 2004 to class C — because of “recent” medical evidence about links between cannabis and serious mental illness.

Actually, the evidence is not all particularly recent. It has been becoming clearer since the mid-1980s that cannabis is associated with serious and long-term mental illness, particularly schizophrenia and psychosis, as well as short-term motivation and memory problems — just as it has been clear for years that hard drugs, alcohol and nicotine can cause terrible damage, too. What is recent is that people like Clarke have begun to believe it.

He belongs, as I do, to a generation that did not believe anything our elders and betters said about drugs, because it was quite clear that they did not know what they were talking about. Our elders disapproved of drugs not on medical but on moral grounds and were quite prepared to repeat scare stories and deliberate disinformation without evidence. Neither they nor we knew anything about the real damage that even soft drugs could do, and it was obvious that some self-appointed experts were too partisan to trust.

Besides, I have known many people who have taken hard drugs over long periods without becoming addicts. Similarly, young people know that hundreds of thousands of people take ecstasy every weekend without, apparently, any ill effects. Considering the numbers, the few deaths involved have been statistically insignificant and young people are well aware of that and become less and less prepared to pay attention to exaggerated warnings.

I did not believe the most serious warnings about cannabis until two years ago when the teenage son of some people close to us had a frightening psychotic episode after smoking a lot of “skunk” at a party. Like most London teenagers, he and his friends had always smoked weed without obvious ill effects, but skunk is much stronger than the cannabis of my youth.

Overnight this boy became paranoid, anxious, disoriented and depressed; his psychiatrist said “skunk psychosis” was becoming common and it is true that most teenagers will know of someone who has suffered it. This boy recovered in about six months and has given up drugs; even so, research published in November last year suggests that just one such episode is likely to be the precursor of mental illness later.

It was, of course, irrational of me to be convinced of the dangers by one instance and, of course, most people are not. Young people tend to think they are immortal and that risk is for other people. We know that only some smokers get cancer or coronary artery disease and that only some people become alcoholics. Different drugs affect different people differently and this confuses people about the risks. They know the risks vary according to the individual, but they don’t know how.

It seems increasingly clear that genetic predisposition is important. Research published last year by the Institute of Psychiatry found that one in four cannabis users is genetically predisposed to become mentally ill as a result of smoking it and is 10 times more likely to suffer psychotic disorders than other smokers. The problem with genetic predispositions is that for now, at least, little is known about them. Apart from family history, there is for the most part no way of identifying individuals with particular predispositions.

All this presents an intractable problem, especially for libertarians. It seems wrong to restrict the freedom and pleasures of the many because of uncertain risks to the unknown few — to ban alcohol because some people will become alcoholics, for instance. In any case it is almost impossible. Prohibition did not work in America and the illegal drugs trade is out of control across most of the world, even in places such as China where dealers and users are executed.

However, we can tell the public the truth, as far as it is known, scrupulously and strikingly. This is most unlikely to happen. Public health campaigns, when not merely ineffectual, have all too often been manipulative or untruthful, on subjects from Aids to nits.

Perhaps there could be a new career for Kennedy in public health education — very liberal, very libertarian.