UK heroin trial publishes results

The recent trial of heroin prescribing at the Institute of Psychiatry published its results last week in an article in the prestigious medical journal The Lancet. They provide significant new evidence as to the effectiveness of providing diamorphine ( pure medicinal heroin) to those who have derived little benefit from orthodox, methadone-based treatment. The primary measure used was abstinence from street heroin, and, unlike many similar trials, this was calculated by urine testing rather than by reliance on the client’s word. The trial tested the effectiveness of injectable heroin, given in daily doses under clinical supervision, against both injectable and oral methadone, all strands receiving counselling and social support services. While all clients showed improvement, it was found that injectable heroin was significantly more effective in terms of reducing use of street heroin. The researchers conclude that, “In the past 15 years, six randomised trials have all reported benefits from treatment with injectable heroin compared with oral methadone. Supervised injectable heroin should now be provided, with close monitoring, for carefully selected chronic heroin addicts in the UK.”
While recognising the controversial nature of addiction therapies, Release hopes that the new government will act upon the substantial and growing evidence base in support of heroin assisted treatment and make this option more widely available for those in clinical need.

More information available here.

Death penalty for drug offences- New IHRA Report

The International Harm Reduction Association (IHRA) has this week published a report providing a global overview of the use of the death penalty in drugs offences. The publication makes alarming reading, finding that the total figure exceeds 1,000 judicial deaths per year. “Hundreds of people are executed for drug offences each year around the world, a figure that very likely exceeds 1,000 when taking into account those countries that keep their death penalty statistics secret,” state the authors, Patrick Gallahue and Rick Lines.

Some 32 states permit the use of the death penalty in drugs cases, mostly in relation to production and trafficking. Of these countries, 13 retain a mandatory death sentence for certain types of drug offences. The leading executors are China, Iran, Saudi Arabia, Vietnam, Singapore and Malaysia; these are the only states that have, in recent years, deployed capital punishment to an extent that the report judges to indicate ‘high commitment’ to the practice. Iran, for example, executed 172 people last year. Some cause for optimism lies in the fact that a number of these countries have, however, greatly reduced their reliance on capital punishment over the last years.

IHRA’s legal experts argue that recourse to the death penalty in drugs cases is contrary to international law, and that the measure should, pending full abolition, be limited to a discretionary option in cases of willful murder.

The report is available here.

News US drug strategy

The new US drug strategy, the first to be published under the Obama administration, was released yesterday. The strategy’s appearance was heralded by the Whitehouse with claims of a new direction for US drug policy, and a new emphasis on combating the problems around illicit drug use by focusing on the demand side of the equation. This tactic is based around a broad set of community based prevention interventions, and an expansion of drug treatment into mainstream healthcare. And while the language itself continues to be rejected, the strategy involves measures which embody the principles of harm reduction.

The strategy can thus be said to build on the administration’s movement away from drug war rhetoric, its repeal of the ban on federal funding for needle exchange, and its acceptance of (or non-interference in) state-level medical cannabis provision. There are also encouraging signs that congress will, over the next year, end the mandatory minimum sentencing disparities between powder cocaine and crack, laws which are racist in effect if not intention.

At the same time, beneath the rhetoric of change there are large areas of continuity with the drug war, readily apparent in the fact that two thirds of the budget remains devoted to law enforcement. A more profound and significant break with the failures of the past would be demonstrated by a strategy aimed not so much at stopping or reducing drug use as such, but at minimising the harms associated with both drugs and drug policies. These harms are tightly interwoven with the mass incarceration of US citizens for non-violent drug offences. Nonetheless, such changes as there are should be welcomed, and it will be interesting to compare the performance of Britain’s new government when its new drug strategy appears.

Mexico: War without end?

Last weekend in Mexico, in a new escalation of the drug war, 24 people were killed in a 24 hour period. While falling short of the grisly record established in January this year, when 69 individuals died violent deaths in one day, it should give pause for thought to anybody who still believes that repressive methods can suppress the illicit drug market. In total, since President Felipe Calderon took office in 2006, over 23,000 people have died in the bloody war the US government continues to support.

Plan Merida, the government’s assault on the country’s massive drug trade, is funded by the US to the tune of $1.4 billion. It relies heavily on military intervention, with the bulk of the money going to equip the Mexican army. However, the project’s ‘successes’—centred on the arrest of cartel bosses—have only exacerbated the violence, creating a power vacuum quickly filled by violent conflict. And, despite the army’s new US weaponry, organized crime appears able to match it, using a combination of corruption and guns flooding in from across the US border. Human rights groups in Mexico have claimed that this southbound traffic is more severe in its consequences than the northward flow of drugs, despite the publicity generated by the latter.

To add to the human rights deficit associated with the drug war, Arizona has recently passed an anti-immigration law that gives the police the right to search and detain anyone they think looks like an illegal immigrant. Naturally, this is going to impact on US citizens of Hispanic appearance, adding a new layer to an old pattern of racism linked to the war on drugs. It has led the Mexican government to issue a travel alert urging extreme caution to its citizens travelling in Arizona. The measures have also been highly divisive inside the US, with mass protests across American cities and opposition from prominent figures including President Obama. In a final irony, traffickers have started avoiding border controls by moving the growing operation into the US, setting up plantations in National Parks, a displacement tactic familiar across decades of prohibition.

‘Crack Babies’- the Final Solution?

The US-based charity ‘Project Prevention’ has this week arrived in the UK. The organisation is offering £200 to addicted women in order to undergo sterilization. In the US, some 1200 women and 50 men have entered into such a contract over the group’s history. Its founder, Barbara Gamble, defends her approach on the grounds that the rights of the child should supersede those of the mother. She has argued her case in the following terms: “We don’t allow dogs to breed like this, we spay and neuter them.”

What Project Prevention is practising is eugenics—the management of racial stock. Its arrival in the UK has been controversial, and rightly so. While there may be real problems associated with bringing up children while dependent on illegal drugs, there are other, less drastic and potentially damaging ways of alleviating them. Contraceptive advice can be offered as a part of drug treatment, and psycho-social support services may offer stability to drug dependent women. No information is provided on the group’s website about the medical practicalities of the sterilization process, and Release is concerned about the medical ethics involved. The issue of informed consent also looms large; one wonder how ‘informed’ this consent really is.

In addition, the assumptions in play here need questioning: there are many drug using families who bring up their children successfully, and many non-drug using families who don’t. Such problems as do arise should be addressed by policies to end the criminalisation of drugs and the stigmatisation of users, to provide high quality treatment and support where it is needed—including heroin prescribing—and offering people meaningful employment and a real chance of building a better life.

Heroin prescribing on the NHS

The topic of prescribing heroin to addicts on the NHS was proposed for debate yesterday at the National Congress of the Royal College of Nursing. The subsequent discussion highlighted the promising preliminary results of the recent UK trial in which diamorphine, the clinical name for heroin, was prescribed at various locations in England to those for whom more conventional treatments, such as methadone, had been unsuccessful. The study found that crime was greatly reduced and that health and social functioning showed significant improvement. Some individuals said that the treatment had given them back their lives.

The debate recognised that this issue is an emotive one, a fact quickly confirmed by an inspection of the comments left by members of the public when the story appeared online in the popular tabloids. Amongst the most vicious, but by no means unrepresentative, is the following contribution: “How about letting them rot in the gutter where all drug user (sic) belong and start saving lives of the good by prescribing life-saving cancer drugs.” The prevalence of such opinions only reinforces the urgent need to remove drug use from the criminal sphere and treat it as a public health issue, since the law as currently framed serves to legitimise prejudice against drug users.

The scientific evidence base for its effectiveness is growing stronger each year, and the prescribing of heroin must certainly be included in the range of treatment options available to those in need.

Manifesto Macho

The major parties have this week published their manifestos for the general election, including proposals for drug policy. All three are light on detail, and political courage and imagination are not strongly in evidence; however, some are certainly worse than others.
The Labour Party’s offering is entitled ‘A Fairer Future for All’, and discussion of drug policy is confined to one short paragraph appearing in a section named ‘Crime and Immigration’, a disturbing pairing of two policy areas not closely related except in the politics of prejudice. The content of the paragraph would not, indeed, appear out of place in such a context, being encapsulated in the following slogan: “Our message is clear: we will not tolerate illegal drugs.” The general tone of Labour’s short reference to drug policy appears calculated to bring it closer to the Conservatives.

The Conservative own proposals, contained in a section named ‘Fight back against crime’, once again link the motifs of drugs, crime and immigration. “Extremists, serious criminals and others find our borders far too easy to penetrate.” The manifesto commits the Party to ‘crack down’ on drugs and build more prisons, and makes inroads into clinical territory normally regarded as the preserve of doctors and others with specialised training. In an obvious reference to the use of methadone and opiate substitution therapy (OST), we are told that “the treatment too many addicts receive just maintains their habits.” The fact that OST is underpinned by an extensive scientific evidence base does not appear to matter. They go on to say that, “We will give courts the power to use abstinence-based Drug Rehabilitation Orders to help offenders to kick drugs once and for all.” This represents a dangerous development, with politicians determining clinical health measures on ideological grounds.

The Liberal Democrats are the only Party to make an explicit promise to base drug policy on scientific evidence, and to ensure that the Advisory Council on the Misuse of Drugs is genuinely independent of government. They are also committed to ensuring that police and court time and funds “are not wasted” on prosecuting and imprisoning drug users.

We leave it to our readers to decide which of these positions is least likely to result in a public health and social disaster.

Public Accounts Committee questions cost effectiveness of drug treatment in the UK

The House of Commons Public Accounts Committee yesterday issued its Report on the government’s strategy for dealing with ‘Problem Drug Use’, a term referring to the estimated 330,000 users of heroin and crack cocaine. The Report quotes figures that problem drug use costs £15.3 billion, of which £13.9 billion is associated with acquisitive crimes to fund dependence. Government spending on the strategy is currently £1.2 billion per annum. The main conclusion picked up by UK media is the Committee’s statement that “we find it unacceptable that the (Home Office) has not carried out sufficient evaluation of the programme of measures in the strategy and does not know if the strategy is directly reducing the overall cost of drug-related crimes.” The MPs did, however, welcome the belated agreement of the Home Office to produce a framework to evaluate and report on the strategy. This step was taken in response to a recommendation from the National Audit Office, and initial reporting will commence in ‘late 2011’, and may represent the beginning of the Impact Assessment of drug polices called for by our colleagues at Transform Drug Policy Foundation.

Release is disappointed, however, at the lack of any honest appraisal of the continued failure of present drug policies or serious discussion of alternative measures. There is no recognition, for example, of the degree to which ‘Problem drug use’ is rendered more problematic, not less, by criminalisation or coercive treatment. The question of supplying heroin addicts with heroin was raised, but the senior Home Office official retorted that this is “absolutely not” government policy; he called it a ‘counsel of despair’ and said such a course meant addicts could never live productively or pay taxes. In fact, people are quite capable of living and working productively while on opiates; while of course individuals vary, much of the despair associated with heroin addiction stems from tying to maintain a steady supply of a drug whose expense is inflated and quality degraded by the illicit market, and the criminal relationships this imposes on users. If the market is legally regulated and distributed, health, time and freedom of attention become available once again to the user. Many productive and fulfilling lives have been lived under these more benign conditions.

Government by Panic

In the wake of the CAT panic reported by Release News last week, Government spokesman David Hanson has announced that mephedrone could be banned and placed under the 1971 Misuse of Drugs Act as early as April 16th. The Home Secretary Alan Johnson has apparently laid a draft order before parliament to this effect. With parliament likely to be dissolved in the next few weeks, prior to a probable general election on 6th May, we are concerned that the move will not receive adequate debate in the House of Commons.

After receiving the ACMD’s recommendation on 29th March 2010 that mephedrone should be a Class B drug, the Home Secretary announced an immediate ban on importation of substances containing mephedrone and other generic synthetic cathinones. Previously notorious for being a legal high, possession and supply of mephedrone will soon be illegal, with possession offences drawing a potential 5 year prison term, and up to 14 years for supply.

Under the Misuse of Drugs legislation, measures such as this require a period of research and review by the ACMD; the reclassification of cannabis, for example, involved over two years of consideration. In this latest case, with the government’s relations with its scientific advisors already under tremendous strain following the sacking of Professor David Nutt, followed by a raft of resignations, it seems clear that the advisory process has been observed merely as the barest of formalities, with the ACMD joining the Government in bowing to media pressure.

There is no doubt that the wild alarm sweeping through the media and politics has driven this process along at breakneck speed, riding roughshod over the procedural requirements imposed by the law. Release is concerned about the swift instigation of the ban, as it seems clear that concern for the health of individuals and society has been overridden by other imperatives derived from media hysteria. This is government by panic, and it does not bode well for democracy.

Panic in CAT Country

Over recent days, a full-blown moral panic has erupted over the spread of mephedrone, a new and currently legal drug that has apparently become something of an overnight sensation among the UK’s young people. To use the term ‘moral panic’ in this case is not to imply that there is no cause for concern, or that the drug is safe. Rather, it’s a term drawn from social science which accurately reflects the situation: popular media have reported developments in the most lurid and sensational terms, with hugely exaggerated claims made for numbers of users and—especially—numbers of deaths, as deaths have been classified as resulting from the use of mephedrone before the evidence is in. In short, all sense of proportion has been lost in regard to this issue.

Why? When a reaction is out of proportion to its stimulus, usually some underlying anxiety is at work. And indeed, there are more diffuse and general fears in circulation about the young generation—its invasion of urban centres, where it prowls, hooded and intent on disorder; its disinterest in parliamentary politics; its sexual practices; its absorption in the internet and electronic gadgets, its casual consumption of illicit substances. The mephedrone scare provides a focus around which a concerned older generation can gather. Add to this underlying social trend the approach of a general election, with press and politicians looking to score points, and you have the classic ingredients of a moral panic. And with it, pressures mount on the authorities to be seen to “do something.”

The appropriate response to the problem is, in fact, fairly obvious. As a number of commentators including Release have pointed out already, what is needed is a reasoned consideration of the research evidence, and a set of actions guided by its conclusions. We do not know yet how dangerous mephedrone is: most of the cases in which it has been present in toxicology reports have shown other substances present, and the precise health and social circumstances of the individuals have yet to be made clear. There is also the broader context of drug control in which the mephedrone question sits: the present regime does not, in reality, provide control at all, but rather hands it over to an illicit market run by organised criminals, with violence, high prices and unknown purity adding hugely to the dangers posed by the drugs themselves. Given this, and the fact that young people will use drugs regardless of warnings, we should make harm reduction information available and so avoid at least the most risky practices. The resort to panic is counter-productive in every respect.

Cocaine in the UK

In a report published today, the House of Commons Select Committee on Home Affairs claimed that cocaine use is growing in Britain, and has become a normal part of life for many people. It calls for increased efforts to be directed at both demand reduction and the international traffic that supplies the drug. The report has initiated a moral panic reminiscent of that which greeted the rise of the country’s first cocaine culture during the First World War and the early 1920s. The national alarm was a prominent factor in the passing of Britain’s first prohibitionist legislation.


In the Daily Mail, Conservative Home Affairs spokesman James Brokenshire (aptly named to carry the banner of ‘Broken Britain’) commented that it is “preposterous” that a line of cocaine is now supposedly cheaper than a coffee in London, while citing the ease with which Johnny Foreigner can slip across the UK’s “porous borders” as the reason for the prevalence of cocaine. He blames the labour government for this state of affairs, while neatly linking the issues of drugs and outsiders—in time-honoured fashion. The Times concentrates more on the role of celebrities in glamorising the drug by ‘getting away with’ its use.

In the Report itself, it’s interesting that Keith Vaz MP, Chair of the Committee, said: “There can be no relenting in the fight against cocaine trafficking. The international trade in cocaine causes untold human misery and social and environmental destruction.” He then lists the issues: the exploitation of drug mules, the destruction of rainforest and health problems for users. The first two of these can be laid squarely at the door, not of cocaine, but of the misguided (and, in the long run, quite disastrous) ways in which 20th century governments tried to deal with the problem of drugs. A regulated drugs market would solve both. As to the third point, again, prohibition has certainly exacerbated the health issues of cocaine use, since the adulterants mentioned by the Report (anaesthetics, animal worming agents and carcinogens) would not exist if legal quality controls were put in place. Despite the Report’s statements to the contrary, many people are fully aware that cocaine can and does cause health problems in its own right, and, if it is to be used at all, is best used sparingly. While fully acknowledging the risks involved with the drug, however, it is difficult to see how these are lessened by leaving its trade in the hands of gangsters.

What the Report does not do is to get to grips with the fundamental issue: cocaine and other drugs are a by-product of globalised consumerism, which works by providing people with goods and services that they want to buy. Drugs remain a curious anomaly in this system, inadequately controlled by an antiquated and discredited set of laws. While drug fashions move in historical cycles, drug use is certainly here to stay; and, like all industries and markets, requires effective forms of regulation to manage the conduct of the participants.

Mexico: the Last Great War of Prohibition?

As we enter the second decade of the 21st Century, the death toll in Mexico’s drug wars has reached new highs, or lows, with 69 people dying in a 24 hour period. A total 283 individuals have died in drug war violence since the New Year turned, including several beheadings.


The context of this rising tide of violence and death lies in the struggle to control the country’s hugely lucrative illicit drug trade. When President Calderón came to power in 2006, he launched an unprecedented campaign to destroy the organized crime groups that control the trade. It has so far resulted in around 14,000 deaths, and some 50,000 soldiers and Federal Police have been deployed by the government. Nonetheless, the death toll continues to escalate. The trade is structured around the activities of 6 major cartels, and killings and arrests of various high profile figures have served only to sharpen the competition for power. Not only cartel soldiers but police and vigilantes are implicated in murder and torture.

The situation has strong historical parallels to the other great 20th century Prohibition: the USA’s ‘Noble Experiment’ with the prohibition of alcohol from 1920 to 1933, which issued in bloody gang violence and gave American organized crime access to almost unlimited funds, and the political and law-enforcement corruption that went them. Mexico’s response to the ills of prohibition has primarily been a military one, a strategy that has received the support of the United States (which is also the source of the firearms used on all sides). It is becoming increasingly clear that this strategy is not working, and that more fundamental measures are necessary to take the drugs industry out of the control of criminal organizations.

Anthrax deaths in injecting drug users

Several anthrax infections in injecting heroin users came to light in Scotland during December 2009. The cases were centred on Glasgow, but have since spread to other Scottish cities; six people have now died as a result of the infection. Other cases are presently in hospital, and though the outbreak is so far confined to Scotland, police and health services in Cumbria have issued warnings to heroin users about a suspected batch of contaminated heroin, which is believed to be the source.


Anthrax is an illness that is caused by a bacterium called Bacillus anthracis; it usually enters the body through a wound or broken skin, and cannot be passed from person to person through airborne contact. In these cases it appears to have been picked up by injecting contaminated street heroin. Anthrax can be fatal if not treated. If it is caught in time, however, the disease can be successfully treated with antibiotics. Symptoms may consist of severe redness and/or swelling at an injection site, fever and an intense flu-like illness. It is vital to seek urgent medical attention (from a GP or an Accident and Emergency unit) if you suspect you may have contracted anthrax.

The batch of heroin in question was probably either made or stored near animals, soil or faeces containing the bacteria. The conditions of production and transport of street heroin are not regulated by any governmental agency, and are consequently covered by no public health or quality controls. One result of this lack of regulation is that dangerous chemicals or infections periodically get into illegal drugs and result in death and illness.

The Heath Protection Agency last night issued a bulletin about the outbreak, which is available here.

Women drug mules imprisoned around the world

Sasha Brooks and Kimberley Anderson are two young working class British women from Nottingham. They are currently in prison in Sao Paolo, Brazil, charged with trafficking offences, having been found with 5 kilograms of cocaine. A chance meeting with some local dealers resulted in what seemed like an attractive proposition—the chance to make some decent money. Instead, they are now trying to come to terms with life in a tough foreign prison, far from those they know and love. The two women share their predicament with large and growing numbers of women around the world: West Indians locked up in the UK for carrying Colombian cocaine, Tajikistanis in Moscow’s notorious gaols for carrying Afghan heroin, Philippinos languishing in Chinese prisons, captured on their way from a resurgent Golden Triangle bearing white heroin from Myanmar. These are just the beginning of a long list.


What all these have in common is that they are mostly female, all poor, and at the lowest rungs of the drug trading hierarchy. The very term “mules” denotes a beast of burden, that which does the labour no-one else wants to do. They are easily recruited, faceless, functional and disposable. Usually they know little or nothing about the people organizing the trade, made up of a sophisticated global alliance of shifting networks, whose upper ranks make money that the mules can barely dream of. Put these people in prison and others just take their place; the only way to dry up the supply is to alleviate the poverty of wealth and opportunity that drives them to take such risks with their lives and liberty.

China and drug law executions

On 29th December 2009, Akmal Shaikh, a British citizen, was executed by the Chinese authorities by means of lethal injection. Mr Shaikh had been in custody since 2007, when he was arrested for carrying 4 kilos of heroin into China. Despite last minute appeals for clemency by his family and the British government, and protests from around the world, China has stubbornly defended its actions and its independent right to punish as it sees fit.


There’s a colonial and imperial background to this: in China, the memory of the opium trade from British India, which was carried on against the express wish of the Chinese government, and against Chinese law, is still fresh, along with the “Treaty Ports” system that allowed the writ of European law to run in Chinese centres of maritime trading.

In this context, one might expect that intervention on the part of the United Nations would have been more effective. However, Professor Philip Alston, the UN Special Rapporteur on summary and extra-judicial executions, wrote to the Chinese asking them to explain the rationale behind Mr Shaikh’s sentence, pointing out that he suffered from a mental illness. His letter was ignored.

This intervention from the UN is welcome. However, the stream of rhetoric coming from the UN drugs agencies, as well as from British and other politicians around the world, helps to maintain the climate that is used to justify the execution. The Chinese embassy in London stated that, “The amount of heroin he brought into China was 4,030g, enough to cause 26,800 deaths, threatening numerous families.” The question of mental illness aside, China regularly executes people for drugs crimes, and the extreme and exaggerated account of the danger that drugs pose lies at the root of the reasoning involved. The ‘War on Drugs’ may be a rhetorical device, but the bodies are real.

Cannabis, Skunk and Psychosis

Researchers at the Institute of Psychiatry in London have published a study looking at the impact of cannabis use on psychosis, which has been a hot political topic in recent years. The research had a specific focus on high-potency, “skunk” varieties of the drug. It compared patients admitted to hospital with first episodes of psychosis with a group of people from the nearby community. There were no differences between the two groups in terms of the proportions of their ever having used cannabis or age at first use. However, amongst the cannabis users, patients with psychosis were nearly seven times as likely to smoke the high potency skunk varieties as the second group. Researchers suggest that the apparent greater risk involved in the use of skunk is linked to its higher THC content and low cannabidiol (CBD) content, two of the main chemicals in the drug. In the traditional resin hash preferred by the control group, levels of THC averaged at 3.4%, with similar levels of cannabidiol. Skunk, by contrast, contains 12-18% THC and 1.5% CBD. It appears that cannabidiol may help to protect against psychosis.

The lead researcher, Dr Di Forti said, “Our study is the first to demonstrate that the risk of psychosis is much greater among people who are frequent cannabis users, especially among those using skunk, rather than among occasional users of traditional hash.” It is unclear whether the researchers are suggesting that heavy skunk use causes psychosis, or whether there is merely a correlation, in which case it may be that those already troubled by symptoms of mental illness are using stronger varieties of cannabis to alleviate symptoms. What is clear is that production of the skunk varieties has been driven by commercial factors in an unregulated market where profit is the sole governing principle.

Cocaine Purity impacts on drug trends

Release is concerned about the impact that low purity cocaine will have on the drug scene in general. The staff on the drugs team, who regularly provide expert testimony at Court, are increasingly seeing cases involving large cocaine seizures where purity can be as low as 3%-4% purity and is on average about 15%. The cost of purchasing on the street is about £40 per gram.

As such many long term recreational stimulant users are not purchasing coke – this is confirmed by calls on the Release National Helpline. Whilst it could be argued that this decrease in purity could be linked to successful law enforcement it is more likely that greed is the real motivator behind this change. Often cocaine powder is being stamped and re-stamped into blocks, being continuously cut, so that the numbing effect traditionally associated with cocaine is now more often the benzocaine or lignocaine used as cutting agents.

Gary Sutton, Head of Drugs at Release states: ‘In my opinion, it is an effect of the recession that we have experienced a lengthening of the supply chain as cocaine passes through more hands from importer to consumer. In a situation not unfamiliar to viewers of ‘The Wire’ we are beginning to see that as benefits become less available to young people and as the availability of work constricts that selling cocaine is seen by as an attractive alternative to unemployment or a MacJob’.

This drop in purity may mean some people are choosing to use other drugs such as Ketamine; mephedrone and other various legal highs. However, it likely that weak cocaine will open the way for methamphetamine – and we will finally witness what has been predicted for years. Not because it is the natural next step in drug use patterns but because when supplies of one drug dry up, people will generally seek out an alternative and, unfortunately, in most cases this will involve a drug that causes much greater harm.

Fear of Music

Release has always had a close relationship with drugs and music. When the organization began, in the heady days of the 1960s (a “more generous decade”, as Leonard Cohen has observed, when it seemed that the world really could be changed by the youth), Release was funded by the counter culture. In practice, that meant largely by rock stars; there were lots of high profile donations, and venues would even put a “tax” on the door so that the bands and audiences who were using the drugs were the ones that paid for Release services: help with bad trips, health and welfare problems and, especially, drug busts. With finances thus secure, Release could even turn down offers of funding by the Home Office, which, to its credit, recognized that the service was worthwhile and deserved government money. My, how the times have changed.

Enough of this wistful sighing. Release aside, the wider point is that there has been a long relationship between drugs and popular music: indeed, it goes far back beyond the 60s. And, of course, it still features big in the media today. As the Mail Online put it yesterday:

“Singer Joss Stone has been condemned for glamorising drugs after an astonishing diatribe in which she claimed cannabis is less harmful than alcohol.”

Hmmm, sounds familiar. Doesn’t this put Joss Stone into the honoured company of Professor David Nutt, with whom we launched ourselves into the Blogosphere last week? Or perhaps the other way around? Either way, the Mail is filled once more with a righteous wrath, commenting that the 22 year-old singer has “enraged anti-drug campaigners” and added that her remarks may be seen in the context of her desire to stump up publicity for her new album. She went on, we are told, to dismiss the dangers of cannabis, in spite of the fact that ministers upgraded the drug’s legal classification from C to B last year. Whatever her motivation, she too seems to have been sending out the wrong message. In another echo of the Nutt affair, David Raynes of the National Drugs Prevention Alliance remarked, “People like Joss Stone should keep their mouths shut about things like this.” Right then.

Since jazz music first appeared in the dance clubs of Soho in the early twentieth century, provoking fears of sexual primitivism and the madness of dancing women, racial interbreeding and the swamping of national identity (yes, all the old favourites), drugs and music have been entwined in the passion of the cultural imagination. Jazz and blues singers smoked marijuana and took cocaine; as the century progressed they became associated with heroin use—and it’s true, a lot of the bebop jazzers believed the drug helped them play. Maybe it did. In the 1950s, the large scale immigration of West Indians into the UK led to new fears, especially when white girls appeared to be drawn to their shadowy all-night clubs, their rhythms and their reefers, their reportedly outsized anatomical adaptations. Cannabis was the symbol of all this. For the authorities it was a fearful thing, to be repressed. For the youth, a marker of new experiences and a promise of exciting social freedoms.

Drugs, it would seem, are made of symbolism as much as they are made of chemicals. It is this symbolic struggle which is still being played out in contemporary culture. And while drugs are associated with music, itself an element of a libertarian popular culture that celebrates drug experience, no amount of “education” is going to stop people using them.

Release blog will return to the relationship of drugs and music in the near future.

Been through the desert on a horse with no brain?

The affair of David Nutt’s sacking has prompted widespread debate. The injustice of the dismissal is, therefore, balanced by the opportunities it has provided to push the boundaries of the conversation that UK society is having with itself about the direction of drug policy and the factors driving it. The new Release blog launches itself onto an unsuspecting world in a week in which discussions about drugs are going on beyond the usual circle of policy nerds, journalists and evasive politicians. One topic of interest lies in an area that is customarily held to be somewhat arcane: the relation between drug policy and evidence.

A couple of times now I’ve had the pleasure of watching Professor David Nutt, erstwhile Chair of the Advisory Council on the Misuse of Drugs, deliver his famous or infamous lecture on Equasy—“Equine Addiction Syndrome” to give it its full title. As widely reported, the presentation takes for its theme the relative hazards of Ecstasy and horse-riding, with that time-honoured and quintessentially English pursuit of the nobility—and lest there be any confusion, I am referring here to equestrianism—standing condemned as the more dangerous of the two. This scholarly but provocative conclusion caused considerable unease amongst the ranks of our elected representatives.

To its credit, the BBC News magazine has just attempted to look further into the facts of the horse-riding plague that is spreading amongst pockets of our youth, even though they remain the better-lined ones. Lucy Higginson, editor of a publication entitled “Horse and Hound” and evidently an apologist for equestrianism, commented: “There have been quite a few fatalities in Britain over the years. Most people accept riding is a risk sport. The reward and the thrills more than make up for it.” Interestingly, the risks are acknowledged but the pleasures afforded are judged to make them worthwhile. Every weekend millions of UK citizens perform the same kind of cost-benefit calculation in relation to their drug use. “Doing an E tonight? Yes, there are risks, but the reward and the thrills more than make up for it.” But because the drugs are illegal, and those who stand guard over the moral well-being of our society are anxious about the “messages” sent to the young and the vulnerable, such considerations are frowned upon when made in the context of drugs. Professor Nutt has begun to make them, and therein lies his sin.

Approached by the BBC, Dr John Silver, a prominent consultant on spinal injuries, observed that the accidents associated with horse-riding generally result from a “mismatch between the skills of the participant and the task attempted”. Again, this is a point that is highly relevant, yet is, explicitly at least, denied entry to the policy considerations of government, and for the same sort of reasons. But the fact stubbornly remains: many, perhaps most, of those who come to grief with illegal drugs, who overdose and who unwisely mix substances—lack the skills and knowledge necessary to make their drug use relatively safe. Drugs and horses have this in common. So do cars and mountain-climbing.

This introduces another set of considerations into the equation, which do not invalidate Professor Nutt’s position, but they do problematize it. How do you make a “scientific” scale of drug harms when the harmfulness of drugs, like horses, is in part a function of the skills sets of those in the saddle? 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. Things are more complex than that: 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 truth is that, despite its claims to be “evidence-based”, the classification system for illegal drugs functions mainly as a vehicle for the government’s beloved “messages” about the dangerousness of drugs. Professor Nutt is surely right to stand up and say so. But 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.