Drugs Without the Hot Air: Minimising the Harms of Legal and Illegal Drugs

Psychologically active drugs may be the least rationally regulated part of our society, with one dangerous and addictive drug advertised and available everywhere (alcohol) and only nudges to disocurage the use of another that kills five million people a year globally (tobacco). Meanwhile, police forces and court systems around the world tie themselves up with investigating, processing, and incarcerating people who own or sell small quantities of much less dangerous substances.

David Nutt was appointed as chairman of the British Advisory Council on the Misuse of Drugs in 2008: an expert panel intended to provide non-partisan advice on drugs to the government. He was fired in 2009 after pointing out that the chances of getting hurt from an hour of horseback riding are about 30 times greater than the odds of dying from taking a pill of MDMA (ecstasy). His book Drugs Without the Hot Air: Minimising the Harms of Legal and Illegal Drugs covers some extremely interesting ground in a convincing and well-argued way.

Nutt describes how policy-making in the area of drugs is often driven by a combination of media-enhanced hysteria and an effort on the part of politicians to seem ‘tough’ on the issue. He categorizes many of the harms that result from this, ranging from criminal records acquired by youth (which harm their lives much more than drugs) to harsh restrictions on the availability of painkillers around the world, leaving many with terminal illnesses to die in a great deal of pain.

Nutt also provides a nuanced and interesting description of the nature of addiction, distinguishing between people who rely on steady access to a drug to control and underlying condition (as diabetics use insulin) and those whose use of a drug has been sufficient to give them harsh withdrawal symptoms when they stop using it, which in turn drives them into a cycle of continuous use. Nutt argues that treating addicts as criminals causes a great deal of harm to the addicts themselves and to society at large, through mechanisms including the suppression of scientific research, the discrediting of the law through its obviously unjust application, the enrichment of criminal gangs, increasing the spread of infectious disease, diverting attention from controlling alcohol and tobacco, and the indirect encouragement of more harmful drug-taking practices because safer alternatives are not available.

My copy of the book is sprinkled with a few typographic errors which I am told have already been corrected in the newest printing. It’s also a bit challenging to square a few of the claims about the relative dangerousness of drugs. Early in the book, Nutt describes a complex exercise in which multi-criteria decision analysis was used to evaluate the relative harmfulness of a variety of legal and illegal drugs across sixteen dimensions, encompassing both harm to the individual and harm to society. The ranking found alcohol to be the most destructive drug overall, followed by heroin and crack cocaine. Methamphetamine, powder cocaine, and tobacco follow. Lower in the list are amphetamine, cannabis, GHB, and benzodiazepines. At the bottom of the scale are ecstasy, LSD, and psilocybin mushrooms. Between ecstasy and benzodiazepines – about 1/3 of the way up the harmfulness scale – Nutt lists ‘butane’ – an inhalant. Later in the book, however, he characterizes butane as extremely dangerous and capable of killing people on the first use if misused. Perhaps the scale is based on the proper administration of the drug. Still, it seems like a drug that carries a significant risk of accidental fatal overdose should probably be rated as more harmful than drugs like cannabis which carry no such risk.

Regardless of the exact ranking of harmfulness that is most appropriate, the book contains a great deal of interesting information, as well as an informative chapter on what parents should tell their children about drugs. Nutt argues convincingly that treating drug addicts as people with a serious medical problem makes more sense than treating them as criminals, and lays out a good case for why the supposed ‘War on Drugs’ has failed. He also provides some interesting information on the functioning of the brain and makes some suggestions about how drugs of all sorts could be regulated to reduce harm. He does a good job of pointing out the hypocrisy in our treatment of tobacco and alcohol and makes some sensible suggestions for how states could effectively discourage the use of the latter.

All told, Nutt’s book provides a scientist’s take on the various substances people consume with the desire to change their thinking, as well as the consequences of the production and use of those substances for individuals and society. By repeatedly pointing out the many areas where policies are poorly informed by reality and counterproductive, he makes a strong case for the need for drug law reform. Both for individuals who wish to educate themselves about drugs and for policy-makers who aspire to regulate them more appropriately, this book could be a very useful reference.

Nutt is now associated with the Independent Scientific Committee on Drugs which has a great deal of useful information about drugs and harm reduction on their website.

Norway’s response to terrorism

A year after Norway’s terrorist attack, I’d say the Norwegians are demonstrating the appropriate way to respond to terrorism: by refusing to be terrorized.

“There have been no changes to the law to increase the powers of the police and security services, terrorism legislation remains the same and there have been no special provisions made for the trial of suspected terrorists.

On the streets of Oslo, CCTV cameras are still a comparatively rare sight and the police can only carry weapons after getting special permission.

Even the gate leading to the parliament building in the heart of Oslo remains open and unguarded.”

I wish Canada and the United States had been courageous enough to follow this model, instead of doubling down on the military-industrial complex approach. Rather than responding to terror with courage and resilience, we have been driven by fear to create huge and unaccountable security states that are ultimately more dangerous than terrorist groups.

Free speech online

The internet is one of the places where people in free societies get to exercise their right to free speech. It’s also a place where a lot of private communication takes place, and where the protection of the right to privacy is a constant struggle.

For those reasons, I suggest people consider joining groups that work to protect our rights as citizens online, like the Electronic Frontier Foundation.

Also, remember that the only way to preserve rights is to use them. Make use of your right to engage in political speech online (maybe a little anonymity too).

Third rule of the internet

Following up on rules one and two, it seems appropriate to add a third: “You should probably worry more about being attacked online by your own government than by any other organization”.

This is really an extension of the point about how governments are more dangerous than terrorists and how institutions of armed power need oversight.

Based on the open source intelligence available, we have to assume that governments all over the world are constantly monitoring the activity of their citizens online, for reasons both reasonably benign and exceedingly nefarious. It is worth remembering that even if the official purpose of a surveillance program is acceptable, it can be abused by anyone who gains access to it for purposes that may be very dubious. Hackers and rogue government agents are well positioned to use internet surveillance to rob or blackmail people, for instance. It is also worth remembering that data is not only being monitored in real time; it is also being archived for unknown future purposes.

Tools for privacy

Thankfully, we do have some tools to make this ubiquitous surveillance more difficult to carry out. You probably cannot encrypt your hard drive well enough to protect the contents if government agents grab it, but you can encrypt your online communications sufficiently well to make it at least challenging to decrypt them. The more people streaming gigabytes of data via encrypted HTTPS connections, the less feasible it is to archive and crack internet traffic taken all in all.

You can also use tools like Tor. People should be willing to assert their right to anonymous communication.

Alcohol licenses

Today I read the first half of Marc Lewis’ Memoirs of an Addicted Brain – a fascinating combination of a personal memoir of a drug-laden life and a scientific description of the neurochemistry of common psychologically active drugs. I have also been watching ‘Boardwalk Empire‘, which explores some other elements of the societal treatment of drugs.

It occurred to me that perhaps the world would be a better place if there was a licensing system for alcohol use akin to the system for driving. Instead of just gaining the right to drink at a set age, we could require people to take a class in high school and pass an exam. The license would be subject to temporary or permanent revocation in the event that a person was causing harm to others though alcohol use. For example, people convicted of driving drunk could have their alcohol licenses suspended or terminated.

It’s an idea that could theoretically be extended to other psychologically active drugs. By educating people, it would allow people to make more informed choices. The revocable licenses would also help maintain the balance between respecting the right that people have to make use of their own bodies with the obligation that people have to avoid harming others. It could also bring in a bit of much-needed state revenue.

Order and chaos in politics

It has often been pointed out that order and chaos are one of the more important dichotomies in the universe, with time inevitably breaking things apart into senseless fragments and living things often working to produce order and meaning in themselves and in the world around them.

While it may seem as though order is the supreme goal of politics (perhaps especially in Canada, where “peace, order, and good government” is the credo), people forget that unadulterated order produces rigid structures that shatter when struck or strained. When conditions remain constant, a society that has become rigidly ordered can contiue to function, though it usually starts getting sapped and weakened by the self-interested agents who run it.

When conditions change – however – the vital importance of chaos in politics is revealed. Faced with something new, we need to improvise. We need the organs within society that can handle improvisation – that can perceive the possibilities of a new world, try new strategies for dealing with them, evaluate how those strategies are doing, and carry on with this process of evaluation and experimentation. These organs of improvisation include art, and they include the everpresent contest between the different locuses of power that well-designed societies always include. The civil service spars with politicians; the courts assert their role in interpreting the law and applying constitutional principles; academics try to affect policy; companies try to buy politicians (and some politicians try to be bought!); voters punish incompetence or reward the ability to inspire; civil society groups wax and wane in influence, and change their programs of action.

Just as the 20th century involved change of a magnitude and complexity that defied anticipation, it seems fair to expect the 21st century to have a similar dynamic quality. We are going to need our improvisational abilility and the mechanisms of chaos that keep societies from becoming frozen and immobile. That’s not to say we can or should throw everything away. The reason why the balance of power works as a way of keeping government effective is because the different organs have comprehensible purposes and identities which they perpetuate through time. (Canada’s Supreme Court means something as an institution, as does Health Canada and the CBC and the University of British Columbia.) Similarly, reaching back into our own history is a way to identify strategies that could help us. Historians as well as artists can be organs of improvisation.

All told, I don’t much like where the world is heading. I think our leaders are mostly a mix of the seriously deluded and those who are primarily in it for themselves. I don’t think global society is effectively applying the knowledge it possesses about the world and, to a considerable degree, we are being carried in a dangerous direction by the momentum of selfish and short-sighted choices. If there is hope for the future, it is that creative forces of chaos can disrupt the most damaging patterns of behaviour humanity has developed. That process is necessarily messy and it isn’t clear while it is happening whether things are being made better, worse, or just less familiar. Still, if we are going to make it to 2100 and beyond, we can’t keep doing what we’re doing now.

Jaccard and others blocking coal trains

Simon Fraser University environmental economist Mark Jaccard and others were arrested in White Rock, British Columbia today while blockading coal trains owned by Warren Buffett.

As reported by the CBC, Jaccard considers Canada’s actions on climate change so far “entirely inadequate” and goes on to say:

I now ask myself how our children, when they look back decades from now, will have expected us to have acted today… When I think about that, I conclude that every sensible and sincere person, who cares about this planet and can see through lies and delusion motivated by money, should be doing what I and others are now prepared to do.

Coal exports from North America result in millions of tonnes of greenhouse gas pollution annually. Just the Westshore Terminal, at Roberts Bank, ships over 20 million tonnes of coal per year.