A hard Nutt to crack
What kind of idiot is Alan Johnson? Is he simply an ignorant idiot, unaware of his folly, or is he a manipulative self-serving sort of idiot? Perhaps he is a self righteous idiot, an innumerate idiot, or the sort of person entirely lacking in the ability to understand evidence. Or maybe he is all of the above. Or then again, maybe he is a subspecies of Homo not so sapiens which even I, with my generous imagination where political vacuity is concerned, have never dared think of.
The problem: Johnson, as Home Secretary, has sacked (ie ‘demanded the resignation of…’) Professor David Nutt, who was until recently the head of the Advisory Council on the Misuse of Drugs (ACMD) which is an ‘independent expert’ body which does what it says on the tin, other than the bit about being independent. It also recommends where drugs should be placed on the ratings system, Class A, B and so on, which determines much of the way in which society and the legal profession deals with the drugs and their users.
Professor Nutt’s sin, in the eyes of Johnson (and his predecessor Jacqui Smith), was to have disagreed with government policy. He could hardly avoid doing this, as the government had casually ignored the advice of the ACMD regarding the classification of cannabis and ecstasy. This was unusual. The ACMD has been around since 1971 and in that time its advice has almost always been taken up by government.
This leaves Nutt in a difficult position. Either he must cleave to government policy, in the face of the evidence which he and his colleagues have collected to the contrary, or he must stand by his evidence and state that it does not support government policy. To his credit he chose the latter. Other members of the ACMD are in a similar position, and two have already resigned.
Much of the discussion about Nutt’s conduct revolves around an article he wrote for the Journal of Psychopharmacology, in which he compared the perception of risk associated with drug use, with that associated with horse riding.
Except he didn’t call it horse riding, he called it “equasy” or Equine Addiction Syndrome. This was unfortunate, because it comes across as the kind of light hearted whimsy you expect from a, well, from a blog rather than from a respected government adviser. The point he is making however is quite valid: all sorts of activities carry a risk of permanent damage or death. Not just horse riding, what about climbing? Or boxing? Why is it that we have such an unbalanced attitude to risk that some activities are viewed as beyond the pale while others carrying similar risks are normal, even healthy?
And yes, they are similar risks. The estimate of the risk of acute harm to person from ecstasy use which he quotes is 1/10000. The equivalent risk for equasy is 1/350. I’ve taken them from Nutt’s paper, and I somewhat suspicious of what they mean. For instance, I can’t tell what ‘acute harm to person’ refers to exactly. But it is clear that ecstasy is not quite what one would imagine from its media profile.
Of course, at least part of the answer comes down to the nature of illegal drug use, which being illegal is unregulated. The illegal drug user is merely the end of a long line taking in everything from people trafficking to casual murder by the organised crime syndicates which run the game. The sort of moron who snorts cocaine at a swanky dinner party in between discussing fair trade batik fabrics rarely considers the chain of suffering which has led to the selfish tickling of their limbic system.
Politicians don’t understand science, and they don’t much like it. Why? Well because a politician’s business is getting into power, and then, once having done so, holding onto it while pushing some faint relict of the ideals which once drove them. But it is the holding on to power which dominates. Unfortunately, science can get in the way of this, when it suggests something which might be unpopular with the electorate, or worse, the press.
I’m not denying that Nutt’s views are politically problematic. Some have tried to excuse Johnson on the grounds that the drug classifications send ‘a sign’ to the public. Because drug classifications are linked to everything from public perception of risk to jail terms, they matter. Downgrading looks like being ‘soft on drugs’. But I cannot think that lying to the public about these issues helps. And make no mistake, it is a patronising lie. For the evidence, just look at the advice of the ACMD.
In place of this Nutt has suggested a more nuanced classification system, which has a lot to recommend it, but might be hard to sell to the media. I can locate within myself one iota of sympathy for Alan Johnson: whichever choice he made, he was going to face trouble. To have accepted Nutt’s recommendations would only lead to a world of political pain for the government.
Because next to the media, Alan Johnson looks like Richard Bloody Feynman. Some time ago I read a front page article about an ecstasy death in the Mail, the Express, or some other sewer of moral panic. I can’t find the link, because the web archives of these august journals only go back a few years. But I wish I could find the journalist who wrote it, because they deserve an award for the single most stupid thing I have seen written on the front page of a national newspaper (and there is stiff competition). I am necessarily paraphrasing from memory, but the point was that “despite this tragic death showing the dangers of illegal drug use, millions of people will take ecstasy this weekend.”
Did you get that? Millions of people.
If the journalist was right, the upshot would be that ecstasy has a pretty good safety profile.
Just to close, I would like to take some quotes from Johnson’s letter to the Guardian, published today, in which he defends himself. I am dissecting it to gain some insight into the way politicians see science.
“[Nutt’s] role as my principal adviser was to (unsurprisingly) present advice. It is the job of the government to decide policy.”
There’s something interesting in there, the use of the word ‘present’. If you want to present something, you need powerpoint. If you want to advise, you need expertise. The focus on presentation suggests that the real role of the ACMD is as presentational window dressing – policy based evidence.
“He was asked to go because he cannot be both a government adviser and a campaigner against government policy.”
‘Campaigner?’ Nutt has not tried to hide his irritation with the way evidence has been ignored, but he’s not manning the barricades yet. This suggests that if a scientist finds evidence in conflict with government policy, he or she must resign. Can you think of a more suffocating stricture for scientific debate? Which scientist in their right mind will bother trying to advise a gang of know-nothings who are only in it for the canapés?
And then, on equasy…
“…it is of course a political rather than a scientific point. There are not many kids in my constituency in danger of falling off a horse – there are thousands at risk of being sucked into a world of hopeless despair through drug addiction.”
Now this is where Johnson finally shreds what remaining respect I might have nurtured for him. The only political point being made here is by Johnson. He has no interest whatsoever about the findings of the ACMD. He knows everything he needs to already. He ignores the evidence, explained by Nutt in a non-technical fashion. He is either innumerate, self delusional, or addicted to the comforting sensation of sand around his head. He is, beyond dispute, an idiot.
There’s been a lot about this in the Twitterverse: Gimpy dreamed up the tag #AlanJohnsonNuttSack. There’s a lot of really good analysis out there.
I’m still amazed that the head of an independent body was sacked after disagreeing with a minister, because it undermined the body’s independence.
i wish I had thought of that tag.
Hurrah!!!!
I’ve been asked to blog about this at work (I love my job) but I think I’m simply going to point to here, because Bill has said all that can be said, and much more eloquently than I could.
[…] I could say a lot more, but I’m about to go and prepare to get on a ‘plane for a conference in South Carolina. Fortunately two of my favourite haunts already have excellent commentary on the matter: Erika Cule at Nature Network has some core links and background, and Bill Hanage froths at the mouth in a funny and intelligent way over at the LabLit blog. […]
The problem I think lies with the fact that the present class system is indeed related with the public’s perception of drugs. What Nutt seemed to propose would certainly have passed the message that the government are getting it slow with the drugs business. I would think that this was the primary reason behind his firing. Unfortunately, as we know, the science is clear and from a purely scientific point of view, Nutt was right in his proposal. But there’s no way that you can go along with this as the government, simply because the population will get the bad impression. And it’s not only a bad impression which reflects on the government but also a bad message to people who’ll basically perceive this as a go-ahead-and-do-drugs message.
What should be done is that a new classification which takes science and public view into account. It is too easy to say that we’re not putting science first. Putting ‘this’ science in the public’s face wouldn’t be good for anyone because sometimes science and governmental policies just cannot be mixed with one another.
Or…how about, let’s keep the drug classification system itself completely scientific – not deny that, for example, cannabis is less harmful than alcohol – give each drug it’s proper rating according to research – but instead acknowledge that laws and sentencing around a particular drug should take into account more than just its numerical value? Otherwise it’s just hypocritical and makes one wonder why anyone should even bother analyzing safety issues in the first place.
There are other considerations: is the rating supposed to be risk of harm per episode of use? Or the population level effect (in which case it is hard to argue with anything being as bad as tobacco or alcohol)?
What about comparing the risk of harm, per annum, for a heavy user with that of an occasional user. And then examining what proportion of drug users fit into each category.
I presume Nutt and the like know the answers to all these questions. I’d be curious to know them too because they seem quite important.
Walking home late at night, I’d rather run into a bunch of stoned blokes, than a bunch of drunk ones. Such additional societal impacts should also be considered. And every time we hear about a middle class mother who has ‘lost’ a child to skunk we should consider how many other mothers have watched their kids get out of their heads on cheap cider night after night, pissing away their hopes of a brighter future. But such parents generally don’t get the press. Or if they do, they are hounded as examples of broken Britain <>
Jenny, that is what I would have thought was the issue all along. Not the “number assigned to the drug” but the overall picture and other things…. (like it is hard to banish alcohol nowadays being so ingrained in our society but if it was made now, I sort of doubt it would be as easily accessable)
anyhow, nice post Bill, thanks a lot for pointing this out! And your last comment here (#8) is very on target with why this is so hard to measure or be solely scientific about it since there is a lot of missing data points out there….
[…] evolving diseases. Now, I’m not an epidemiologist (you should possibly go and talk to my mate Bill if you’re that interested), and the argument therein apply more to a healthcare system that […]
[…] You can read some measured analysis from Bill Hanage, an epidemiologist at Imperial College, at the LabLit blog. Bill also lambasts politicians of all colours for failing to grasp that evidential science […]
[…] This last government has not covered itself in glory when it comes to science. Indeed, it has shown a marked tendency to brush inconvenient scientific advice under the carpet (eg here). Alan Johnson as home secretary has obviously preferred to get his science advice in the form of updates downloaded from the Sun rather than professional scientists who might disagree with him. […]
[…] You can read some measured analysis from Bill Hanage, an epidemiologist at Imperial College, at the LabLit blog. Bill also lambasts politicians of all colours for failing to grasp that evidential science […]