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EDITORIALS: Colin Blakemore Classification of cannabis and ecstasy in the UK BMJ 2009; 338: b731 [Full text]

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Dynamics underneath it

Hatice Selin Buller   (23 February 2009)

Cannabis reclassification, a missed opportunity to begin to make a change in the Misuse of Drugs Act 1971

James R Robertson   (4 March 2009)

Drug classification: a distinction without a difference

Hugh Mann   (12 May 2009)

Dynamics underneath it 23 February 2009
Hatice Selin Buller, SHO psychiatry Grantham Send response to journal: Re: Dynamics underneath it	The use of cannabis is believed to stretch back 4,000 years. Cannabis has been used for recreational, religious or spiritual, and medicinal purposes. The recreational use of cannabis which began during the fifties when migrants from the Caribbean arrived in the UK. Jazz musicians playing in clubs in London were among the first to use it. Elders of the modern religious movement known as the Ethiopian Zion Coptic Church consider cannabis to be the Eucharist, claiming it as an oral tradition from Ethiopia dating back to the time of Christ. During the flower power years of the sixties it soared in popularity. A few politicians have admitted to having tried an illegal drug when they were young. In China, it was used to treat conditions such as malaria, constipation and rheumatism. Even Queen Victoria was given it to relieve period pain. In light of the mentioned above, I believe we need to understand the dynamics underneath the use of cannabis before classifying it. If we start with one of the reasons, is it a coping mechanism to deal with anxiety, anger, boredom or depression ? If it is, what is it causing these mental states and what can we do about it? Competing interests: None declared
Cannabis reclassification, a missed opportunity to begin to make a change in the Misuse of Drugs Act 1971 4 March 2009
James R Robertson, University Researcher and General Practitioner Edinburgh University, EH4 4PL Send response to journal: Re: Cannabis reclassification, a missed opportunity to begin to make a change in the Misuse of Drugs Act 1971	Cannabis reclassification, a missed opportunity to begin to make a change in the Misuse of Drugs Act 1971 The current debate about the health effects of cannabis and the benefits for individuals and society of better control of its use by repositioning it in schedule B rather than in schedule C have been well stated by several contributors to the British Journals and Professor Blakemore’s editorial on the topic summarises the increasingly urgent position with regard to classification of drugs of abuse (1,2,3). At the personal level of the individual drug user it should be obvious to everyone from users to health and social carers as well as politicians that the drug is a powerful psychoactive with potential to cause serious consequences. This damage is perhaps individual related and probably dose related. It is also important to note that at the time of reclassification in 2002 and again in 2005 the advice given to the Home Secretary from the Advisory Council on the Misuse of Drugs started with the statement that Cannabis is a dangerous drug with serious health damaging potential (4,5). The decision to reschedule the drug in group C was therefore taken in full knowledge of its dangers. However, it was important then, and remains a powerful argument, for reducing penalties for drug use that individuals experiencing problems from cannabis (or any other drug) should be encouraged to access help and support. This is more likely to happen if the criminal element is low. There is little point in addressing a health problem with a blunt enforcement and coercion tool. Most importantly is the bigger picture of legislation concerning drugs such as cannabis, heroin and cocaine and ecstasy. For some years a debate has continued about the value of a hostile and punitive approach to drug control. Often prominent in this debate are Chief Constables and legal representatives who witness the complex and futile revolving door activity of drug users in the criminal justice system. Most recently a report from the Royal Society of Arts concluded that the Misuse of Drugs Act (1971) was outdated and not fit for purpose (6). Close to home the ACMD is considering ways of amending this piece of legislation in favour of controls which recognise the individual dangers of drugs, and presumably with the subtext of reducing the emphasis on law enforcement as the primary intervention. It would seem contrary then to reconsider cannabis scheduling. The move from B to C was the first constructive change in many years in the direction favoured by many observers to reduce penalties and decimalise the drug problem. This has been a small impact in the War on Drugs in the direction of humanity and pragmatism without too much collateral damage. Sadly a lack of insight and perhaps a misunderstanding of the potential benefits for individuals and society has reversed this opportunity to start a gradual process to a more responsible and sustainable drug law framework. The UK has always been active and influential in drug legislation and not always in line or harmony with countries like the USA and Sweden. This is an important decision at National and International levels. It represents more than just a debate on the statistical evidence of a few studies on cannabis psychosis. It is a watershed in drug policy and marks a way forward or a retreat to a stalemate position which has lasted 30 years or more. It is hard to see now how the Government of the UK can make any progress when short term political expediency take preference over seriously addressing the catastrophy of our current drug problems. 1. Blakemore, C. Classification of cannabis and ecstasy in the UK. BMJ 2009;338: b731 2. Degenhardt l, Hall W, Roxburgh A, Mattick RP. UK classification of cannabis a change needed and why? Lancet 2007;370:1541 3. Lloyd C. UK cannabis classification: a flawed debate. Lancet 2008;371: 300-301 4. Advisory Council on the Misuse of Drugs. The classification of cannabis under the Misuse of Drugs Act 1971 2002 Home Office London 5. Advisory Council on the Misuse of Drugs. Further consideration of the classification of cannabis under the Misuse of Drugs Act 1971 2006 Home Office London 6. RSA Commission. Drugs-facing facts. The Report of the RSA commission on Illegal Drugs, Communities and Public Policy 2007 RSA. London Roy Robertson FRCP FRCGP Department of General Practice, Edinburgh University, EH8 8DX Member ACMD 1994-2004 Roy.Robertson@ed.ac.uk Competing interests: None declared
Drug classification: a distinction without a difference 12 May 2009
Hugh Mann, Physician Eagle Rock, MO 65641 USA Send response to journal: Re: Drug classification: a distinction without a difference	Drug classification is a mixed blessing. It draws fine distinctions between the addictive potential of different drugs, but in so doing it tends to minimize the addictive potential of some drugs. Since drug classification is primarily a medico-legal device, and is not intended for the public, I propose that drug classification include prominent caveats for the public that emphasize the very real addictive potential of all drugs, regardless of their classification. Competing interests: None declared