Misuse of harmful, illegal stimulant drugs grows in developing world, UN warns

That either I personally or Transform Drug Policy Foundation hold a
particular view in the drug policy debate does not constitute a conflict
of interest in the context of a debate on drug policy.

My affiliation to Transform is clearly stated. Transform's position
is widely known and in no way concealed - quite the opposite; we have a
campaigning remit. Our critique of current policy is clear from my post,
and what we advocate is also more than clearly spelt out in the linked
documents, our website homepage, our mission statement and all of our
literature.

I would much rather you engaged with the points Ive made regards the
wider evidential and ethical basis for the classification system, than a
rather sad and misplaced attempt to undermine my credibility.

Competing interests:
None declared

I think Peter O'Loughlin does the ACMD and its chair a disservice by
prejudging the scope and findings of the upcoming ecstasy review that has
yet to be completed or published. He is absolutely right that poly-drug
use is major contributer to drug risks but I feel confident that the ACMD
will take this, and other cultural/behavioural variables into account in
their assessment, one which will likely be as detailed, rigorous, and
objective as can be hoped for, and indeed as has been seen by similar
reviews in the past of other drugs.

Transfom Drug Policy Foundation's submission to the review process
(1) certainly highlighted the issue of poly-drug use around ecstasy that
O'loughlin rightly flags up, as well as the difficulties in assessing the
risks of a generic street drug sold as 'ecstasy' that not only describes
pills/powders of unknown strength and dosage, but also that frequently
contain various other drugs, either separately or in combination with
MDMA. We have suggested that a comparative review of the harms associated
with the use of the street drug 'ecstasy' in parallel with a review of the
literature on MDMA toxicity specifically, would produce potentially
important conclusions with useful policy implications. It is clear that
the legal status of a drug impacts directly on the harms associated with
its use.

Whether Ecstasy is appropriately ranked within the ABC system or not,
however, misses the bigger issue which is that the system itself, used
not primarily to send out public health messages but rather to determine a
hierarchy of criminal penalties, is fundamentally flawed.

The Transform submission concluded that

- The ecstasy review is a distraction from the fundamental flaws with
the classification system (outlined above and in more detail in the
appended paper (2)). It is unconscionable for the ACMD to simply proceed
with a systematic review of classification of all drugs covered under the
Misuse of Drugs Act (which, at the current rate will take many years to
complete) when there is simply no evidence that an ABC system for
determining a hierarchy of criminal penalties produces positive public
health outcomes, and a substantial amount to demonstrate it is actively
counterproductive and harmful.

- It is of paramount importance that the ACMD assert the primacy of a
scientific approach not only in terms of producing first class reviews of
individual drug harms but also in terms of evaluating the policy impacts
of ACMD recommendations, their implementation, and the system within which
they operate. This is specifically in reference to the evidential and
ethical basis for an ABC drug harm ranking system rooted within punitive
criminal justice legislation.

- Transform, therefore, hope that the appointment of a new ACMD chair
will provide a fresh opportunity for the ACMD to instigate the long
overdue root and branch review of the entire classification system; its
aims and objectives, its outcomes on key indicators, and the legislative
and institutional structures within which it operates.

- Such a review was promised by the Home Secretary in the House of
Commons in 2006(3), but despite a review consultation paper being fully
drafted and ready for dissemination, the review was abruptly cancelled
when a new Home Secretary was appointed. Such a review was supported by
the Science and Technology Select Committee, the ACMD itself and, to the
best of our knowledge, everyone in the drugs field. The absurd reason
given by the Home Office for this review being cancelled was that ‘The
Government believes that the classification system discharges its function
fully and effectively and has stood the test of time’(4).

- The ACMD cannot stand idly by whilst the Government so blatantly
prioritises its own political posturing over rational policy evaluation
and review, and dismisses a scientific approach on the basis of entirely
un-evidenced ‘beliefs’. That such political games interfere with
reclassification recommendations is beside the point (there is no evidence
classification changes have any impact anyway). The more significant
danger is that a policy infrastructure that has been such a manifest
failure for over three decades remains unchallenged, perpetuating systemic
failure and in a very real sense, costing lives.

- The ACMD should demand of the Government that the classification
review process be re-instigated with some urgency, and failing this
undertake or commission such a review themselves.

1. http://www.tdpf.org.uk/Transform%20ACMD%20ecstasy%20submission.pdf

2. http://www.tdpf.org.uk/DAATOct2007.pdf

3.
www.publications.parliament.uk/pa/cm200607/cmselect/cmsctech/65/6112201.htm

4.

www.publications.parliament.uk/pa/cm200506/cmselect/cmsctech/1031/103102...

Competing interests:
None declared