Sunday, April 11, 2010

Drug legalisation debate

Drugs can be safe and should be legal
Intelligence Squared

The usual high quality debate summary from I2.


Drugs can be harmless fun
Many - perhaps most - occasional drug users take drugs for one simple reason: they enjoy it. Social drinkers know how welcome a couple of beers or glasses of wine can be in the evening - they are not seeking obliteration, and few slide into alcoholism. They are simply treating a drink as one of life’s many pleasures. The same is true of most users of cannabis, LSD or ecstasy, none of which are particularly addictive, and all of which have fans who insist that using them enhances their lives. The psychotherapist Gary Greenberg praises the ability of ecstasy "to foster open, fearless communication" in his recent book Manufacturing Depression, and describes feeling total love for his girlfriend when they took the drug together. Such enjoyment is a widespread human trait - indeed, Ronald K Siegel, a professor in the Department of Psychiatry and Biobehavioral Sciences at UCLA, believes that it is universal. In his book Intoxication: The Universal Drive for Mind-Altering Substances, Siegel argues that the human instinct to seek mind-altering substances is so strong and persistent that it deserves to be recognised as the "fourth drive" alongside hunger, thirst and the need for shelter. Our current drugs policy fails to acknowledge this, banning relatively safe drugs like cannabis and ecstasy (the latter is no more dangerous than riding a horse, according to David Nutt) while permitting nicotine and alcohol, both of which are fairly harmful. This conservatism is misguided. Rather than trying to eliminate the desire for intoxication, we should embrace it. If we allowed scientists to research non-addictive highs that didn’t harm health, we would be opening the door to new, safe pleasures that everyone could enjoy if they chose. It would be pure, harmless fun. We build theme parks and create new cuisines to stimulate ourselves, and designer drugs are no different.

Drugs play an important role in society
Recreational drugs don’t just benefit individuals. They also play an important role within wider societies, and always have done. Alcohol is an integral part of Northern European culture, dating back at least to the Vikings, who are thought to have been committed boozers and never took an important collective decision unless drunk. Peyote, a hallucinogen, has spiritual importance for many indigenous Americans, just as cannabis does for Rastafarians. The effects of this sort of social drug use can be very positive - pubs are often community hubs across Britain, and the coffee houses where people could gather in 17th century Britain arguably contributed to the development of newspapers, the Glorious Revolution and even the Enlightenment. The same is true of currently-illegal drugs. LSD contributed to the liberating, free-wheeling atmosphere of the 60s, and many look back on the ecstasy-fuelled raves of the early 90s with great fondness. Drugs have also contributed to great art (as well as some dreadful rubbish). Sartre used amphetamines for writing philosophy and mescaline for writing fiction; Graham Greene took a lot of Benzedrine while writing The Lawless Roads and The Power and the Glory. As John Lanchester says in the New Yorker, "The paranoid and menacing atmosphere of that superb novel…surely owes something to Greene's pill-chugging". Getting high is an important communal activity. New ways to do so will create new cultural institutions, and this is something to look forward to.

You’ll never get rid of drug use...
Even if you don’t like the idea of people getting high, there is no point in trying to stop them. Every attempt to ban popular drugs - even the most draconian - has failed. When Sultan Murad IV took over the Ottoman Empire in 1623, he introduced the death penalty for using tobacco, alcohol or coffee, and is even said to have carried out the penalty himself, walking the streets of Istanbul in plain clothes and using his mace to execute anyone caught using tobacco. Russia introduced a similar ban on tobacco at the same time – first-time offenders would have their nostrils slit or be exiled to Siberia, and repeat offenders earned the death penalty. But smoking continued in both countries until the laws were repealed later in the 17th century. During Prohibition in America, even Presidents Warren Harding and Herbert Hoover drank secretly. Our current laws on heroin and cocaine have inflicted huge problems on the developing countries where they continue to be grown, put users in danger of taking contaminated doses of unpredictable sizes and allow drug barons to grow rich.

...and policing it is only going to get harder
Drug regulation is only set to get more difficult, as dealers continue to develop new - and therefore legal - highs by tweaking the chemical formulae of existing drugs to reproduce their effects, as occurred with mephedrone. Mephedrone was just one of over 400 new drugs identified in a report commissioned by the EU into the scale of the problem. New chemical formulae will continue to emerge and gain popularity. They have never been tested, and some will inevitably prove poisonous. Creating, rigorously testing and then selling safe drugs in a controlled way is the only solution. David Nutt is currently working on a harm-free alternative to alcohol at Imperial College London, based on drugs known as benzodiazepines or "benzos", which include Valium and temazepam. It would make users pleasantly tipsy, and they could simply take an antidote when they wanted to sober up. We need far more of this kind of work - it would save the lives of countless users, innocent road accident victims and those caught up in drug-related violence.

New drugs will enhance our future
Drug use need not just be a matter of simple enjoyment. New psychotropic substances have real potential to enhance our lives by releasing us from archaic notions of human nature - we can choose how we want to be by choosing the substances we take. Cognitive enhancers like Modafinil and Ritalin - developed, respectively, for sufferers from narcolepsy and ADHD - have been shown to enhance concentration and short-term memory in healthy users. Modafinil has been tested by both the British and American armed forces, and could one day offer a substitute for the caffeine and amphetamine "go pills" the US army and air force have long relied on for night-time operations. It has also become increasingly popular with students on tough deadlines and hedge fund workers trying to keep up with 24-hour markets - many say it is a vastly superior alternative to caffeine, allowing them to work long and hard without unwanted side effects. Scientists are currently investigating the effects of oxytocin, the "love drug", a hormone released in mothers’ bodies during birth, which contributes to bonding and trust. It appears to help people with Aspergers Syndrome to function better, and may also make healthy people feel more inclined to kindness. Propranolol, a beta-blocker currently used to treat high blood pressure and prevent migraines in children, may help to reduce the pain of traumatic memories without eliminating their content - potentially allowing us to learn from terrible events in our pasts without being tormented by the psychological agony they are normally associated with. We don’t need to fear this brave new world - drugs are going to make us cleverer, kinder and less scared


Real joy and fulfilment cannot be chemical
The pleasure brought by any drug is fleeting and hollow compared with real happiness, and the fact that people search for chemical highs is a worrying sign that they are not satisfied with their ordinary lives. As the great 19th century British political theorist John Stuart Mill put it, "It is better to be a human being dissatisfied than a pig satisfied”. One of the key things offered by many popular drugs - from alcohol to heroin - is an opportunity for obliteration. We seek to escape our problems but the long term solution should be to address them rather than finding new ways to avoid confronting them. In an ideal world we would not need even alcohol or caffeine to feel good - and we should be working towards such a situation rather than creating new alternatives for mental escape. To paraphrase Marx, opium is now the opiate of the people, a way to keep the public - particularly those who are unhappy and dissatisfied by the status quo - sedated and untroublesome. Governments, scientists and the medical profession should be encouraging us to embrace the world and reform it where needed, with its many subtle everyday pleasures, rather than searching for ways to get out of it. A society dominated by escapism is a society that is bound to rot.

Drugs destroy cultures in many different ways
Drugs - especially new drugs - can have devastating effects on cultures. History should teach us to be very wary of introducing them. Particular psychotropic substances may have historic or spiritual importance for some groups, but those societies are likely to have developed ways to limit their potential for harm - with alcohol, for instance, children can be introduced to the idea of drinking in moderation as part of a culturally acceptable way to socialise. With newly invented drugs, there is no opportunity for this to happen, so the effects may be catastrophic. They may also be unpredictable. Alcoholism is far more widespread among Australian Aborigines and indigenous Americans than the cultures which introduced alcohol to them, for instance. Even if you test drugs extensively to make sure they are not toxic or addictive, the entire point of them is to modify people’s behaviour, and the impact of this on society as a whole can never be foreseen. Some have even suggested that the recent recession could be blamed on heavy cocaine use by city workers. The drug, which makes users feel indomitable, arrogant and powerful, was widely used by bankers in London (so widely used, in fact, that one study found that 99% of bank notes were tainted with it) and might well have encouraged the kind of risk-taking which caused the crash.

Legalisation has terrible consequences
The current law on drugs may be flawed and badly applied, but legalisation is no solution. No substance which has a profound effect on our bodies or minds can be totally safe physically or psychiatrically. We should always be fighting drug use, and the law remains a deterrent. The fact that it forces drugs to be used and sold relatively covertly also reduces the opportunities for peer pressure, especially among the young. Legalisation would inevitably increase the number of users, therefore increasing the number of people exposed to risk. You might expect David Nutt's now notorious study on the relative risks of horse-riding and ecstasy to have been a serious work of statistics. In fact, it was nothing of the sort. It was based on questionnaires of professionals, was riddled with subjective judgement and was just the kind of scientism - the belief that only science can tell the truth about the world - that gives proper social research a bad name.

The dangers of drugs take time to emerge...
It may in theory be possible to use some recreational drugs in a harmless way, but in practice new drugs are likely to have terrible effects. These may take time to emerge - when heroin was discovered by drug company Bayer in 1898, it was thought to be a harmless alternative to morphine, and was marketed as a remedy for coughs and a range of other ills. The Boston Medical and Surgical Journal wrote in 1900 that heroin is "not hypnotic, and there's no danger of acquiring a habit." Sigmund Freud was one of many who believed that cocaine had great potential as an antidepressant as well as a painkiller. He even prescribed it to friends, including the Austrian physiologist Ernst von Fleischl-Marxow, who may then have been the first person to ever die of a speedball, an intravenous mixture of heroin and cocaine. These kinds of risks may be worthwhile when drugs also have a positive medical impact, but simple fun-seeking is not justification enough.

...and we have no idea what terrible world we might inadvertently create
The potential for abuse is inescapable - on both an individual and a societal level. It's possible to imagine a happy world in which people took cognitive enhancers in order to get their work done and rush home to be with the family, for instance. But the idea that we can choose our own psychologies using a pharmaceutically provided selection is an illusion - we are too much shaped by our history and the culture we live in. In reality, the huge majority of Modafinil and Ritalin users do so to work ever harder and more competitively. The idea of using chemicals to rewire our brains is dangerous for our sense of ourselves - our personalities are made up of our bad experiences and bad traits as well as our good ones. Do we really want to be able to wipe out the pain associated with bad memories, and wouldn’t it be dangerous to allow our soldiers to do so? This might be a route to creating ranks of remorseless killers. And how will they be used next? We understand so little about the way that society, culture and humanity depend on each other that messing with its fundamental psychological components is a risk just not worth taking.

1 comment:

JP said...

I strongly recommend a read of David Nutt's Estimating drug harms - a risky business?. Here are a couple of excerpts:

The precautionary principle with MMR has been clearly shown to be wrong – it has harmed more people than it has helped. So we need to be very cautious about simply invoking the precautionary principle in relation to drugs. Another very sad example is that of a young woman from the Shetland Islands who died of a heroin overdose. Why was she taking heroin? The problem according to her friends was that she wanted, like her friends and other teenagers to try cannabis. In this isolated community it was, however, much easier to get heroin, presumably because it has a higher unit price and is easier and more pro. table to import than cannabis. This is something we should bear in mind. We don’t know how many deaths are caused by a failure of people to access drugs that are relatively less dangerous because more dangerous drugs are being made available. Making all drugs class A would be a logical conclusion of the precautionary principle, but would be a supreme mistake.


Scottish graduate, Alasdair J M Forsyth, looked at every single newspaper report of drug deaths in Scotland from 1990 to 1999 and compared them with the coroners’ data. Over the decade, there were 2,255 drug deaths, of which the Scottish newspapers reported 546. For aspirin, only one in every 265 deaths were reported – clearly aspirin was of no interest. For paracetamol, there was one newspaper report per 50 deaths, and for benzodiazepines (diazepam and temazepam) one in 15 to one in 50. For morphine, one in 72 deaths were reported, indicating that editors were not interested in this opiate. They were more interested in heroin, where one in . ve deaths were reported, and methadone where one in 16 deaths were reported. They were also more interested in stimulants. With amphetamines, deaths are relatively rare at 36, but , , one in three were reported; for cocaine it was one in eight. Amazingly, almost every single ecstasy death – that is, 26 out of 28 of those where ecstasy was named as a possible contributory factor – was reported. So there’s a peculiar imbalance in terms of reporting that is clearly inappropriate in relation to the relative harms of ecstasy compared with other drugs (Nutt et al., 2009). The reporting gives the impression that ecstasy is a much more dangerous drug than it is. This is one of the reasons I wrote the article about horse riding that caused such extreme media reactions earlier this year (Nutt, 2009). The other thing you’ll notice is that there is a drug missing, and that’s cannabis. Also missing is alcohol, which will have killed a similar number, 2,000 to 3,000 people, in Scotland over that time, maybe more. Of course, cannabis wouldn’t have killed anyone because it doesn’t kill. And that’s one of the reasons why we thought cannabis should be class C because you cannot die of cannabis overdose.

Here's the freebie paper article that led me to it:

Don't ban meow meow - give it out in nightclubs
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