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Tuesday, 2 November 2010

The MAIN reason Professor Nutt is bad for our health

There are many, many reasons to be angry, frustrated, or simply full of despair at former Drug Czar Professor David Nutt's latest outburst claiming alcohol is more damaging than any other drug, including crack and heroin.

There's the fact that many reputable news outlets chose yet again to illustrate the story with a picture of cask ale, the least damaging, lowest alcohol drink on the market.

Or the fact that in many places Nutt was reported as 'confirming' or 'revealing' how damaging alcohol is, rather than 'claiming' alcohol to be more damaging - accepted as fact, rather than challenged in any way.

There's the fact that Nutt has a serious conflict of interest which has gone uncommented on - that he is working with a team at Imperial College to develop a synthetic drug that gives a temporary alcohol buzz without the effects of drunkenness - something that will surely have a commercial application if trials are successful - meaning he has a personal, potentially profitable interest in undermining alcohol's place in society - a fact that, at best, means his findings should be scrutinised rather than simply accepted.

There's the fact that in the methodology of his study, the scores given to each drug are a combination of harm to the self and harm to others.  And when you break it down, even according to Nutt's own research, ALCOHOL IS NOT THE MOST DAMAGING DRUG TO THE INDIVIDUAL.  The reason alcohol gets the highest overall score is because it is calculated to give by far the highest score for damage to others - which I'll come on to in a sec.  But Nutt's own research shows heroin, crack and methylamphetamine are more damaging to the user than alcohol.  This is determined by a combination of different factors, such as dependence, mortality etc.  Serious concerns have been raised regarding the relative weighting of these factors.   But never mind the fact that the methodology is flawed - even though the report DOES NOT CLAIM that alcohol is more harmful to the individual than any other drug, that's exactly what has been reported.

The 'harm to others' bit is made up of scores given to various factors such as crime, injury, damage to the environment, cost to communities etc.  For many of these, there is no way of calculating them accurately.  Earlier this year I detailed serious doubts about the methodology of calculating economic cost, crime, cost to the health service, etc.  And where there is no data available, Nutt and his team simply MADE THE SCORE UP.  As the excellent Phil Mellows reveals this morning - these expert, scientific scores were determined not by months of research but by a one day workshop where they sat around and chatted, assigning scores as they saw fit.  Scientific? About as scientific as a bunch of blokes in a pub working out a top ten list of shaggable birds.

And Nutt's previous writing on alcohol reveals a worrying lack of knowledge even about current alcohol policy.  In a recent '21 point action plan' to combat what he inaccurately refers to as an alcochol epidemic, this 'expert' on policy seemed unaware of the introduction of the mandatory code that limits promotions encouraging excessive drinking, and he repeated various 'facts' and figures that have been shown to be dubious. (My point-by-point response to his ill-informed action plan is comment number 44 beneath his post).  I don't believe that, on the basis of the knowledge he displays here, Nutt is qualified to determine the cost of alcohol to society.   And then there's the dodginess around weighting of different factors again.

Most obviously, Nutt doesn't take into account the simple fact that alcohol is drunk by millions - of course it's going to have a bigger impact.  But when over 80% of us drink within the government's recommended guidelines, the simple fact - that is completely ignored here - is that the vast majority of people drinking alcohol do so without causing harm to themselves or others, and the same cannot be said of many other drugs calculated here.

So - of course - the entire thing is a load of bollocks that has been widely accepted as fact.  So far so predictable.

But here's the main reason why I think this report is damaging:

I agree with what Nutt is trying to do.

When Nutt was sacked for saying alcohol was more harmful than LSD or cannabis, what he was actually trying to do was draw attention to the fact that government classification of drugs is completely out of whack with those drugs' actual harmful effects.  He's right.  The vast majority of 'harm' caused by illegal drugs is, in many cases, because of their illegality.  Heroin users contracting diseases through using shared needles.  Drug users turning to crime to fuel their habit.  Drug pushers forming organised international crime cartels.

Cannabis, used in moderation, isn't harmful - just like alcohol.  And yet it's illegal.  The number of deaths from ecstasy use is tiny compared to the proportion of people using it - and it could be argued they were at least partially due to lack of information, because the drug is illegal.  As Bill Hicks said memorably, no one ever took LSD and said "Let's go and beat some people up".  And despite popular myth, there has been no recorded case of someone jumping to their death because they were tripping and thought they could fly.  British aristocracy has a long history of heroin users living to a ripe old age because, although the drug is highly addictive, if you have access to a regular, clean supply, take it in the right doses, and you're free to lie around doing nothing all day being really boring, and you have people to look after you, it doesn't actually do you that much damage.

The only reason cannabis is illegal in America is because the hemp industry posed a serious threat to the dominance of the petrochemical industry in the 1920s, who were a very powerful lobbying force, which is why not just cannabis but any hemp product - even cloth - was made illegal. I'm paraphrasing, but read this excellent book for more details on the hypocrisies and inconsistencies of drugs policy.

Many people working with addicts suggest the best way to deal with drugs is to legalise them.  Schemes where drugs have been made readily available to users, in a controlled environment, have consistently shown huge success in getting people off those drugs.

Policy on drugs is driven by political ambition, expediency, and commercial lobbying interests far more than it has anything to do with damage to the individual or society.  On that I'm sure David Nutt and I would agree 100%.  But because he's an unashamed publicity seeker, every time he tries to make this point he does so by attacking alcohol in a way that is at best distorted, and at worst deliberately inaccurate.

That's what makes me most mad.  Because if Nutt truly wants a sensible debate about the relative harm that drugs do, all he succeeds in achieving is giving ammunition to the neo-prohibitionists who would rather any intoxicating drug be banned outright.  Nutt's approach is never going to make anyone say 'Why isn't cannabis or ecstasy legal?'  All he's doing is encouraging people to be as stupid and wrong about alcohol as they are about other drugs.

And that's why it is David Nutt who is causing huge damage to individuals and to society as a whole.


Curmudgeon said...

On a web forum I use, there's a strong advocate of cannabis legalisation who is constantly banging on about the evils of drink, and how it is much worse than cannabis. Whatever the merits of his argument about cannabis, that's hardly likely to endear me, or any other drinkers and pubgoers, to his cause.

Rabidbarfly said...

Once again Pete, you've hit the nail on the head. Well said.

BLTP said...

PB: was amazed to see that story asbout his Nutts "synthi-hol" never seen it mentioned until found that telegraph story shows how little research goes into the news. Sounds grim like the booze version of quorn.
Heard Peter Hitchens laying into Nitt on "Today" worried I am now on the same side as PH except PH isn't pro drink he wants us all to sit on spikes, eat sprouts and read the bible.

StringersBeer said...

Californians are voting (on prop 19) today.

Ed said...

I noticed the glass of beer picture too. I wonder if any research has been done into the relative dangers of drinking beer compared to drinking spirits?

Cooking Lager said...

A significant reason for the illegality of drugs is that between the wars it was noted that widespread addiction to a substance only available from a foreign power was a threat to national security, based on an observance of the small number of opiate addicts. The converse of maintaining a threat to foreign powers was that the British Empire was quite happy to engage in the opium trade so long as we were profiting by weakening our enemy and not weakening ourselves. An Empire can’t have a large portion of its society beholden to foreign powers. Can a small island off the coast of a Europe it doesn’t wish to be part of?

Northern Snippet said...

Whenever a study like this comes out there always seems to be an underlying aim or body funding it which isn't exactly without bias.
Well said BTW.

Marty McCann said...

Hmm- so it is okay for the author of this blog to have a vested interest in a substance and not Prof Nutt? Surely if your argument that his interests invalidate his research then you are open to that generalisation as well?

Now as a drugs worker (you know-someone who actually knows about these things and works with them on a daily basis as opposed to gathering knowledge based on simplistic, hysteria based media reporting) I see a lot of people with a lot of issues- and no matter what, alcohol still comes top as the major cause for concern. None of the cannabis users I work with are going home and beating their partners or kids, nor are they causing thousands of pounds to be spent to clean up the town after them at weekends. While they are doing harm it is generally to themselves.
Heroin actually causes less neurotoxicity in the body than alcohol- it is the lifestyle that has grown around heroin use (precipated by its illegality) that causes most problems. Last week I had two men of similar age come to see me at different times- one has been misusing alcohol since he was 12 and the other using heroin since he was 13- the heroin user was the healthier of the two with fewer health issues, whereas the alcohol misuser had health and legal issues.
I am not saying that heroin is a better choice than alcohol- there are issues attached to each- but the simple fact is that if we tackled alcohol abuse properly we are well on the way to tackling other substance misuse as well.

Phil said...

Like you, I'm deeply disappointed in Nutt, who I genuinely thought had libertarian views on drugs. I thought the 2007 classification of drugs in order of dangerousness was basically sound, and I really liked Nutt's "Equasy" paper. But this is dreadful stuff.

Nutt doesn't take into account the simple fact that alcohol is drunk by millions - of course it's going to have a bigger impact.

Actually it's worse than that: he turns that logic on its head, arguing that "alcohol is the most harmful drug because it's so widely used" (direct quote, emphasis added). I'm now beginning to wonder what he'd be saying if Ecstasy were legal.

Pete Brown said...


First, thanks for commenting - it's good to have dissenting voices as often the only people who read my stuff are those who already agree with me.

Onto the points you raise:

Of course I have a vested interest - I declare it at the top of the page. But there's a HUGE difference.

Professor Nutt writes as a scientist. So every time he says something, it's accepted as fact. Every time anyone criticises alcohol in the media, it's accepted as fact if it comes from a medical or scientific source, even if the qualifications of said scientist or medic are not relevant to the matter in hand (e.g. a GP talking about how advertising affects children) or if they are expressing a belief or opinion rather than the results of scientific research they are qualified to conduct.

I've blogged extensively in the past about how medical practitioners and scientists talk about an alcohol epidemic, when the NHS' and government's own data say there is no such epidemic, if you look at the raw numbers and the direction they're going in.

David Nutt stands to make commercial gain from measures to control alcohol, and yet he is being treated as an impartial, factual commentator on it, despite the fact that his views and methodology are deeply flawed. As far as I can see, no news coverage of his report contains a comment from someone on the other side of the debate. If it did, they would simply be hit with the attack you use against me - "well, you would say that - you're pro-booze". No one EVER says that to the anti-drink lobby and the pseudo-scientific research they regularly have reported as fact.

In order to cast doubt or disprove their claims, all I do is look at methodology and the data their conclusions are supposedly based on. I don't spin. If you think my arguments are flawed or deliberately misleading, or my reading of data is mistaken, please specify where.

As for your comments on the relative harm of alcohol versus other drugs - I agree - that's precisely what I said at the end of the post - or didn't you read that far?

Finally - I would never say there is no problem with alcohol dependency and abuse. I am very close to people who have been deeply affected by it. But anti-alcohol hysteria, that seeks to demonise a drug that is, on balance, overwhelmingly beneficial, only serves to demonise the vast majority of people who drink with no ill effects, and doesn't in my opinion do anything to help those who suffer directly or indirectly from alcohol abuse.

ILT said...

I do not know what the intentions of David Nutt are but I truly agree with the opinion that alcohol is generally the root cause of various accidents involving innocent people. So this may create a general belief that alcohol is a major contributing factor as far as inflicting harm on the society is concerned. But saying that alcohol is more damaging than other drugs is a totally unfair allegation.

DJ said...

As soon as I saw the article about Nutts study I was anticipating your response Pete. No-one out there can disect this kind of crap on the level that you can, I only wish your opinions could get the same media cover that this fool gets.

Curmudgeon said...

It's also noteworthy how nobody was brought on the radio to put across an opposing point of view. You could have done this yourself, of course, Pete, or Brigid Simmonds could have expressed the very reasonable views stated here.

And where are CAMRA when all this is going on? Hiding behind the bar?

Gary Gillman said...

I don't know if Professor Nutt is right or not, I've read persuasive views on both sides. But in the end, does it matter? All who have an amateur or professional interest in alcohol know it can be highly dangerous. I think we need to focus on education, not banning certainly, or restricting (overly), the sale of alcohol. It should be a part of the curricula in every country, from elementary school on. Doctors and clinics should be encouraged to disseminate warnings and information at an early stage in the treatment of patients, especially young people.

At one time and still in some countries, this function was performed organically as it were, by families and related organisations (notably the church), but it needs official sanction today.

This is the answer in my view. And I think the alcohol industry can see it the same way, it is in its interest to do so. Is it not better to sell the same amount of alcohol to more people who will use it less than to fewer who will abuse it more? But hard decisions will have to be made. I have never felt for example that universities should sell alcohol (via students' unions and such). It does not belong on campus in my view.


Alexander D. Mitchell IV said...

With all due respect, sir--I even referenced your blogpost in my blog--I'd prefer that you do a little more research on the "urban legend" that "the only reason marijuana is illegal is [name a capitalist might that had an interest in suppressing hemp--paper industry, W.R. Hearst, petrochemical, pharmaceutical] had it suppressed!"

I suggest you contrast the findings of "Cecil Adams" at The Straight Dope: .

Pete Brown said...


In 1937, when cannabis was legal, the annual report of the DuPont corporation - then an arms maker - urged investment in petrochemical based synthetic products. At the time, the chief investor in DuPont was Mellon Bank. When he worked for the treasury, Andrew Mellon of said bank appointed Harry Aslinger to the Federal Bureau of Narcotics and Dangerous Drugs. Aslinger was America's most vocal critic of cannabis. He also just happened to be Mellon's son-in-law.

Aslinger's testimony to congress - which was both racist and inaccurate - was fundamental in the decision to ban cannabis.

As for WR Hearst - his newspapers conducted an orchestrated campaign against cannabis use because it was associated with Mexicans, and Hearst, also a racist, hated Mexicans. Headlines in his papers included "hasheesh goads users to bloodlust" and "Marihuana makes fiends of boys in 30 days".

The claim that cannabis turned blacks and Mexicans into violent thugs was one of the main arguments used to ban it.

Conspiracy theory? Maybe. But there's a little more to it than 'urban myth', surely.

SteveF said...

There's an additional problem here - comparison between alcohol and drugs is difficult because many of the problems associated with drugs stem from their illegality.

Liam said...

I think you have a point, but aren't you being as biased and one-sided as you claim proff Nutt is?! I've worked in pubs and restaurants for many years now, and seeing what alcohol did to my customers persuaded me to quit drinking. As with everything else, its ok in moderation - maybe attitudes to drink need to change as much as drug laws?

Martyn Cornell said...

Drug workers - and doctors - see many drinkers with problems. This leads some drug workers, and some doctors, to conclude that if only drink could be "tackled", then they would see far fewer problem drinkers. This ignores (1) the huge numbers of people who drink with no problems, whose lives are made more pleasurable through drink, and whose pleasures would be badly affected by draconian attempts to "solve the drink problem"; and (2) if problem drinkers weren't abusing alcohol, they'd be abusing something else, from heroin to glue-sniffing. It's not the alcohol that is the real problem with alcohol abusers, but any number of other issues permed from, but not exclusive to, poverty, despair, anger, alienation, abuse, and a desire for at least temporary escape from their troubles. But those are normally rather more difficult problems to tackle: much easier to say, 'Sorry,we're taking your drink away from you.'

Gary Gillman said...

My point (if I may elaborate) is just to teach kids early on to think about drinking. That drinking is not something necessarily normal or expected, that it's fine not to drink at all, that you don't have to get sozzled every time you do drink, that you should count the units you take in and not exceed a safe amount over a reasonable interval. Don't bolt a drink, enjoy the taste, don't drink to oblivion so you forget the social occasion of which drink was or should have been the lubricant.

So many problems come from people not thinking about it until it is too late. Of course many of these people may well have some underlying problem driving it. But not all, and education will assist to prevent some abuses. The great majority do in fact drink responsibly, I believe that, but education will tend to ensure this for the future and even increase the numbers of responsible drinkers. It should be education, delivered soberly (sorry) but not in a mood of reproof or moral outrage.

But I do believe it should be avoided by students. They have other priorities at that stage of life. Or at least, make it harder for them to get the stuff. They will have lots of opportunities to find it once out of uni.


Phil said...

The great majority do in fact drink responsibly, I believe that, but education will tend to ensure this for the future and even increase the numbers of responsible drinkers.

On your own argument, this education would only be needed by a small minority - and would presumably not be absorbed by all of them, making the minority who were effectively educated even smaller. It doesn't sound cost-effective, to say the least. And what would the effects on the majority be? They might ignore it altogether and be neither worse nor better off, but some of them might react against it - and, given the small size of the positive effect, it would only take quite a small negative reaction to make the balance sheet entirely negative.

Things are not that broke, basically, and trying to fix them could be a dangerous experiment.

Anonymous said...

Two comments though I agree with what you're saying. I think saying that Professor Nutt has a serious conflict of interest because of his prior work is a little similar to saying that you have conflict of interest in compiling the cask report because you want to sell more copies of Hops and Glory. Secondly if I could publish in the Lancet after an afternoons work then I would be doing a lot better as an academic - the process is much more involved than that and the paper should have been independently reviewed prior to publication to assess the feasibility of the study.

Gary Gillman said...

In my view, the majority today act as they do to traditional influences or factors which seem to be on the wane: the nuclear family; relative non-mobility; the teachings and influence of numerous churches.

I think these factors will weigh much less for future generations, and therefore alcohol education will be helpful to caution people whose ancestors would have received similar advice but in a different context.


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