More often than not the subject of drugs and rational discussion and debate are mutually exclusive entities as emotion and the search for quick, easy solutions take precedence over all other considerations. A vivid example of this has occurred over the past few weeks. Several deaths in quick succession have been reported in the press to be associated (please note that qualification) with a legal drug called mephedrone (not to be confused with methadone or methamphetamine). Its a legal drug because its not subject to classification under the UK Misuse of Drugs Act, is available to order over the internet and is also sold over the counter in various shops. Because it is not illicit mephedrone is one of a range of substances that are known as ‘legal highs’.
The history of drugs since the 19th century has been that all the currently illicit substances such as heroin, cannabis and cocaine have been initially legal highs, which for various reasons, not least their addictive potential, have become the subject of public, medical and political concern and subsequently been banned. Every so often a new substance arises, or more accurately is discovered, and enjoys a brief underground existence as a sort of cult amongst the cognoscenti who use it before breaking into public consciousness as a result of media attention which usually stems from reports of harm being attributed to the drug, especially fatalities.
Media attention then becomes even more focused on the substance and its potential or alleged effects dramatically highlighted, politicians demand action, relatives of those affected testify to its devastating affect on their loved ones and a clamour grows to ban it and make it subject to the Misuse of Drugs Act. The government of the day reacts by urging its senior scientific forum on drugs, the Advisory Committee on the Misuse of Drugs (ACMD) to “consider” the drug at its next meeting. ACMD duly convenes and in spite of some dissident voices, recommends it be banned. The government responds by doing so and police activity follows; the drug and those using it are now criminalised.
Mephedrone is following this trajectory with precision. It has yet to be made illegal, but after the headlines and pressure of the past few weeks it will almost certainly be made illegal in Britain within the next few months. There will be a few voices urging more research, debate and reflection before banning it, some will even oppose this step, but these will be swept aside, if even paid any attention to, as yet another pharmacological substance is added to the wide array of drugs that we have made illicit in our attempts to grapple with one of the most insidious problems of the late 20th and 21st centuries: drug addiction.
And yet, we know with great certainty what will happen next. Mephedrone and its use will not disappear; in all probability a flourishing black market will develop around it. But for those who wish to avoid being busted and earning a criminal record, other legal highs will be sought out on the internet and elsewhere. For a while these substances will avoid the media radar until some event or series of events such as deaths and other harmful consequences can be linked to them and then the trajectory begins again leading to the next legal high being banned. The point is how far can we go in banning every conceivable substance that can be linked to harm given that there is a virtually limitless range of substances out there that can be tweaked and modified to become legal highs to keep ahead of the law and the law makers? As Graeme Pearson, former head of the Scottish Crime and Drug Enforcement Agency (SCDEA) points out: “…when the government identifies one, manufacturers (of legal highs) can change the formula and create something slightly different but almost the same”.
Though you would be forgiven for not knowing it given all the hype of the past few weeks, mephedrone hasn’t actually been definitively established as the cause of death in any of the reported fatalities linked to it. In almost all cases where the people who had taken it died, they had also consumed considerable quantities of other substances; in the widely reported case of two young men from Scunthorpe this included large quantities of alcohol and the heroin substitute, methadone. Both of these are extremely powerful and addictive drugs, particularly methadone which if taken for non-prescribed reasons almost invariably proves to be highly dangerous, often fatal. In other words we seem to be dealing with a cocktail of drugs of which mephedrone is one component and where another component, alcohol, is perfectly legal except for age restrictions.
Any search for rationality and consistency in the UK and international laws around drug use are hard to find. The three substances which incontrovertibly cause the most harm to society are tobacco, alcohol and over-the-counter medicines/ prescribed drugs. Between them, these three cause far more deaths in a country like the UK than all the other illicit drugs put together. To take one instance: the National Toxicology Unit based in London reported that for the 10 year period 1990-99, there were 66 deaths in which MDMA/ecstasy use was a factor. These included some very high profile cases which attracted considerable attention. But the unit also reported that in one year of that decade alone, 1996, there were 666 deaths entirely attributable to overdosing on one widely available legally prescribed substance, paracetamol. Very few of these deaths gathered any attention.
There is a huge fear and abhorrence of illicit drugs and all the real and potential harm they can cause intercut with an incredible tolerance and acceptance of legal drugs which actually cause greater levels of harm. A colleague of mine working within the addictions field once experienced first-hand the double-standards around drug use in our society when he went to deliver a presentation to people living in a council estate in the west of Scotland in the late 1990s. There had been a reported upsurge in heroin use and discarded needles and syringes on the estate and he was asked to talk about drugs and their effects on behalf of a national drug agency. The estate was bleak, gray, wind-swept and run-down and some 60 people, almost all middle-aged to elderly, overwhelmingly female, turned up to a dilapidated community hall to hear the presentation. By his own admission, in an act of reckless naivety and arrogance, he decided to put some ‘perspective’ on the situation by starting with a question to the audience: what are the three drugs that cause most harm? Back in unison, came a chorus of “heroin”, “ecstasy” and “cannabis”. When he unveiled the statistics on tobacco, alcohol and medicines he was met with a furious response; at one point indeed my colleague thought he was going to be lynched.
This predominantly female audience of worried and careworn mothers, grandmothers, aunts, sisters and daughters were there to talk about heroin and their fears, concerns and even terror around that drug. They most assuredly did not want to hear some ‘official’ lecture them on fags, booze and pills because a) they did not genuinely associate these with the word “drug” and all that term implies, b) apart from some warning labels on cigarette packets in the 90s there was no high profile campaigns such as the current one around alcohol in Scotland and c) as evidenced from the hordes of smokers gathered around the entrance to the hall before and after the presentation, most of this audience smoked, probably quite a few took a fair amount of alcohol and a not inconsiderable number of them would be on pills for depression, anxiety, stress and even sleeplessness. In short, the official statistics my colleague presented were too close to home and, therefore, unsettling. And, apart from a greater willingness to accept alcohol as a source of problems, those same sentiments are likely to be shared in communities across Scotland today.
To an extent this is not helped by the reduction of what passes for debate and discussion around drugs in this country becoming polarised around whether to legalise or decriminalise drugs or to keep the existing laws banning drugs and, where necessary extending them to new drugs coming along as with mephedrone. A complex and multi-faceted social problem such as addiction is being high-jacked around a simple either/or axis: to ban or not to ban.
The proposal that we should legalise or decriminalise illicit drugs because legal drugs cause far more harm, as we saw with paracetamol, is superficially very compelling, until one realises that like is not being compared to like. Quite simply the number of people using alcohol or tobacco (even though use of the latter is declining) is many times greater than that of heroin or cocaine. If the number of people using the latter two substances was to rise to that of alcohol and tobacco then the numbers of deaths and harm related illness caused would be likely to rise in proportion to a far greater level than already exists, even allowing for a fall in criminality if the substances were legalised
In terms of potential harm and addictive potential, alcohol and tobacco are lethal, but so too are heroin and cocaine, irrespective of any criminality attached to them. It is clear that attempting to ban already popular substances such as alcohol and tobacco would be counter-productive, as was vividly illustrated with the disastrous consequences of Prohibition in the United States. But there is no compelling evidence that completely legalising or decriminalising heroin or cocaine would seriously prevent or reduce levels of addiction or harm.
There have been a multitude of reasons put forward for why people become addicted. Fecklessness, moral enfeeblement, disease, alienation and anomie, stress, hedonism, deprivation, genetics are among many reasons that have been put forward and the sheer variety of suggested causes attests to only one thing: there is absolutely no consensus as to what causes addiction and more importantly why of two individuals in exactly the same circumstance, one becomes addicted and their life spirals into chaos while the other refrains from using drugs or is able to control their use of drugs.
In many ways the whole debate around legality is a side-show to the main issues in relation to addiction which is why so many people in modern societies want to get high, blot out reality and generally blanket themselves in the false comfort zone of reliance on a multitude of substances to get by, with invariably catastrophic results.
But one thing is clear: we can’t go on banning an indefinite series of substances because they are ‘legal highs’. At some point, we have to call a halt to the rush to ban and replace emotion, knee-jerk reactions and simplistic solutions with rational and informed discussion if we are ever to even begin to get a handle on our society’s morbid and ambiguous affair with addictions. Now, that would make for a wise and intelligent policy agenda for the forthcoming general election from any of the political parties.