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UK: They should tell the truth about drugs

Minette Marrin

The Sunday Times

Sunday 08 Jan 2006

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Poor Charles Kennedy is not alone in his unhappy struggle with the demon
drink; Britons lead the way in drinking themselves to death, according
to the headlines on Friday. In more sober language, figures published in
The Lancet last week showed a steep recent rise in Britain in deaths
from cirrhosis of the liver (commonly caused by drinking too much),
whereas the rate is falling fast in most other European countries.

In the 1950s England and Wales had by far the lowest rates of liver
cirrhosis deaths in western Europe and Scotland's rate, although higher,
was still relatively low. That has changed completely; in the 1980s the
death rate went up fast and in the 1990s it rose by two-thirds in
England and Wales and doubled in Scotland. These alarming increases
affect both men and women across all age groups and are accelerating.

Writing in The Lancet, Professor Robin Room blamed the UK government for
turning "a determined blind eye to the problem" and for failing "to make
the reduction of the population's alcohol intake a policy goal. Through
the new alcohol licensing law, and the new official guidance on it, the
national government has also done its best to tie the hands of local
government on this issue".

It would be unfair to blame the government for whatever it is that makes
people drink so much. But it is certainly fair to blame Labour for
making it so much easier to drink, regardless of the explosion in
underage drinking. It is fair to blame it for the extraordinary licence
that it seems determined to legislate, for reasons which remain obscure.
Not only does it seem to wish us to drink night and day; it has also
tried to press us to gamble more and to relax about cannabis.

Now, not surprisingly, ministers are being driven to backtrack. Tessa
Jowell was making recantatory noises about gambling and its dangers last
week and Charles Clarke felt obliged on Friday to hint at a humiliating
U-turn on cannabis; he appears to be thinking of turning it back into a
class B drug -David Blunkett had downgraded it in 2004 to class C
-because of "recent" medical evidence about links between cannabis and
serious mental illness.

Actually, the evidence is not all particularly recent. It has been
becoming clearer since the mid-1980s that cannabis is associated with
serious and long term mental illness, particularly schizophrenia and
psychosis, as well as short term motivation and memory problems -just as
it has been clear for years that hard drugs, alcohol and nicotine can
cause terrible damage, too. What is recent is that people like Clarke
have begun to believe it.

He belongs, as I do, to a generation that did not believe anything our
elders and betters said about drugs, because it was quite clear that
they did not know what they were talking about. Our elders disapproved
of drugs not on medical but on moral grounds and were quite prepared to
repeat scare stories and deliberate disinformation without evidence.
Neither they nor we knew anything about the real damage that even soft
drugs could do, and it was obvious that some self appointed experts were
too partisan to trust.

Besides, I have known many people who have taken hard drugs over long
periods without becoming addicts. Similarly, young people know that
hundreds of thousands of people take ecstasy every weekend without,
apparently, any ill effects.

Considering the numbers, the few deaths involved have been statistically
insignificant and young people are well aware of that and become less
and less prepared to pay attention to exaggerated warnings.

I did not believe the most serious warnings about cannabis until two
years ago when the teenage son of some people close to us had a
frightening psychotic episode after smoking a lot of "skunk" at a party.
Like most London teenagers, he and his friends had always smoked weed
without obvious ill effects, but skunk is much stronger than the
cannabis of my youth.

Overnight this boy became paranoid, anxious, disoriented and depressed;
his psychiatrist said "skunk psychosis" was becoming common and it is
true that most teenagers will know of someone who has suffered it. This
boy recovered in about six months and has given up drugs; even so,
research published in November last year suggests that just one such
episode is likely to be the precursor of mental illness later.

It was, of course, irrational of me to be convinced of the dangers by
one instance and, of course, most people are not. Young people tend to
think they are immortal and that risk is for other people. We know that
only some smokers get cancer or coronary artery disease and that only
some people become alcoholics. Different drugs affect different people
differently and this confuses people about the risks. They know the
risks vary according to the individual, but they don't know how.

It seems increasingly clear that genetic predisposition is important.
Research published last year by the Institute of Psychiatry found that
one in four cannabis users is genetically predisposed to become mentally
ill as a result of smoking it and is 10 times more likely to suffer
psychotic disorders than other smokers. The problem with genetic
predispositions is that for now, at least, little is known about them.
Apart from family history, there is for the most part no way of
identifying individuals with particular predispositions.

All this presents an intractable problem, especially for libertarians.
It seems wrong to restrict the freedom and pleasures of the many because
of uncertain risks to the unknown few -to ban alcohol because some
people will become alcoholics, for instance. In any case it is almost
impossible. Prohibition did not work in America and the illegal drugs
trade is out of control across most of the world, even in places such as
China where dealers and users are executed.

However, we can tell the public the truth, as far as it is known,
scrupulously and strikingly. This is most unlikely to happen. Public
health campaigns, when not merely ineffectual, have all too often been
manipulative or untruthful, on subjects from Aids to nits.

Perhaps there could be a new career for Kennedy in public health
education very liberal, very libertarian.

 

 

 

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