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Let’s get the War on Drugs out of our hospitals and laboratories

David Nutt      

11th June 2013

There are politicians in every major party who hold sensible attitudes to drugs, and a few of them even have the integrity to air these attitudes in public, rather than just acknowledging them in private, or when they have left office. Unfortunately, while they serve in government and have a chance to tinker with the creaking old banger of our drug policy, they only ever pick up the hammer or wrench to toughen and tighten the rules. They never reach for the oil or the fuel that might ease the rusted up axles and make our policy actually work.

Beneath the rust, our drug policy does have the mechanisms in place to operate (whether an entirely different mechanism might work better is quite another question). There are twin engines under the bonnet, the familiar Misuse of Drugs Act (MDA 1971), which details how different drugs are controlled to prevent ‘misuse’, and the lesser known Misuse of Drugs Regulations (MDR 2001), which details how different drugs are controlled to allow legitimate use for research and medicine. If our drug policy ‘worked’, we’d see the harms associated with drugs driven down through MDA 1971, and the benefits associated with medical advances and scientific progress driven forward by MDR 2001. Sadly, these engines seem to have seized up.

Today, with Les King and David Nichols I’m publishing a paper in Nature Reviews Neuroscience which with your support will kick-start a debate on one of the principal failings of our drug policy, one that could be mended tomorrow if politicians knew that most voters want their drug policy to work, rather than to sit there symbolising something about the tough values of its engineers. I am highlighting the fact that here and internationally, the Regulations on using controlled drugs in research are so illogical and obstructive that they amount to the greatest act of censorship on scientists since Galileo was tried before the Inquisition, and texts advocating the sun being the centre of the universe were banned.

The Regulations classify drugs into several ‘Schedules’, with different degrees of control. Schedule 2 for example contains drugs with significant dangers, but also medical uses, like morphine. They are regulated to allow legitimate use in hospitals and laboratories whilst minimising the risk of the drugs getting into the wrong hands. Schedule 1 is for the most tightly controlled of all, it contains drugs that, at the time of writing the laws, were deemed not to have any proper medical value. Therefore, in theory, those drugs could be stringently restricted with no compromise to future human welfare. With political motivations often trumping evidence, into the bottomless pit of Schedule 1 went LSDmagic mushroomscannabis, and ecstasy, each of which actually have considerable therapeutic potential. More recently, our government has tipped into this black hole barrowloads of totally un-researched new chemicals (e.g. cannabinoids, cathinones, arlycyclohexamines) because they are chemically related to banned drugs. All these drugs are caught in purgatory, stuck in a paradox; without an established medical use they can’t be freely researched, but without this research, any medical potential they may have will never be uncovered.

Drugs get sucked into the black hole of Schedule 1 all too easily, but no evidence of medical value seems enough to get them out. We need to resist the scary fairy-tale that removing drugs such as cannabis from Schedule 1, or reforming the Regulations, will open a Pandora’s box. There’s much more reason to believe that we’ll unleash a Neuroscientific Enlightenment, making new discoveries about the brain and consciousness, developing new treatments for debilitating disorders like PTSD, depression and chronic pain, and giving a boost to our economy along the way.

LSD was used as a therapeutic tool, and research thrived before UN Conventions and domestic laws controlled it as if it were akin to smallpox. The controls on Schedule 1 drugs like LSD, magic mushrooms and MDMA are purported to counter the threat of diversion, yet far more harmful drugs including heroin, (categorised as Schedule 2), are safely researched and used therapeutically in UK hospitals under more proportionate controls. Research on Schedule 1 drugs is technically still permitted under licence, and indeed some goes ahead, allowing the authorities to deny that scientific progress is being stifled, yet the figures tell their own story. Since this censorship began, there have been just one or two studies published on the therapeutic potential of LSD in human subjects, compared to the hundreds of studies before. With Schedule 1 licences costing thousands of pounds, and with endless bureaucratic obstacles, it is remarkable that any research on these drugs is done at all.

I’m not calling for scientists and doctors to be let off from the rules on drugs that apply to other citizens. I’m calling for the regulations on controlled drugs to be proportionate to the risks they pose. One simple gesture that could be introduced tomorrow would be to introduce minimum quantity thresholds below which a lower tier of regulations apply. It’s hard to argue that a 50mg reference sample of MDMA in a locked cabinet,- less than a single dose- poses a greater threat to public health than the cleaning products and medications in our bathroom cupboards. Another progressive change would be to make Schedule 1 licences free, which would be cost-effective considering how the economic powerhouse of biosciences in the UK would be invigorated. Moreover, it is essential that new compounds, with no known dangers and unknown therapeutic potential, are not lost into the black hole of Schedule 1.

I hope for regulations that support scientists and the biosciences industry to uncover new knowledge and treatments, rather than holding them back. If you agree, why not write to your MP?

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