Classification of illegal and harmful drugs
BMJ – August 03, 2006
Source: OpenAlex
Summary
The House of Commons Select committee reveals the UK's drug control classification system is "not fit for purpose," causing considerable confusion. Government policy lacks evidence-based decision-making, with "harm" undefined, leading to inconsistent law and medicine applications. For instance, ecstasy, used by 6.8% of 16-59 year olds in England and Wales, remains Class A despite recommendations. The Advisory committee's complacency impacts political science and drug use policy. Critically, no evidence suggests classification deters drug use, and addiction research funding is woefully inadequate.
Abstract
This week the House of Commons Select Committee on Science and Technology published the report of its inquiry on the classification of illegal drugs in the United Kingdom.1 The report high-lighted glaring anomalies in the classification of illegal drugs into classes A, B, and C and reflected a broad agreement that the current system is not fit for purpose. The committee also reported considerable confusion over the remit of the Advisory Council on the Misuse of Drugs and serious flaws in the way that the council conducts its business. The select committee's report criticises the government for failing to meet its commitments to evidence based policy making. Indeed, the inquiry on illegal drugs was part of a wider investigation into how the UK government handles scientific advice, risk, and evidence. Launching the whole inquiry last November, the committee chairman, Phil Willis MP, said “We keep hearing from government ministers that policy is based on evidence. We want to... (know what that) means in practice.” The classification system (based on the United Nations Single Convention, 1971, and the Misuse of Drugs Act, 1971) was designed as a way to control the use of illegal drugs according to their relative harmfulness (table).2 The Misuse of Drugs Act created the Advisory Council on the Misuse of Drugs to oversee the system. Table 1 Current classification of harmful drugs in United Kingdom Although classification is based on the concept of harm, this term is not defined. When the inquiry on illegal drugs began, the then Home Secretary Charles Clarke repeatedly asserted that “clinical, medical harm is the... predominant consideration.” But the chairman of the advisory council contradicted this, stating that social and medical harms were given equal weight. The government has handled the classification of specific drugs inconsistently. Despite the many harms associated with use of tobacco and misuse of alcohol, these two substances are not covered by the classification system and the committee now recommends that they should be. After a long running debate about the classification of cannabis, and at the request of the then Home Secretary David Blunkett, the advisory council recommended in 2002 that cannabis should be reclassified from class B to class C. This recommendation was accepted with effect from January 2004. In contrast, in July 2005 the government reclassified magic mushrooms as class A drugs. Sir Michael Rawlins, the chairman of the advisory council, told the committee “I have no idea what was going through the minds of the group who put it in class A.”1 The committee thought the council's failure to speak out against the government's placement of magic mushrooms in class A was complacent, damaging to the credibility of the council, and made the council look as though it endorsed the government's decision.1 The classification of the drug ecstasy is equally controversial. Both the Runciman report in 20003 and the Home Affairs Committee in 2002 suggested that ecstasy should be reclassified from class A to class B. These recommendations were rejected by the then Home Secretary David Blunkett on the grounds that reclassification would be “irresponsible.”4 Ecstasy is used widely, with a reported prevalence in 2001-2 among 16-59 year olds in England and Wales of 6.8%, which made it the second most frequently used illegal drug after cannabis.5 Yet the advisory council has never reviewed the drug's class A status or voluntarily presented recommendations on the drug to the government. The select committee's report this week suggests that the advisory council should be more proactive in providing scientific advice on drugs policy. The advisory council has also made inconsistent decisions on methamphetamine. In November 2005 the advisory council told the home secretary that there was no basis for reclassifying methamphetamine from class B to class A.6 In May 2006, after appearing before the Committee on Science and Technology and after a flurry of media reports about the drug's harms, the advisory council revised its position on methamphetamine and recommended moving it to class A. Did the council realise that it had made a mistake or did it succumb to outside pressure? Such an approach to policy making is opaque and could be seen as a knee jerk response to a media storm. The select committee expressed surprise that the advisory council had never formally discussed the case for reviewing the classification system, and regarded its failure to alert the home secretary to its serious doubts about the system as a dereliction of duty.1 As well as calling for a less confusing approach to the classification of drugs, the committee's report urges the government to increase considerably its investment in research on addiction to improve the evidence base. Current funding of research on addiction was described by Professor John Strang of the National Addiction Centre (an expert witness to the committee) as “an embarrassment”1 and by the committee itself as “woefully inadequate.”1 One main purpose of classification of illegal drugs is to produce a deterrent effect by linking legal penalties to the harms associated with particular drugs. The committee found no evidence of any such effect. Furthermore, the committee recommends in its report that the government should uncouple classification on the basis of harm from the penalties for possession and trafficking of illegal drugs. Other countries that have also signed the UN drug control treaties, such as the Netherlands, United States, and Sweden, have very different policies on drug legislation from those in the UK.7 The select committee concluded that the UN drug control treaties do not pose a major barrier to reform of the UK drug classification system and that the conventions allow more room for manoeuvre than is generally understood. It is clear that it is now time for that reform.