Scientific Advice and the ACMD – why the Government should pause for thought

Imran Khan is the Director of the Campaign for Science and Engineering.

The media has reported that the government has put forward proposals to downgrade the importance of scientific advice in the formulation of drugs policy.

The moves have come via the Police Reform and Social Responsibility Bill (‘Police Reform Bill’), published last week. Two clauses of the Bill relate to the work of the independent Advisory Council on the Misuse of Drugs (ACMD).

The ACMD was established almost 40 years ago under the Misuse of Drugs Act 1971, it brings together a range of independent experts who advise the Government on drugs policy. Their reports are based on how you go about minimising the harm that drugs may cause. They take into account everything from addiction and crime to public and personal health. Ministers aren’t bound by this advice – they can take it or leave it.

Importantly, the 1971 Act specified that the experts appointed by the Government had to include a medical doctor, a veterinarian, a dentist, a pharmacologist, a representative of the pharma industry, and a chemist.

Downgrading advice?

This may be about to change. The Police Reform Bill quietly sets out in clause 150:

“In Schedule 1 to the Misuse of Drugs Act 1971 (constitution of the ACMD), in paragraph 1-

(a) in sub-paragraph (1), omit the words after “appropriate”, and

(b) omit sub-paragraph (2).”

If enacted, this would change the legislation to say that “The ACMD [...] shall be appointed by the Home Secretary after consultation with such organisations as he considers appropriate”, doing away with the requirements for specific professions. It would give Theresa May the freedom to have a committee which lacked, for instance, a medical doctor.

Home Office Minister James Brokenshire claims that the changes “will allow us greater flexibility in the expertise we are able to draw on”, rather than move away from having expertise. But the Home Office already has that flexibility – only six posts on the committee are defined, with the rest left to the government’s discretion. It’s difficult to imagine a situation in which you would not wish to have, for instance, a doctor on this committee, so the Government’s objectives are unclear at best.

Temporary bans

Clause 149 of the Bill also sets out new powers for the Home Secretary to speedily ban any substance for up to one year. This is probably a response to the mephedrone “legal high” crisis that concerned politicians earlier in the year. The new legislation would allow the Home Office to put a temporary ban in place if

“it appears to the Secretary of State that—

(a) the substance or product is a drug that is being, or is likely to be, misused, and

(b) that misuse is having, or is capable of having, harmful effects”

There may well be a need for a mechanism which allows ministers to rapidly deal with harmful substances, but one would hope that some thought would be given perhaps to at least consulting the ACMD, given that the Government has a ready-made body of experts on drug policy.

The government should be wary of rushing headlong into these changes because the status of the ACMD is something of a raw nerve for the scientific community. It is not so long ago that a third of the committee resigned when the previous Home Secretary, Alan Johnson, decided to sack the committee’s chair, Prof David Nutt. Nutt is Chair in Neuropsychopharmacology at Imperial College, and a past President of the European College of Neuropsychopharmacology. In his academic capacity he had published findings which appeared to contradict the Government’s drug policy.

But there is a bit more background to this story.

Recent History of the ACMD

In 2007, Cannabis was a Class C drug. The Government – reacting to concern about mega-strong skunk’s potential to cause schizophrenia – asked the ACMD to review the classification. A year later, after a thorough investigation, the ACMD wrote back. They told the Home office that, based on the research, Cannabis should stay in Class C.

Home Secretary Jacqui Smith – as it was her right to do – rejected this advice, and announced that the drug was to be reclassified as a Class B substance. As well as scientific advice, politicians will consider public opinion, media and political pressure, party politics, manifesto commitments, and perhaps even personal opinion. But there was significant concern from scientists at the time, including the former Government Chief Scientist Lord May.

In February 2009, the ACMD released its report on Ecstasy, recommending that it be downgraded from Class A to Class B. Jacqui Smith again decided not to concur with this expert advice, with the Home Office announcing that it “will not send a signal to young people and the public in general that we take ecstasy less seriously“.

ACMD Chair David Nutt later, in his capacity as an academic, wrote a paper which compared the harms of taking ecstasy to the harm suffered by victims of horse-riding accidents, in an apparent attempt to provide a perspective on relative risk. It appeared in the Journal of Psychopharmacology. As a result, the Home Secretary criticised Nutt in the House of Commons and asked him to apologise. Many felt was this was unfair, given that it was Nutt’s job as a scientist to set out the facts as best he saw them, and he wasn’t publishing the paper in his ACMD role.

Months later, Nutt – again, in his personal capacity – gave a lecture entitled “Estimating drug harms: a risky business?” In this lecture he, amongst other things, set out research seeming to show that cannabis was less harmful than alcohol – a claim which was picked up by the media.

The media coverage prompted the new Home Secretary, Alan Johnson, to claim he had “lost confidence” in Nutt, and dismissed him, despite it never being clear that Nutt had broken any guidelines or codes of practice.

Independence of Scientific Advice

CaSE worked with Sense About Science and a range of scientists to draft the new Principles for the Treatment of Independent Scientific Advice which highlighted the academic freedom of scientific advisers, in an attempt to ensure there could not be a repeat occurrence of Nutt’s dismissal. The Principles were sent to Downing St by the then President of the Royal Society, Lord Martin Rees, and a slightly watered-down version of the Principles was eventually incorporated into the Ministerial Code.

That brings us almost up to date. The other wrinkle is that there is an outstanding issue over the independence of scientific advice to government. In October, the coalition set out a list of ‘quangos’ (formally, non-departmental public bodies, or NDPBs), which were being scrapped or reformed. Unfortunately, some of these NDPBs include Scientific Advisory Committees. The ACMD is unaffected, but many of its sister bodies could be at risk. CaSE has provided evidence to the House of Commons setting out the possible implications for the independence of scientific advice.

While the Home Office may genuinely feel that the ACMD needs to be reformed and brought up to date, not only good practice but history demands that any such reform must be done sensitively and with care. Unilaterally removing requirements for expertise is not the way to go about it. It gives the impression of a lack of respect for the independence and importance of expert scientific advice, which we hope is not the reality.

The Police Reform and Social Responsibility Bill gets its first debate in the House of Commons on the 13th of December, the start of a long process during which it will pass through both Houses of Parliament. We anticipate a lot of debate on this issue, the first real test of the coalition’s commitment to evidence-based policy.

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8 Comments

  1. Mafficker
    Posted 05/12/2010 at 23:49 | Permalink

    At least proposed temp bans criteria under MDAct:
    http://dlvr.it/9XW7r
    support
    @freecasey’s legal grounds in his judicial reviews against SSHD & ACMD re alcohol and tobacco! http://j.mp/cUcOjp

  2. Mafficker
    Posted 06/12/2010 at 01:26 | Permalink

    Could it be that the lack of good scientists coming forward for the ACMD ‘situations vacant’ is driving the Council’s cognitive castration?

  3. Chris Lawson
    Posted 06/12/2010 at 01:58 | Permalink

    “it appears to the Secretary of State that—
    (a) the substance or product is a drug that is being, or is likely to be, misused, and
    (b) that misuse is having, or is capable of having, harmful effects”

    This wording appears to give sweeping and arbitrary power to the Secretary of State. Every drug can be misused and every drug is capable of having harmful effects, including aspirin, paracetamol, and fat soluble vitamins. The purpose of this law seems to be to grant the Secretary the power to react reflexively to any popular media scare story regardless of evidence.

  4. Posted 06/12/2010 at 10:59 | Permalink

    This amounts to nothing less than a descent into immorality and corruption.

    All that the people seek is that drugs policy should be based on facts and evidence. Even the Public Accounts Committee and the National Audit Office have criticised the government for basing drugs policy on opinion rather than evidence.

    The government’s only concern is to be able to pursue the policies it wants irrespective of public opinion, science, facts or evidence. It is a shameful perversion of democracy. When it doesn’t like the truth it lies. When others speak the truth it silences them.

    These are crimes every bit as serious as those of Hitler, Stalin or Saddam Hussein. Such is the British government of 2010.

  5. Evan Harris
    Posted 06/12/2010 at 13:14 | Permalink

    Great post Imran and very comprehensive!

    For accuracy, though, four points:

    1) Ref: “In February 2009, the ACMD released its report on Ecstasy, recommending that it be downgraded from Class A to Class B. Jacqui Smith again decided not to concur with this expert advice, with the Home Office announcing that it “will not send a signal to young people and the public in general that we take ecstasy less seriously. ACMD Chair David Nutt *later*, in his capacity as an academic, wrote a paper which compared the harms of taking ecstasy to the harm suffered by victims of horse-riding accidents, in an apparent attempt to provide a perspective on relative risk. It appeared in the Journal of Psychopharmacology.”

    In fact he had written and published the paper *prior* to the submission of the ACMD advice on ecstasy.

    2) Ref “Months later, Nutt – again, in his personal capacity – gave a lecture entitled “Estimating drug harms: a risky business?”

    It was in his academic capacity that he gave this lecture.

    3) Ref “CaSE worked with Sense About Science and a range of scientists to draft the new Principles for the Treatment of Independent Scientific Advice which highlighted the academic freedom of scientific advisers, in an attempt to ensure there could not be a repeat occurrence of Nutt’s dismissal.”

    It would be more accurate to say that “Liberal Democrat MP, Dr Evan Harris, worked with CASE, Sense About Science and a range of scientists to draft the new Principles for the Treatment of Independent Scientific Advice”

    4) Ref “a slightly watered-down version of the Principles was eventually incorporated into the Ministerial Code” it would be more accurate to say “a significantly worse version of the Principles was eventually incorporated into the Ministerial Code” since it allows ministers to sack an adviser merely on the basis of an un-evidenced assertion of a subjective “loss of trust” despite the adviser having broken no code of practice.

  6. Posted 07/12/2010 at 19:41 | Permalink

    Could it be that the reason why the government are removing the requirement for scientific advisors on the ACMD is due to a failure to recruit that required expertise? The ACMD currently lacks its mandated scientists, and is therefore inquorate. Decisions made by the government subsequent to consulting an inquorate ACMD may be legally questionable, which would be untenable for government.

    The ACMD lost its requisite personnel in the wake of the sacking of Professor Nutt, and the subsequent mephedrone madness, which prompted the scientists on the ACMD to resign. The Home Office then advertised for a Chair and eight members to replace those who had left.

    The advertisement is available here:

    http://www.homeoffice.gov.uk/publications/drugs/acmd1/acmd-ad-appoint-nov10?view=Standard&pubID=840117

    After the dismissive behaviour of Jacqui Smith and Alan Johnson towards its scientific advisors, it would be a surprise if the Home Office was flooded by applicants. Indeed, we believe they drew a blank.

    Concluding, in spite of James Brokenshire’s assurances, the desire to abolish scientific expertise from the ACMD seems more probably a result of the government’s inability to fill the vacant positions. Therefore, under the Freedom of Information Act, I shall write to the ACMD to ask how many applications they had received by the closing date November 18th 2010.

    If this is the real reason for the new proposals for the ACMD, then clearly we are in deep trouble: due to political interference, mutual trust between government asnd scientific advisors has been blown apart, with appalling consequences for policy in the United Kingdom.

    Edwin Stratton
    Drug Equality Alliance
    http://www.drugequality.org

  7. Posted 07/12/2010 at 20:47 | Permalink

    Could it be that the reason why the government plan to remove the requirement for scientific advisors on the ACMD is due to a failure to recruit that required expertise? The ACMD currently lacks its mandated scientists, and is therefore inquorate. Decisions made by the government subsequent to consulting an inquorate ACMD may be legally questionable, which would be untenable for government.

    The ACMD lost its requisite personnel in the wake of the sacking of Professor Nutt, and the subsequent mephedrone madness, which prompted the scientists on the ACMD to resign. The Home Office then advertised for a Chair and eight members to replace those who had left.

    The advertisement is available here:

    http://www.homeoffice.gov.uk/publications/drugs/acmd1/acmd-ad-appoint-nov10?view=Standard&pubID=840117

    After the dismissive behaviour of Jacqui Smith and Alan Johnson towards its scientific advisors, it would be a surprise if the Home Office was flooded by applicants. Indeed, we believe they drew a blank.

    To conclude: in spite of James Brokenshire’s assurances, the desire to abolish scientific expertise from the ACMD seems more probably a result of the government’s inability to fill the vacant positions. Therefore, under the Freedom of Information Act, we shall write to the ACMD to ask how many applications they received by the closing date, November 18th 2010.

    If this is the real reason for the new proposal for the ACMD, then clearly we are in deep trouble: due to political interference, mutual trust between government and scientific advisors has been blown apart, with appalling consequences for policy in the United Kingdom.

    Edwin Stratton
    Drug Equality Alliance

  8. Posted 08/12/2010 at 01:05 | Permalink

    Further study of the Bill reveals more cause for concern.

    Another shocking proposal in the Police Reform and Social Responsibility Bill seeks to shift the target of selective drugs prohibition from its duty of protecting society from the harmful effects of drugs, to the goal of directly limiting the freedom of the individual.

    John Stuart Mill’s harm principle sits at the core of British jurisprudence; individual liberty is respected even if the individual plans to do him or herself lethal harm. This is reflected in the Misuse of Drugs Act 1971, in that the harm a drug represents to the individual is irrelevant in law. The legislation is drafted specifically to protect society from the harmful effects of drugs, and not to encroach on individual liberty. This is why Parliament stopped short of prohibiting the use of most drugs (except in the case of opium, the only drug whose unauthorised *use* is prohibited under section 9). The 1971 government understood that it cannot legitimately justify interference in our individual liberty unless there is a social problem, which is why the Act was worded in the following precise terms:

    “It shall be the duty of the Advisory Council to keep under review the situation in the United Kingdom with respect to drugs which are being or appear to them likely to be misused and of which the misuse is having or appears to them capable of having harmful effects sufficient to constitute a social problem” [MDA, S1(2)]

    Note that in the above phrase: “and of which the misuse is… having harmful effects sufficient to constitute a social problem”, it is the conjunction “and” which guarantees the democratic character of the Act. Government power can only be legitimate if it is exercised to protect society; protecting responsible individuals from themselves is no business of the state.

    However, in the new Police Reform and Social Responsibility Bill, this democratic legitimacy is to be undermined within the proposed addition to the Misuse of Drugs Act: ‘Section 2A’.

    The new ‘temporary class drug order’ powers to be awarded the Home Secretary to control people with interests in new drugs, will substitute the term: “harmful effects sufficient to constitute a social problem”, with the shorter “harmful effects”. Social problems are surplus to requirements. The anti democratic implications of this reorientation are enormous.

    It is truly alarming that the government seeks to grant the Home Secretary such sweeping and arbitrary powers to imprison people for up to 14 years for supplying new substances, without being compelled to seek the advice of the ACMD, without regard to whether society is adversely affected, and without a requirement to evidence the belief in a substance’s ‘harmful effects’.

    The relevant text of the bill is as follows:

    “2A Temporary class drug orders

    (1) The Secretary of State may make an order (referred to in this Act as a “temporary class drug order”) specifying any substance or product as a drug subject to temporary control if the following two conditions are met.

    (2) The first condition is that the substance or product is not a Class A drug, a Class B drug or a Class C drug.

    (3) The second condition is that it appears to the Secretary of State that—

    (a) the substance or product is a drug that is being, or is likely to be, misused, and

    (b) that misuse is having, or is capable of having, harmful effects.”

    [Schedule 16, Para 3, "Amendments to the Misuse of Drugs Act 1971" Police Reform and Social Responsibility Bill]

    Edwin Stratton
    Drug Equality Alliance
    http://www.drugequality.org

    Securing equal rights and equal protection through the rational and objective administration of laws.

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