Can Drug Policy Really be Evidence-Based?

If you have not heard about the ongoing controversy surrounding drug policy in the U.K., you might want to read about it. It's a fascinating example of the troubling incompatibilities between science, politics, and morality.
drug-policy-estimating-harms-report-coverProfessor David Nutt was recently fired from his position as chair of the British government's Advisory Council on the Misuse of Drugs (ACMD).
His problems began when he agreed to publish a report through the widely regarded Centre for Crime and Justice Studies at Kings College London.

The report, "Estimating drug harms: a risky business," based on a lecture from this past July, discussed the relative risks posed by various forms of drug use. 
Nutt is a professor of Neuropsychopharmacology at Imperial College London. Naturally, he approaches the issue of drug use as a scientist. He weighs the evidence about harms caused by various forms of drug use and he assumes that public policy should be consistent with that evidence. In other words, severe harm should prompt an aggressive policy response, while less severe harm can be dealt with less aggressively.
 
Professor Nutt got himself into trouble when he drew a number of conclusions based on his knowledge of the science of drug use harms.
 
Things like:

  • government policy toward drugs is more responsive to public opinion than it is to science or fact;
  • the public prefers a non-criminal approach to the issue of cannabis/marijuana;
  • the most harmful drug of abuse is alcohol;
  • the media distort public perception of drug dangers (e.g., news media are far more likely to report the few deaths associated with ecstasy use than the thousands of deaths due to alcohol use);
  • statistically speaking, the dangers of ecstasy use are comparable to those of horseback riding.

Oops. These comments were not well-received by the government. In the official termination letter to Nutt, the British Home Secretary (comparable to the U.S. Attorney General) expressed concern that Nutt's speech and the report that followed it went "against the requirements on general standards of public life."
 
It is not clear to many Brits why the Home Secretary was even able to fire Professor Nutt for writing about scientific findings. It was clear that Nutt was not speaking for the Advisory Council or for any other arm of government. By taking this action, the Home Secretary appears to have injected politics into a scientific discussion. (Note: In recent days, other members of the Advisory Council have resigned in protest over Nutt's firing.)
Nutt recently appeared in person at the Centre for Crime and Justice Studies to discuss the whole affair and describe how he "got the sack" (click on image at left to see the video).
He acknowledged that he may have misjudged his role as a scientific advisor. It became clear to him that government drug policy is not based on an actuarial assessment of the harms caused by drug use, but by a combination of harm assessment and moral judgment.
 
Nutt described how he got tangled up in the "drug policy triangle." During his remarks to the audience at the Centre for Crime and Justice Studies, he characterized drug policy as developing through the interaction of three competing points on the triangle: science, politics, and morality.
 
He finds that the real trouble starts when people speaking from the vantage point of morality dress up their comments in the language of science.
 
Nutt argues that the British government is happy to include scientists in the policymaking process so long as their scientific evidence is consistent with moral or political judgment. When it is not, the government doesn't hesitate to disregard science.
 
Doesn't sound much like evidence-based policy, does it?
 
 

Updated: November 20 2009