Science and Drug Policy

    David Hadorn, M.D.

        From International Journal of Drug Policy, 1997; 8: 67-69.

    Anyone who has reviewed even a few of the twenty-odd major English-language studies on drug policy [1-21] realises that our present prohibition policies are inconsistent with available evidence and scholarly analysis. Without exception, all of these studies conclude that the use of cannabis and other illegal drugs is not intrinsically very harmful, and that punitive and law-enforcement approaches to adult drug use should be abandoned.
    Moreover, these studies, which represent many years of careful analysis and research by distinguished scholarly bodies, have refuted virtually all of the charges commonly made (still) by those who advocate prohibition policies, including the myths that cannabis is addictive, leads to harder drugs, causes schizophrenia, and destroys brain cells.
    Many citations from the works could be offered, but the clarity of the evidence showing the relative safety of adult cannabis use is perhaps best reflected by recent editorials in the British Medical Journal [22] and the Lancet [23], both of which called for the legalisation of cannabis. The lead sentence in the Lancet was succinct: "The smoking of cannabis, even long term, is not harmful to health."
    Indeed, in twenty years as a physician, researcher, and policy analyst I have not encountered any other health-related subject concerning which the evidence is so overwhelming and so uniform. Paradoxically, neither have I encountered another area where science and policy have become so thoroughly decoupled.

Hostility to Science

    The problem here is not simply that politicians have ignored reports from commissions that they themselves have set up. That kind of thing happens all the time.
    What is noteworthy, rather, is the positive disdain and hostility evinced toward scholarly work on drug policy. U.S. President Richard Nixon set the tone in his response to the report prepared by his own National Commission on Marihuana and Drug Abuse, which he had carefully stacked with conservatives and prohibitionists. After studying the evidence from all angles for two years, the Commission concluded (almost inevitably, it would seem) that cannabis is relatively harmless and ought to be legalised.
    Nixon's dismissal of the Commission's report was brisk: "I read it and reading it did not change my mind." As recounted by former Wall Street Journal reporter Dan Baum in his new book Smoke and Mirrors, Nixon offered no reason for his decision. None of the big newsweeklies reported on the commission's findings. After years of emotional back and forth about the medical, legal, and social implications of the boom in marijuana use, a commission of Nixon's own choosing recommended legalization, and the press let Nixon bury the story (p.72).
    In a subsequent chapter, Baum describes how William Bennett, drug czar under Ronald Reagan, carried anti-scientific fervor to new heights. When Bennett was selected for this position in 1984 (fittingly), Reagan's advisors had already decided that a key element of their strategy would be to close off debate on the subject of drug legalisation. All use of currently illegal drugs was to be considered abuse, morally wrong, and discussion of these issues was not permitted. In particular, questions of science were not going to get in the way.
    To an administration determined to close debate, Bennett was a godsend—an anti-intellectual intellectual. Though both a Ph.D. in philosophy and a Harvard-educated lawyer, Bennett like to rail against "elites" and "intellectuals"; scholars and scientists, in Bennett's view, were not to be trusted. Anybody quoting "facts" or a "study" was suspect. Scholars, Bennett wrote, "have hitched their intellect to the service of ideology" (p.189)

Bennett might have been talking about himself.

    Most drug policy commissions following the Nixon Commission have met with similar fates. Indeed, because the scholarly work characteristic of such commissions is by now predictably incompatible with prohibitionist orthodoxy, such commissions have become an endangered species.
    So much was starkly evident from a recent exchange in the British Parliament, in which Leader of the House Tony Newton, who heads a Cabinet subcommittee coordinating strategy against drugs, told MPs "We have no intention whatever to legalise or decriminalise any currently illegal drugs" (PA News 21 June 1996). In reply, Labour home affairs spokesman George Howarth rushed to express his desire to "firmly place on the record" his party's support for the Government's opposition to decriminalisation.
    As part of the price for accepting such support, Tory Lady Olga Maitland challenged Mr Howarth to "condemn completely and utterly" shadow transport secretary Clare Short's suggestion, made last year, that a Royal Commission might be formed to study the issue of drug policy. "It's an outrageous statement for a public person to make when so many young lives are at risk," she said.
    Like a penitent eager to confess another's sins, Mr Howarth replied that Ms Short had "argued, and then retracted, that there should be a Royal Commission established."
    The Opposition position, which I have consistently maintained, is that there is no point in establishing a Royal Commission. . . [Establishing a commission would imply] that you would be willing to accept that if a Royal Commission came up with an argument in favour of decriminalisation or legalisation, that you would be willing to accept it. I cannot see the circumstances in which the Labour Party would accept that. So I don't see there is an argument for a Royal Commission.
    Rarely has a public official so explicitly evinced such hostility toward science. Clearly science and scholarship should play no role in formulating drug policies! Moreover, we see here again how drug prohibitions seek to keep the debate closed. The very idea that a commission might be set up is considered blasphemous—the same reaction, of course, experienced by then-Surgeon General Jocelyn Elders when she had the temerity to make a similar suggestion. As noted by Dan Baum in Smoke and Mirrors, to even suggest a re-think on drug policy has effectively become forbidden speech.

A Common Theme

    Coincidentally (?), three similar, unrelated displays of hostility toward science and free debate occurred around the world within a three day period spanning Mr Howarth's remarks:
    Item: Melbourne, Australia 20 June 1996 (AAP). Victorian Liberal backbencher Geoff Leigh told state parliament that teachers who didn't adhere to the government's line on cannabis should be punished. Mr Leigh related how a teacher in his electorate had told students that cannabis was no worse than tobacco. The teacher had circulated articles on the topic to his students, including work by Dr. David Pennington, former vice-chancellor of the University of Melbourne and now chairman of the Premier's Drug Advisory Council, which, among other things, has recommended legalising cannabis. Mr Leigh said it was "highly inappropriate" to recommend such articles as background reading, and teachers should stick to the official government line on marijuana. "I believe the education profession should adhere to that, and if they don't they should be punished," he said.
    Item: Chicago 23 June 1996 (New York Times). The conservative American Medical Association was embarrassed when a scientific report it commissioned called for the legalisation of cannabis. The report was "shelved after some medical experts who reviewed a draft copy expressed outrage at its recommendation that marijuana be legalized and criminal penalties removed from other illegal drugs. As a result, the volatile issue will be absent from the association's agenda when its annual meeting begins Sunday in Chicago."
    Item: Bangkok 21 June 1996 (IPS) Japanese police officials participating in an Interpol Asian Regional Conference complained that Japanese people were bringing liberal ideas from their holidays in Europe. Pointing his finger in particular at the Netherlands and its policy of de facto legalisation of cannabis, Osamu Murashita of Japan's National Police Agency noted that many Japanese who travel to Europe and encounter the "Dutch experience" return to Japan, where they spread the word that cannabis use is all right and that authorities should be more flexible in their anti-drug campaign. "Many young people think cannabis is okay and not so harmful compared with heroin or cocaine or methamphetamine," Murashita said. "This is the sort of thinking in Europe—decriminalization for possession of small amounts of cannabis. So Japanese people, young people, are influenced by such ideas."
    . . . This hostility to science and to the open exchange of ideas is not surprising, coming as it does from a rigid orthodoxy that depends for its survival on misinformation and unquestioned acceptance of prevailing dogma.

What Are the Scientists Doing?

    What is surprising is the extent to which the scientific community has failed to speak out against the anti-scientific statements propounded by prohibitionists. The fact that prohibition policies are diametrically opposed to what good science and sound policy analysis would dictate should be trumpeted from the rooftops, one would think, by those who actually know the science and the policy analysis. Unfortunately, scientists who depend on government grants often find it difficult to speak out against even monstrously misguided governmental policies. So much is, perhaps, understandable.
    On the other hand, what is clearly unacceptable is for a scientist to make false or misleading statements, in the name of science, in order to support prohibition policies. Such an event occurred recently—indeed, concurrently with the news items cited above. Speaking at the Collegium Internationale Neuro-Psychopharmacologicum meeting in Melbourne, psychiatrist Graham Burrows opined that he would not want any of his family to use marijuana, which in his view was not a soft drug but is actually a hard drug. It deposits in the brain and causes damage and people who take it don't realise what adverse effects it's having on them. . . .We know that it makes psychiatric illness worse, worsens depression and schizophrenia and probably precipitates psychiatric illness but we can not prove it causes schizophrenia (AAP 25 June 1996).
    One must admire Dr. Burrow's restraint in withholding a concluding "yet" from the latter clause.
    Similarly, Professor Fred Goodwin of the George Washington University, and former director of the US National Institute of Mental Health, was reported as saying that THC, the main psychoactive component of cannabis, in the reporter's words, "stuck to cells in the brain and stayed there for five days, giving a staircase effect over years." Dr. Goodwin was also quoted as saying "Even regular light use can be harmful as occasional use does lead to more frequent use. In the long term it can cause possibly irreversible brain damage—a study of regular heavy users showed loss of brain tissue over time."
    The principal problem with these statements is that they run counter to the vast majority of scientific and scholarly work. Indeed, all of the statements attributed to these physicians have been effectively refuted by the major reports cited above. Moreover, no new data has been reported and accepted by the scientific community in support of these claims. (An excellent summary of the current clinical evidence can be found on the internet at: http://www.norml.org/research/aa/aaMSPP_cont.html)

A Conspiracy of Silence?

    I became concerned upon reading these news reports. As it happens, I subscribe to an internet-based discussion group sponsored by the American Psychological Association, to which are subscribed over 400 psychopharmacologists and scientists in related disciplines. On occasion, this group has been drawn into discussions of drug policy, but on the whole they are reluctant to go on record as opposing government policy. However, when Drs. Burrows and Goodwin's comments appeared in the newspapers, I felt these scientists had a duty either to speak up for the truth or to advise me in what ways I was mistaken that the statements in question were false or misleading. I posted the following message to the group:
    I refer your attention to two recent newspaper articles reporting on statements made by Prof. Fred Goodwin and colleagues in a recent meeting in Australia. I am concerned that many of these statements do not have a good factual basis and as such are misleading and inflammatory. I am referring to statements implying a causal effect in triggering or worsening mental illness, THC "sticking to brain cells" and producing a "staircasing" effect, and others. I thought the discovery of the cannabinoid receptor had laid most of these hoary chestnuts to rest once and for all. In addition, isn't it flatly irresponsible to claim a (net) causal effect of cannabis on mental illness without a single prospective study? [abridged]
    I appended the text of two newspaper articles concerning the reported comments. Aside from earning a rebuke from the list owner about "histrionic" and "ad hominem" posts (a rebuke for which he later apologised, sort of), I received no reply to this message.
    This failure of scientists to speak out even when destructive, anti-scientific policies are supported by unscientific statements emanating from their own kind, is unfortunate at best. Among other things, such a failure encourages demogogues to peddle their moralist and politically expedient policies under the guise of science, and to refer—glibly and superficially—to isolated (and often badly flawed) studies which happen to support their position, while ignoring the vast bulk of scholarly research.
    As a recent example, consider the following justification put forth by a hard-core prohibitionist U.S. senator, Republican John Ashcroft, in defense of his proposed law to increase the already draconian penalties applied to cannabis use and possession:
    With less prevalent drug use, fewer crimes would be committed. Studies have shown that a direct link exists between illegal drug usage and crime. For example, one study demonstrated that 80% of crack cocaine users reported involvement in a major felony at least once in the previous twelve months. Still other studies have revealed that many of today's most powerful narcotics make the user extremely violent. Illegal drug usage and the destructive violence that results are intolerable and must be ended. These statement are tantamount to lying. Virtually all of the voluminous literature on drug use and crime, much of which is present in the reports cited above, stands in direct contradiction to these claims. For example, the crime that is committed by drug users is almost always directly attributable to the high prices for drugs produced by prohibition policies, a fact conveniently ignored by Mr Ashcroft et al.. Cannabis, in particular, appears to make people more docile; the only drug truly linked to violence is alcohol.
    But who cares? What's the risk to the senator in making such outrageous claims? Who is going to stand up and challenge such anti-scientific ravings? No one, apparently.
    As a final illustration of the depth of anti-scientific feeling views currently found within the prohibition camp, consider this excerpt from a recent letter by the president of Drug Watch to the editor of American Spectator magazine (July 1996), in support of an editorial which had opposed drug legalisation:

    You are right when you refer to the drug legalization debate being dominated by intellectual sophisticates. While the topic of legalization may make for an interesting debate among the so-called elite, if it were implemented, it would spell disaster for the rest of society, causing increased drug use and addiction, more crime, and higher health care costs.

    Both the writer's disdain for science and her ignorance of scientific findings are equally evident.
    What will it take to put science back into drug policy? Nothing less than courageous leadership, both from the scientific community and from politicians. At present such leadership is conspicuously lacking. Thus, for the foreseeable future, the public must pay the price of anti-scientific policies, in terms of dollars, destruction of civil liberties, and ruined lives, while the scientific community looks on—passive, vanquished, impotent.

References

1. Indian Hemp Drugs Commission, 1893-94.

2. Panama Canal Zone Military Investigations, 1916-1929.

3. Departmental Committee on Morphine and Heroin Addiction, Report, 1926 (The Rolleston Report).

4. The LaGuardia Committee Report, 1944.

5. Interdepartmental Committee, Drug Addiction, 1961 (The First Brain Report)

6. Drug Addiction: Crime or Disease? 1961 Joint Committee of the American Bar Association and the American Medical Association on Narcotic Drugs.

7. Interdepartmental Committee, Drug Addiction, Second Report, 1965 (The Second Brain Report).

8. Advisory Committee on Drug Dependence, Cannabis, 1968 (The Wooten Report).

9. The Report of the Canadian Government Commission of Inquiry into the Non-Medical Use of Drugs, Interim Report, 1970 (The Le Dain Report).

10. The Consumers Union Report on Licit and Illicit Drugs, 1972.

11. Drug Use in America: Problem in Perspective (Marijuana: A Signal of Misunderstanding), National Commission on Marihuana and Drug Abuse, 1973.

12. The Nation's Toughest Drug Law; Evaluating the New York Experience, published by the Joint Committee on New York Drug Law Evaluation, of the Association of the Bar of the City of New York in 1977.

13. The Facts About Drug Abuse; The Drug Abuse Council, 1980.

14. An Analysis of Marihuana Policy, National Research Council of the National Academy of Sciences, 1982.

15. "In the Matter of Marijuana Rescheduling Petition: Opinion and Recommended Ruling, Findings of Fact, Conclusions of Law and Decision of Drug Enforcement Agency Administrative Law Judge Francis L. Young '' by Hon. Francis L. Young September, 1988.

16. AIDS and Drug Misuse, Advisory Council on the Misuse of Drugs, Part 1, 1988; Part 2, 1989.

17. The Twentieth Annual Report of the Research Advisory Panel for the State of California, 1989.

18. "The Twin Epidemics of Substance Use and HIV" The National Commission of AIDS, July 1991.

19. A Wiser Course: Ending Drug Prohibition, A Report of the Special Committee on Drugs and the Law of the Association of the Bar of the City of New York, June 1994.

20. Victoria Premier's Drug Advisory Council Report; May 1996

21. The Health and Psychological Consequences of Cannabis Use: National Drug Strategy Monograph Series No. 25 National Drug and Alcohol Research Centre Prepared for the National Task Force on Cannabis.

22. Editorial. Deglamorising cannabis. The Lancet 1995; 346: 1241. P 23. Editorial. The war on drugs - Prohibition isn't working; some legalisation will help. British Medical Journal 1995; 311: