Equivalence in death
Having read the latest instalment of the "ecstasy classification" row, I wonder whether anyone is tempted to "lash out at the home secretary" for "trivialising" the dangers of riding horses and showing "insensitivity to the families of victims" of horse-riding accidents.
I ask after Jacqui Smith publicly rebuked the head of the Advisory Council on the Misuse of Drugs for suggesting that the risks from horse riding were significantly greater than the risks from taking ecstasy.
The Press Association describes how the home secretary "lashed out at the government's top drug adviser for suggesting taking ecstasy was no worse than riding a horse".
"For me, that makes light of a serious problem, trivialises the dangers of drugs, shows insensitivity to the families of victims of ecstasy and sends the wrong message to young people about the dangers of drugs," the home secretary told the Commons.
So what of the loved ones of the 10 people who die in horse-riding accidents each year in Britain and the many more who must live with the permanent neurological and physical damage from such incidents? Ms Smith told MPs that "there is absolutely no equivalence" between those who are killed or injured in "the legal activity of horse riding and the illegal activity of drug taking".
Some might argue, however, that the "equivalence" is very great between the parent of a young person who dies taking drugs or dies falling from a horse. The sense of loss and the grief may well be remarkably similar. If there is a significant difference, it is that people are much more likely to be harmed from riding a horse than taking ecstasy. It might be handy for people to know that.
And that was Professor David Nutt's point; once again, we are witness to the spectacle of a scientific point being obscured by a political one.
As head of the Advisory Council on the Misuse of Drugs, Professor Nutt's job is to assess the harms and risks associated with illicit drugs. He has developed a nine-point "harm matrix" to bring the best science to the process.
However, there is obvious frustration that having asked him and his committee to use their scientific expertise to make rational judgements about the relative risks and harms associated with different illicit drugs, politicians then ignore their advice.
It is probable that, on Wednesday, the ACMD will advise ministers that ecstasy be downgraded from Class A to Class B, and that ministers will take no notice.
In his provocative article, Professor Nutt complains that "the drug debate takes place without reference to other causes of harm in society, which tends to give drugs a different, more worrying status".
So he invents an addiction called "equasy" to make his point. He reveals how the harmful consequences are well established - "about 10 people a year die of it and many more suffer neurological damage". He adds that "it is also associated with over 100 road traffic accidents per year - often with deaths".
Equasy, he then reveals, is Equine Addiction Syndrome, "a condition characterised by gaining pleasure from horses and being prepared to countenance the consequences, especially the harms from falling off / under the horse".
Using the same nine-point scale that his committee employs for drugs, he compares 'Equasy" and "Ecstasy". In terms of "acute harm", riding a horse is proportionately 28 times more dangerous than taking ecstasy.
Now, this is clearly an absurd comparison, but Professor Nutt is employing satire. "Making riding illegal would completely prevent all these harms and would be, in practice, very easy to do", he writes. He acknowledges that there would be "little public or government support for such an option".
"This attitude", he continues, "raises the critical question of why society tolerates - indeed encourages - certain forms of potentially harmful behaviour but not others, such as drug abuse."
"Is there a lesson from these relative comparisons of harms and risk that regulatory authorities could use to make better drug harm assessments and thus better laws?", he asks. "The use of rational evidence for the assessment of the harms of drugs will be one step forward to the development of a credible drugs strategy."
There will be a few people, perhaps, reading this post who will have been directly affected by the damage that ecstasy can do. There are, however, likely to be many more directly affected by the harm from pain killers.
A study in Scotland in 2001 titled "Distorted? A quantitative exploration of drug fatality reports in the popular press" reviewed 10 years of media reporting of drug deaths.
It found that the likelihood of a newspaper reporting a death from paracetamol (unclassified) was one in 250 deaths. For diazepam (Class C), it was one in 50. For amphetamine (Class B), it was one in three.
For ecstasy (Class A), every associated death was reported. And I very rarely read reports in the national press about those deaths from horse-riding accidents.
I'm 
© MMIX~RS~q~RS~~RS~z~RS~16~RS~)
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Here's my question: what do we know about the long-term risks of frequent or regular use of ecstasy? Presumably, if you ride horses all your life and avoid having serious accidents then you wouldn't suffer any ill-effects, but as far as I'm aware the jury is still out on whether there could be long-term detrimental effects on the brain if you keep using a drug like ecstasy. What does the report say about this?
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"Equeasy", that's very good.
Since when has rational thought EVER entered the political debate about the risks of taking drugs?
As politicians always pander to the lowest form of tabloid debate on this issue, I'm sure they'll will quietly ignore this recommendation.
It would be interesting to compile an informed list of all society accepted activities that people do on a regular basis and that are more dangerous than ecstasy....
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This has shown that the popular media are in power. Politcians just follow their lead in the quest for public approval. The use of drugs/death due to stabbing are enhanced so the situation is seen to be an epidemic.
Clearly, drug abuse and stabbing are bad, but so are lung cancer from pollution and suicide.
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While the riding of horses is not illegal per se, I wonder what the figures are for those killed while committing an illegal act on a horse. I recently witnessed a group of horses (a hunt in actual fact) attempt to cross a traffic-light-controlled bridge. The first few horses crossed on green but when the light changed to amber and red, the troupe continued to cross. At this point there was a disturbance on the bridge when one of the horses jumped over the side of the bridge into the river below, dumping its rider into the water. Fortunately on this occasion, the rider was unhurt but, sadly, the horse had to be destroyed. Of course, the rider could always have been on ecstasy, or maybe the horse was on ketamine.
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But E is a C or was that a B or maybe just E.
What the guy said is right after all ts just figures and graphs ain't it?
Any death regardless of the pursuit is tragic. All deaths in both instances are accidental without blame. so why did he loose his job ? Because he went against the Smith.
Maybe if drug education wasn't one sided and horse riders work full body armour there would be less deaths.
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Mark, your capacity to understand the "drugs debate" needs encouragement and should run long and hard over the previous commentators views about populist media stances and the irrationality of political interference in human behaviours.
Assessing relative harms and risks from all activities, substances and behaviours, asks more about humans than we all like to know.
The Prime Misisters Office used to publish a "Best Policy" practice guide. When applied to drug policy it was seen to be very flawed. Drug policy remains embedded in the 50's stereotypical view of "my drugs" ( Tobacco and alcohol, and we know where that got us) are OK, whereas "your drugs" (Heroin, Cannabis,Cocaine etc ) aren't OK!
I refer you to Thomas Harris' classic review of relative positions in "I'm OK, You're OK" .
Attempts to get some rational debate on relative harms and risks, will go a long way to showing politicians, the strangely motivated media and the public how dishonesty and hypocrisy are rejected by those in the know, the substance users and the horse riders.
Young people love to take risks, and get a serious amount of joy from doing it. Whether they understand the psychopharmacological (prof NUTT's speciality) effects and reinforcers only behoves us all to make more effort to communicate the Chemistry, sociology, criminality, politics and economics of all Human activity.
Rationality is a long time coming when emotion and politics, both very risky and rewarding, are allowed to cloud the issues.
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When I worked in the NHS years ago my Health Authority was well aware of this hierarchy of harm and we had regular discussions of it.
When I asked my Chief Executive why we didn't publicise this he said [words to the effect that] the politicians actively didn't want to know about this as their only interest was playing to the Mail / Express gallery.
Later, another boss in a different public sector organisation characterised the Government attitude to research as "policy-based evidence". Governments don't want evidence on which to base policy. They make policy then seek evidence to support it, and dismiss evidence which doesn't.
Jaqui Smith is only the latest in a very long line, although she's up with the best.
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The big difference in horse riding and taking E is Jaqui preferes horses.
It could change though, she may just ban horses next.
People do fall off and hurt themselves, and some people (shock horror) gamble on them.
We wouldn't want to be as bad as the banks, addicted to it.
Why does she stick her nose in and enjoy tearing strips of the poor Prof.?
Because she can.
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More research should be done into the long term effects of horse riding. The jury is out on whether sustained shocks to the spinal column and repeated impact cause detrimental long term effects in the neurological systems of long term horse users.
Wonderful article. Drug policy is based primarily on the need to posture, not protect.
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The article doesn't say how many die from ecstasy use, but if we assume from the article that it's the same as for the horse riding that it's comared to then it's 10 per year.
Isn't that about as many as die each DAY as a result of drunken driving?
So if we want to live long and safely what would be a more beneficial use for our energies?
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It is about time politicans wise up about drugs. To spout populist clap trap about the supposed dangers is not credible with the audience they need to reach if they genuinely want to reduce the individual harm such drugs can and do cause.
It seems to me that politicans and media commentators are all locked into an establishment position, a position that censors the truth in fear of the ill informed backlash speaking it will cause.
In truth very few people die from taking ectascy, there is little evidence that is classification as class A has had any real deterrent effect. The case for dopes illegality is even weaker whilst the harm done to society by crime to fund its purchase at artificially inflated prices is immense.
We live in society that prizes freedom and individual responsibiliites. Make drugs legal and criminalise illegal behaviours. Someone steals to buy drugs, prosecute them for theft, goes on a drug fuelled violent bender, prosecute them for GBH.
In a legalised situation the authorities can enage in a meaningful way with users in order to address their addictions removing the reluctantance to engage caused by the threat of prosecution.
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Following the same logic...
20 million cars in the disunited kingdom.
40% of drivers routinely exceed 30mph limit by a small amount (31-35mph) everyday on multiple occassions. Millions of risk incidents per DAY.
A handful of deaths per YEAR occur as a direct result (ie. the death would not have occured if car travelling at 31-35 had been travelling at exactly 30mph)
This equates to a risk level even smaller than ecstacy.
Yet there is a near frenzy regarding the evil of driving at 31mph. Millions are spent on road humps, road narrowing: millions more are lost to the economy due to delays caused by them. On one day alone I have had the police point a camera at me three times in case I was doing 31mph, but when I got burgled they had no CID or SOCO to attend the same day.
31 MPH - very low risk index - should it be legalised?
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It is not surprising that some journalists looking for a cheap story or politicians looking for a cheap shot may seize on Prof Nutt's comparison, remove its context and then portray it as making light of parents’ pain or saying taking drugs should be as acceptable as riding a horse, but I find it incredible that the Home Secretary herself should stoop so low. Surely it is her job to explain and defend the thought-provoking and clarifying work of one of the government’s senior Advisory Scientists.
The minister has made herself, her ministry and the government in general appear illogical, unable to understand a simple scientific/philosophical analogy, foolish and unreliable.
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Dear Mark Easton!
Such comparisons of the head of the Advisory Council on the Misuse of Drugs are just always silly and stupid! Ecstacy can be dangerous - so can horse-riding - but both in very different ways!
Greetings from a German (still) living in rural Wales. A good article, Mark Easton.
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Anyone who has read 'Flat Earth News' is unlikely to be surprised by the revelation that reporting of the real risk from drugs is unlikely to be assessed in a calm and rational way.
I guess the one serious question here, and where I might disagree with Professor Nutt, is about the question of 'dosage'.
Of course, if one compares the 'average' user of Ecstasy and the average 'Equasy' rider, one can draw these assessments of risk, and that in my view is quite valid.
But at the margin, are there people who are taking, say, 20 - 30 times the dosage of 'Equasy' by being able to go riding every single day ? If so, one suspects that their risk is not multiplied by 20-30 times, as they may become more proficient and they may be at less risk.
On the other hand, there may be many young people who could, potentially, in one week, consume 20 - 30 times the dose of the 'average' Ecstasy user, and the risks of doing that are, one suspects, higher than going riding every day [ although this is just my 'gut feeling' - and of course may be swayed by the media hype and furore..].
This would make the valid comparison Prof. Nutt is making invalid for specific people, and the research might therefore slightly miss the point. However I do applaud him trying to present scientific information in an understandable way, and deplore the way the government has 'shot the messenger' by 'playing the man' and pillorying him in this way.
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I can understand the logic of comparing the relative danger of taking ecstasy with horse riding, but they are entirely different circumstances. When you get on a horse (or ride a motorcycle, or skydive, or ski, or whatever) you know the risks involved and it is your choice as to whether to participate. The danger with taking any drugs which are not strictly regulated and made under controlled conditions, is that you have no idea how you will react - many illegal drugs are manufactured with various additives to make them more addictive (so you will go back for more), and when a 'client' buys some in a nightclub they have absolutely no idea exactly what they are taking and how the drugs have been manufactured, and so they cannot really know what risks they are taking.
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10. At 3:09pm on 10 Feb 2009, Marshfoot wrote:
30 deaths a year "Isn't that about as many as die each DAY as a result of drunken driving?"
Wrong, the figures for total Road Deaths is less than 3000 from all causes.
Yet another example of the Government making a problem look like a national disaster so they can seek to control the Subjects lives even more.
Drugs, alcohol, motoring, flying, sex there are real statistics and the Goverment scare figures.
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The Home Secretary's attack constitutes, to me at least, a gross misuse of her position. What she has said in effect is that any advice or observations made MUST comply with the governments position. If the Home Office decline to reclassify a drug downwards then that is their prerogative. Personal attacks that seek to destroy the credibility of their advisors are not. Rational decision making relies upon rational advice. Even when that advice is unpalatable or inconvenient.
No reasonable person argue that taking drug's is anything other than dangerous. If only because you don't know what you are actually taking.
Any drug is dangerous, including those properly prescribed for illness. Sometimes it is a simple question of benefit against harm.
e.g. The drug might harm/kill them but the illness, if untreated, will.
I also think it a great pity that politicians don't have the basic integrity to wait until the report is published and read through in it's entirety first.
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I think that the comparison between riding a horse and taking ecstacy is meaningless. It is true that both are dangerous, but whereas taking ecstacy has no health benefits, riding has many, both physical and mental.
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Agree with #19. Also, following safety guidelines, wearing a helmet, knowing your horse and holding tight reduces the risk of a riding accident a lot. I'm not aware of similar guidelines for the safe use of ecstasy.
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@ 20
The horse rider is given guidelines and safety standards for their equipment. The drug mis-user is not.
If the supply of 'recreational' drugs beyond alcoholand nicotine was legalised it too would become open to simmilar guidelines, standards of quality etc
In that circumstance it would be possible that the number of serious untoward events associated with ecstacy might turn out to be far lower than for equestrian sports.
This type of comparison needs to be made more frequently. To much policy has no evidence or the evidence is pushed into the wrong shape by applying 'scenarios' as with the 'Dodgy Dossier'. Other times the risk alone is used to justify actions as in eating at the wheel increase your risk of an accident by 25% ..... from (I am guessing the figures) 1 every 100 000 miles to 1 every 80 000 miles
That is 80 000 driven with a banana in your hand ..pitiful isn't it how our political masters feed rubbish statics to the media so as to whip up hype to support their quest for power over us mortals.
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A lot of hot air is talked about legalisation; both for and against.
For a drug to be introduced into the legal market, it must undertake multiple stringent trials over a period of a a number of years. This then allows the necessary authorities to determine the frequency and consequences of adverse reactions, physical and mental.
Assuming the drugs can overcome these hurdles, why shouldn't they be legalised.
This would make it safer for the users and the large majority of currently banned drugs would stay that way in their current form.
An additionals benefit would be that the producers would need to police the channels to market as they do with cigarettes and alcohol to protect brand/ revenue and more importantly avoid litigation due to bad practice
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what about a life time of bouncing up and down on a horse surely there must be long term damage too the body, spinal damage arthritis et cetera?
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Thank you, Mark, for a reasoned article.
What concerns me (although it shouldn’t surprise me) is the Home Secretary’s unreasonable reaction to Prof. Nutt. The data as provided suggest that mortality and morbidity do not support the hypothesis that ecstacy is more dangerous than equasy. Jacqui Smith should either:
1) Challenge the data themselves, or
2) Accept these data, and provide an alternative and reasonable means to measure the risk to individuals and society of recreational activities, or
3) Acknowledge that the way government regulates recreational activities is irrational.
I share with Smith a troubling feeling over these data. I suspect it stems from an instinct that people who engage in activities defined as socially unacceptable represent a threat. Without data this remains a prejudice. I am even more troubled about a Home Secretary who is unable to articulate the reasoning (or lack of it) behind government drugs policy, and MP Laurence Robertson who make assertions without data to back them up.
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#22
Of course it is possible to legalise an illegal drug through clinical trials and marketing authorizations. However, who is going to pay for that? The whole process costs houndreds of millions. Somehow I do not think it would be acceptable if a bunch of Columbian narco-barons come round with suitcases full of greasy dollars and start conducting clinical trials with marijuana or extasy.
In order for a drug to be legaly sold on the market not only its safety must be proven, but its benefit as well. Extasy might be relatively safe, but what is the benefit of it? Without a benefit, even small safety concerns are going to make it unapprovable. Therefore it is absolutely impossible for the Government to legalize a drug that has not passed the same rigouros testing as all other medications for human use. Just because some extasy junkies demand its legalization does not mean that the regulations regarding the marketing of drugs can be skipped.
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Ah, lets not be silly about this, when did
the Government ever let a little thing like
the truth interfer with their control agenda?
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this is a good read a bit of history and the eventual hystiria that followed.
http://www.economist.com/science/displaystory.cfm?story_id=12792611
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Nice one, Mark
The silly thing right now is that the Daily Mail and co. right now are more interested in showing Smith and Brown as the bigots they are and so aren't playing the mass hysteria card over these comments about ecstasy - and as such public opinion is being quite well-informed by the rational argument that horse riding actually is more dangerous and that ecstasy is much less harmful than alcohol or smoking - it really shows how much sensationalist headlines drive our society
If you ever get the chance, Mark, could you ask Smith or Brown on what evidence have they decided to keep ecstasy as a class A - some figures or stats perhaps, not just the usual "it's bad" response - there is not even a shred of logic to their view and I would love to see them cornered on it
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The present Drug policy is a shambles.
The ingriedients to xtasy are varied, so how on earth can anyone classify it or regulate it?
This is nothing more than public showboating.
We need a radical rethink to all drug policy and also the real control and regulation of all drugs by legalizing the lot, yes everything.
That way strength purity and ingredients can be regulated and perhaps classification of drugs would then mean something.
I would rather capitalize than criminilize people for what they will do anyways.
And put the money back into rehabilitation and education.
Thats the key to stopping future generations taking drugs, education.
The same as we have done with tobacoo and alcohol.
Prohibition will only cause a black market time and time again.
Look at the failure on cannabis regulation, now you have triad gangs running it instead of the taxpayer and economy reaping the benefits.
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When a drug is illegal it's manufacture, quality, quantity, distribution, price and profit are entirely surrendered by the state to the criminal.
Cannabis, another drug oft vilified these days, is used, on average, at least once by 3 million people a year in this country. That's 3 million people each year who find it harmless and are left wondering what all the fuss is about. Each week approximately 250,000 people try ecstasy. They too recognise it's harmlessness. In both cases word of mouth serves to undermine and ridicule the holier than thou attitudes of the politicians and the press.
So why is a drug, ecstasy, that is statistically harmless, illegal? No good reason at all that I can think of.
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Question Time was mind-boggling this week
Monty Don was on our side, being pro-legalisation
Kevin Mackenzie (he of Sun fame) - was being a tabloid hack at his best - 'tell the parents of the 17 people who died we should legalise it' - right...hence the horse riding analogy KM: 'that's not a criminal activity'
don't think he's quite all there, or he's just a hate filled hack who likes stirring up the mob
and don't expect to get anything out of a tory government, both they and labour spouted the same tripe - 'I see in my constituency every day the harm that drugs do' - that's a really helpful, productive comment that doesn't even address the issue
politics really is sickening
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I think that the real point has perhaps been missed here. A keen horserider will find that their self esteem, confidence and sense of self will increase as they persue their passion and are likely therefore to develop into a strong, happy person, able to play a positive role in society and improve the mood in the community around them. A young person who gets involved in drugs is less likely, in my opinion, to achieve any real level of lasting fulfillment as there is no level of pride or sense of achievement that can be derived from such an activity. Drugs can also often be an easy way of escaping from the prospect of having to face up to the real problems that face a person. Everyone will die in the end, that is the only thing that is certain but it is up to each individual to choose how they spend the time of their life. You can either spend it hiding and wasting your mind in a haze of drugs or you can decide to throw caution to the wind and pursue your dreams. In short, it is the effect of the activity on the soul rather than the risk of death that should really be used to balance an argument such as this one.
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This article is unworthy of Mark Easton's usual high standards. It looks as if the ACMD has spoonfed him info about points which detract from the issue: the harm which drugs cause to millions including children and future generations. 25,000 children were treated for drug misuse last year, according to the National Treatment Agency for Substance Misuse. Even one child is too many. Why are people so willing to experiment with children's lives?
Look also to recent EMDDDA reports on car accidents and drug-driving, where ACMD and cannabis features most highly alongside alcohol.
The fact that the ACMD submissions have not been dissected as assiduously as Dr Parrott's (and that was selective), seems to confirm that Mark was spoonfed the info.
PLEASE - a return to your previous high standards, Mark!
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Also, the horse riding anology is misleading: putting a loaded gun into toddlers' hands is more accurate.
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32 yorkmatt
that's nice of you, pour disdain on everyone who doesn't agree with your sense of morality
maybe ban video games while you're at it
but you are quite right - it is up to every individual how they spend their life - and not be preached to by the state
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[Personal details removed by Moderator]Good day Mark
My name is Kwame. I'm an MA in International Journalism student at City University. I would like to interview you about coverage of the Baby P story for an assignment. Please e-mail your contact information to [Personal details removed by Moderator]
Thanks
Kwame
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I wonder just how populist the "populist claptrap" really is. Reclassification or decriminalisation of certain illegal drugs is percieved as a "vote loser" because the Mail/Express says so, but there are millions of people in the UK who use/have used "soft" illegal drugs or those aware of their effects. Should there ever be a referendum on this issue, I suspect that the results would be far reaching and shake the perceptions of many. Of course, there are too many vested interests (on both sides of the law) in maintaining prohibition to even entertain any rational debate on the issue.
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Sir Booby Robson .v. Jade Goody
Both terminally ill. One, a famous football legend, doing everything possible in his final days to do what he can for others. The other, already a more than well off "reality" TV star (and I use that first term, and the last in the broadest possible context) doing what she can in her final days to make more money than would possibily make that much more difference for her 'husband' and kids.
And yet somehow, one is getting far more front page coverage than the other?
Give me a break! if this is where we are in today's society, then do me a favour and 'get me out of here'!
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Ke(l)vin McKenzie is "pond-life" and doesn't deserve ha;f the air time he gets.
A man, only half man enough, to turn down an opportunity to explain, or at least apologise for, the filthy, untruthful lies the paper under his editorial control published about the Hillsborough disaster, on a Question Time panel a few months ago.
Anytime he'd like to defend his position, one on one on air, would suit me fine.
Fortunately for me, I can RIP knowing what awaits him when he eventually, and not too soon for me, meets his maker.
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This comment was removed because the moderators found it broke the House Rules.
How many people die from politicians claiming excessive expenses?
Every penny extra to the Home Sec. is a penny less for :
the NHS
or for providing troops in Afghanistan safer equipment
or repairing our roads or railways
or giving young people a decent education to make decent lives instead of turning to crime and drugs....
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The point being serially missed by Prof Nutt (you couldn't make it up) and apparently all else, is that many activities while not without danger are positively beneficial in many ways. Horse riding being one such, the use of analgesics (in accordance of course with the prescribed dose) being another. I am, as yet, unaware of any such benefits to ecstasy use, only downsides such as fatialities and long term nuerological damage and the enrichment of drug dealers. That, then, is a pretty major difference and no amount of hug-a-druggie can change that. So, class A it should be then.
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Sirius: Enrichment of drug dealers is of course a side-effect of it being illegal, and nothing to do with it's inherant risk, so it's not relevant to this debate.
Also, you can find a "positive" in anything; and, actually "enjoying it" is a pretty major positive as well - assuming it doesn't become an addiction, people being happy is a good thing for society.
I'm not convinced the government should classify the legality of things based on how "beneficial" they are, anyway. It should be on how dangerous they are.
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