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Ecstasy: Class A drug?

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Mark Easton | 13:41 UK time, Friday, 26 September 2008

What is the point of the Advisory Committee on the Misuse of Drugs? Today they sit around a table earnestly discussing whether the latest scientific evidence means they should advise the home secretary to reclassify methylenedioxymethamphetamine (MDMA or ecstasy) as a class B rather than class A drug.

Ecstasy or MDMABut Jacqui Smith has clearly already made up her mind. "The government firmly believes that ecstasy should remain a class A drug", her spokesperson said.

Yet again, we watch as politics and science collide like protons in Cern. The result is a big black hole in public understanding which threatens to squeeze the life out of a coherent drugs strategy.

The ACMD was set up in 1971 to give ministers expert advice on the control of dangerous or harmful drugs including classification and scheduling under the Misuse of Drugs Act.

Home office ministers have told Parliament that the committee provides "the key advice" on what class a drug should be and ensured that its policy was "evidence based".

But that doesn't mean they always take their advice. Earlier this year the government said it would raise cannabis to a class B drug despite the fact the experts advised to keep it at class C.

Today, as before, we are told that following the ACMD's recommendation would send out a "dangerous message".

So is drugs classification about comparing harm (science) or influencing attitudes (politics)?

A couple of years ago Home Office Minister Vernon Coaker told Parliament's Science and Technology Committee it was both.The purpose of classification was to "categorise drugs according to harm" but Ministers also recognised that the system "does send out messages; it does send out signals to people, in a way which people understand".

The parliamentary committee was not impressed. "The government's desire to use the class of a particular drug to send out a signal to potential users or dealers does not sit comfortably with the claim that the primary objective of the classification system is to categorise drugs according to the comparative harm associated with their misuse" the MPs stated.

"It has never undertaken research to establish the relationship between the class of a drug and the signal sent out and there is, therefore, no evidence base on which to draw in making these policy decisions."

Indeed, Professor David Nutt, who takes over as head of the ACMD in November, is among a growing number of experts who believe "the evidence base for classification producing a deterrent is not strong".

So if class of a drug makes little or no difference to whether people take it, the only point in having such a system is to provide the public with an evidence-based and rigorous appraisal of the relative harms caused.

That, certainly, was the conclusion of the ACMD who in 2006 told the House of Commons Science and Technology Committee: "We suggest a new system for evaluating the risks of individual drugs that is based as far as possible on facts and scientific knowledge.


Using what they called a "harm matrix", the independent experts came up with an evidence-based classification system. The committee considered physical harm, psychological and physical dependence and the wider social harms associated with a drug.

Legal drugs including alcohol and tobacco were ranked alongside illegal substances so the public could understand how risks compared. Ecstasy is close to the bottom of the table.

In January 2006 the then Home Secretary Charles Clark also decided the system needed an overhaul. He ordered a review to ensure that "decisions were based on their wider harm to society and not just a health assessment of the clinical evidence".

But that review has been quietly bundled into the long grass where, presumably, it still lies.


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