Friday, 6 July 2018

Will cannabis kite go up in smoke?

The issue of legalising cannabis has been in the news in recent weeks. It began with the heart-rending story of a small boy having up to 50 epileptic seizures a day and his mother’s wish for him to receive medicinal cannabis oil which relieved his symptoms. The Home Secretary obliged with a temporary licence but made it clear there were no intentions to legalise cannabis for recreational use.


The only mainstream political party in the UK that supports the creation of a legal, licensed market for recreational cannabis is the Liberal Democrats. However, pressure for change is increasing, with Canada and nine US states legalising cannabis for “medicinal purposes” or full legalisation. Can change in the UK be far behind?

What are the arguments? Research indicates about three million UK adults regularly smoke cannabis – 7% of the adult population. The reputation of cannabis as a “soft drug” has become tarnished in recent years because the nature of cannabis itself has changed. Let me explain. Cannabis contains two chemical compounds – tetrahydrocannabinol (THC) and cannabidiol (CBD) – and it’s the THC that gets you stoned! But THC can also cause mental health problems in a small but significant number of users – particularly people with a history of mental illness. High doses of THC can cause psychotic episodes and paranoia. CBD, on the other hand, acts as a natural anti-psychotic medication and mitigates the chances of the mental health problems that can arise from THC use.

“Traditional cannabis” contained a balanced mix of THC and CBD but in the first decade of this century it was pushed out of the black market by sinsemilla – “skunk” – which has a high level of THC and very little CBD. Mental health referrals began to climb. Between 2006 and 2014 it is estimated the use of skunk declined 25% but THC-induced mental health referrals rose 50%. Skunk is a product of cannabis prohibition because it can be grown indoors using hydroponic equipment and doesn’t need to be smuggled-in across borders.

Those advocating legalisation argue we’ve failed to suppress the mass market for cannabis and a licensed, legal market would be a better way of managing use and reducing harm. However, this is not a simple or one-sided argument. If legalisation is to deliver better outcomes and eliminate the black market for skunk, the government would have to get the licensing model right.

How might this work? First, government would have to mandate a maximum level of THC (say 15%) and a minimum level of CBD to create a safer product. But the new, legal, “safer” cannabis would also have to be cheaper than black market skunk. There’s plenty of margin to play with as a gram of skunk currently sells for about £10 so there is a margin for producers, retailers and government, which would introduce a cannabis duty and levy VAT. It would also be necessary to ensure the product was easily available at chemists, off-licences and a network of cannabis cafes.

But let’s take a step back. If we enable a new, fully legal industry of intoxication and make cannabis safer to use, cheaper to buy and even easier to get hold of, what would happen to the level of demand? Again, research indicates a 10% reduction in price would trigger a 7% increase in consumption – at a time when it is falling. But it would be increased consumption of a safer product. Police time would be saved and government would gain perhaps £1bn a year in tax revenues.

Here’s where it gets complicated. THC-induced mental health problems didn’t start with skunk – they just got worse. So if consumption of legal cannabis remained the same, the incidence of mental health referrals would fall. If consumption significantly increased, the incidence of mental health referrals would still fall but the absolute number might rise.

You can see why this is a difficult issue for politicians. On the face of it, if we accept we can’t suppress a mass market in an open society and a failed policy of prohibition just lines the pockets of criminals, licensing sales of a quality-controlled product where we can control strength and ingredients and deliver a revenue stream for government seems a win-win situation. But think how the Daily Mail would spin this. Who would grow and produce cannabis products? The tobacco industry is best placed to do so. And who would retail them – bar or coffee chains? You can imagine the narrative of those opposed to change – Big Tobacco and Big Alcohol are behind this.


My own view is that, on balance, a licensing system offers a better chance of public protection and harm reduction than the status quo. But politically, I just don’t think this kite will fly in the UK.

Friday, 22 June 2018

Moving the goalposts

I am always intrigued to hear “public health” labelling any research paid for by the alcohol industry as “tainted by commercial interests”. What kind of naivety is it that causes people to believe money is the only source of corruption? Do these people think there’s an endless supply of benevolent millionaires willing to fund research into issues they have no opinion on? The fact is, funding has to come from somewhere and research should be judged on its own merits, regardless of who funds it. 

So it is regrettable, in my opinion, that a large-scale research project in the US into the health outcomes of moderate drinking has been abandoned because Big Alcohol was jointly funding this research along with a large dollop of public money. And who was objecting? The usual suspects – so-called “public health” bodies and taxpayer-funded temperance charities whose ideological bias taints their thinking and just about every piece of research they’ve ever produced. Is it a coincidence the voluminous research funded by the Institute of Alcohol Studies, for example, has failed to produce a single piece of work, ever, with anything positive to say about beverage alcohol? Yet this organisation regularly receives money from the World Health Organisation and the UN to fund its “scientific research”.

What methods do the Big Public Health ideologues use to pursue their objectives and skew research and public debate? Moving the goalposts is the preferred method of choice and there are numerous examples. In June 1998, 25 million Americans suddenly became overweight. Previously the official threshold for being overweight was a body mass index (BMI) of 27. Your average American at this time had a BMI of 26. On 17 July 1998, the government lowered the BMI threshold to 25 and almost one in ten adults in the US became part of a new obesity “epidemic” overnight. Subsequent research has proved a BMI of 27 is optimal for health, while so-called overweight people, as opposed to obese people, actually live longer than those of a supposed healthy weight. 

Then there is the drive to reduce sugar consumption. It’s all about “saving the children”. Children are currently consuming twice their daily recommended limit of five grams of sugar. However, three years ago the guideline was halved from ten grams to five and all of a sudden this moving of the goalposts doubled the number of kids at risk! But at risk of what? Five grams of sugar is roughly 100 calories. The recommended guideline for calorie consumption for a growing 11-year-old is 2,000 calories a day. Does it really matter whether 100 or 200 of those calories come from sugar as opposed to some other source?

In 2014, new drug Selincro was approved in the UK for treatment of “mild alcoholism”, a previously unknown medical condition that used to be called “moderate drinking”. Subsequent research has proved this drug to have no medical efficacy whatsoever when compared with the results of blind trials involving placebos. 

In the examples I have given above, if you want to find a “baddie” look no further than the pharmaceutical industry, which vigorously promotes diet pills and treatments for newly invented illnesses.

My favourite, of course, has to be the scientifically unjustified lowering of the low-risk alcohol guidelines in January 2016. This created hundreds of thousands of hazardous drinkers overnight and provided new impetus for the temperance lobby and its sock-puppet charities such as Alcohol Concern and Alcohol Focus Scotland – just when alcohol consumption, binge-drinking and under-age drinking were all declining and the percentage of teetotallers was growing – particularly among the young.

Does money corrupt research and policy-making? Not nearly as much as ideological bias

Thursday, 10 May 2018

THE HAMMERS ARE OUT

The 1st May 2018 was an historic day, we’re told. This was the date that minimum unit pricing (MUP) of alcohol came into force in Scotland. The SNP government spent the day congratulating itself for ensuring that Scotland was the first country in the world to introduce MUP, despite having spent years telling us that Canada had already introduced it, and its success there was part of the “evidence base” used to justify its introduction in Scotland. The other part of the “evidence” was the speculative numerology provided by the now-infamous Sheffield University alcohol pricing model.

That numerology produced some very specific predictions about what MUP at 50p per unit would achieve in Scotland. In the first year alone, it is supposed to achieve the following results:

·        60 fewer alcohol-related deaths
·        1300 fewer alcohol-related hospital admissions
·        3500 fewer alcohol-related crimes
·        A reduction of 3.5% in alcohol consumption per head
·        A reduction of 7% per head for “harmful drinkers”

So, 354 days to go and counting…

How will the achievement of these outcomes be measured? NHS Scotland is charged with overseeing this evaluation, but the anti-alcohol zealots from Sheffield and Stirling Universities will conduct much of the research. The academic reputation of the Sheffield University group depends on the real-world outcomes of MUP in Scotland vindicating the years of research and lobbying effort they’ve put in to this. The alcohol research departments at these universities have been lobbying for MUP since 2009, so I expect this to be little more than an exercise in the kids marking their own homework.

And hard on the heels of MUP in Scotland comes the announcement that the UK government will produce a new alcohol strategy, and they have commissioned Public Health England (PHE) to evaluate minimum pricing. PHE is little more than a four billion pound a year lobbying group which, since its inception in 2013, has been campaigning for MUP. If Big Alcohol produced research casting doubt on MUP it would immediately be called-out as a conflict of interest. But Big Temperance? They just get away with it.

What is heart-warming to see are the beginnings of the Scottish consumers’ revolt over MUP. Twitter is awash with images of Scottish consumers visiting supermarkets in Carlisle and Berwick on Tweed to buy slabs of beer not subject to minimum pricing. And online sales despatched from England are booming too – Amazon is reportedly doing a roaring trade! These sales appear to be for personal consumption, but how long will it be before White Van Man realises there’s a tidy profit to be made from giving Scottish consumers what their own government denies them?

There are elements of the on-trade in Scotland who think that the health lobby must be thrown some red meat, and if MUP appeases them that’s a price worth paying. But bullies always come back for more. Already health campaigners are calling for a ban on off-licence sales after 8 p.m., separate aisles for alcohol sales in supermarkets, banning new pubs and bars from opening in “stress areas” and the introduction of a Social Responsibility Levy to fund alcohol services. This levy is a tax that would be paid by all sections of the trade, not just supermarkets. Please remember the end-game here, which is to de-normalise alcohol use, reduce sales and availability from all sections of the trade, and achieve prohibition by stealth. It is not about tipping people out of the living room and into the tap room; it is most emphatically not about “helping pubs”.


When you look at the escalation of demands from the health lobby in Scotland just in the past week since the introduction of MUP, it’s clear that whether it works or not is almost beside the point. Minimum pricing is the thin end of the wedge, and now the hammers are out.

Wednesday, 2 May 2018

THE DEAD LICENSEES’ FUND

I support the recent call from Tim Page, chief executive of CAMRA, for industry trade bodies to do more to combat the tide of anti-alcohol propaganda from so-called “public health”. This often takes the form of research undertaken or funded by anti-alcohol charities, but how are these charities themselves funded?

In England the two main neo-prohibitionist charities are Alcohol Research UK (ARUK) and Alcohol Concern (AC). These two announced a merger in December 2016, and the shiny, new organisation that will combine supposedly objective alcohol research from ARUK with the anti-alcohol campaigning of AC will launch later this year. So, why is this merger happening?

AC lost funding from the UK government after it withdrew from the government’s voluntary alcohol responsibility deal in 2012. Since then they’ve survived on handouts from the Welsh Assembly government and the National Lottery fund, plus some money from big pharmaceutical companies that produce “treatments” for alcoholism, like Selincro. This wasn’t enough to sustain them, so a merger with ARUK, which has very similar charitable aims, provided a solution.

So, how is ARUK funded? ARUK’s research is paid for by the money earned from an investment fund that is managed for them by an asset management company called Investec. The investment fund was established in 1981 through the Licensing (Alcohol Education and Research) Act, following the winding up of the ‘Licensing Compensation Scheme’. This Scheme was effectively a tax levied on licensed premises that was established under the 1904 Licensing Act to provide compensation for the owners of licensed premises that were closed through no fault of their own, but where it was deemed that the density of licensed premises in an area was too high.

The Scheme was not popular. Temperance campaigners at the time called it “the Licensees’ Benevolent Fund” but the trade dubbed it “the Licensees’ Burial Fund.” It didn’t take long for the Scheme to fall into abeyance, but it was not until the 1981 Act that half of the residual funds were transferred to establish the Alcohol Education and Research Council.  In 2011, the AERC was wound up and the investment fund was transferred to a new charity, Alcohol Research UK - ARUK.

On their website ARUK say they “will not accept funds, in cash or in kind, from the alcohol industry.” But: “Alcohol Research UK may accept donations from people who were formerly but are no longer employed in the industry and do not have a significant residual financial stake in it (e.g. through shareholdings).”

In practice this means ARUK won’t accept money from companies or people involved in the alcohol industry unless they’re dead! Living off a “Dead Licensees’ Fund” is leeching of the first order. Now they’re joining forces with the preachers of AC. This union of Leechy and Preachy is a marriage of financial convenience between the closet prohibitionists of ARUK and Poundland prohibitionists of AC and it may yet turn out to be an uneasy alliance. I think government should act to take back ARUK’s funding from the compensation scheme and give it to the Licensed Trade Charity, which helps people who have retired from the licensed trade and have personal or family problems.

And talking of preachiness provides an ideal segway to Alcohol Focus Scotland (AFS), Scotland’s alcohol charity. This organisation exemplifies the kind of batshit-mental extreme anti-alcohol zealotry that arises when campaigning and research are glued together by the swivel-eyed moral certainty of true believers.

Having championed minimum unit pricing in Scotland on the basis that it will be “good for pubs”, they are now calling for pubs to be closed, or not opened in the first place. AFS funded research, published this week, that made fatuous correlations between the density of licensed premises and crime rates. It found that in areas with the most pubs, clubs and off-licences crime rates were four times higher and alcohol hospitalisation rates and deaths twice as high as in areas with a low density of premises. It would probably turn out that there was a similar correlation between high crime rates and the density of street lighting, since the high density of anything except sheep is more likely in urban areas, but don’t let that stand in the way of a good headline!  “Alcohol availability boosts crime rate” said the BBC news website.

Pause, sigh, breathe: we’ve been here before – this is a variant on the “availability drives consumption” argument that is constantly pushed by AFS, AC and ARUK. As the IEA’s director of lifestyle economics, Chris Snowdon, put it: “Suppliers respond to demand. If the ‘public health’ lobby could get this simple fact into their skulls they would be halfway towards understanding how the world works, and three-quarters of the way towards understanding that commercial activity is not a conspiracy against the public.”  


And who funds AFS? Yes, it’s the SNP government – to the tune of £500,000 a year of Scottish taxpayers’ money. These faux charities can’t get sufficient voluntary donations, so whether its live taxpayers or dead ones, we don’t really get a choice, do we? 

Friday, 20 April 2018

PURITANISM IS A VIRUS – AND IT’S SPREADING!

With minimum unit pricing (MUP) set to be introduced in Scotland in May, the puritans of the health lobby have been emboldened to push this policy out to the rest of the UK. The Welsh Assembly has been debating this issue in recent months and commissioned the Sheffield Alcohol Research Group (SARG) to produce a Welsh version of their model that depicts the effects of MUP at different price levels on consumption, harms and how many lives can be “saved” if MUP is introduced. The SARG research predict 66 lives will be saved a year in Wales if a 50p minimum price is introduced. This assumes that people will respond to the imposition of higher prices in ways that seem implausible to many. One of the persistent criticisms of the SARG model are the assumptions it makes about ‘price elasticities of demand’ – assumptions about how much people will reduce their consumption in response to an increase in price. There are approximately 1,500 alcohol-related deaths a year in Wales so it seems unlikely that it will be possible to measure whether this claim of 66 lives saved annually is fulfilled or not. The media has feigned shock at the claim that 75% of alcohol consumed in Wales is drunk by 22% of the population, who are defined as hazardous or harmful drinkers. And within that number are 3% who are the very heavy drinkers - accounting for 27% of alcohol consumed.  Why this should surprise anyone is beyond me – “Shock, horror – most alcohol is drunk by people who drink the most” is a “dog bites postman moment” and a statement of the blindingly obvious. Let’s put these figures into perspective. About 20% of Welsh adults don’t drink at all. 58% drink at or below the government’s low-risk guideline of 14 units a week (less than a pint of beer a day). So, that’s 78% at no risk or virtually no risk. Only 22% consume more than 14 units a week including 3% “harmful drinkers” – defined as drinking 50+ units a week for men, and 35+ units a week for women. Only in the oddball world of the activist academics of SARG is a person drinking a couple of pints a day classified as a “hazardous drinker”. The focus of harm-prevention really ought to be on the 3% of harmful drinkers, yet the Welsh Government has accepted that minimum pricing won’t help these drinkers, who most likely have an alcohol dependency. MUP is a policy which the Institute for Fiscal Studies has said will raise the price of 70% of off-trade sales. So MUP isn’t targeted at people at greatest risk, but at those who, by the standards recognised by most people, are light to moderate drinkers. MUP isn’t about targeting those most at risk, it’s about denormalising the use of alcohol and pricing it out of reach. The minimum price will only ever go up. Those reading this who are thinking: “Good, about time we bashed Tesco” need to realise three things: Firstly, that denormalising the use of alcohol will affect all sections of the trade. Secondly, making alcohol more expensive in the off-trade may reduce consumption a bit, but it will also reduce consumers’ discretionary spend overall and that is likely to mean less money to spend on going out. The notion that MUP will tip people out of the living room and into the tap room is a health lobby lie. Thirdly, now that the genie of minimum pricing is out of the bottle, how long will it be before government regulators – national or local - apply a higher MUP to the on-trade?

Talking of which: the government in the Isle of Man is now considering introducing MUP. Chief Constable Gary Roberts appeared at the opening of the triennial licensing courts, which sees licensees applying to renew their alcohol permits. Addressing the court, Mr Roberts said a new substance misuse strategy from the government looks likely to introduce a minimum price per unit for alcohol.

He told the licensing bench such a move would “save lives and help the on-licence trade regain its vibrancy.”

The same lies are being perpetrated by health lobby puritans wherever this “silver bullet” policy is proposed. It is always presented as a pub-friendly proposition, when in reality it is the thin end of the wedge. If even a rinky-dink assembly like the Tynwald can introduce this for the off-trade, what odds would you take for it being introduced by the UK Parliament for England – and then spreading to the on-trade, because a city council like Newcastle decides it’s needed to curtail binge drinking in the night-time economy.

For those who think I’m scare-mongering, I have three words: the smoking ban.


BIG TEMPERANCE VS BIG ALCOHOL

The recent announcement of a partnership between Dutch brewing giant Heineken and the Global Fund to Fight AIDS, Tuberculosis and Malaria has drawn a scream of protest from the alcophobe fanatics of Big Temperance. Heineken has agreed to aid the Global Fund by providing its experts on supply chain logistics, to better deliver medicines and health care products to people living in African countries to help the fight against these three major killer diseases.

This has prompted an Open Letter to the Global Fund from IOGT International and over 70 other alcohol health charities and NGOs, calling for the Fund to immediately end its partnership with Big Alcohol. IOGT International is the International Order of Good Templars by another name – an anti-alcohol group with its roots in the nineteenth century temperance movement. IOGT is also a dominant presence in the UK’s Alcohol Health Alliance and had members on the Public Health England committee that fiddled the revised low-risk alcohol drinking guidelines. These are the people leading the fight against Big Alcohol in Africa.

The crux of their argument is that alcohol (not just alcohol abuse) is a major cause of ill-health and that drinking it makes people disinhibited and therefore more likely to have unprotected sex, leading to more HIV/AIDS infections, so a big conflict of interest, they claim, between the Global Fund and Heineken. But this argument is a mere smokescreen for people who think it more important to stop the spread of alcohol use than the spread of AIDS, TB and malaria.

The Global Fund gets 95 per cent of its revenue from governments – taxpayers - around the world. Only 5 per cent comes from private donations, including companies. They administer a $4 billion annual budget. Any sensible person would welcome the help of a wealthy global brewer. To be sure, this is not entirely an act of selfless philanthropy, Heineken want to sell their products in Africa and to present themselves to African governments’ as good corporate citizens. But there is a powerful reason, from a health perspective, why Heineken and other global drinks’ producers should be encouraged to make their products more widely available in African countries, and at a price local people can afford. That reason can be summed up in one word: moonshine.
Anyone who knows anything about alcohol abuse in Africa will tell you that the problem is not the legal market for well-known brands, which many Africans can’t afford anyway, but the illegal market for moonshine. Every year, countless numbers of Africans risk their health and their lives drinking illegal alcohol. The illicit brewing market in Africa is worth an estimated $3.5bn a year. With names like “Kill me quick”, “The dog that bites” and “Goodbye Mum”, African moonshine has a frightening reputation.
Over the years, thousands of Africans have been killed, blinded or rendered sterile by drinking these lethal concoctions. In one of the worst recorded cases, 128 Kenyans died and a further 400 were harmed after drinking a particularly poisonous batch of illicit booze.
In Libya, where alcohol has been banned since early in Gaddafi’s rule, a bottle of Chivas Regal can cost more than $100, so Libyans drink a local concoction called “bokha”. There was recently a major health crisis related to poisoned bokha. Someone had added methanol to a batch and some 1,500 patients flooded into Tripoli’s hospitals within a few days.
The World Health Organisation says that about half of all the alcohol drunk in sub-Saharan Africa is produced illegally, with 85% of consumption in Kenya and 90% in Tanzania coming from the illicit market.
Barley, the essential ingredient in beer, is still not grown in many parts of Africa. High taxes and poor supply chains have also pushed up the price of legitimate goods. Toxic homebrew plugs the gap in the market. Africa's booming cottage industry is made up of clandestine breweries, where maize and sorghum is fermented, using water that itself is often filthy. The alcohol content is bolstered, using anything from embalming fluid to stolen jet fuel. The resulting grog may sell for as little as 20 US cents a glass. But for the poorest Africans, living on a couple of dollars a day, it is often the only way of blotting out their troubles.
This is the folly of trying to ban legal means of accessing properly produced, quality-controlled beverage alcohol products. All that happens is that the demand is met by illicit supply of poisonous concoctions that can kill or blind people on the spot.

And yet IOGT and its virtue-signalling fellow-travellers are worried about Africans knocking-back a pint of Heineken’s lager!

DRINKING BY NUMBERS

As the ‘public health’ hysteria over alcohol and the clamour for minimum pricing in England continues, it’s useful to get an overview of the issues by looking at some straight statistics. I increasingly think that the Office for National Statistics (ONS) is an oasis of calm objectivity in a sea of opinionated, emotionalised subjectivity emanating from alcophobic activists. So, I’ve been looking at stats published in 2017 by NHS England which are based mainly on ONS data and some from Public Health England.

What do these numbers tell us about alcohol use and abuse and its consequences? First, the much-vexed question of alcohol-related hospital admissions: there were 339 thousand such admissions in England, representing just 2.1% of all hospital admissions - which has changed little in the last 10 years. This statistic is a measure of the number of hospital admissions where an alcohol-related disease, injury or condition was the primary reason for the admission, or where it was a secondary diagnosis related to an external cause, e.g., an alcohol-fuelled fight. This is known as the “narrow measure” of alcohol-related hospital admissions; it is a record of “admission episodes” – not people admitted, which is a much lower figure.

The so-called “broad measure” records 1.1 million admissions, but includes primary diagnoses plus admissions where an alcohol-related condition was a secondary diagnosis, i.e., not the reason for the admission. The important distinction between the two measures is that the narrow measure is a count of actual admissions to hospital for an alcohol-related cause, whereas the broad measure includes that count, but provides further information about alcohol-related conditions that a patient may have had in addition to the reason for their admission. This provides an indication of the health burden that alcohol misuse has across the whole population. Newspaper headlines often confuse the two to create alarmist headlines.

So, 2.1% of hospital admissions caused by alcohol misuse isn’t a crisis, it isn’t growing like topsy, and it won’t bankrupt the NHS.

In 2015 there were 6,813 deaths that were related to the consumption of alcohol, 65% of which were for alcoholic liver disease (4,428). Alcoholic liver disease sufferers drink at the very top end of the harmful drinkers’ spectrum. Harmful drinkers are classified as men drinking over 50 units a week, or women drinking over 35 units a week. Most of those dying from alcoholic liver disease drink around 200 units of alcohol a week or more – the equivalent of a bottle of scotch a day. Every one of these deaths is an avoidable tragedy, but just over 25 million adults in England drink alcohol at least once a week, so harmful drinking and deaths from it arise from the product being abused by a very small minority.


The number of adults in England who report drinking alcohol in the previous week has fallen from 64% in 2006 to 57% in 2016 – a fall of nearly 11%. The UK ranks 19th out of 31 countries in terms of annual alcohol consumption per head at just over 9 litres.