THE SILLY SEASON HAS COME EARLY THIS YEAR!

The Silly Season: it happens every year and usually coincides, for some reason, with the party political conference season. This year it has come a little early. 

First, a little levity: the Palace of Westminster in which our MPs sit is a wonderful Gothic building; but it’s crumbling and needs more than just running repairs. Some may see this as a metaphor for our entire political system. When you look at the political events since the Brexit vote, and the state of turmoil in the political parties, it’s enough to drive MPs to drink!

And therein lies a tale. MPs are due to move out of their offices to enable much-needed reconstruction to the Palace of Westminster that will commence in 2020 and last for six years. However, the Department of Health offices they will move into are in a building called Richmond House which is held under an Islamic bond scheme that forbids the sale of alcohol. So, where will our heroic representatives of the people go for a little taxpayer-subsidised libation when the House of Commons ceases to be the best gentlemen’s club in London? Well, there is a nice little pub between the two buildings called the Red Lion, and it has been reported that nationalising it in order to reserve it for MP’s use was on the agenda. Fortunately the owners have refused to sell.

There is more than a little irony to all this. There has been a growing tendency to denigrate alcohol and to favour a temperance approach among some parliamentarians; well MPs, be careful what you wish for, a little Islamic teetotalism might be just what you need – remember what Chief Medical Officer Dame Sally Davies said “there is no safe level of alcohol consumption” - so prepare to set a good example.

Meanwhile there is a House of Lords all party committee looking into the workings of the Licensing Act 2003. How is the Act doing? Do we need more licensing objectives? How about one on ‘health and wellbeing’ or one that requires licensees to ‘promote equality’? They can’t leave it alone can they? I do suspect that this committee is really about banging the health drum and calling for a health licensing objective, but I could be wrong. 

But the House of Lords seems particularly exercised by alcohol at the moment. Lord Tariq Ahmad, our unelected new Aviation Minister, is concerned about incidents involving drunken people at airports or on board flights; to the extent that he is looking at restricting the hours of opening of airport pubs and bars. Helpfully he has said “I don’t want to end merriment altogether”. So, just a bit then? And on what basis does he consider this to be a problem? There are approximately 241 million people going in or out of UK airports every year. A FOI request by the Press Association revealed that there had been just 442 drunken incidents at UK airports in 2015 – just 0.0001% of the total throughput – time for a moral panic then!

Our politicians’ attitude to alcohol at both national and local level has historically been driven by paternalism. Some people feel quite nostalgic about this. So, July saw a spate of articles about the ‘Carlisle Experiment’. In July 1916, while the Battle of the Somme was raging, a new pub opened in Carlisle called the Gretna Tavern; it was our first nationalised pub. The Defence of the Realm Act was then used extensively to create a Central Control Board (Liquor Traffic) and to nationalise five breweries in Carlisle as well as 235 pubs in the Carlisle, Gretna and Annan area. In 1917 pubs in the Enfield Lock area of London and Invergordon in Scotland were taken over. In all some 363 pubs were nationalised over 300 square miles either side of the English-Scots border around Solway Firth, where a giant munitions factory was being built; the idea was to keep the munitions workers sober and turning up on time for work.

The Central Control Board then took an axe to licences, with 40% of all alcohol licences in the area being declared ‘redundant’, including all grocers’ off-licences. Some authors today see this as a noble experiment to ‘civilise’ the pub; they suggest this was a successful example of nationalisation because the Central Control Board made a profit out of these pubs for every year it ran them. Well, I guess if you can buy a packet of already profitable pubs using taxpayers’ money, and then use your legal powers to close down most of the competition to them, that might give you a flying start!

Since the Labour Party appears to be undergoing a terrible attack of socialism at the moment, I wonder whether Diane Abbott might have a little word with Jeremy and see if he would like to nationalise some pubs along with the railways. Peoples’ quantitative easing; the peoples’ railways; the peoples’ pubs. You never know. It all depends on how long this year’s Silly Season lasts.

NETFLIX CAUSES CANCER

‘Netflix causes cancer’ is the title of an article written by Hank Campbell, who is the President of the American Council on Science and Health. It’s a satirical title of course, and the article that followed was designed to show how epidemiology can prove that almost anything can either cause cancer, or protect against it, which is why epidemiology is an excellent vehicle for creating moral panics about alcohol, amongst other things. My article today relates back to my last blog for Propel Opinion in which I referred to an opinion piece in the journal Addiction, in which the author wrote about alcohol as a cause of cancer at seven different sites in the human body. There was nothing new in this article, but the media picked up on it and declared it was a new study. The headline read: “Finally proof that alcohol causes cancer”, when in fact it was just an article, an opinion piece.

Hank Campbell, in his article, had this to say: “You may have seen renewed recent media claims that alcohol is linked to cancer, based on a new commentary in Addiction. While overuse of alcohol can certainly cause something like fatty liver disease and then cirrhosis, so can too many cheeseburgers. Lots of things can be harmful when misused, that is why the American Council on Science and Health talks about dose-response when environmentalists only want to talk about hazard.”

And then this: “It has been commonly established in longitudinal studies that alcohol in moderation has some positive effects, like with cardiovascular disease risk, but then some meta-analyses say it causes cancer. Which is it? If you are in the media, it doesn’t matter; you write about both as the Big Story. Many of us are reductionists; we want to eliminate bad luck and true randomness as much as possible, so we try to find cause and effect for everything. Which is why we love to read articles claiming X is a Miracle Product or later that X will Cause Cancer – and we do, over and over, like last week with alcohol causing cancer. Again.”

And then he goes on to give a template for how activist academics can misuse science to get publicity for their pet cause by following a well-tried template. Here’s how it works, the way to show Netflix causes cancer in 10 easy steps:

1. Get a random sample of 1,000 people and ask them to recall their viewing habits
2. Find out how many watch Netflix
3. Find out which disease they share in common
4. Do some data-dredging and use the seductive certainty of significance to suggest that your p-value is relevant
5. Pay to publish it in an open access journal, or find a niche relevant journal desperate for impact factor
6. Pay AAAS Eurekalert to carry the press release
7. Answer emails from harried science journalists writing three articles that day. Send snappy quotes about implications for longevity. Slate, Vox, etc. then write blog posts about the newspaper articles and then Inquisitr, Mashable, etc. rewrite those blog posts
8. Someone writes a New York Times bestselling book based on it
9. Academics needing R01 grants rush to produce papers validating the claims in the book
10. Academics like Marion Nestle write about all of the new papers and declare anyone disagreeing is a shill for Big Streaming.

There you have it. Your first epidemiology paper. And this will get read, because a lot of people have Netflix.

My point in quoting this article is to illustrate how activist academics exploit fear of cancer in relation to alcohol precisely in order to generate headlines and to justify the “there is no safe level of alcohol consumption” narrative. Below is a graphic which illustrates the distribution of studies that show how what we eat either causes or protects against cancer:

I’ll never believe an epidemiologist again!

Paul Chase

MEDIA-DRIVEN MORAL PANICS

Cancer = Death. And sooner rather than later, or at least that’s the public’s perception. So any link between alcohol and cancer implies precisely that equation and is therefore guaranteed to generate headlines. So last week headlines in the I-online and Guardian newspapers that screamed “Alcohol directly causes seven kinds of cancer, says study”, and “Proof: drinking alcohol causes cancer” were designed to alarm public opinion and to feed into the ongoing ‘public health’ narrative that “there is no safe level of alcohol consumption”.

So, presumably, in order to justify these headlines there must be some new weighty piece of research that’s been published, or perhaps a meta-analysis of numerous other peoples’ research that give us, finally, irrefutable proof of this claim. But actually nothing of the sort! What the newspapers were referring to was an opinion piece by an academic named Jennie Connor, who works at the University of Otago, New Zealand, and that was published in the Journal ‘Addiction’. It consists of just over 3,700 words plus references.

Without wishing to be overly pedantic, it is not ‘alcohol’ but the drinking of alcohol, mostly in copious quantities, that causes a number of different cancers and there is nothing new in this claim nor is it, for the most part, disputed. The issue here is about which alcohol-related cancers require the drinker to really work at it by drinking to excess and which can be triggered by relatively low levels of consumption. The alcohol mortality statistics for England show that over 80 per cent of deaths from diseases caused by alcohol consumption are deaths from alcoholic liver disease (4,333 in 2014) and liver fibrosis/cirrhosis (1,520 in 2014). Bear in mind that some 28 million people in England drink alcohol on a weekly basis, so these drinkers are at the extreme end of consumption – often drinking in excess of a bottle of Scotch a day for many years.

The claim made in the article by Jennie Connor is that alcohol-attributable cancers make up 5.8 per cent of all cancer deaths worldwide. But if you look at the alcohol mortality statistics for England you will not find any recorded deaths from lip, oral cavity and pharynx cancer, oesophageal cancer, colorectal cancer or cancer of the larynx. As I said above, alcohol-related deaths are mostly caused by alcoholic liver disease or liver fibrosis/cirrhosis.  Curiously, there is no reference to deaths from alcohol-related breast cancer in the official figures, but studies estimate that about 94% of breast cancers are linked to causes other than alcohol, so separating out alcohol-related breast cancer let alone those cases that result in death is extremely speculative.

And this is the crux of the matter: at what point can we say that a statistical association between alcohol consumption and a disease becomes sufficiently well established to conclude that the relationship is causal? For what it’s worth, I think that Jennie Connor’s claim that the statistical association is strong enough for us to conclude that alcohol consumption causes cancers at seven sites is probably correct (oropharynx, larynx, oesophagus, liver, colon, rectum and female breast). But with the exception of the liver and a tiny minority of breast cancers these cancers are rare and rarely result in death.

The link between alcohol consumption and some rare cancers needs to be balanced by an appreciation of the clear proof that there are overall health protective effects from light to moderate drinking, particularly in relation to heart disease and stroke. I am of course talking here of the famous j-shaped curve that shows that regular, moderate drinkers live on average longer lives than either heavy drinkers or ‘never drinkers’, and are less likely than never drinkers to die of heart disease or a cancer. Jennie Connor, in her article, casts doubt on that hypothesis and space prevents me from going into detail on that, although I have done so in previous articles. Her scepticism of the j-curve hypothesis rather spoils what is otherwise a rational article that largely avoids bias.

My main criticism is of the media. Even supposedly ‘high-brow’ newspapers like the Independent and the Guardian cannot resist the temptation to get a wowser headline  by bigging-up an article that contains nothing new into a ‘study’, when it isn’t. This is how moral panics are started and sustained by a public media that creates and perpetuates myths which get repeated so often they become “well-known facts”. Are the media behaving cynically? Do they know they’re doing this? I am left with the thought that a man who tells a lie is merely hiding the truth; a man who tells a lie so often he’s convinced himself has forgotten where he’s put it.

BALANCING THE PICTURE

It’s that time of year again when the latest statistics on alcohol and health are published and the usual attempts are made, by the usual suspects, to misinterpret them to keep the moral panic on alcohol going. The figure that made the newspaper headlines were of the “More than a million alcohol-related hospital admissions in 2015” variety. This particular statistic – it is 1.09 million to be precise – is actually the number of hospital admissions in England where the patient being admitted had a medical condition that was or might be related to alcohol, regardless of whether the diagnosis that led to admission was alcohol-related or not.

This 1.1 million figure (which, with little variation is quoted every year) is the most hotly contested alcohol statistic ever produced! It is actually a measure of the prevalence of alcohol-related medical conditions of all people admitted to hospital in a given year, regardless of whether the reason they were admitted in the first place was alcohol-related. The purpose of collecting alcohol disease statistics on all in-patients was to give the NHS a means of planning resources; to understand what alcohol-related illnesses might be coming down the pipeline, it was never intended to be represented as being a “count” of the number of hospital admissions related to alcohol, and to quote it as such, as much of the media and politicians consistently do, is a gross misrepresentation.

The truth about hospital admissions, where the primary or secondary diagnosis leading to admission is an alcohol-related condition, or has an alcohol-related external cause, is buried in the official HSCIC figures and is as follows:

	2013/14	2014/15	DIFFERENCE
Narrow Measure*:	152,120	144,270	-7,850
Broad measure**:	322,030	319,090	-2,940

* Narrow Measure: alcohol-related admissions where the primary diagnosis was for a condition wholly or partly attributable to alcohol.   

** Broad measure: alcohol-related admissions where the primary or secondary diagnosis was wholly or partly attributable to alcohol. 

It’s important to recognise that the numbers in the table above represent the number of alcohol-related hospital admission episodes, not the number of people admitted to hospital because of alcohol. Which brings me to ‘frequent flyers’. We know from Parliamentary answers that 54% of those admitted had been admitted two or three times in the year; and that 26% had been admitted four or more times. So how many people generated these alcohol-related hospital admissions? Let’s take the 2014/15 figures as an illustration:

Using the ‘broad measure’ we can see that there were 319,090 alcohol-related admissions in England in 2014/15, where the primary or secondary diagnosis was for an illness wholly or partly attributable to alcohol, or where there was an alcohol-related ‘external cause’ – such as an injury received during a drunken fight. If 54% of these admissions were of people admitted two or three times, then that equates to 86,154 people. If 26% of them were of people admitted four or five times then that equates to 20,740 people. Which leaves 63,819 people who were admitted only once. Add the three numbers up and it turns out that these 319,090 hospital admission episodes were generated by 170,713 people.

There are 1,880 hospitals in England which have an A&E department and where people can be admitted for overnight stays. Clearly alcohol-related hospital admissions will not be distributed evenly between them, but if we divide 319,090 admissions by 1,880 hospitals that is an average of around 170 admissions per hospital, per year – just over three a week – and these admissions are generated by just 90 people per hospital, per year or 1.7 people per hospital, per week.

How often do we read or hear it said that the burden of alcohol-related admissions will “bankrupt the NHS”? And yet the NHS as a whole deals with over a million patients every 36 hours! It is utterly disingenuous for the media and politicians to spout scaremongering statistics that grossly exaggerate the impact of alcohol on the NHS. For the health lobby this kind of statistical shenanigans is so ingrained that I doubt they even know they are doing it anymore. 

Paul Chase

AND NOW FOR SOMETHING COMPLETELY DIFFERENT!

In the wake of the EU referendum result, and the momentous political events that have followed over the past week, it seems almost banal to return to everyday stuff. I watched the results of the referendum over the course of the night and into the early hours – sleeping fitfully, but returning to the TV screen to see the unfolding picture. For me as a ‘remainer’ the nightmare was happening whilst I was awake! But the decision is made and I don’t intend to rehearse the issues of the campaign (you’ll be glad to hear). But I feel that more has changed than just our relationship with the EU.

I find myself returning to everyday normality, but with a strong Pythonesque sense of the surreal. Take the issue of minimum unit pricing (MUP): Readers may recall that the European Court of Justice (ECJ) published a judgment on this measure in December 2015. They kicked the decision back to the Scottish courts on the basis that MUP did break EU free movement of goods regulations, and taxation might be a better way for the Scottish government to achieve its health goals in relation to alcohol. The Scottish government now has to convince the Scottish Court of Sessions that there is no measure they could take that would be less trade-restrictive than MUP and which could achieve the same results. And of course the boys and girls from Sheffield University were on hand with a new mathematical model.

What strikes me as surreal is that in a couple of years’ time the UK will no longer be a member of the EU and therefore not covered by the jurisdiction of the ECJ. Except that Nicola Sturgeon would like, somehow, for Scotland to remain in the EU, even in advance of another Scottish independence referendum. But the UK is in until it is out – and both sides in the MUP case have stated they will appeal the Scottish court’s decision to the Supreme Court in London, should they lose. 

Will any of this matter in a couple of years’ time? We will have left and therefore Scotland can impose MUP if they want to and the EU won’t be able to do anything about it, right? Well, not quite. If Scotland, outside the EU, introduces MUP then the ECJ won’t be able to act, but the EU will be able to impose trade sanctions on, for example, exports of Scotch Whisky. Maybe a quota system, or a 15% surcharge. Of course we will have “got our sovereignty back” and we will “no longer be subject to the dictats of a foreign court” so that’s alright then. People should reflect on which is preferable: an orderly judicial process or a trade war – echoes of gunboat diplomacy and the whiff of cordite – we don’t have Lord Palmerston any more, but we do have, er…Boris. Oh, but we don’t – he’s just bottled it and declared he’s not standing for leader. He who wields the knife rarely wins the crown!

Another unwelcome development earlier this year was the publication of the new low-risk Alcohol Guidelines. The Guidelines proposed an upper limit of 14 units of alcohol a week for both men and women and a new mantra: “There is no safe level of alcohol consumption”. On Tuesday the 28^th June Byron Davies, Conservative MP for Gower, secured a debate in Westminster Hall on the alcohol consumption guidelines. The minister, Jane Ellison and her Labour counterpart Diane Abbott were both present and summed up the government’s and the opposition’s viewpoint respectively.

Byron Davies made an excellent speech, criticising the unrealistic level of ‘low-risk’ consumption; the way that decades of science that proved the health-protective effects of low and moderate consumption had been ignored by the Review; and the disproportionate influence of members of the temperance movement whose members served on the advisory committee that drew up the Guidelines. All good stuff.

But again, I found this more than a little surreal. Diane Abbott gave a speech in which she banged on about cancer and alcohol-related ill-health, completely missing the point of the whole debate. As far as she was concerned alcohol was A Bad Thing, and anything that was intended to reduce consumption was therefore A Good Thing. This prompted Andrew Griffiths MP for Burton to comment “Your speech is ridiculous.” But perhaps Diane Abbott had other things on her mind - like the disintegration of the  Shadow Cabinet and the coup underway against Jeremy Corbyn. It amazes me that in the wake of the political earthquake taking place in both the main political parties, Abbott can still find the energy for an anti-alcohol rant. 

I said at the beginning of this article that I thought something more had changed than just our relationship with the EU. I respect the considered views of those who want to leave, but I can’t help but feel that the whole tone of the debate has exposed a dark side to our political discourse. The upsurge of hate crimes comes to mind. Michael Gove commented on what experts had said about the economic consequences of Brexit:  “I think the country’s had enough of experts.” Perhaps he could give us an example of where anti-intellectualism has ever led to anything other than bigotry. Introducing the politics of identity into the Brexit debate was playing with fire. Fear of foreigners and an upsurge of racism have somehow slithered onto the agenda.

Perhaps the way to restore some sense of normality and stability is to retreat into the small stuff; the everyday stuff. I fear that prospect might be some way off.

THE CASE FOR ‘REMAIN’

My starting point in the EU referendum debate is that the burden of proof is with those who advocate change. It is for them to convince the rest of us that the change they propose would be beneficial. For me the most important issues are the economy and access to the single market; and democracy and political stability in Europe. I believe both are better served by staying in rather than leaving the EU.

But I’m a believer in small government, less meddling, less red tape and bureaucracy, so why would I support membership of the EU? In one word: globalisation. That’s the elephant in the room in respect of this whole debate. Margaret Thatcher and President Reagan didn’t invent globalisation, but they gave it a hell of a push off the side when they abolished currency controls and controls on the movement of capital. These changes let the genie of globalisation out of the bottle and we cannot now stuff it back in. Money and capital and are now traded in global currency and stock markets 24/7, and the globalisation of business ownership, which was already well under way when these changes happened, has accelerated apace ever since.

When I hear the Leave campaign talk of “taking back control” and “regaining our sovereignty” it seems to me they are in denial of globalisation. Their view of sovereignty is that it’s a zero-sum game; a bit like virginity – either you’ve got it or you haven’t! They’re living in a nineteenth century world when capitalism was nation-state based and the British cabinet was a committee of British businessmen who owned big factories, mills, ship yards and mines; their hands directly on the levers of economic power. And we had an empire on which the sun never set. That world has vanished and capitalism is now global.

Vast quantities of money and capital swirl around the global financial system; recent decisions about our steel industry were taken not in Westminster, or by faceless bureaucrats in Brussels, but by businessmen sitting in a room in Mumbai. If we are to have any chance of “taking back control” of the global forces that impact our economy and prosperity we are better able to do so as part of something bigger than ourselves – an EU of 28 nations which pool their sovereignty and act together – rather than as a single country acting on our own. Sitting in a boat in the middle of the Atlantic singing “Rule Britannia” whilst sailing off into the sunset isn’t an exercise in sovereignty, but in futility.

The Leave campaign has moved the goalposts on the economy. At the beginning of the Brexit debate they advanced a ‘cake and eat it’ argument: that it was possible to resign our membership of the EU club, but negotiate retention of the terms of trade benefits conferred by the single market – whilst at the same time not having to pay the club’s annual membership fee or abide by its rules. The notion that we can ditch the costs whilst retaining the benefits has always seemed to me to be a fundamentally improbable proposition. 

The Leave campaign has now abandoned that position and stated they want to leave the single market and become part of the European free trade area or revert to WTO trading rules – which would result in our goods being subject to tariffs of up to 10%. 

In terms of democracy and political stability, I remember when Spain, Portugal and Greece weren’t in the Common Market because they were ruled by fascist dictators. I remember when a host of former Soviet satellite countries weren’t able to join because they were communist dictatorships. Now they are all functioning democracies and all members of the EU. The EU has held the political centre together.

On the Leave side the one argument that is cutting through is immigration. Again, this is couched in terms of taking back control. And you hear members of the public in some of the televised debates saying things like “we should put up the shut sign.” Have these people been to an international airport recently? Take Heathrow as an example: 75 million passengers arrived or departed that airport in 2015. On its busiest day, 17^th August, 257,312 people arrived or left – and 69% of them were international passengers, not domestic ones. You see how this works Boris? How exactly do you “put up the shut sign” or “take back control” in an era of mass travel? 

My father visited France for the first time on D-Day – with a Bren-gun strapped to his chest – as did many members of his generation. Now anyone can jump on a plane and visit Paris or another European destination for £50. 200,000 British families now own houses in France; 300,000 Brits have retired to, or work in Spain; there are some 50,000 Brits living in Italy. Immigration isn’t something done to us by foreigners whilst we all stay in dear Old Blighty watering our spider plants. We’ve moved on.  

Ultimately the issue of immigration is another state versus the market argument. No matter what the state does it is ultimately our jobs market that will determine the immigration volumes – unless we’re prepared to sacrifice economic growth and trash our economy on the altar of public incomprehension of what it means to live in a globalised world.

I’ll be voting for ‘Remain’!

SIMPLE SOLUTIONS FOR COMPLEX PROBLEMS

One of the interesting things about the EU referendum is the public clamour for “the facts”. People are bamboozled by claim and counterclaim and long for someone just to explain things to them in a simple, factual manner, without spin or bias. I’m not proposing to discuss the ‘Neverendum’ in this article, but this desire for ‘simple facts’, and for simple solutions to complex problems that will supposedly arise from simple facts, has a much wider resonance. There are three examples of it currently in the news: the Scottish alcohol consumption figures, leading to a renewed call for minimum unit pricing (MUP); the challenge posed by the National Obesity Forum to established science on nutrition; and the banning of so-called legal highs, otherwise known as New Psychoactive Substances (NPS).

Scotland has for a long time had a greater level of alcohol consumption per head than England and Wales and the news that consumption per head of population has risen in Scotland for the second year running was coupled in the media with the observation that Scots drink 20% more alcohol than their English and Welsh counterparts. This gives the erroneous impression that consumption in Scotland has risen by 20%. It hasn’t. It has risen by 2%. And that 2% rise in consumption is over two years – 2014 and 2015. This needs to be placed in the context of a 9% fall in alcohol consumption between 2007 and 2013, so the simple fact is that alcohol consumption in Scotland is still 7% lower than in 2007.

But this tiny upturn has been blamed by campaigners on the alcohol industry’s desire to arrest the decline in sales. At the same time we have seen a big increase in the amount of alcohol consumed at home – 74% of alcohol is now bought from off-sales retailers - so, blame the dastardly supermarkets? Well how about we look instead at the lowering of the drink-drive limit in Scotland as something that has driven people out of pubs and into home drinking - where we know that people pour themselves bigger measures than when they drink in the supervised environment of the pub.

According to Alcohol Research UK weekly alcohol consumption per head in England and Wales in 2015 was 17.4 units; in Scotland it was 20.8 units. This is moderate drinking by anyone’s standards except the anti-alcohol zealots of Alcohol Concern and Alcohol Focus Scotland. And what is the Scottish health community’s solution to this over-hyped, over-inflated problem? Why, minimum unit pricing of course!

And what of the National Obesity Forum’s assertion this week that high fat diets are good for you and that low carb and low sugar diets are the answer? This assertion from a bunch of Atkins Diet cranks is another example of how tiny special interest groups feed into the public’s desire for simple solutions. Identify one ingredient – sugar – and tell people to consume as much bacon and eggs, beef dripping and lard as they want – just cut down on the sugar, and you’re giving people another simple solution to a complex problem. And government bows to this kind of campaigning by introducing a tax on fizzy drinks – something that will have no effect whatsoever on levels of obesity.

My third example – the ban on ‘legal highs’ - kicks in today. Readers are probably aware of substances like Spice, which is a synthetic drug that mimics the effects of cannabis, and M-Cat, which has similar effects to strong amphetamine drugs. These and many other compounds are available on the internet and at so-called ‘head shops’ on the high street. They have been linked to around 400 deaths over the past few years, and Spice in particular is blamed for an upsurge of violence in our prisons. The problem for the government is that every time they banned a new legal high the chemical composition was changed slightly so that it became legal again. The government’s response was to ban everything except those intoxicants that were explicitly legal – essentially alcohol, nicotine and caffeine. I can understand the government’s desire to be seen to do something about this problem, but there are problems with this prohibition-style approach.

Firstly, many of these drugs mimic the effects of existing illegal drugs – cannabis, cocaine and ecstasy. Given that successive governments’ have ruled out decriminalising or medicalising their supply, prohibition becomes the only option. So, first criminalise the three main recreational drugs, and then when that leads to the creation of a market for cheaper, ‘legal’ synthetic alternatives, criminalise them too. Sale of these drugs will now move to the dark web and it is unlikely that anyone who wants them won’t be able to get them. There is no simple solution to the drugs problem, but we must surely be able to come up with something more intelligent than repeating a failed strategy of prohibition because the public expects something to be done.

Paul Chase