David Nutt and drugs

In 2009, Professor David Nutt was sacked from the Advisory Council on the Misuse of Drugs after claiming that ecstasy and LSD are less dangerous than alcohol. The government couldn’t have thought much of Nutt if they sacked him. Some people seem to think he is the best thing since sliced bread. He has written a paper on drugs that explains his position. I think the war on drugs is a moral catastrophe in terms of the persecution of drug users and those who sell to them. It is also intellectually bankrupt, and David Nutt has swallowed many of its worst ideas hook, line and sinker. If he ends up making any improvements to drug policy, it will be a matter of pure luck.

Nutt claims that experts can decide how drugs ought to be classified in a “rational” and “scientific” manner by looking at their effects. He divides these effects into three categories. Physical effects: if you drink too much alcohol your liver is damaged, heroin can lead to respiratory arrest and so on. Dependence: some drugs produce withdrawal symptoms and so it can be difficult to stop taking them. Social effects: drugs can break up families and cost the taxpayer money for healthcare of people who are ill as a result of taking drugs. The idea is that you can look at medical evidence and statistics and stuff like that and use them to decide government policy.

However, all of the categories above raise moral issues and he doesn’t address any of those issues. For example, taking heroin, say, may make it more likely that you will die and many people will think this is bad. But some people might want to die and so might value heroin specifically because it will kill them. At present, it is basically illegal to commit suicide. If you’re caught trying to do it you will be locked up. Thomas Szasz argued that this is one of the roots of drug prohibition: the government wants to make it difficult for a person to kill himself. The government is at least more or less explicit about this. Does Nutt favour the persecution of people who want to commit suicide or not? I can’t tell from the paper.

What about dependence? Many people seem to like dependence. Most people prefer to be dependent on a person rather than a chemical. Many people commit suicide after the end of a personal relationship such as a marriage. This is well-known and yet many people choose to get married: many people value being dependent on another person over their life. Now, admittedly this dependence involves a person and not a drug, but is there any relevant difference? I’m not saying there is no relevant difference, just that Nutt hasn’t bothered to address the issue. Should we ban marriage as well as heroin or alcohol or whatever? I think both marriage and heroin are bad ideas. However, the people involved in both marriage and taking heroin want to do those things and the people involved could walk away if they thought they had a better option. I don’t know how to provide people with better options and none of the people involved want anything better so I can’t see that it makes sense to force them to do something else.

What about the social effects? It costs the taxpayer money to look after people who have destroyed their health with drugs. But there is a problem. Most people seem to think that healthcare should be provided for by taxation, not by voluntary subscription. The reason given for this policy is that people who are ill shouldn’t have to pay for healthcare. So if this is a cost that people want to pay, why is anybody bitching about the cost of medical treatment for drug users? After all, the whole reason for the policy is to prevent ill people from having to consider the cost of treatment. There is a deep issue here. The problem goes like this: healthcare is a complex technological and personal service. It’s not like saying that you have a right not to punched in the face because it is easy to refrain from punching people in the face: it requires effort to punch somebody in the face. Curing diseases requires thought and deliberate action. If you deem that people have a right to healthcare, then there is no way to draw a principled line to demarcate what care they can’t have. Are you going to say that some people don’t deserve healthcare because they made a self-destructive choice to take drugs? But then why not say that you can deny this ‘right’ to everybody who makes the self destructive choice not to save or get insurance to cover medical expenses? If you admit one you’ve undermined the rationale for the other.

I can’t see any sign in the paper that Nutt differs from the government on any substantive moral issue. As such, any improvements he make will be tinkering around the edges. More substantial changes in how people think about this issue are needed. First, we should openly admit that this is a moral issue. Taking drugs is behaviour, not disease. Disliking that behaviour for whatever reason, is a moral position about how people ought to behave, not a medical position. Second, people should become much more reluctant to drag the use of force into disputes. If somebody isn’t using violence or fraud against you but you don’t like what they’re doing, then leave. Third, if a drug user fails to hold down a job or whatever that’s his problem and the government should not be using tax money, which is not contributed voluntarily, to support their bad habits, as it does now. And of course this policy should apply to anybody else who fails. It’s very difficult for people to learn competence if they are not allowed to fail.