The slow death of the ACMD

As part of its drug law review, the Law Commission has recommended an overhaul of our Government’s drug classification body – the Expert Advisory Committee on Drugs. Internationally, these independent advisory bodies play an important role by injecting scientific expertise into the often fraught politics of drug policy.

Jeremy Sare details how Britain’s drugs advisory body, the ACMD, has been systematically undermined by petty politics.

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If the UK’s Advisory Council on the Misuse of Drugs (ACMD) were a vehicle, it would be a beat-up old VW camper van. Formerly sturdy, multi-functional and efficient, its successive owners’ negligent behaviour has reduced it to a barely drivable wreck. Only a huge overhaul could now save it from its last ride to the scrapheap.

The Council has suffered from serial intellectual assault by politicians and commentators over the last 10 years. The public may well equate ‘ACMD’ with the word ‘resignation’ – there have been seven in as many months following the sacking of its Chair, Professor David Nutt, last November.

Of course, the Council wasn’t always so maligned and marginalised. It was established on 1 January 1973 when the Misuse of Drugs Act 1971 first came into force. The opening words of Section 1 of the Act, “There shall be constituted… [an] Advisory Council”, underlined its pre-eminence in all governmental considerations relating to drugs.

Home Secretary ‘Sunny’ Jim Callaghan, latterly Labour Prime Minister (1976–79), presented the legislation to Parliament in a cogent and confident speech. Callaghan, to his credit, recognised “the social, educational and medical approaches are as important as the legal”. His studied and patient address to MPs contrasted markedly to the shrill and emotional tub-thumping of more recent holders of the drugs brief. They have invariably tied legal changes to the illusory ‘messages’ they send out to young people.

Of the Advisory Council, Callaghan set a high ambition – it should have “a strategic planning role…for treatment, rehabilitation, education and research.” In 2010, it carries out precisely none of those functions.

Ruth Runciman (ACMD member 1974–1995) recalled how the Council was held in much higher esteem in its early years. For one thing, they did not spend most of their time bickering with ministers about the classification of various drugs, but on considerably more weighty studies, aiming to actually address and reduce the impact of drugs on people’s lives.

The majority of her tenure was governed by successive Conservative Secretaries of State, such as Michael Howard. But despite the Tories’ notoriously robust views on criminal justice, they proved quite receptive to their experts’ advice and were “always prepared to engage”.

Baroness Runciman chaired the Council’s three ‘AIDS and Drug Misuse’ reports whose recommendations had a major influence on drug policy across many countries. The pressures around drugs were not materially different then, but the Government’s response on AIDS proved to be sound and humane.

She recently told The Times, “The [ACMD report] attracted considerable public and press hostility. Nevertheless, Margaret Thatcher’s government, after some hesitation, took the bold step of accepting the ACMD’s recommendations and implementing a wide range of harm reduction initiatives including needle exchanges. As a result, we now have one of the lowest rates in Europe of HIV among drug users.”

What has been largely overlooked in the ensuing years is that these reports were not agreed by the Home Secretary but by the Health Secretary (Kenneth Clarke). The decline in the status of the ACMD can be traced precisely to the eventual dominance of the criminal justice approach to drugs policy. For a recent example, the debates on controlling mephedrone were carried through Parliament by Police Minister David Hanson.

The drafting of the Drugs Act 2005 proved to be a seminal moment for the ACMD. In October 2004, Prime Minister Tony Blair invited several senior Police over to No 10 Downing Street and seemingly asked them to spill out any half-baked suggestions for new tough laws on drugs. Not only were the ACMD not treated with equal respect, they were not even invited to comment.

It was not until the Bill had reached its Committee stage that ministers conceded, begrudgingly, they had a duty to consult the ACMD over the proposed, heavy-handed restrictions on magic mushrooms. A cursory email was sent round, but the Council’s protesting responses were largely ignored.

The Drugs Act evolved into a series of pointless, posturing measures aimed primarily at the tabloids prior to the 2005 election. These included additional penalties for dealing “in the vicinity of school premises”, a law that has hardly ever been utilised. The provisions have had next to no impact on policing, prevalence, treatment or drug education. It appears to be the most dysfunctional Parliamentary Act of any recent government.

Blair gave way to Brown in 2007, and the new Prime Minister immediately made clear his intention to reverse the downward reclassification of cannabis. Unfortunately, he appeared oblivious to the ACMD’s existence. He installed Jacqui Smith as Home Secretary to force this media-driven change, regardless of the scientific evidence or the well documented views of the experts. Something had to give.

Former ACMD Chair Professor David Nutt said, “I think the downward spiral for the Council began with the mushrooms saga but got decidedly worse when Brown came into office and tried to get tough on cannabis. Jacqui Smith then took on this challenge, and the two of them lobbied aggressively against the ACMD for the full duration of her term. As soon as I tried to fight back, I was sacked.”

Dr John Marsden of the Institute of Psychiatry was one of a host of eminent academics to resign from the ACMD in disgust at Nutt’s treatment.

He said, “There was a categorical rejection by ministers of a nuanced debate about the health and social risks and harms of drug use, because a ‘strong message’ had to be sent out to the public. The ACMD was rapidly heading in a pointless direction.”

Although the government tried briefly, like a negligent parent, to mend relations with its own drug scientists, clearly its heart was not in it. Its first test was controlling the new synthetic amphetamine mephedrone; it failed miserably.

The process was badly hampered by a fatal lack of expertise in the rump of the remaining Council. When the media demanded swift action, the ACMD was compelled by ministers to hurriedly compile a report that was in parts quite shoddy and incomplete. It is the only ACMD publication I have read that is less than excellent.

I spoke to a current member who witnessed the whole sorry episode. The member revealed that the Council only had about 2 hours to consider the whole report and described the meeting as “rushed with little discussion… people were left a bit open-mouthed… shocked, amazed, baffled at the whole process.”

The confidence of the Council was hardly strengthened when the interim Chair, Professor Les Iversen, described as “very stressed”, was hauled out before the end to announce its findings to the voracious press.

A Home Office official, who wished to remain anonymous, summarised the Council’s current predicament. “The real problem for the ACMD is that it is required to provide scientific justifications for what are essentially political questions.”

That may be something of a truism, but the collapse in standing of the ACMD can also be attributed directly to the denigration of independent scientific advice. This is an inevitable consequence of a government working to an agenda dominated by news management.

David Nutt’s new group, the Independent Scientific Committee on Drugs (ISCD), is already a lap ahead of the ACMD in terms of expertise. Although it has yet to determine its relationship with government, the ISCD is clearly in a strong position to usurp the ACMD’s intellectual authority on drug science. Nevertheless, the ACMD is still the statutory body, pending any future review of the Misuse of Drugs Act 1971.

Anyone in the drugs field would agree this decrepit old banger, the ACMD, needs full service and repair. But it would also benefit hugely from a transfer of ownership to the Department of Health where scientific truth can more easily co-exist with politics. Only something fundamental can prevent all the wheels coming clean off.

• Jeremy Sare is a freelance journalist based in the UK.