A COLLAPSE IN INTEGRITY OF SCIENTIFIC ADVICE IN THE UK

Over the past 6 months the UK's Advisory Council on the Misuse of
Drugs (ACMD) - an independent expert body that advises government on
drug-related issues - has hardly been out of the headlines.

One sacking and seven resignations is not a good track record for any
organisation. The public's discontent at the ACMD over how it
operates and how it is unduly influenced by government has left a
bitter taste, together with a crisis in confidence about
evidence-based policy making in the UK.

The trouble at the ACMD began in October, 2009, after the
controversial sacking of the then chairman, Professor David Nutt for
criticising the government's policy over cannabis and ecstasy.

Five more members quit soon after in protest.

In January, 2010, the equally distinguished neuroscientist, Professor
Les Iverson, was appointed interim chair.

In March, 2010, Dr Polly Taylor was the next to leave, outraged by
the publication of the revised Code of Practice for Scientific
Advisory Committees, the rewording of which compromised scientists'
independence and would dissuade them from giving objective advice
lest they disagreed with government policy.

The current outcry at the ACMD is over the recreational drug
mephedrone (4-methylmethcathinone), a synthetic stimulant most
similar chemically to amphetamines. It is a derivative of cathinone,
a compound found in the plant called khat. Clinical and
pharmacological research on cathinones is sparse and knowledge about
the human effects of this drug class have been reliant on anecdotal
reports from users and physicians. Adverse reactions include
tachycardia, hallucinations, vasoconstriction, increased anxiety, and
possible psychosis.

The substance has received substantial media attention in the UK
after reportedly being linked to 25 deaths. Indeed, the ACMD has
suggested that media coverage has increased the use of the drug.

The most recent resignation was Mr Eric Carlin in response to the
reclassification of mephedrone to class B together with its
subsequent ban alongside other cathinone derivatives. According to
Carlin, the decision-making process focused primarily on the
chemistry and legality of the drugs, and too little on the public
health measures that could reduce harm. Furthermore, the ACMD report,
Consideration of the cathinones, which recommended the ban,
documented the very scanty evidence on mephedrone, including the
absence of a direct causal link between the reported deaths and the
drug. Alarmingly, the report, which was only a draft, was still being
discussed by the ACMD when Iverson rushed out of the meeting to brief
Home Secretary Alan Johnson of their recommendation in time for a
press briefing.

Carlin states on his blog: "We were unduly pressured by media and
politicians to make a quick, tough decision to classify."

Equally notable was the very quiet release on the same day of the
ACMD's other report, Pathways to Problems-a detailed progress report
on recommendations made in 2006 on hazardous drug use. The report
contains some potentially unpalatable conclusions on tackling young
people's problems, including not enough being done on alcohol and
tobacco, as well as calling for a review of the Misuse of Drugs Act
1971. Yet this report received no media attention or a response from
the Home Office. Instead, it conveniently got buried under
discussions on the legal status of mephedrone. There was little time
to consider carefully the scientific evidence on mephedrone. The ACMD
did not have sufficient evidence to judge the harms caused by this drug class.

It is too easy and potentially counterproductive to ban each new
substance that comes along rather than seek to understand more about
young people's motivations and how we can influence them. We should
try to support healthy behaviours rather than simply punish people
who breach our society's norms. Making the drug illegal will also
deter crucial research on this drug and other drug-related behaviour,
and it will be far more difficult for people with problems to get help.

The terms of engagement between ministers and expert advisers
endorsed by Alan Johnson have been blown apart.

During the past 12 years the Labour Government has done a great deal
to build up a strong science base in the UK and enhance the important
role that science plays in our economy and society.

However, the events surrounding the ACMD signal a disappointing
finale to the government's relationship with science.

Politics has been allowed to contaminate scientific processes and the
advice that underpins policy. The outcome of an independent enquiry
into the practices of the ACMD, commissioned by the Home Office in
October, 2009, is now urgently awaited.

Lessons from this debacle need to be learned by a new incoming government.