Abstract
Last year saw the banning of several new synthetic stimulant drugs and many of their analogues. The impetus for this was the rise in use of mephedrone (also known as M-cat, miaow-miaow, Drone, etc.) which was imported from China and which may have been used by up to a million young people. They used it because it was legal, so readily available over the Internet or from ‘headshops’ and because they knew that what they got was what they bought. In contrast most of the alternative stimulants particularly MDMA (ecstasy), amphetamine and cocaine were of markedly lower quality, often less than 15% of the supposed drug concentration [Home Office, 2010] and on occasions without containing the drug at all.
This rise in the use of mephedrone caused a great consternation bordering on hysteria in the press, which then translated into political action. Lurid reports of deaths occurring as a consequence of mephedrone were front-page news even though it subsequently transpired that none of the so-called victims had actually taken the drug. Nevertheless the government, conscious of an upcoming election, rushed to ban mephedrone and related drugs in March 2010. Subsequently there was a rise in the sales of the analogue naphyrone, which in turn was banned late that year despite almost no documented use or harms [Nutt, 2010a].
So what? You might say. Banning a drug even if it does not really cause harm cannot do any harm, can it? Well perhaps it can, let me explain.
The first harm was that it brought the Misuse of Drugs legislation into even greater disrepute than before so undermining health education messages. Mephedrone was banned before its pharmacology let alone its harms were known. The ACMD report has a series of question marks over its pharmacology and there was no toxicological data either [ACMD, 2010]. The principle by which it was banned appears to have been ‘if its structurally like amphetamine then it should be controlled like amphetamine’, which is a Class B drug and mephedrone now sits alongside it. Class B means up to 5 years in prison for personal use. However, it now seems that mephedrone was probably one of the least harmful stimulants, being less potent than most alternatives.
The ban itself was an embarrassment to the government as they got the science wrong. In the rushed legislation and their attempt to show the public that they were hard on controlling ‘mephedrone’ they made the wrong enantiomer illegal. Thus, for a year active mephedrone was still legal. This loophole has just been closed by another act of parliament (see http://www.publications.parliament.uk/pa/cm/cmtoday/cmstand/output/deleg/dg01110216-01.htm).
Secondly, it appears that mephedrone might have actually saved lives. In 2009 there was a significant drop in deaths from cocaine [Bird, 2011]. It seems that users switched to mephedrone for reasons of cost quality and availability and about 40 fewer deaths from cocaine were recorded. This is an example of the harm reduction principle in action; give drug users a safer drug and less harms will ensue. It will be of interest to see what happens now mephedrone is banned. Will people switch back to cocaine so deaths rise?
Another benefit to the army is that the number of soldiers testing positive for cocaine fell greatly [Savage, 2010]. This appears to have been due to soldiers switching from using cocaine on their days off to mephedrone. As this was not tested for at the time, fewer users were detected and so hundreds fewer soldiers were drummed out of the army, saving taxpayers huge amounts of money and improving the army’s capabilities.
Third there was the issue of import duty. Mephedrone netted £600,000 for the treasury, not a huge amount, but an indication of the financial benefits that regulated sales of some drugs might bring to the UK [Hope, 2010]
Finally, and most importantly for psychopharmacology, the legislation controlling mephedrone encompasses compounds of known therapeutic benefit; in particular the antidepressant and antismoking agent bupropion (Wellbutrin, Zyban). Although this was excluded from the act so is still legal, the fact that any analogues or derivatives are very likely to be caught in the act means that no pharmaceutical company is likely to work in this area again. The banning of naphyrone will have an even more detrimental effect on drug discovery as this and related compounds were discovered in a research programme into potential treatments for drug abuse and depression [Nutt 2010b; Meltzer et al. 2006].
A critical point that must be made by all of us who want new treatments for psychiatric disorders is that the (possible) misuse of drugs by a subgroup of young people should not be allowed to derail research into new therapeutic agents. We need clear voice of reason from the scientific community and a sensible balanced view of risks/benefits from those in government scientific advisory committees to defend the whole field of drug innovation in the face of media pressure to ban every new drug.
David Nutt was a member of the ACMD, the government’s advisory committee on drugs, from 2000 to 2009. He is now chair of the Independent Scientific Committee on Drugs http://www.drugscience.org.uk