Using the pharmacy retail model to examine perceptions and biases of a UK population sample towards regulation of specific psychoactive drugs

Abstract

Background:

Contemporary research indicates that the legal classifications of cannabis (Schedule 2, Class B), 3,4-methylenedioxymethamphetamine (MDMA) (Schedule 1, Class A) and psilocybin (Schedule 1, Class A) in the United Kingdom are not entirely based on considerations of harm and therapeutic utility. The legal classifications of the substances discussed are typically determined by legislators such as Parliament and, therefore, may be a reflection of the views or perceived views of the general public.

Objective:

The aim of the study was to provide an indication of the underlying psychology regarding the legislated sale of alcohol, tobacco, cannabis, MDMA and psilocybin in pharmacies according to a UK general population sample.

Methods:

A sample of 105 UK nationals was selected for the survey. Participants were asked questions on perceived relative harm of the five substances. After viewing contemporary information on reported relative harm and therapeutic applications, the participants were asked questions related to using the pharmacy retail model for the sale of the substances discussed. Participants who opposed the substances being sold primarily in pharmacies were asked to explain their rationale according to a predetermined list of options for each of the five drugs. Participants were also asked whether they consider it a human right to be legally permitted to consume the substances.

Results:

The participants' perceptions of relative harm (tobacco > MDMA > psilocybin > alcohol > cannabis) were not in agreement with the relative harm reported in the literature (alcohol > tobacco > cannabis > MDMA > psilocybin). Principal objections to the currently illicit substances being legally available in pharmacies include it sending the wrong message; it feels wrong; it is too dangerous; disliking the smell of cannabis; disapproval of the people; and not liking the idea of people using psychoactive drugs for entertainment or to have mystical/religious experiences. Overall, the participants determined that being legally permitted to consume the substances discussed is an issue of relevance to human rights. A majority of the male participants concluded that being legally permitted to consume alcohol, tobacco, cannabis and Psilocybe mushrooms is a human right in contrast to the majority of female participants who solely considered alcohol consumption to be a human right.

Conclusions:

The data suggest that the legal classifications may not simply be based on considerations of harm. Misperceptions of the dangers, biases and non-health-related aversions likely contribute to the continuation of policies that do not reflect the state of scientific research.

Keywords

alcohol aversions biases cannabis harm reduction human rights MDMA multivariate analysis perceptions pharmacy psilocybin regulation tobacco

Get full access to this article

View all access options for this article.

References

Aguinaco

Barra

(2017) Cannabis for personal use in the Supreme Court of Mexico: Legal case and potential for policy change. International Journal of Drug Policy 50: 9–10.

Amar

(2006) Cannabinoids in medicine: A review of their therapeutic potential. Journal of Ethnopharmacology 105: 1–25.

ASH (2015) Smoking statistics. November 2015. Available at: https://webarchive.nationalarchives.gov.uk/20180328130852tf_/http://content.digital.nhs.uk/catalogue/pub17526/stat-smok-eng-2015-rep.pdf/ (accessed December 2018).

Baker

Pryce

Giovannoni

, et al..(2003) The therapeutic potential of cannabis. The Lancet: Neurology 2: 291–298.

Barrett

(2010) Security, development and human rights: Normative, legal and policy challenges for the international drug control system. International Journal of Drug Policy 21: 140–144.

BBC Science and Nature. Available at: www.bbc.co.uk/sn/tvradio/programmes/horizon/broadband/tx/drugs/survey/ (accessed June 2019).

Bhattacharyya S, Wilson R, Appiah-Kusi E, et al. (2018) Effect of cannabidiol on medial temporal, midbrain, and striatal dysfunction in people at clinical high risk of psychosis: A randomised clinical trial. JAMA Psychiatry Epub ahead of print 29 August 2018. DOI: 10.1001/jamapsychiatry.2018.2309.

Blinderman

(2016) Psycho-existential distress in cancer patients: A return to “entheogens”. Journal of Psychopharmacology 30: 1205–1206.

Bogenschutz

Forcehimes

Pommy

(2015) Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study. Journal of Psychopharmacology 29: 289–299.

10.

Bone

Seddon

(2016) Human rights, public health and medicinal cannabis use. Critical Public Health 26: 51–61.

11.

Brewster

(2018) The structured ambivalence of cannabis control in England & Wales. International Journal of Drug Policy 53: 125–132.

12.

Buss

(2009) How can evolutionary psychology successfully explain personality and individual differences?. Perspectives on Psychological Science 4(4): 359–366.

13.

Cabral

(2017) The 15th anniversary of the Portuguese drug policy: Its history, its success and its future. Drug Science, Policy and Law 3: 1–5.

14.

Canal

Murnane

(2017) The serotonin 5-HT2_C receptor and the non-addictive nature of classic hallucinogens. Journal of Psychopharmacology 31(1): 127–143.

15.

Carey

(2012) The Epigenetics Revolution, London, UK: Icon Books.

16.

Carhart-Harris

Nutt

(2010) User perceptions of the benefits and harms of hallucinogenic drug use: A web-based questionnaire study. Journal of Substance Use 15: 283–300.

17.

Carhart-Harris

Bolstridge

Rucker

, et al..(2016) Psilocybin with psychological support for treatment-resistant depression an open-label feasibility study. The Lancet: Psychiatry 3: 619–627.

18.

Carhart-Harris

Roseman

Haijen

, et al..(2018) Psychedelics and the essential importance of context. Journal of Psychopharmacology 32(7): 725–731.

19.

Carod-Artal

(2015) Hallucinogenic drugs in pre-Columbian Mesoamerican cultures. Neurologia 30: 42–49.

20.

Cerda

Kilmer

(2017) Uruguay's middle-ground approach to cannabis legalization. International Journal of Drug Policy 42: 118–120.

21.

Couchman

Frinculescu

Sobreira

, et al..(2019) Variability in content and dissolution profiles of MDMA tablets collected in the UK between 2001 and 2018 – A potential risk to users?. Drug Testing and Analysis 11(8): 1172–1182.

22.

Crocq

(2007) Historical and cultural aspects of man's relationship with addictive drugs. Dialogues in Clinical Neuroscience 9(4): 355–361.

23.

Cropley

(2013) Creativity and Crime: A Psychological Analysis, Cambridge, UK: Cambridge University Press.

24.

Daftary

(1990) The Ismailis: Their History and Doctrines, Cambridge, UK: Cambridge University Press.

25.

Delman E (2015) Is smoking weed a human right? The Atlantic. Available at: www.theatlantic.com/international/archive/2015/11/mexico-marijuana-legal-human-right/415017/ (accessed February 2017).

26.

Dessing

(2000) Ethics applied to pharmacy practice. Pharmacy World & Science 22: 10–16.

27.

Diep F (2015) 8,000 years ago, 17 women reproduced for every one man. Pacific Standard. Available at: www.google.com/amp/s/psmag.com/.amp/environment/17-to-1-reproductive-success (accessed November 2018).

28.

Doblin

(1991) Pahnke's “Good Friday Experiment”: A long-term follow up and methodological critique. Journal of Transpersonal Psychology 23: 1–28.

29.

DuPont

Voth

(1995) Drug legalization, harm reduction and drug policy. Annals of Internal Medicine 123: 461–465.

30.

Elliott

Ezra-Nevo

Regev

, et al..(2010) Resilience to social stress coincides with functional DNA methylation of the Crf gene in adult mice. Nature Neuroscience 13: 1351–1353.

31.

El-Seedi

De Smet

PAGM

Beck

, et al..(2005) Prehistoric peyote use: Alkaloid analysis and radiocarbon dating of archaeological specimens of Lophophora from Texas. Journal of Ethnopharmacology 101: 238–242.

32.

Elsey

JWB

(2017) Psychedelic drug use in healthy individuals: A review of benefits, costs, and implications for drug policy. Drug Science, Policy and Law 3: 1–11.

33.

European Court on Human Rights (2010) European Convention on Human Rights. Available at: www.echr.coe.int/Documents/Convention_ENG.pdf (accessed June 2019).

34.

European Court on Human Rights (2019) Guide on Article 9 of the European Convention on Human Rights: Freedom of thought, conscience and religion. Available at: www.echr.coe.int/Documents/Guide_Art_9_ENG.pdf (accessed June 2019).

35.

Fast

Shoveller

Kerr

(2017) The material, moral, and affective worlds of dealing and crime among young men entrenched in the inner city gang scene. International Journal of Drug Policy 44: 1–11.

36.

Fine

Rosenfield

(2013) The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides Medical Journal 4: 1–15.

37.

Freeman

Hindocha

Green

, et al..(2019) Medicinal use of cannabis based products and cannabinoids. BMJ 365: 1–7.

38.

Garcia-Romeu

Griffiths

Johnson

(2014) Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction. Current Drug Abuse Reviews 7: 157–164.

39.

Ghodse H, Corkery J, Claridge H, et al. Drug-related deaths in the UK. Annual report 2012.

40.

Gilmore

(1996) Drug use and human rights: Privacy, vulnerability, disability, and human rights infringements. Journal of Contemporary Health Law and Policy 12: 355–447.

41.

Griffiths

Richards

McCann

, et al..(2006) Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology (Berl) 187: 268–283.

42.

Griffiths

Johnson

Carducci

, et al..(2016) Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology 30: 1181–1197.

43.

Griffiths

Richards

Johnson

, et al..(2008) Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. Journal of Psychopharmacology 22: 621–632.

44.

Grotenhermen

Muller-Vahl

(2012) The therapeutic potential of cannabis and cannabinoids. Deutsches Arzteblatt International 109: 495–501.

45.

Handley

Ramsay

Flanagan

(2018) Substance misuse-related poisoning deaths, England and Wales, 1993–2016. Drug Science, Policy and Law 4: 1–8.

46.

Hartogsohn

(2016) Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology. Journal of Psychopharmacology 30(12): 1259–1267.

47.

Hartogsohn

(2017) Constructing drug effects: A history of set and setting. Drug Science, Policy and Law 3: 1–17.

48.

Health and Social Care Information Centre (2015) (2015) Statistics on Alcohol, Leeds, UK: Health and Social Care Information Centre.

49.

Heinze

Armas-Castañeda

(2015) Public policies on the use of drugs in Mexico and Latin America. Drug Science, Policy and Law 2: 1–11.

50.

Hendricks

Crawford

Cropsey

, et al..(2018) The relationships of classic psychedelic use with criminal behavior in the United States adult population. Journal of Psychopharmacology 32: 37–48.

51.

HESA (2018) Higher Education Student Statistics: UK, 2016/17 – Qualifications achieved. Available at: www.hesa.ac.uk/news/11-01-2018/sfr247-higher-education-student-statistics/qualifications (accessed June 2019).

52.

Hickman

Vickerman

Macleod

, et al..(2007) Cannabis and schizophrenia: Model projections of the impact of the rise in cannabis use on historical and future trends in schizophrenia in England and Wales. Addiction 102: 597–606.

53.

Hine

(2019) Women and criminal justice: Where are we now?. British Journal of Community Justice 15(1): 5–18.

54.

Home Office (2018) Drug misuse: Findings from the 2017/18 crime survey for England and Wales. National Statistics. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/729249/drug-misuse-2018-hosb1418.pdf (accessed July 2019).

55.

Huestis

(2007) Human cannabinoid pharmacokinetics. Chemistry & Biodiversity 4: 1770–1804.

56.

Hurley

(2017) Parents against prohibition: Campaigning for drug law reform. BMJ 357: j1876.

57.

Hurley

(2018) Cannabis, cannabis everywhere: UK to review medical cannabis policy as Canada plans imminent legalisation for all uses. BMJ 361: k2695.

58.

Ingraham C (2015) Mexico's supreme court rules that smoking pot is a fundamental human right. The Washington Post. Available at: www.washingtonpost.com/news/wonk/wp/2015/11/05/mexicos-supreme-court-rules-that-smoking-weed-is-a-fundamental-human-right/?utm_term=.c84cbbedd96f (accessed January 2017).

59.

James

Robertshaw

Westwell

, et al..(2018) Pharmacies as potential providers of harm reduction services: A preliminary online survey. Drug Science, Policy and Law 4: 1–14.

60.

James

Robertshaw

Westwell

(2019) Emerging from the dark side: New therapeutic applications of scheduled psychoactive substances. Future Medicinal Chemistry. Epub ahead of print. https://www.future-science.com/doi/full/10.4155/fmc-2018-0447.

61.

Johnson

Hendricks

Barrett

, et al..(2019) Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. Pharmacology and Therapeutics 197: 83–102.

62.

Johnson

Richards

Griffiths

(2008) Human hallucinogen research: Guidelines for safety. Journal of Psychopharmacology 22: 603–620.

63.

Jones

(2007) The Native American church, peyote, and health: Expanding consciousness for healing purposes. Contemporary Justice Review 10: 411–425.

64.

Klein A and Potter GR (2018) The three betrayals of the medical cannabis growing activist: From multiple victimhood to reconstruction, redemption and activism. International Journal of Drug Policy 53: 65–72.

65.

Klein

Doyen

Leys

, et al..(2012) Low hopes, high expectations: Expectancy effects and the replicability of behavioral experiments. Perspectives on Psychological Science 7(6): 572–584.

66.

Lader D (2015) Drug misuse: Findings from the 2014/2015 crime survey for England and Wales. Second edition. London, UK: Home Office.

67.

Lamb N, Rolles S, Barton M, et al. (2016) A framework for a regulated market for cannabis in the UK: Recommendations from an expert panel. Available at: https://d3n8a8pro7vhmx.cloudfront.net/libdems/pages/10794/attachments/original/1457398164/A_framework_for_a_regulated_market_for_cannabis_in_the_UK.pdf?1457398164 (accessed September 2019).

68.

Loflin

Earleywine

(2015) No smoke, no fire: What the initial literature suggests regarding vapourized cannabis and respiratory risk. Canadian Journal of Respiratory Therapy 51: 7–9.

69.

MacLean

Johnson

Griffiths

(2011) Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness. Journal of Psychopharmacology 25: 1453–1461.

70.

Martin

Nichols

(2017) The effects of hallucinogens on gene expression. Current Topics in Behavioral Neurosciences 36: 137−2.

71.

Matheson

Bond

Tinelli

(2007) Community pharmacy harm reduction services for drug misusers: National service delivery and professional attitude development over a decade in Scotland. Journal of Public Health 29: 350–357.

72.

McAndless D (2009) Drugs and the BNP: Introducing information is beautiful. The Guardian. Available at: www.theguardian.com/news/datablog/2009/nov/06/drugs-bnp (accessed July 2009).

73.

McPartland

Matias

Di Marzo

, et al..(2006) Evolutionary origins of the endocannabinoid system. Gene 370: 64–74.

74.

Measham

(2004) The decline of ecstasy, the rise of ‘binge’ drinking and the persistence of pleasure. Probation Journal 51: 309–326.

75.

Metzner

(1998) Hallucinogenic drugs and plants in psychotherapy and shamanism. Journal of Psychoactive Drugs 30: 333–341.

76.

Mithoefer

Feduccia

, et al..(2018) 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post–traumatic stress disorder in military veterans, fire fighters, and police officers: A randomized, double-blind, dose-response, Phase II clinical trial. The Lancet: Psychiatry 5: 486–497.

77.

Nadelmann

(1989) Drug prohibition in the United States: Costs, consequences and alternatives. Notre Dame Journal of Law, Ethics & Public Policy 5: 782–808.

78.

Nour

Evans

Carhart-Harris

(2017) Psychedelics, personality and political perspectives. Journal of Psychoactive Drugs 49(3): 182–191.

79.

Nutt

(2014) Mind-altering drugs and research: From presumptive prejudice to a neuroscientific enlightenment?. EMBO Reports 15: 208–211.

80.

Nutt

King

Phillips

(2010) Drug harms in the UK: A multicriteria decision analysis. The Lancet 376: 1558–1565.

81.

Nutt

Rehm

(2014) Doing it by numbers: A simple approach to reducing harms of alcohol. Journal of Psychopharmacology 28: 3–7.

82.

Office for National Statistics (2011) UK Census. Available at: www.ons.gov.uk/census/2011census (accessed December 2018).

83.

Office for National Statistics: Alcohol-related deaths in the UK. Available at: www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/alcoholrelateddeathsintheunitedkingdom/previousReleases (accessed December 2018) 2013.

84.

Ogunbodede

McCombs

Trout

, et al..(2010) New mescaline concentrations from 14 taxa/cultivars of Echinopsis spp. (Cactaceae) (“San Pedro”) and their relevance to shamanic practice. Journal of Ethnopharmacology 131: 356–362.

85.

Palamar

(2014) An examination of opinions towards marijuana policies among high school seniors in the United States. Journal of Psychoactive Drugs 46: 351–361.

86.

Pawlowski

Atwal

Dunbar

RIM

(2008) Sex differences in everyday risk-taking behavior in humans. Evolutionary Psychology 6(1): 29–42.

87.

Reddon

Fast

DeBeck

, et al..(2019) Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study. International Journal of Drug Policy 69: 16–23.

88.

Richards

(2005) Entheogens in the study of religious experiences: Current status. Journal of Religion and Health 44: 377–389.

89.

Roettger

Swisher

Kuhl

, et al..(2010) Paternal incarceration and trajectories of marijuana and other illegal drug use from adolescence into young adulthood: Evidence from longitudinal panels of males and females in the United States. Addiction 106: 121–132.

90.

Russell

Rueda

Room

, et al..(2018) Routes of administration for cannabis use – Basic prevalence and related health outcomes: A scoping review and synthesis. International Journal of Drug Policy 52: 87–96.

91.

Santiago

Moreno

Cázares

, et al..(2016) Traditional knowledge and use of wild mushrooms by Mixtecs or Ñuu savi, the people of the rain, from Southeastern Mexico. Journal of Ethnobiology and Ethnomedicine 12: 35.

92.

Sartim

Sales

Guimarães

, et al..(2018) Hippocampal mammalian target of rapamycin is implicated in stress-coping behavior induced by cannabidiol in the forced swim test. Journal of Psychopharmacolgy 32(8): 922–931.

93.

Satoshi

(2003) A General Evolutionary Psychological Theory of Criminality and Related Male-Typical Behavior, New York, NY: Nova Science Publishers.

94.

Saugy

Avois

Saudan

, et al..(2006) Cannabis and sport. British Journal of Sports Medicine 40: i13–i15.

95.

Scholten

(2018) Global commission on drug policies misses the mark. Drug Science, Policy and Law 4: 1–3.

96.

Schubart

Sommer

IEC

van Gastel

, et al..(2011) Cannabis with high cannabidiol content is associated with fewer psychotic experiences. Schizophrenia Research 130: 216–221.

97.

Sessa

(2015) Turn on and tune in to evidence based psychedelic research. The Lancet: Psychiatry 2(1): 10–12.

98.

Sessa

Sakal

O'Brien

, et al..(2019) First study of safety and tolerability of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in patients with alcohol use disorder: Preliminary data on the first four participants. BMJ Case Reports 12(7): e230109.

99.

Stevens

(2018) Medical cannabis in the UK: Patients should not be criminalised for seeking benefits. BMJ 363: 1–2.

100.

Stringer

Maggard

(2016) Reefer madness to marijuana legalization: Media exposure and American attitudes toward marijuana (1975–2012). Journal of Drug Issues 46: 428–445.

101.

Szmigin

Griffin

Mistral

, et al..(2008) Re-framing ‘binge drinking’ as calculated hedonism: Empirical evidence from the UK. International Journal of Drug Policy 19: 359–366.

102.

Tafur J (2017) The Fellowship of the River: A Medical Doctor's Exploration into Traditional Amazonian Plant Medicine. Phoenix, Arizona: Espiritu Books.

103.

Tamas

Kocsor

Gyuris

, et al..(2019) The young male syndrome—An analysis of sex, age, risk taking and mortality in patients with severe traumatic brain injuries. Frontiers in Neurology 10: 1–13.

104.

Thiessen

Walsh

Bird

, et al..(2018) Psychedelic use and intimate partner violence: The role of emotion regulation. Journal of Psychopharmacolgy 32(7): 749–755.

105.

Tinasti

Fordham

Taylor

DRB

(2017) WHO and UNDP change in leadership: What views on drug policy and harm reduction?. Drug Science, Policy and Law 3: 1–3.

106.

Uchida

Hara

Kobayashi

, et al..(2011) Epigenetic Status of Gdnf in the ventral striatum determines susceptibility and adaptation to daily stressful events. Neuron 69: 359–372.

107.

United Nations (1948) Universal declaration of human rights. Available at: www.un.org/en/universal-declaration-human-rights/ (accessed February 2017).

108.

United Nations Office on Drugs and Crime (2017) Market analysis of synthetic drugs. Available at: www.unodc.org/wdr2017/field/Booklet_4_ATSNPS.pdf (accessed August 2018).

109.

van Amsterdam

Nutt

Phillips

, et al..(2015) European rating of drug harms. Journal of Psychopharmacology 29: 655–660.

110.

van Amsterdam

Opperhuizen

Koeter

, et al..(2010) Ranking the harm of alcohol, tobacco and illicit drugs for the individual and the population. European Addiction Research 16: 202–207.

111.

van Ree

(1998) Drugs as a human right. International Journal of Drug Policy 10: 89–98.

112.

Wall

Pope

Freeman

, et al..(2019) Dissociable effects of cannabis with and without cannabidiol on the human brain's resting-state functional connectivity. Journal of Psychopharmacology 33(7): 822–830.

113.

Walsh

Hendricks

Smith

, et al..(2016) Hallucinogen use and intimate partner violence: Prospective evidence consistent with protective effects among men with histories of problematic substance use. Journal of Psychopharmacology 30(7): 601–607.

114.

Weaver

ICG

Cervoni

Champagne

, et al..(2004) Epigenetic programming by maternal behavior. Nature Neuroscience 7: 847–854.

115.

Werb

Kerr

Nosyk

, et al..(2013) The temporal relationship between drug supply indicators: An audit of international government surveillance systems. BMJ Open 3: 1–8.

116.

Winkelmann

(2017) The mechanisms of psychedelic visionary experiences: Hypotheses from evolutionary psychology. Frontiers in Neuroscience 11: 1–17.

117.

Parrott

Ringwalt

, et al..(2009) The variety of ecstasy/MDMA users: Results from the national epidemiological survey on alcohol and related conditions. American Journal on Addictions 18: 452–461.

118.

Wyn III

Stroman

Almgren

, et al..(2012) The pharmacist “toolbox” for smoking cessation: A review of methods, medicines, and novel means to help patients along the path of smoking reduction to smoking cessation. Journal of Pharmacy Practice 25: 591–599.

119.

Yaden

Nguyen

Kern

, et al..(2017) Of roots and fruits: A comparison of psychedelic and nonpsychedelic mystical experiences. Journal of Humanistic Psychology 57: 338–353.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.71 MB