Monday 1 November 2010

Agent Nutt Highlights The Ineptitude Of Just About Everyone

If you didn't notice the biggest 'science' story of today, you may want to check your pulse. That, or you should be in a state of wonder at how you manage to get internet access in such a remote location seeing as it was covered by all UK newspapers and media outlets (the BBC went particularly blanket on it), along with (random selection of thousands) the Chicago Tribune, The Sydney Herald, The Times of India, and the China Daily.

It is, of course, Professor Nutt's research which states categorically that alcohol is the most harmful drug known to man.

Considering the worldwide scrutiny (or lack of it) afforded to the revelations, it's worth pointing out the period of time taken for this research. After all, it must take months to forensically assess harms to society of 20 different drugs, yes?

Well, it would appear not, since Prof Nutt and his team just gave it one day in July.

Method: Members of the Independent Scientific Committee on Drugs (ISCD), including two invited specialists, met in a 1-day interactive workshop to score 20 drugs on 16 criteria: nine related to the harms that a drug produces in the individual and seven to the harms to others.
But then, how long does it really take to have a chat with one's colleagues on something with which you all agree?

The ISCD, you may remember, is the organisation set up by Nutt - and colleagues who resigned in sympathy - following his sacking for saying exactly the same thing this time last year. In fact, all this cosy little pow-wow did was reiterate Nutt's 2007 Lancet study, and re-issue the same message as when he was paid by the government in 2009, albeit with a few tweaks in the weighting of each harm to satisfy critics of his original method (one of which, you'll be interested to know, was ASH's Deborah Arnott. Didn't like tobacco being placed behind cocaine, no doubt).

Yep, that's all it was. An opinion voiced by Nutt and others who believe currently illegal drugs to be wrongly demonised in relation to alcohol. The full eight page report did little more than produce some pretty graphs of what they had discussed, along with an explanation of how they had treated the 'scores' they had attributed, amongst themselves, to each of the 20 substances. They particularly talked about the new way of weighting each on its importance.

The specific measure being ...

“How big is the difference in harm and how much do you care about that difference?”
Hmm. Just a guess here, but for those who think currently illegal drugs aren't comparatively dangerous to alcohol, the level of concern for the damage accruing to such substances would be pretty low, doncha think?

Now, I know you're thinking that this is no way to approach such an important subject. After all, I could sit around a table with a few friends and we could all agree that Jamie Oliver is more dangerous than typhoid, but Nutt and his friends have a perfect explanation for their methodology.

[...] data are not available for many of the criteria, so the expert group approach is the best we can provide.


The weighting process is necessarily based on judgment, so it is best done by a group of experts working to consensus.
In other words, there is no evidence to back all this up, so we're ... err ... creating it.

What's more, the ISCD was boosted by a couple of friends of theirs from Holland who dragged themselves away from a coffee shop long enough to endorse Nutt's findings.

In an editorial accompanying the Nutt team's report, Jan van Amsterdam of the Netherlands National Institute for Public Health and the Environment and Wim van den Brink of the Amsterdam Institute for Addiction research note that the legal penalties prescribed by various nations’ drug policies are out of synch with the actual harms caused by different drugs.
Which is only fair considering v Amsterdam and vd Brink were referenced in the study.

Our findings lend support to the conclusions of the earlier nine-criteria analysis undertaken by UK experts1 and the output of the Dutch addiction medicine expert group8.
The 8 refers to the Dutchies, the 1 refers to 'experts' who wrote a study in 2007 ... Nutt's one, to be precise. Yep, these findings, incredibly enough, 'lend support' to what Nutt has said previously.

I know! Stunning, isn't it?

Fortunately, Nutt is diligent enough to qualify his conclusions with a very important observation.

Limitations of this approach include the fact that we scored only harms. All drugs have some benefits to the user, at least initially, otherwise they would not be used, but this effect might attenuate over time with tolerance and withdrawal. Some drugs such as alcohol and tobacco have commercial benefits to society in terms of providing work and tax, which to some extent off set the harms and, although less easy to measure, is also true of production and dealing in illegal drugs.
Indeed, harm is usually the only side of the equation addressed by those involved in the public health business, so power to Nutt's elbow for even recognising the existence of benefits.

However, it didn't stop him spouting soundbites this morning of how "the public subsidise alcohol usage to the tune of £1,000 per taxpayer" (not verbatim) which is, of course, execrable nonsense, as Tim Worstall has pointed out before.

And how Nutt can talk about cost in such detail is a mystery since his report doesn't mention figures at all, merely theory. There's not a pound sign in the entire piece. It's a dog's breakfast, it really is. Yet it has flown around the world.

Despite the deficiencies of all this, however, it's not Nutt who fills me with exasperated rage tonight. I tend to agree with him, in fact. Yes, currently illegal drugs are being treated by legislators in a caricature fashion. Their harm is hugely exaggerated and there should be a much more sensible approach.

But what have we seen from the worldwide MSM in response? The blind, lazy shrieking that alcohol is EVEN more dangerous than the drugs the MSM currently raise to laughably demonised levels.

If any journalist, anywhere, has offered a calm considered view - and I'm pretty certain they didn't have to search for the full text like I did - instead of jerking their knee for a cheap headline, I haven't seen it.

Meanwhile, one usual suspect thinks Christmas has come early with a report he didn't even have to throw cash at.

[Don Shenker, the chief executive of Alcohol Concern, said:] "[The] government should now urgently ensure alcohol is made less affordable and invest in prevention and treatment services to deal with the rise in alcohol dependency that has occurred."
Thereby missing the point entirely.

One day, some sanity may well return to the lifestyle vs public health debate. Today certainly isn't that day.


Anonymous said...

Never see any of my mates who drink a few beers shoplifting or stealing.
Wonder why ?
I mean it's worse than heroin.

Junican said...

One thing that I realised only recently was that the word 'harm' in relation to alcohol statistics includes accidents resulting from 'alcohol abuse'. I found this out when I was looking at USA statistics regarding death from alcohol 'harm' (85 000 per an in the states and, oddly enough, 85 000 in Europe - has someone got their stats mixed up? Oh, and Patricia Hewitt said 85 000 deaths per an from smoking).
But I think also that Nutt is comparing TOTAL 'harms' rather than simply the relative level of 'harm'. I do not trust this study any more than I trust any other (and that includes global warming).
Let's put it this way.
Suppose that I overdose on alcohol every night for a week, and you, Dick, overdose on heroin every night for a week, who is most likely to peg out? (By the way, has anyone ever heard of a person overdosing on tobacco?)

Bill Sticker said...

Nutt by name.......

nutty said...

In Nutts world peanuts are more dangerous than cyanide capsules. Many folk have choked on peanuts or had allergy problems but not many people have died from taking a cyanide capsule because they're too hard to get access to.

TB said...

The original article, if you're interested!

Mark Wadsworth said...

Nutt is a free man and allowed to say what he likes. What's sickening is that the BBC in particular said that this means there should be a 'clamp down' on alcohol.

Anonymous said...

As an heavy smoking non drinker
I await with a great enthusism
the witch hunt and vindictive
vendetta on the yellow streaked
boozers. Yes you ,you who sat back,
tutted a little and did,nt give a
toss when the old,the disabled,the
lonely were made to huddle between
waste bins for a smoke.Just like
Judas you obeyed the Pharisees and
shit on your friends and family,now comes the day for your crown of thorns.
Before any frothy pip squeek chirps up in reply,give us the low down on
What did YOU do when your mates got stuffed
If something ...good on yer
If nothing......Shut it

Free for all...or none

Anonymous said...

Don't forget, Nutt has more than a passing 'health expert' interest in Alcohol Control.


Sam Duncan said...

That's pretty much my view on it, Dick. There's no doubt that the danger of illegal drugs is grossly exaggerated, in reputation by the media and in fact by their prohibition, but Nutt very clearly has some kind of prejudice against alcohol. Fair play to him for accepting there are benfits, though.

Anonymous said...

Look, before people start sniggering about this and criticising things, please remember this:

Y'see, Professor Nutt is a Professor. And so he's an authority. People like him Know What They're Talking About. And he's been perevude. He's been perevude in the Lancet, no less. And that's an authoritive journal.

Did I mention that he's a Professor? And an authority? And an author? And that he knows what he's talking about? Because that's the important thing.

It doesn't matter that he thought it all up one afternoon with his mates. The important thing is that he's a professor, and a Dr, and an authority who knows what he's talking about. All his mates are professors and drs too, and they know what they're talking about too. They know their onions. Oh yes. Why else do do you think this is such a big story, and the BBC is all over it?

Because he's a professor and a dr and an author and he knows what he's talking about and he's been perevude and published in the Lancet, that's why! How many times do I have to tell you, for crissakes.

richard said...

Prof. Nutt might have a point, despite his lack of proper science. I asked a policeman friend once (who was on the switchboard for a while due to a back injury; he had to send constables to investigate incidents in response to phonecalls from the public) how many of his calls last week were alcohol-related. "All except two, an old lady who had fallen, and a burglar. All the rest involved drink."
I like a drink myself, to put it mildly, but if it causes so much reported crime in fellows less affable than I, maybe there's a case for Nutt's assertions. Perhaps if Drunk and Disorderly resulted in an overnight stay in the cells, magistrate in the morning, and 14 days jail, then alcohol would magically cease to be as "harmful". .

Dick the Prick said...

Never having tried smack or crack is the same cure a bacon & egg butty with brown sauce washed down with copious amounts of tea? Perhaps the prof could enlighten us.

I accidently 'worked' (bollok juggled) for the National Treatment Agency for a bit and had the lovely experience of meeting some right proper junkies - gaddzooks. And I thought I was a wreckhead with me booze & pot; bleedin' amateur.

Oh, and the Jamie Oliver thing - hmm, well, yeah, he is kind of an arse but he's got this new show on Ch4 at 5.30pm and yesterday's was veggie lasagne & a fancy salad and it hit all the right boxes.

PJA said...

He does have a point, but the bit on 'aggressive' alcohol harm reduction is 1) only the last sentence. 2) specifically says harm, not alcohol itself. and 3) will be misconstrued by vested interests to be a reason for doing something more harmful than the original problem.

Incidentally, the ISCD website is generally a wonderfully sane piece of work, concentrating as I think all sensible people should n harm reduction rather than hysteria. I think he needs at least 2.79 cheers for it.

Dick Puddlecote said...

Lol @ Anon 11:59 :)

lenko said...

Watching Nutt interviewed by the Beeb yesterday, I couldn't help noticing that he had to squeeze himself onto the BBC sofa, owing to an excess of stomach. I wonder if the Prof has taken into account the fact that EATING TOO MUCH causes more harm than all the drugs and alcohol put together?

Note: I made this statistic up, but what the hell, so did he.

Anonymous said...

Further to what Richard said, 2 November 2010 12:07

Someone suggested the following (I don't, unfortunately remember who). (I may have some of the details wrong)

In well known misuse of drink problem areas:

Install a stripped-down goods transport container. Said container to be empty apart from heavy duty cages to sub-divide the area and a bucket in each.

Put troublesome drunks into individual cages as the evening progresses. Leave well alone until morning.

Remove hungover drunks.

Hose out the interior.

Remove container until next weekend.

I believe something like this has actually been proposed but was turned down because the conditions would breach the drunks' Human Rights!


Ian R Thorpe said...

Dick, I find that among those who believe 'science' and statistics are the same thing there is a woeful ignorance of how to interpret statistics.

So when all the seventy year old Ernie Spitmuscles turn up a their GPs with a grumpy liver after supping six pints a night for the past fifty years it can only be the alcohol to blame. And because alcohol users are commonplace and intravenous heroin users still relatively rare then that proves alcohol is the more dangerous drug.

That is an example of the wekll known scientific method of starting from an answer and working bacwards.

Junican said...

As Ian says, the stats are very unclear, especially when you are not permitted to see them.

I have just been on to the ONS (office of national stats) website in order to try to find the AGE RANGES of deaths which are supposed to have been caused by smoking, in particular, by lung cancer and heart disease. I have found pretty good figures for NUMBERS in 2009 (eg. heart disease = 42,455 males = 17% of all deaths in 2009 = 113 per 100,000 of the population). There are also good comparisons of these figures with 2006. Other causes are liver 'problems' and Alzheimers. But there are no stats for the associated AGE RANGES.
I have emailed the ONS with a query. I have done this before (very respectfully!) and they have responded quite quickly. I shall wait and see.

I think that the importance of these numbers cannot be over-estimated. If 99% of these 'diseases' occur in deaths over 75, for example, there really is no STRENGTH in the argument that passive smoking kills people. I am sure that you understand why I put the word 'strength' in capitals. But, we also have to accept that the age ranges might show that it is possible that smoking is an important factor, if there are significant numbers dying 'prematurely' from these conditions.

I think that it is worth the effort to discover the facts.
If the ONS put me off, I feel that I could justify a 'freedom of information' request. In this case, even though I have never done it before, I feel that I could probably phrase the request in a way in which it could not be denied.

We shall see.