Jeff Stier in a review in
Reason notes "the sad story of psychopharmacologist David Nutt’s brief term as chairman of the British Advisory Council on the Misuse of Drugs".
Shortly after he was appointed to the position in May 2008, the Sun reported that Nutt thought Ecstasy and LSD should be removed from the legal category ostensibly reserved for the most dangerous drugs, kicking off a Fleet Street frenzy.
Instead of backing down, Nutt doubled down. In a satirical article published by the Journal of Psychopharmacology in January 2009, he analyzed “an addiction called ‘Equasy’ that kills ten people a year, causes brain damage and has been linked to the early onset of Parkinson’s disease.” Nut added that Equasy “releases endorphins, can create dependence and is responsible for over 100 road traffic accidents every year.”
Had Nutt not revealed that Equasy was simply the time-honored sport of horseback riding, activists certainly would have rushed to introduce a ban. Nutt pointed out that since Equasy causes acute harm to one out of 350 riders, it is far riskier than Ecstasy, for which the fraction is one out of 10,000. His point, of course, was that prohibition has less to do with risk than with the importance society attaches to a risky activity. As Snowdon puts it, “If the cultural baggage is put to one side, and activities are assessed on the basis of mortality rather than morality, there are glaring inconsistencies in the way laws deal with different hazards.” In October 2009, British Home Secretary Alan Johnson fired Nutt for failing to recognize that “his role is to advise rather than criticise.”
Nutt's 'Equasy − An overlooked addiction with implications for the current debate on drug harms' in 23(3)
Journal of Psychopharmacology (2009) 3-6 [
PDF] comments that -
arguments about relative drug harms are occurring in an arcane manner, at times taking a quasi-religious character reminiscent of medieval debates about angels and the heads of pins!
The reasons for this are multiple and complex, but one major element is that the drug debate takes place without reference to other causes of harm in society, which tends to give drugs a different, more worrying, status. In this article, I share experience of another harmful addiction I have called equasy to illustrate an approach that might lead to a more rational and broad-based assessment of relative drug harms.
The dangers of equasy were revealed to me as a result of a recent clinical referral of a woman in her early 30’s who had suffered permanent brain damage as a result of equasy-induced brain damage. She had undergone severe personality change that made her more irritable and impulsive, with anxiety and loss of the ability to experience pleasure. There was also a degree of hypofrontality and behavioural disinhibition that had lead to many bad decisions in relationships with poor choice of partners and an unwanted pregnancy. She is unable to work and is unlikely ever to do so again, so the social costs of her brain damage are also very high.
So what was her addiction – what is equasy? It is an addiction that produces the release of adrenaline and endorphins and which is used by many millions of people in the UK including children and young people. The harmful consequences are well established – about 10 people a year die of it and many more suffer permanent neurological damage as had my patient. It has been estimated that there is a serious adverse event every 350 exposures and these are unpredictable, though more likely in experienced users who take more risks with equasy. It is also associated with over 100 road traffic accidents per year – often with deaths. Equasy leads to gatherings of users that often are associated with these groups engaging in violent conduct. Dependence, as defined by the need to continue to use, has been accepted by the courts in divorce settlements. Based on these harms, it seems likely that the ACMD would recommend control under the MDAct perhaps as a class A drug given it appears more harmful than ecstasy
Nutt went on to state that -
Making riding illegal would completely prevent all these harms and would be, in practice, very easy to do – it is hard to use a horse in a clandestine manner or in the privacy of one’s own home! I suspect there would be little public or government support for such an option despite the banning of inter-species violence from equasy recently enacted in the Anti-Hunting bill. Indeed why should society want to control harmful sports at all? This attitude raises the critical question of why society tolerates –indeed encourages – certain forms of potentially harmful behaviour but not others, such as drug use. There are many risky activities such as base jumping, climbing, bungee jumping, hang-gliding, motorcycling which have harms and risks equal to or worse than many illicit drugs. Of course, some people engage in so called ‘extreme’ sports specifically because they are dangerous. Horse riding is not one of these and most of those who engage in it do it for simple pleasure rather than from thrill seeking, almost certainly in complete ignorance of the risks involved. Other similarly dangerous yet fun activities are rugby, quad-biking and boxing. With the exception of boxing, which is outlawed in some European countries, sports are not illegal despite their undoubted harms.
So why are harmful sporting activities allowed, whereas rela- tively less harmful drugs are not? I believe this reflects a societal approach which does not adequately balance the relative risks of drugs against their harms. It is also a failure to understand the motivations of, particularly younger people, who take drugs and their assessment of the perceived risks compared with other activities. The general public, especially the younger generation, are disillusioned with the lack of balanced political debate about drugs. This lack of rational debate can undermine the trust in government in relation to drug misuse and thereby undermining the government’s message in public information campaigns. The media in general seem to have an interest in scare stories about illicit drugs, though there are some exceptions ...
