MR VERNON COAKER, PROFESSOR SIR MICHAEL RAWLINS AND PROFESSOR DAVID NUTT

22 NOVEMBER 2006

  Q100  Chairman: So having a drug in the wrong classification is all right?

  Mr Coaker: If the ACMD looked at it and we received advice from them then obviously we would make a judgment. All I am saying is that at the current time—

  Q101  Chairman: Professor Nutt was just saying that he would like to see a five-year examination of the existing drugs classification, a systematic review in order to make sure that there is public confidence within the classification system. You are rejecting that?

  Mr Coaker: I thought you were asking particularly about magic mushrooms.

  Q102  Chairman: I am using that as an example.

  Mr Coaker: I am sorry, I misunderstood your question. It is always open to the ACMD, they do not have to wait for us to ask. The ACMD if they wish to do so can look at drugs and make recommendations to us and then we make judgments accordingly. All I am saying is that if the ACMD came forward with a recommendation we would obviously look at that. Whether we would accept it or reject it would be a matter of judgment that we made on the basis of the evidence we received and from other evidence as well.

  Professor Sir Michael Rawlins: I do not think Professor Nutt really wants to look at everything every five years. There is no point in looking at crack cocaine and heroin and things like that every five years. You have to be selective in some ways.

  Q103  Dr Harris: Professor Nutt pointed out that there is very little evidence of social harm that justifies putting the pharmacological agents of fresh magic mushrooms in Class A and indeed that there is some evidence of a perverse effect in so doing. If the ACMD were asked for its opinion by the Government before fresh mushrooms were added to Class A. I wonder therefore whether it was not unreasonable for someone to suggest that the ACMD might have looked at this and suggested that it was perhaps not the right category to put either the fresh variety or the unfresh variety in Class A, for the reasons that Dr Iddon and Professor Nutt have set out. That is not an outrageous suggestion, is it, Professor Rawlins?

  Professor Sir Michael Rawlins: I think I probably misunderstood your report. It seemed to me that the criticism was that we had not done a special study of the fresh mushrooms rather than dried mushrooms.

  Q104  Dr Harris: Who prepared your response?

  Professor Sir Michael Rawlins: I did.

  Dr Harris: You did? Could you clarify—

  Chairman: Were you pretty angry at the time?

  Professor Sir Michael Rawlins: Yes.

  Q105  Dr Harris: Angry is not the word; paranoid maybe—and we will come on to that.

  Professor Sir Michael Rawlins: One of us should stop taking the pills!

  Q106  Dr Harris: Did you point out given our discussion and now that the light has dawned on you about what our report actually says, will you confirm or retract the assertion in your own work that the Committee (presumably Dr Iddon and myself as the two who questioned you on this) displayed "considerable ignorance about the basic principles of pharmacology" underlying the questions that we have just had. I think that would also apply to Professor Nutt then since he agreed with Dr Iddon.

  Professor Sir Michael Rawlins: I accept that but perhaps the Committee's report could have been written in a way that a pharmacologist could understand. It seemed to me that you were criticising the fresh magic mushroom decision without, allegedly, having evidence of fresh magic mushrooms causing harm. What I was saying was that psilocybin and psilocin—

  Chairman: We will take that as an apology. Brooks?

  Q107  Mr Newmark: On the subject of ecstasy, the ACMD has said that it will assess the evidence on ecstasy to establish if there is enough to undertake a review. Given that in March you, Sir Michael, said that there was not sufficient evidence for a review, how likely is it that the ACMD will undertake a review now?

  Professor Sir Michael Rawlins: We will undertake a review. You have asked us to undertake a review and we will undertake a review. What we will be looking for is not just the question of classification but two other aspects. Firstly, we will be looking to see whether better methods of harm reduction can be used, because that is an important part of our role, and also what other research questions arise from it.

  Q108  Mr Newmark: If there is not enough evidence relating to ecstasy, who should be responsible for plugging the gap in the evidence base?

  Professor Sir Michael Rawlins: It rather depends on the nature of the gap. If it is neuropharmocological or clinical then we would look to the Research Committees or the NHS R&D programme. If it was more sociological then we might look to the NERC or to the Home Office.

  Q109  Mr Newmark: If the ACMD discovered new evidence when it undertook the review, would you consider reclassifying ecstasy?

  Mr Coaker: We would consider their evidence. As I say, we have no plans to reclassify ecstasy. The ACMD is independent of government, we obviously respect what they say, and they will bring their report forward, but the Government has no plans and no intention of reclassifying ecstasy.

  Q110  Dr Harris: You say that you do not propose to move ecstasy and it will remain a Class A drug. Is that an evidence-based policy?

  Mr Coaker: That is a judgment the Government makes on the basis of what we believe to be something that is in the interests of the public at large to keep ecstasy as a Class A drug.

  Q111  Dr Harris: Is it an evidence-based view?

  Mr Coaker: It is a judgment that we make based on all the evidence we have had no recommendation from anybody to reclassify ecstasy from an A to a B. We think it is a drug which is harmful. There is no safe dose of it. We were talking about alcohol earlier on and one of the problems you have with alcohol is there probably is a safe dose. Like many here, I have a drink now and again, but there is no safe dose of ecstasy, we think it would send out totally the wrong messages and, as I say, we have no intention of reclassifying ecstasy.

  Q112  Mr Newmark: Because it kills unpredictably?

  Mr Coaker: As I say, there is no safe dose. This is the point, just half a minute—

  Q113  Dr Harris: There is no safe dose of tobacco.

  Mr Coaker: It just does make the point very well, the exchange that we have just had between two members of the Committee, quite rightly, about the difficulties that there are in this area and the different views and opinions that people have. I think what we all wrestle with is using evidence and using science and also trying to think about it from a non-scientific point of view in the social judgments and the individual judgments and the community judgments that we make. We wrestle with that and, as I say, as a Government we have no intention of doing anything with respect to ecstasy because we do not believe there is a safe dose, it is harmful, it kills unpredictably, as Brooks has said, and we just think that it is a very important way to use the classification system.

  Q114  Dr Harris: If the ACMD reviewed the evidence and that review made recommendations to you, are you saying now it is not worth them doing it because your decision on this will not be evidence based, it will just be a reassertion of your "no intention to reclassify ecstasy"? Even if they said there will be fewer deaths, for whatever reason, if it is reclassified, are you saying that you will never consider an evidence-based decision on this drug?

  Mr Coaker: I am not saying that at all. What I am saying is the ACMD, of course, can conduct research and look at whatever they wish to with respect to drugs and make recommendations to the Government. What I am saying quite clearly is that we have no intention of reclassifying ecstasy.

  Q115  Dr Harris: I am keen to pursue this one. I understand you have no intention and I assume that is current because I do not think you could bind your successors if the evidence changed. Is it your view that all drugs for which there is no safe dose should be in Class A or is there something special about ecstasy which means it is one of the drugs for which you say there is no safe dose which means it must be in A?

  Mr Coaker: In talking about ecstasy, it kills unpredictably, we do not believe that there is a safe dose; we will not reclassify ecstasy.

  Q116  Dr Harris: Does that apply to all drugs that meet those criteria?

  Mr Coaker: What we try to do where we have evidence and where people come to us with recommendations is make individual judgments, as we will do whenever people come to us. All I am saying with respect to ecstasy is that we have no plans and no intention of doing so.

  Q117  Dr Harris: So do you think you are wasting your time, Professor Rawlins, if you end up doing a review in this area?

  Professor Sir Michael Rawlins: No, I think we will give advice on whatever we feel is appropriate but perhaps in a way more importantly we will also be able to, I hope, give better advice on harm reduction, which is actually rather important, and on what further research is needed in order to understand the dangers of it.

  Q118  Dr Harris: Will the fact that the Minister has said quite categorically that he is not going to change the classification have any bearing on whether you follow through and do a report?

  Professor Sir Michael Rawlins: None at all because we are going to do it.

  Q119  Dr Iddon: Can you tell us, Professor Rawlins, the current situation on cannabis? We understand that your Committee is reviewing cannabis use yet again. That is the first question. The second question is would you agree with me that there are difficulties with cannabis in that it comes in various varieties and we do not tend to differentiate when we are talking about cannabis between the different varieties. As much as 70% of the material sold in Britain, I understand, is grown in Britain and is skunk, which has a particularly high content of tetrahydrocannabinol. Do you feel, as I do, that we should get the message across that it really depends on which cannabis the person is using?

  Professor Sir Michael Rawlins: We produced a report relatively recently earlier this year on cannabis and we have no intention of revising it as of today, but of course if new evidence emerged we would. The point you make about the tetrahydrocannabinol (THC) content is very well made. There are two points really. One is that some forms, particularly with the flowering heads, have much higher levels of THC in them than the leaves and the stalks. Secondly, the surveys which have been done have shown extraordinarily wide variations even between the seeds and the heads. We made this very clear in our report that just because you once smoked some pot and you had not come to any harm, that does not mean to say that you will not come to any harm next time because the last lot may well have had almost nothing in it. The real difficulty we have, which we also made clear in our report, is that the material that everything is based on is seizures by the police where they are going to prosecute. What we really need is the material that is, frankly, bought the normal way and you should look at that, and we recommended to the Home Office that research in that area should be done to find what is actually being used, not what the police seize and are going to prosecute on.

  Mr Coaker: What we have done, Brian, just to reassure you about the enforcement of the law and tackling this as a problem, there was a recent operation by the police on cannabis farms, Operation Keymer, which was very successful according to the police. We have also reinforced in the drug education pack which looks at cannabis which we send to schools (which I think is an important message to send out from this Committee) the fact that cannabis remains an illegal drug and is an illegal drug. Alongside that, we have also just launched a few weeks ago an advertising campaign through TV and cinemas and so on particularly related to cannabis and mental health risks, which we called Brainstorm.