Managing ‘Legal Highs’
Whilst significantly reforming the Misuse of Drugs Act, 1971 may be politically difficult under the current circumstances, there are a number of less radical approaches that a government open to reform could implement in order to help reduce the harms associated with new legal highs:-
The Class D Model
An option is the addition of a new class to the current Misuse of Drugs Act classification – the class D model – which has been adopted in New Zealand with some success.
Should a risk assessment of a new legal high determine that it is relatively harmless (aside from short-term behavioural risks associated with any form of intoxication) it could be placed in a Class D “holding” category. Within this category: sales are limited to over-18s; the product is quality-controlled and clearly labelled, so users know what they are purchasing, and doses are limited as far as possible to safe levels; and the product carries health-education messages. This procedure gives scientists and government the chance to limit sales and to collect data on use, while investigating the harms associated with a new substance. Manufacturers and shops that disobey these regulations can be punished, and users can be protected but not criminalised.
A Medicines Act
An alternative approach would involve a Medicines Act, which would require manufacturers to provide evidence of the safety of their products (Gee et al., 2007), removing from government the need to prove that a new substance is unsafe. Web sales and distribution could be banned, and availability restricted though licensing of vendors, the establishment of legal requirements of sale (as with alcohol and tobacco products), and restricted advertising. Accurate information about product composition, standardization, quality control, dose recommendations and contra-indications could be enforced under existing consumer protection legislation. New substances could also be taxed.
Education: A Rational Scale of Harm
A third legislative option is to focus on education. As Professor David Nutt has noted, drugs are rarely intrinsically harmful if used in a safe way. Many young people use the most popular legal high – alcohol – in a highly dangerous fashion. Most recent deaths from legal highs have occurred in the context of drinking. Alcohol can dissolve judgement of harms and encourage risky behaviours, including drug taking. Some drugs interact with alcohol to form more dangerous substances – for example, cocaine is converted to cocaethylene, which is more toxic to the heart.
Beckley Foundation seminars have repeatedly highlighted the confusing and inflexible nature of the current classification system for illegal drugs, which often bears little relationship to the real harms of the different classified substances.
Currently in the UK, controlled substances are segregated into three classes—A, B, and C—that are intended to indicate the dangers of each drug, class A being the most and class C the least harmful. The classification of a drug has several consequences, and in particular determines the legal penalties for importation, supply and possession, as well as the degree of police effort targeted at restricting its use. The current classification system has evolved in a haphazard way from somewhat arbitrary foundations, often with inadequate scientific basis. Critics argue that the classification of drugs in the UK has become more a political tool than the expression of evidence of harm, that a more systematic and scientific approach to drug classification is needed, and that evidence should be at the core of all messages, especially to young people.
In 2003 discussions with Professor Colin Blakemore at the Beckley Foundation seminar: an Interdisciplinary Perspective on Alcohol and Other Recreational Drugs, led to a collaboration which attempted to address the issues of the U.K classification system, which in 2007 created a Lancet article a Rational Scale to Assess the Harm of Drugs of Potential Misuse. The scale rates each substance based on the latest scientific knowledge about aspects of harm, broken down into 3 categories: physical harm, dependence and social harm. This scale gives the general public transparent and scientifically-validated data about the actual relative harms associated with the substance, whether, legal or illegal. The Scale of Harm highlights the lack of scientific evidence within the current UK drugs classification system.
Were the current classification system amended in accordance with the Scale of Harm, the general public would be provided with a rigorous and transparent system that can be easily updated as knowledge advances about the harms associated with both legal and illegal substances, so assisting the public to make informed decisions about its drug usage.