The Nutt affair – or, the thin line between evidence and policy

This article first appeared on November 4th, 2009, on Liberal Democrat Voice. I've written on this excellent site a few times, you can read my previous contributions here.

Firstly, a disclaimer: I am a scientist, who is also interested in governance and politics, so the following post may come across as somewhat heated. Apologies, but I do feel that the recent furore over Prof. David Nutt’s sacking as Chair of the Advisory Council on the Misuse of Drugs (ACMD) goes right to the heart of why I took up both science and politics as profession and interest respectively.

We begin with Prof. Nutt’s most recent criticism of the government’s drugs policy, which attracted headlines for claiming that alcohol, despite being legal and freely available, was more harmful than the Class A narcotic ecstasy (MDMA). At first sight this may seem like an outlandish statement to make, but the evidence, collated by Prof. Nutt, suggests otherwise; granted, the recent publication from Nutt’s The Centre for Crime and Justice Studies (CCJS) at King’s College London wasn’t peer-reviewed, but the methodologies used to calculate his ‘harm index’ were so, and published in one of the most respected medical journals, The Lancet in 2007 (the full article is behind a paywall, contact me if you want the pdf...). Just to repeat this – using what seems to me to be a robust method, taking into account everything from physical harm to the user to social harms at large, ecstasy does indeed seem to be less dangerous than alcohol, and it’s using this tried and tested method of enquiry that Nutt used to conclude that cannabis should remain a class C drug.

I thought it worthwhile to go into the details of how Nutt came to his conclusions because this process – of evaluating evidence and coming to a conclusion based on objective data where possible – is familiar to me as a scientist, indeed it’s the bedrock of the profession. Often, evidence on emotive issues such as drug use can be counter-intuitive, strikingly odd, perverse even. But that’s the point – evidence trumps pre-suppositions, guesses, intuition, anecdotes, the lot. And here’s the choice policy-makers are faced with – claim that your policy is evidence-based, in which case you take the evidence as presented and fit your policy around it, or base your policy on any number of considerations other than evidence, from morals to popularity.

Fair enough – unless you want it both ways, which appears to be the current government’s position. On a host of policy issues, from military to medical, high profile government advisers are appointed, meetings are arranged, reports are published and... well, not much else really happens, as the policy which emerges from this process, given the veneer of respectability, authenticity and objectiveness by the independent advisers, all too often flies in the face of the very advice they offer. Which brings us back to Prof. Nutt. He had the temerity to reinforce his stance (a stance based, lest we forget, on objective evidence) on both the classification of cannabis and the harm caused by alcohol and tobacco – and was dismissed (or ‘asked to leave’) by Home Secretary Alan Johnson. His predecessor, Jacqui Smith, had already clashed with Nutt earlier in the year over the ecstasy non-reclassification, and this latest (perceived) foray into politics provoked his removal as the head of the government’s drugs advisory council. Johnson’s justification for sacking Nutt was that the latter had” "crossed the line between offering advice and then campaigning against the government on political decisions".

Nutt is understandably aggrieved – in an interview with the journal Nature (hat tip - Gimpy) he expresses his disappointment at how he came to be sacked, and at how the government has overtly ignored advice the ACMD has provided. But the repercussions of his sacking may well stretch beyond even the ‘mass resignations’ of the rest of the ACMD reported to be planned – two have already quit in anger – into so many fields of policy-making.

Having a respected scientist, military man, economist or some such expert report on the evidence in a given field could, could, add much-needed legitimacy, ‘stardust’ even, to government policy – provided said expert is not hounded out and banished for daring to publish inconvenient truths deemed to be politically uncomfortable. Indeed, given Jacqui Smith’s maxim, enunciated on last week’s Question Time (‘advisers advise, Ministers decide’), it’s all the more vital that good advice based on solid evidence is provided to them so that Ministers can in fact make the right decisions. For if we are to ensure that policy decisions are not made on emotive hunches, on opinion polls in newspapers or on some other arbitrary reasoning, but rather is based on evidence of what works, we need the best advice to be heeded and acted upon – and at this rate no self-respecting expert will ever volunteer to be a government adviser again, for fear of being silenced for publishing what is ostensibly the truth.

In sacking Nutt, Johnson said

"What you cannot have is a chief adviser at the same time stepping into the political field and campaigning against government decisions. You can do one or the other. You can't do both."

With respect Mr. Johnson, what you cannot have is a government claiming that its policy is based on evidence, then sacking its advisers for not agreeing with policies which defy said evidence. You can have one or the other, you can’t have both.

Edited to add: Since I put this post together, some rather good blog posts on this issue have apppeared from bloggers somewhat quicker off the mark than I am - check these out at Apathy Sketchpad and The Lay Scientist.