Within Reason - #84 David Nutt - The Truth About Drugs

Episode Date: September 22, 2024

David Nutt is an English neuropsychopharmacologist specialising in the research of drugs that affect the brain and conditions such as addiction, anxiety, and sleep. He was the UK Government's chief advisor on drug policy. He was fired in 2009 after criticising the Government's approach to drug harms. Learn more about your ad choices. Visit megaphone.fm/adchoices

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Conditions apply. David Nutt, welcome to the show. It's a pleasure to be here. Thank you. As regular viewers of this show will know, I am just obsessed with the topic of drugs. And I'm really excited to speak with you today as someone who I've been trying to get on the show for a long time to give a sort of alternate view of drugs than was given by the previous guests who I had on my show talking about drugs, a certain Mr. Hitchens from the mail on Sunday. So hopefully this will offer something. an antidote to that particular episode. But for those who aren't aware of you, Professor Nutt, you were the government's chief drug advisor. You were the UK government's chief drug advisor,

but you got fired. Can you tell us why? Well, the short answer is for pointing out that government policy wasn't evidence-based. That was not a insight the government were prepared to take on board, particularly not with the 2010 election on its way. Sure. Now, some of the headlines said, Professor Nutt fired for saying that taking ecstasy is safer than riding a horse. Is that true?

It certainly is, yes. Particularly if you, when you're riding your horse, you're jumping over things. Eventing is considerably more dangerous than taking ecstasy. if you look at the harms per hour engaged in the activity, definitely would be banning, eventing, and allowing legal consumption of ecstasy

if you had a rational policy. What kind of irrationality are you talking about here when you say that the government policy on drugs is not evidence-based? What specifically are we talking about? Well, we're talking about the fact that the most harmful drug in Britain is alcohol, which is not even considered a drug. In fact, it was only after my sacking that the government conceded that alcohol was a drug and therefore should be assessed using similar criteria to the way we assess of the drug. So the reality is that we apply

different regulatory regimes to different drugs, not based on harm. Not even based on value, but based on politics. And that's really what I was saying. And it's dangerous to say things like that to politicians because that's kind of undermining their sort of myth that they like to create, that they're actually doing things properly. But behind the scenes, you know that they're not. Behind the scenes, it's always a combination of self-aggrandizement

and staying in power and taking backhand us from the industry, etc. How do you work out how harmful a drug is to say something like alcohol is the most harmful drug in Britain? Yeah, well, that's one of the major contributions that I think I've made to the drugs debate globally, in fact. Because when I was invited to be the chair of the Scientific Committee of the Advisory Council on the Missions for Drugs in 2000, I sat in on a couple of their meetings, and I was horrified. that there was no structured assessment of drug harms. Decisions were being made completely at the whim of individuals. I remember a horrified.

I mean, a professor in a medical specialty, I won't specify, which said, I'll never support downgrading ecstasy from Class A. And I said, well, why not? Because it's dangerous. How dangerous? I'll never do you know it was so I said to the government I said look the home office I said I've come on I'll chair the committee which I did pretty effectively for nine years because that's when they promoted me to be the czar if you allow me to develop a scheme I've been working on for the previous 10 years or so which is a way of properly characterising the multiple different harms of drugs and the and comparing them and they said sure and actually during the that first half of the 2000s, and Blunkett was Home Secretary. He was very keen on it. He actually, we used this

methodology to come to the conclusion that cannabis should be downgraded to see. Eventually in 2007, we published a paper in the Lancet, which was the first attempt at a proper nine-point scale of harm. And as a result of that paper, I was approached by a man called Larry Phillips from the London School of Economics, who's a world expert on decision theory. And he said, David, that's quite a nice paper you've written in the Lancet, but you could do better. You could use a technique called MCDA, multi-critory decision analysis, which I'd never heard of.

But I met with him, and I also met the MRC, we're interested. So we met with the head of the MRC, Colin Blakemore at the time. And the MRC and the Home Office funded a study to essentially answer the question you asked. how do you assess the harms of drugs? And the way you do that is to look at all the harms of drugs and then come up with definitions of them and then scale them, compare them. It turns out, and it's quite a big challenge,

it took almost a weekend to work out what the harms of drugs were and how you can define them. When you do it very systematically, there are 16 different ways in which drugs can harm you. There are nine harms to the, user and they range from dying every time you take the drug or the risk of death to things like dependence and withdraw, etc. And there are seven harms to society. And the really sophisticated innovation of MCDA is that you can scale all these different harms because

they obviously are very different metrics. Death is a very different metric to community disruption from, say, intoxication to deforestation in the air. Amazon as a result of trying to stop cocaine production. There are many, many different harms, but you can scale them all and compare them all using a ratio scale, ratios of the worst to the least. And that's what we did, and we had another conference. It went through 20 drugs, scaled them all, weighted them all. And the paper was published again in the Lancet in 2010, and it showed slightly to my

surprise, but it was clearly a reliable outcome because it's now been replicated by experts in Europe, in Australia and recently New Zealand, that alcohol is the most harmful drug overall. And that is because of its wide use. It's not the most harmful drug to the user, the drugs like crystal meth, crack cocaine, heroin, fentanyls. They're more harmful to the user. But because alcohol is wider use, but because alcohol is widely used, It's the most harmful drug in the UK. And all I was saying was, look, come on, guys, if you worry about drug harms,

then do something about the most harmful one, which is alcohol, which interestingly, every government from Blair onwards has said they were going to do something about it. Well, they never have. And I carried out, I just beat that drum. I said it was wrong, it was unethical, and not to deal with it.

And they said, well, farewell, resign. And I said, no. And they said, well, you're sacked. So I was. Yeah, there's a lot of talk about doing something about alcohol. It's a common comparison to make, especially in the discussion around the decriminalization of marijuana. I think a lot of people just think, well, it'd be great if we could criminalize alcohol, given that it's so harmful, but it's just so embedded into society that we can't. They think of prohibition, for example, and how disastrously that failed.

But there are other things we could potentially do to reduce alcohol harms involving government intervention that aren't just sort of straight out ban, right? Well, yeah, absolutely. There are loads of ways we can induce the harms of alcohol. But before I get onto those, can I just emphasize the point you made? There's this total paradox that everyone says, even the most anti-drug politicians, they all say, alcohol prohibition was a disaster. To which I say, well, hang on.

Why do you think other drug prohibitions aren't the same? Yeah, and specifically, why was it a disaster? Like, what went wrong in prohibition that caused a complete 180? Well, it's because, you know, of the inevitable rise of criminal gangs taking over the market of alcohol, people aren't going to stop drinking, they're going to start developing speakeas and there's going to be corruption. Okay. I mean, if that's a good enough reason to do away with the prohibition policy, Hello?

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I mean, alcohol prohibition was a fascinating experiment. It was also occurring in other countries. It's occurred in Sweden and Finland and Norway as well. It was driven by the time. And nearly in England. That's right. There was this amazing, most people don't know this. You may or may not, but it's worth sharing with your audience.

I think in the 1923 general election in Dundee, there was a certain Winston Churchill standing, I think possibly for the Liberals then. And he was just absolutely wiped out by the Temperance Party. I think the Temperance Party had about 13,000 more seats in him. So there was enormous pressure to get abstinence to alcohol prohibition in the UK. Well, who were the Temperance Party? Well, they were the people that wanted alcohol prohibition. I mean, this is a movement which really started in the 186s, 1870s.

It was driven most interesting. It was very, very much driven by women who were seeing their men, spending all their weekly earnings on booze at the weekends and argued that we should stop having bars so that people couldn't waste their money on booze. And it got close to having some kind of power in Britain. And obviously it worked in the States. But what people didn't realize or didn't predict, I think, was that alcohol is, it's very much part of society.

And people went to great lengths to carry on drinking. And you mentioned speakeasy. I mean, what's a speakeasy? Well, a speakeasy is an underground bar. And how do you keep an underground bar functioning when it's illegal? Well, you have a policeman standing outside who's paid off. And in fact, alcohol published in the States has effectively corrupted every American policeman. And that's why they had to create their untouchables to fight the mafia who were providing the booze to the speakeas.

And, of course, they weren't successful, although they became quite famous. The problem with them was that there was a lot of them. By the time alcohol prohibition was repealed in 1933, there were 35,000 of them, and they were all facing redundancy. And so their boss, Harry Anslinger, decided to come up with a new problem, which wasn't alcohol, was cannabis. And then the whole attack on cannabis, which basically has perpetuated right to the beginnings of this century in this day. States as a sorry, the first real war on drug started because the drug enforcement agency, the anti, the untouchables twitched them cannabis and then they moved on to heroin and moved on to cocaine, etc. It's got a job creation for anti-drug policemen. So the prohibition

era sees the police become entirely corrupt because everybody's still drinking, everybody's paying off the police. So the US government set up a brand new agency of super strict enforcers of their new drug policy, which eventually becomes what we know today as the drug enforcement agency, the DEA. Correct. And when prohibition is repealed, this DEA don't really have anything to do anymore because the sort of alcohol that they are focusing on keeping out of people's hands is now just perfectly legal. And so the leader of whatever it was. called then, now the DEA, decides to create this new boogeyman and does so with cannabis. And in fact, if I'm not mistaken, I suppose we're in the realm of hypothesis here, but this

renaming of cannabis to its other popular name of marijuana is done to make it sound more Mexican so that it can be attached to Mexican immigrants and therefore demonized and therefore tied up in issues of immigration and xenophobia in order, what it seems to be you're implying here, in order to keep the DEA in a job? Exactly. Absolutely. Yep. It's an extraordinary story.

It's an extraordinary. It gets worse. It gets worse when you come to the 70s and 80s when the CIA are pumping cocaine into into downtown American cities and heroin as well getting large fractions of the black

in population addicted and then the feds fighting a war against them I mean the whole thing is actually it's a nightmare it's a collection of well I mean it's actually I was going to say errors

but I think it's not errors it's a collection of deliberate deliberate misinformation deliberate denial of the evidence in order for what it's in the end all drug laws are essentially built for political gain and that's that's how it's they've been rolled out for the last hundred years but why why I mean I understand this historical picture of you know the DEA that we've just spoken about but but today when and we'll talk

about some criticism soon I want to I want to put some of these ideas that that I've talked about on the podcast before to you, but if it is true what you're saying, that drug laws are not based in evidence, that they are causing more harm. Why? Like, why? Why is the government not listening? I mean, typically the government is famous for not listening to the experts, et cetera, but it just seems so straightforward on this issue. What is their interest in keeping drugs illegal? Yeah, well, that's an extremely good question, and it's actually quite a complicated answer. So you've got a series of different lobby groups.

And you've also got, perhaps this is the most important one, you've got the fact that drug users are usually young and don't vote. So their voice doesn't really carry anywhere. So punishing young people of using drugs doesn't have any political repercussions, really. But it does have a great political advantage because elderly, people who don't use drugs like to see young people punished. You know, it's part of the sort of the great British tradition of hurting others. You know, it's sort of kind of national sadism. So attacking drug users is a very good way of getting votes from middle class, middle age, elderly people. So

so that the politics has always been, you know, quite central to that. But then on the other side, you've got powerful lobby groups. I mean, one thing that happened when alcohol prohibition was repealed in the States was it in all countries, the alcohol industry decided it was going to make sure it never faced that threat again. And the best way of avoiding focus on its harm was to get everyone focusing on the harms of other drugs. And that was the point I was making. That's why I was sacked. People do not want to confront the harms of alcohol. Even though we now know, it's an amazing statistic. It is the leading cause of death in men and women under the age of 50 in this country.

But we don't want to confront that because so many of us drink. Politicians in particular drink enormously. I mean, it's weird. The decision-making on alcohol policy can be made by people who are drunk. In fact, the drinking in Parliament is notorious. They have five subsidized bars. You know, there are politicians who have been so drunk. They could not get through the House to vote.

And yet, you know, you're asking them to change the law or the regulations on alcohol. Come on. I mean, then there's another side. There's another really powerful lobby group, and that's the pharmaceutical industry. We've seen since about the 1850s is we seem a morphing of medicines from natural products. You know, like, for instance, the opium poppy, like for instance, the bark of the willow with making this. aspirin-like pain killer, those have morphed into modern pharmaceuticals where the active ingredient has been extracted, has been modified very slightly to get a patent, and then has been sold

at enormous profits to make the biggest pharmaceutical companies in the world. And those companies don't want natural products, they don't want people using things that they're not selling. So they've actually tried to, they've pushed the market away from natural products into synthetics. And then it's come at another interesting cost. It's come at a cost of actually more potent drugs

because synthetics are usually more potent than natural products and then more harms from those two. So the rise of fentanyl now, you know, in the States with, what is it, 100,000 deaths last year for Ventim is a classic example of, a pharmaceutical development that has actually been distorted the market

so that now almost all the heroin or the opiate market is fentanyl rather than heroin, which itself is not safe but it's definitely a lot safe for the fentanyl and was it, why do we have heroin? Well, because in around about 1910

there was a pressure to stop people smoking opium because that was seen as competition for the companies that have made pure extract of morphine and heroin. So we went from people smoking a bit of opium to people injecting morphine and heroin and then all the consequence addiction and all the other viral infections which come from that. So the pharma industry has played quite a big role in distorting the market and also trying to demonise drugs, but at the same time providing ones which can be used by the people

they demonize. It's so often the case that attempts to reduce drug use to combat drug harms through legislation have the exact opposite effect. It's this strange counterintuitive series of causation. A perfect example of this, I think, is the UN in the 1990s banning saffrol, or how have you pronounce it. Can you tell us about that? Yeah, I mean, it's hard to come up with an example where policy has,

actually not made things worse, which is why it is useful to look at some of the worst examples. So, yeah, so the Saffrol story is truly horrific. So Saffrole is a, an oil that comes from the Sassafras plant. And Saffrol is one of the precursors of MDMA ecstasy. MDMA was made illegal in various countries in the 70s, 80s and 90s, globally in the 90s. But that didn't stop use. So the United Nations got very upset. Well, we've banned this drug and yet young people are still using it. We've got to stop them using it for no good reason.

I mean, the panning of ecstasy was one of the worst successes because it actually, as I'm going to talk about in a second, made things worse. But on top of that, it was not, it truly, that truly was a political decision. driven by the drinks industry, not wanting competition from an alternative drug, which people actually found more pleasant and more socializing than alcohol. So the UN decided to ban the precursor saffrol. That'll stop and making MDMA, won't it? Well, it didn't until, I think it was, when was it, what is it, about 2006 or so, there was a massive seizure, like 50 tons of saffrol in Thailand, and half the world supply, they

poured down the drain and celebrate it. Where you have broken the back of the MDMA market. Now they won't be able to get any MDMA. Don't forget in a minute to ask me about heroin and the same story with fentanyl. But the MDMA story is there first. So what happens? Well, what happens is this is basically the underground chemists in China, they're confronted with it.

They have an order of, you know, five kilos of MDMA for Rotterdam by next month. they can't get saffrol, what do they do? Well, they turn to anathol. Anathol is another one of these organic solvents that is using everything, you know, perfume, soaps, food. It's central to manufacturing. So they just put anathol into their saffrol process.

But surprise, surprise, it doesn't make MDMA. It makes something called PMM. Phenotomythal amphetamine. And it turns out that that's actually way more toxic than MDMA. But it was sold as MDMA, and it started killing people because it actually, it's got much slower uptake. So people were taking a tab thinking, oh, this is rubbish. I haven't come up in half an hour.

I'll take another one. And then by the time it does get into their brain, it's actually essentially you've overdosed, and you're also blocking some of the enzymes which break it down. So you have this toxic reaction. and you die. And so we had probably hundreds of deaths in Britain from PMA or a related one PMMA as a result of this attempt to stop people using ecstasy.

So it created more deaths than it saved. And then the underground chemist went, well, they realized this wasn't so good. So they started working at other ways of making an MDMA. And they came up with another precursor, which they then made. and they started making it, it became much cheaper than Saffro because Saffro is a natural product. You had to extract it from forests. So now we've got a vast surfeit of the precursor,

so MDMA prices have gone right down, and that's why tablet sizes have gone right up. So it's just in every level it's been a disaster. Now, there was one country, at least, the Netherlands, which did not experience when this happened, and PMA was being used. instead of MDMA and sold as NBMA, killing people in our country. The Netherlands did not have any PMA-related deaths.

Why is that? Well, the Netherlands listens to its scientists. It's a rather special country and kind of almost unique in the world, in that it has science-based policies around, certainly around drugs, goes back to the decision to try to. to get cannabis out of the hard drug market, get cannabis away from dealers of heroin and crack and setting up the cannabis coffee shops. And the reason they didn't have death from PMA was because about, wow, it must be 20 years, 25 years ago now. They set up a testing system called the DIM system,

and basically they facilitated a whole series of university hospitals around the country to do drug testing. People could take their drugs to the hospital and have it tested. And when they discovered that PMA was being sold as ecstasy, they told people, this is, people will, this is not ecstasy, this is PMA, it's much risk here, don't take it. And if you do take it, they think a lot less. So they essentially warned their population and so no one died. But not only that, I learned from, I learned from your book that the Netherlands upon learning this also decided to warn the UK government that this was happening. But the UK, but the UK government refused to warn UK citizens for fear that it would be seen as encouraging drug use.

Well, that's right. I mean, we are a very odd country, aren't we? You know, we think that people dying from using drugs is a deterrent from people taking drugs. And you kind of think, well, if that were true, we'd have less people taking drugs and we'd have less people dying. But, you know, year on year, we've got people more and more people dying because of opiates. And the reality is that people who use drugs are often using in states of extreme tension with extreme urgency, often in states of often very profound withdrawal. And the reality, in a way, the risk of death is something they've already confronted many times, particularly youth opiates.

So it's not a deterrent. It almost never has been a deterrent. But we pretend it is. The way that you put it in a, and I should mention the book's title, Drugs Without the Hot Air, I'll leave a link in the description. A wonderful, wonderful book, just super eye-opening. And one of the sentences that jumped out at me was when you said, it's not at all clear that governments are especially influential on whether or not someone tries a drug, whereas government policies can be very influential on whether or not an individual is harmed. buy a drug. Exactly.

Exactly. And that's what we should be doing. The Dutch policy is kids will use drugs. In fact, if drugs don't harm them, why does it matter? If you say that to a British politician, they will mostly will say, because it's a bad thing. We don't, it's, there's a sort of, in Britain, we have, there's a, there's an almost a moral opposition to people using drugs other than alcohol. It is weird. To be quite honest with you, I don't fully understand why we have it, because we certainly know we've got plenty of politicians

who use drugs, and yet they still condemn drug users and they still pretend that this prohibitionist policy works. I mean, but it probably reflects the fact we have also a pretty, unimpressive political system where people generally lie all the time. So, you know, lying about drugs is just part of the way they do business. Whereas, I mean, if you've ever been to parliaments in other countries, it is quite fascinating. Most European parliaments don't. They're not like the chaotic scenes of schoolboy shouting that our parliament is. They're much more measured. People actually listen. What's a fantastic concept. You know, listen to what, an argument made by a politician.

I mean, rather than just shout them down is this country. Well, perhaps we can talk about some of those moral considerations in a second, but first you said you wanted to tell a story about heroin and it's attempted harm reduction. Why do we have a fentanyl crisis in America? The answer is, in part, because of the attempt to stop the use of heroin. I mean, the American opiate crisis is truly, it's one of the most spectacular examples of doing things so wrong.

So, so wrong. Why do we have an opiate crisis at all in America? Well, it's partly, everyone knows it's due to the fact that a lot of Americans were using painkillers, a whole range of painkillers, but the one that's come to prominence is oxycontin, oxycodium. And they were using those because there was very little control on the prescribing of them. And particularly because American health is devolved to states, individual states, crossing the state line to get more pills was actually very easy. So there was essentially no attribution of drug prescriptions to an individual in different states. So you don't know how much someone's getting. That was the first thing.

the second thing was the sort of growing realization that this was a problem lots and lots of people being over-prescribed opiates so what did the governments do well what they did was they stopped prescribing or they massively reduced prescribing put some doctors in prison now one of the things it everyone who works with opiate addiction knows. And if you stop someone's opiate, they don't kind of put a hand up and say, oh, sorry, Doc, I won't take any more now. Thanks. Thanks for telling me I'm dependent on opiates. I'll go away now and sort myself out with exercise or cold baths. Now, what they do is they say, if you don't prescribe, I've got three hours to stop, to get some more before I'm going to

withdraw. So then they created the black market. That black market was heroin. And so there's a massive rise in heroin use in the States imported from Mexico and more deaths, okay, because heroin, if you inject it, is a damn site more dangerous than taking oxy-contin tablets. So what happened? Well, so there was a crackdown on heroin. At worse, the UN decided it would reduce heroin availability by reducing the amount of the precursor that was being made. There's an international control on how much theban is made and what each country can have in order to make heroin. And that led to crises. That led to problems in Britain where we couldn't get enough heroin for pain control in hospitals

or for treating people with heroin addiction. So you've got a lot of heroin addicts who can't get heroin. What do they do? They go to their dealer and say, I've got to have something. And the Mexican cartels had by that time worked out that fentanyl was a good alternative. In fact, they kind of regret not having worked this out decades ago because fentanyl is, what, 50 times more potent and half the price to make. And so then people switch from heroin to fentanyl, and it's way more toxic.

And there are multiple fentanyls, some of which are a thousand times more potent than heroin, so potent, and no one knows how to weigh them out in a safe dose. So we've got this tsunami of deaths because we have tried to stop people using relatively less very less harmful oral opiates and now we're on to these terrible potent injectables yeah we talk quite

sort of almost laughing when we tell some of these stories because they're so ridiculous and silly but it is we're talking about real deaths of real people being caused by real government policy it's it's something that um that I think you know

it's as a subject no laughing matter and in fact I think that's why so many people get so passionate about this, because even if they're totally wrong, there's still this undertone that we're talking about something deathly serious here. Well, yeah, absolutely, but who's to blame? Well, I mean, drug users aren't to blame. I mean, well, I don't think drug users to the blame. I mean, you know, no one sets out to become addicted to a drug.

And some people do, and we know the reasons why people are more likely to become addicted. But even the majority of heroin or opiate users don't become addicted unless they're getting over-prescribed by doctors who are somewhat dishonest. But the problem are the politicians who are failing to do the best thing by that population. And again, it comes back. Opiate drug users don't vote, so who cares about them in America? I mean, yeah, that's a lot of deaths, but there are, you know, there are quotes from politicians saying the only good addicts are dead addicts. I mean, it's, thankfully, I haven't heard of British politicians say that, although, you know, when you get into discussions with British politicians about safe injecting rooms over those prevention centres, they often come to the point, you know, where they, they're actually, you know, they believe that. You know, they don't care if they die.

They just don't want them dying in their front door. I must put to you some of the objections that have been sort of swirling up in my mind to the things that you've been saying. most notably the things that were said to me by Peter Hitchens in that interview that I mentioned in which he actually ended up getting up and storming out. It's the most viewed thing on my channel excluding YouTube shorts, quite an extraordinary episode. Well, join the club. He's walked out of my talks too.

He's walked out of a number of things. I remember him once telling a group of students that he hopes they rot in hell. It's something about the subject that I think really riles him up. But one thing that he said to me was that, well, I opened by asking about cannabis. It was around the time that Suella Braverman, our then Home Secretary, had suggested upgrading cannabis to a class A drug. And its current status is a class B. Now, you were mentioning earlier the idea of, you know, lowering it to class C. Now, I asked, yeah.

So I asked Mr. Hitchens, you know, she said she wanted to do this because cannabis is a gateway drug. and I asked him if he thinks it's a gateway drug and he said no it's perfectly harmful as it is it doesn't need to be a gateway drug he said that there's a correlation between cannabis use particularly at a young age and quote mental health illness of an incurable and disastrous kind he's also separately said that addiction is a fantasy that it doesn't exist and where you said just then I don't think drug users is to blame he would say well of course they are I mean you talk about addiction you talk about allergies of the mind you You talk about, he had this argument with Matthew Perry as well, but ultimately it stems from willpower. Sure, if you have some alcohol, you might be the kind of person that then can't stop drinking. But the decision lies with you to take that first drink, and it's a failure of willpower. And also, the third thing, and we can take this individually, is that, yeah, you know, the war on drugs isn't working. And there's been a total disaster. But in his opinion, that's because it's the war we never fought.

That's the name of his book, which publishers have also referred to as, you know, the book that, was never bought because it was completely ignored by most reviewers. Yeah, it's there, it's there somewhere and well annotated, I'm sure. And so there's a few different elements here. The first thing being this point about cannabis, cannabis is stupefying. You asked a moment ago, you know, why is there this moral element of drug taking? Well, Peter Hitchens would say, because it stupefies you. It sort of dampens your brain. It prevents you from thinking clearly. It also is linked to mental health problems. We hear about cannabis and its links to schizophrenia. Is there any truth in this? Is cannabis this much more dangerous drug than we're often sold?

Well, cannabis is another example of where policies have made it more harmful. I mean, I like to remind people that the Dutch School of Painting, Rembrandt and his colleagues, they use cannabis is a way of trying to improve their understanding of colour and depth of colour. So there was a massive use of cannabis in creative arts, particularly in Paris in the mid-1800s. It underpinned quite a lot of some of the more interesting music and art at the time. So the reality is that cannabis, if used in a way to facilitate brain function, can be really quite positive.

What we have seen in the last 50 years in the attempts to stop people in Britain having access to cannabis is the market changing. From what was essentially import, cannabis in the 60s, 50s, 60s, 70s was imported from Lebanon or from Morocco. And it was a relatively benign,

mixture of 4 to 5% THC, you know, 4 to 6% calibre dial, the sort of counteracting agent, and very little evidence that it actually caused problems and was generally liked, used by students, used by

you know, writers. It was sort of part, you know, being stoned was sort of part of the, of the, I suppose, you know, the media, media, art culture in the 60s, it was fine. But we tried to stamp it out. and by stamping it out, we actually, it's quite, I mean, cannabis is very easy to detect

because it's bulky and smelly. So we got quite good at limiting or cutting down imports. And so people started growing their own. Now, when you grow your own, you're looking for bangs for your bucks. So people move to hydroponic growth under ultraviolet light. And that changed the whole nature of the plant. So we began to get very, very high strength. THC. Now, 95% of all cannabis bought on the streets is over 12% THC. And having done that, that strong

THC, comes at the cost of having no cannibalial, so the counterbalancing agents gone. So now, pretty much everyone who uses cannabis is using a more harmful form of cannabis, more harmful in terms of likelihood to cause addiction and dependence, and probably more likely to cause paranoia. So we've created the problem. And again, that's one of the reasons the Dutch went down the more rational route of allowing access to cannabis so that people didn't at least have a choice in Holland. You can choose what cannabis to use. In Britain, you're forced to use skunk. Does cannabis cause schizophrenia? No, cannabis doesn't cause schizophrenia, but what we see, I mean, cannabis can produce a sort of paranoid state.

if you're very stoned, particularly if you're a naive user, but that's not schizophrenia. And that's one of the problems, because some of the studies which have said it causes schizophrenia, have actually asked this question, have you ever had a psychotic experience? Yes, most people who've smoked cannabis would have a psychotic like experience because that's what being stoned is. So that's not schizophrenia. So does cannabis, it doesn't cause schizophrenia. what the problem with cannabis and schizophrenia is a is a rather interesting problem because it's centered around in the UK it's centered around people living in South London who are schizophrenic who are also dependent on cannabis and why are they dependent on cannabis because they're using skunk

because that's all they can get and they're using skunk to deal with some of the mental traumas it schizophrenia produces it calms them down but he also makes the voices louder so we've created a subgroup of people who are very susceptible to the paranoia of super strong cannabis who are also psychotic. So it aggravates people. Schizophrenia is aggravated if you take a lot of skunk. Now, what do you make of Peter Hitchin's assessment that addiction is a fantasy? In fact, you'll have seen his spat with Matthew Perry, the actor Chandler being the late Matthew Perry, and they had a debate about this on television, and on the day of Matthew Perry's death, Peter Hitchens tweets out a link to an article he wrote with a picture of Matthew Perry

called The Fantasy of Addiction. Now, he claims he did this because people were all day sending him messages about this particular interview. I like to think I might have waited at least a day, perhaps a week or so before doing so, but he asserts that, look, ultimately it is up to you to decide whether at least the first time to use these drugs or not. And in fact, if addiction was a real thing, then the best thing we could possibly do is have a strong legal deterrent to stop people from taking it in the first place to prevent them from getting addicted. But he thinks that ultimately it's a failure of willpower.

Do you think there's any credence in that position? Well, yeah, what is willpower? Willpower is the ability of your brain. to help you stop doing things or to do things, you know, or to do things in a different way. And to understand addiction, you have to understand that people get addicted to drugs because drugs commandeer their brain. I mean, the majority of people, I'm sure Matthew Perry included,

do not want to be taking drugs in excess. They do not want to be forced to have them. But the drugs have taken over their will. power. So it's not a failure of willpower. It's the fact that the drugs are now their will. And that's, we know the biology of that. We know, you know, how drugs distort brain processes to make the drug the main goal. Rather than abstinence the main goal, that's, that's, so in a way, it's very trivial. You know, I mean, it's the willpower is the drug rather than not the drug. How can you stop that? Well, yes, if no one ever took a drug, that's true.

ever took a drug, they wouldn't be addicted to a drug. That's absolutely true. But the reality is that ain't going to happen. And do we even want it to happen? That's quite a much more interesting question. What would a society where no one took drugs? Well, there's never been a society like that. So I don't suppose maybe, maybe monks, maybe monks, I don't know, but most is. Although monks, of course, famously were good for preserving alcohol. Well, precisely. Yes, I mean, there are probably some strains or whatever you call them of months who don't drink. But you're right. The point is humans take drugs, why, because humans are interested in the effect of drugs, why?

Because humans are interested in maximizing the benefits, maximizing the capacities of their mind. And drugs have contributed enormously to that. I mean, you've got this paradox, you know, you've got, I think, Of the first six American Nobel Prize winners in literature, five of them died of alcoholism. And, you know, and that's bad and good. You know, I mean, many of them would say, you know, it was the drink that I could, the writing was driven by the drink rather than the other way around. Look at psychedelics.

We have a whole new branch of art and a whole new branch of music. And now a whole new branch of medicine that come from psychedelics. And what are the harms of psychedelics, relatively slight? You know, so drugs expand human consciousness in most cases in a very positive way. The problem has come, as we've already talked about, the problem has come, by trying to stop people accessing safe drugs, or relatively safe drugs. Interestingly, of course, at least in the case of psychedelics, whilst it does sort of open the mind, subjectively speaking,

it actually has the opposite effect on the brain, right? If you actually look at brain activity when people are taking psychedelics, you expect that brain activity would start going crazy and increase. But if I'm not mistaken on psychedelics, brain activity actually decreases. Yeah, that's because psychedelics switch off the bits of the brain, which are controlling your brain. And by the way, that's why we are now starting studies of psychedelics, addictions because we want to switch off those circuits which are driving people to keep taking

drugs because it's that ability to disrupt ingrained patterns of brain function that make them so powerful. Doesn't Aldous Huxley have a good quote on this? Yeah, in terms of what is he said, yes, as a result of taking mescaline and having the experience of having his mind opened he said something like well he came up with he reasoned that

if his mind had been opened by mescaline there must have been something closing his mind and he said ah the brain is an instrument of focusing the mind and that's one of the great insights in modern science I mean, because that's exactly 50 years on, we showed he was right.

We said it psychedelics switch off the brain to allow the mind to expand. This, by the way, is the concentric circle between all of this drug talk and the usual subject matter of my channel, which is philosophy. I think when I first heard you say this on another show that I was listening to, I had to like pause and stare into the air for a moment. Hold on. That subjective feeling, the qualia of the consciousness, the experience, expanding and going crazy and increasing, is correlated with the material thing, the brain switching off, as if it sort of releases this other part of the – there's something fascinating in there that needs to be investigated, not just, although, of course, it does need to be investigated by you wonderful scientists, but I think that philosophers of mind should spend a bit of time thinking about that, too. I'll tell it I highly completely agree with you I think trying to explore

consciousness without studying psychedelics is now missing a trick it might be impossible in fact to do it seriously without taking it into consideration I wouldn't disagree with you

but I don't want to overstate I'm not a philosopher of consciousness but I wouldn't disagree with you yeah I won't quote you on it I did have a well actually first I should ask quickly about Peter Hitchin's assertion that the war on drugs isn't actually being fought like you know that there's the 420 celebration in London if you go to Hyde Park on the 20th of April there will just be people smoking weed everywhere and the police are not exactly you know dying to arrest everybody there so he'll say look the war isn't even really being fought right well you can't fight a war on the majority of the population I mean you know it is absurd isn't it? You know, we know six, what is it? 40, 60% of students or smoke cannabis. Do you want to arrest them all? Do you want to give them more?

I mean, the police don't fight, don't fight that war in Britain because they know it's pointless. They've got much better things to do. I mean, you know, it's so what, you know, let's put those resources to something useful. And the, you know, and so I think, but it's, you know, it's not, I mean, it's not, it's still a bit random, though. I mean, not all police forces, turn the sort of blind nose or whatever, a blocked up nose. And there are people still being prosecuted for growing cannabis, even for medical purposes. It is quite, it is, you know, it's definitely not legal. Let's be clear about that. You can get it meat, but you can't grow it legally. Now, I just want to take a quick pivot near the end here to ask two questions about

another concentric circle, which is royalty. I learned two very interesting facts from reading your book, one of which is that Henry the 8th, yes, that one, the famous king, once passed a law requiring all farmers with at least 60 acres of arable land to grow cannabis. Yes, so it was hemp, in fact. Yeah, that's right. The cannabis plant is a remarkable plant. and it's he in that law was to provide both canvas hemp and the cannabis plant

the fibres are phenomenally strong and they used to make strong canvas and also make ropes so the British Navy essentially the British Navy until the days of the iron clads and the steam engines were basically propelled and

managed by woven pieces of the cannabis plants. And so there's this decree that stipulates that for every 60 acres of arable land that a farmer owned, a quarter acre was to be sown with hemp, and that came right from the top. Oh, how times change. Yes. On a similar but related note, a question that I just have to ask, I've been dying to ask you about this, was Queen Victoria a stoner? well I suspect she was using cannabis I think she would be she would argue that she was using

it medicinally she wrote about the value of cannabis she used it as a tincture rather than as a smoking it so the effect would be more slower and onset and more of a sort of gentle plateau. She used it for period pains, she used it for the pains of, after the pains of childbirth. And when I'm in my more mischievous moments, I wonder whether, whether, maybe they, maybe it helped some of those long nights in Balmoral go by a bit more entertainingly because she used it for other reasons too. You certainly had a lot of, well, how do we know that she was, that she was using cannabis? Well, we, we don't, she did write about the value of the medicine she was getting. She did write to her ladies in waiting about the tinctures that were being that she was

finding very helpful. But the other pointer is that her physician, J. Russell Reynolds, wrote the definitive textbook on medical cannabis in the 1890s. It seems pretty unlikely that the man who was pioneering celebrating, encouraging British medicine to use medical cannabis, wouldn't have been using it on his most important patients. Hmm. Yeah, he sort of lords it. It's wonderful. And it's demonstrative as well. I think that the chapter of your book, which talks about this, is called something like cannabis, you know, from the medicine of Queens to public enemy number one. This is amazing journey that cannabis has gone through from being, you know, lauded by the physician of the head of state to sort of being demonized as a result of prohibition attached to Mexican immigration. you know, and then suddenly that sort of comes over to the UK. It's this amazing journey that cannabis has been on. It is absolutely. It's a horrific story.

And what the worst thing of all is that the US has effectively repealed cannabis laws in most of the states, not all of them, but most of the liberal states. Most Americans have access to medical cannabis. A large proportion of Americans have access to legal cannabis. But we haven't done the same. We still comply with the ban that America told us to do. America made us ban medical cannabis in 1971 because then they were trying to get rid of cannabis and they thought that medical cannabis was encouraging recreational cannabis was complete falsehood.

But we have stuck with these bans and we've only recently allowed medical cannabis and we're not allowing it to be prescribed. There's only five prescriptions on the NHS in five years. And that's really problematic to families with children with severe epilepsy who have to pay privately often in other countries to get their kids treated. And that's really, it's actually, I think it's one of the most shameful pieces of failure to rectify drug laws that we have. Children are dying as a result of the fact that we are not allowing access to medical cannabis because we still think it's dangerous. yeah we've we've hardly touched on that side of things and again your book details some of these cases particularly billy coldwell the the child having thousands of epileptic seizures every single

month taken to a canada i think by his parents treated with cannabis and and just just night and day difference coming back to the UK and being told sorry you can't bring it with you and then the seizures return and it's just a it's an unthinkable sort of lapse i think and legal judgment. And yet parents are dying probably each month because their parents cannot afford to buy cannabis either internally or overseas. It's, it is, I think it's, I think it's the biggest medical scandal since the Bristol heart scandal. But I cannot, I'm struggling to get the medical profession to take it seriously. But at some point they will. And then we'll have, like we've had, you know, with the heart scandals, like we've had with Grenfell. People will look

back and say, oh, we got it wrong. But it's very difficult, you know, to get anyone to take it seriously at present because the government doesn't want things. You know, politicians find being hard on cannabis a useful tact to take. And in this future where medicinal cannabis is legal and usable, would you also wish to see recreational cannabis be legal, or do you think it should still be illegal, but perhaps lower to class C. What do you think should be done with the recreational side of cannabis? Of course it should be available as an alternative to alcohol. Of course it should.

I mean, it's, yeah, because it's less harmful than alcohol. So it's immoral. The only, since they ban nitrofoil, the only intoxicant that you can legally use is alcohol, which is quite likely to cause dependence and is really quite toxic in my dosis. So, you know, cannabis, on those 16 measures of harm, we did a paper 10 years ago comparing, on those 16 measures of harm, cannabis is less harmful in alcohol on every measure except one. And that's intoxication, where they're both equally intoxicating. So, of course, it should be recreational.

And that would also facilitate people getting low-cost access to medical purposes as well. yes well david nut thank you for come on the show hopefully those people that you're trying to reach with this message uh well hopefully there'll be there'll be more of them reached with a podcast like this i found it fascinating as i say the book is drugs uh without the hot air and there are other books that you've read in like the book about drinking which was equally eye-opening for me i'll make sure they're linked in the description thank you what a what a wonderful conversation this has been thanks so much for coming on and also i should say thank you for not storming off halfway through yeah well it's been an absolute pleasure and let me know when it goes out and i'll be tweeting

it all right for sure awesome thank you