David Nutt: ‘I was sacked, I was angry, I was right’

‘I’m not so much anti-establishment as pointing out the obvious.’ Imperial College London/Layton Thompson

The John Maddox Prize for standing up for science is awarded to individuals who are judged to have “promoted sound science and evidence on a matter of public interest” and especially those who have faced difficulty or hostility in their endeavours. This year’s winner, David Nutt, talks about his work and taking on the establishment.

I was always interested in pushing the edges and got into science through teachers demonstrating remarkable things like air pressure. They revealed how the world was even more sophisticated and complex than we imagine. I got into psychology and psychiatry because of people like neurophysiologist and robotician William Grey Walter – he developed the first self-feeding robot which he called turtle. And Aldous Huxley, who explored the idea of drugs and consciousness.

Where science has materially influenced laws, I like this to be based on evidence not opinion. And it’s not just drug laws but climate change, healthcare and even policies on driving.

I’m particularly pleased to get the John Maddox prize. It’s an interesting concept, and recognises doing what science should be out there doing in the real world – having an impact. The fact it was awarded by senior people in science and publishing tells me that I was probably right. I’ve been standing up, and it gives me great energy to carry on.

My sacking from the Advisory Council on the Misuse of Drugs was pretty hurtful, insulting and I was very angry. Has it impeded my career? Probably not. It may have slowed down my getting a top level of pay in the NHS. Did it give me a much greater voice in terms of thinking about the science? Probably. Overall it was a net benefit to the scientific field I work in.

Any sensible person or scientist knows that the drug laws are not based on the science of drugs. And it’s a collusion among scientists, politicians, and to some extent the public, to ignore that. It is anti-establishment, but also not, in that it’s such an obvious thing. It’s like the emperor’s new clothes – someone needed to speak up.

Keeping step

I assumed that once there was a scientific body of evidence saying the laws were wrong then things would change. What’s interesting is that they have changed; they’ve changed in the US with cannabis, they’ve changed in Uruguay with cannabis, they’ve changed in New Zealand with legal highs.

But Britain has gone backwards in the last ten years in its desperate attempt to prove that some drugs are really harmful: reclassifying cannabis [from C to B] and failing to reclassify MDMA down. Social sciences tells us that what we do makes little difference. We ban mephedrone and use doesn’t go down. We’ve got to have acceptance that there’s a value in at least trying to be rational.

Governments are often very explicit about the fact that they’re interested in evidence to support their policy. It’s going back to the old Churchillian adage that science should be on tap not on top. And that’s just the wrong way round. Policy should follow evidence. They also seek out evidence, or fund research, that will produce the kind of evidence that will only support what they want to do.

A good example of this was in US drug policy, which meant it was impossible to get grants from the US government to study harm reduction. That wasn’t allowed to be discussed. Therefore scientists couldn’t get grants to study it. That was a kind of censorship of ideas.

Building trust in science

There certainly have been systematic attempts by some governments, including ours, to undermine scientific criticism of their policies. In my field, we see a continued deluge of misinformation from the Home Office about the relative harm of drugs and how the drug policies are working when they’re not. And people don’t know quite what to believe, because you really don’t want to believe that all governments are dishonest all the time so you kind of assume that some of the things they say might be right and the scientists are wrong. And that undermines science.

There’s another aspect to this though – perhaps less spoken of – which is that it’s the scientists themselves in the end that cease to see the bigger picture and their visions get limited to what you might call the possible. People don’t research the difficult topics because it’s too difficult. And so you don’t get evidence-based work in those challenging fields and therefore the field never develops. The most obvious example in the UK is the health benefits of cannabis which have been systematically denied to a point where no-one researches and it’s almost impossible to research, so they will always be denied.

Scientists developing drugs

If you really cared about health you would encourage the development of safe alternatives to alcohol because alcohol kills 2.5m people a year worldwide and it would be perfectly possible to ask scientists to go away and find a safer version, just like people have gone away and found much safer versions of tobacco. We could do the same for alcohol. But there’s absolutely no support for this idea. There’s hostility because there’s a very great likelihood that any such substance would be made illegal because it was a drug. This irrationality about drugs means that we continue to live in a world where too many people are killed by alcohol.

It has to be the scientific community that changes societal attitudes because the general public surely would trust scientists more than politicians or newspapers. We need scientists to stand up and say let’s do the right kind of science to actually improve health, and let’s make it such that the laws allow the therapeutic potential of drugs like MDMA to be developed.

Instead we have the systematic banning of new drugs through the temporary banning orders. We know in the last month they’ve banned a whole series of compounds which were being developed for treatment of Parkinson’s Disease and a new tracer which looks to be the best for measuring serotonin in the brain. And they’ve done that without even knowing that these drugs were being developed for those purposes. They’re just so obsessed with the recreational use of drugs that they miss the science.

MDMA in some people with Parkinson’s Disease does have a very profound beneficial effect, making their abnormal movements better. So groups have been working on finding analogues [new compounds with similar chemical structures] that aren’t illegal so they can be made more easily available to patients – and it was a series of these compounds that have just been banned under a temporary banning order because they fall under a general structural terminology of a benzofuran. So people can’t work on them anymore.

And I think it’s been done without any proper knowledge that they might have therapeutic utility. It’s simply the fact that it’s being sold on the internet to kids and there’s some hysteria about the possible harms that you’ve got to ban the drug without seeking to balance out that science can be impaired and the net benefits of the drug could be greater than the harms.

A lot of people don’t want to fund this work, even scientists just talking about it – there’s a stigma of even engaging in the debate.

David Nutt was speaking to Jo Adetunji