True mumblings, from a junior doctor...

I Disagree - Bad Science Column on Drugs

I like Ben Goldacre. I think his writing is very well constructed and researched. But sometimes I don't agree. His drugs column is one I don't agree with.

Unfortunately he is basing his argument on an unreleased (either through a). conspiracy and censorship, or b). not being complete) 1995 WHO document about Cocaine and it use/misuse, which apparently the US government required be lost. It's existence is now denied by the WHO but is 'available' on Transform Drug Policy Foundation, who's existence is to bring about a 'just, effective and humane system to regulate and control drugs at local, national and international levels'. this is an admirable aim, but the implication is that the current status quo is not one. Therefore obviously they use evidence to back up their thought processes - again admirable. It is merely unfortunate that they are the only repository of this leaked document. That does NOT mean it's credibility is necessarily in question, but it is a happy coincidence.

Anyway, the sad thing is that this document is I believe out of step with the current situation - it is after all 14 years old at least. Does this correspond with current knowledge on the long-term damage of differing patterns of drug consumption in a more sedentary and unfit populace? Do the statements regarding positive effects on indigenous Andean populations correlate with improved life expectancy and quality of life compared to matched indigenous controls? The reason why the majority of negative consequences are due 'legal' drugs such as nicotine and alcohol is because these are legal and therefore freely available.

The actual negative effects of cocaine seem to be quite important - it is associated with increased rates of STIs - such as HIV, Hep B and Hep C. This is significant - especially in a world dramatically different to that of 1995. It is also associated with increased rates of mental illness.

In the past 14 years purity of cocaine and cocaine use has vastly increased along with the cost dramatically reducing - such that it is now cheaper than cigarettes and alcohol. The key thing is not the legality. People will take it whether it is illegal or not, if they want to. But should that be a reason to legalise it? If you legalise it you unleash a whole new wave of problems on the vulnerable and under-privileged. Sometimes the law is there not to punish but to protect. Too many people have heart attacks under 30 due to cocaine. We do not have enough long-term evidence (10+ years of scientific research) to state that there are no long term consequences to industrially produced, chemically powerful drugs

But that's just my impression having seen many people have problems.