Cannabis Harm Minimisation:

The report is now on  the ACMD website  .

A bit of a frustrating day - I was told I would get a call back on Radio 5 live today in which the topic was “What would make you stop smoking cannabis” and sitting there nervous for an hour and they did not ring.

In spite of my extreme frustration I’m going to be positive - there are lots of challenges in the media today to this nonsense. I mean the nonsense of the decision by the government to go against the recommendations of ACMD.  Harm minimisation rules OK !!

And watch out for input from Transform on the media circuit today

Helen

Gordon Brown will be announcing today the decision on whether cannabis should be reclassified.

We will be able to find out if he is taking advice from a panel of experts  or from the Daily Mail .  We shall see if he has thought through “giving a message”

What worries me most on a personal level is the effect a move to “B” would be likely to have on people with severe mental health problems.  And I don’t mean it will be “gving a message” to them about risk because it won’t.  Plenty of people are already telling them about risks of cannabis alcohol tobacco and other drugs.  No I mean increase of stigmatism  and there is plenty of that already.  Let us hope that the  mentally ill are not blamed for any change in the law. 

I want my son to be supported in his specific vulnerability, not punished by the law.  And I don’t want his vulnerablity to be seen as a reason to punish others. That would not help his rehabilitation

And children? How are we going to stop children using cannabis ?  By division or working together?  Do we deal with the problem of drunk teenagers by arresting adults having a glass of wine with their meal? No we do not, and nor should we take this approach with cannabis. 

Moving to “B” would be a sad blow for getting messages across about risks.

Re previous post - I got an invitation to go the night before and I was not able to rearrange my day and travel that far - so I did not attend this meeting. 

I emailed several people who I knew were attending and requested that this was read out.  I do not know if it was or not

There is a meeting at the house of commons tomorrow Monday 28^th April of the “All Party Parliamentary Group on Cannabis and Children”  It will be chaired by Graham Brady Conservative MP and apparently has 3 vice chairs from other parties.

I have emailed 4 times asking if I can come to this meeting .  Emails to Debra Bell of Talking about Cannabis, Graham Brady  and to the contact email on Debra Bells site (which bounced)

I was ignored; no one even had the decency to tell me to bugger off   The only answer I got was from Graham Brady’s secretary who said she had passed my email to Debra Bell who is doing the administration for the group.

I’m pretty disgusted with this – not just about the personal slight but about the structure of government in this country.  As a carer – the mother of a young man who is seriously affected by mental illness – I have for several years been campaigning  for a greater understanding of the specific risks of the use of cannabis  by children and those with a mental illness.  

I would have said at this meeting  – if I had been invited which I was not – is that any action to raise awareness, to discourage children’s use for example , has got to WORK.  And to find out what works there MUST be engagment of those affected by the issues , (not just people who agree with you!).   Where is the evidence that moving cannabis back to B would “get the message across”.?  Threats of punishment get people’s backs up. Alienating the people you wish to inform is not the way to go  Moving it back to B would put the dampers on proper imaginative health information which is what is needed.

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STOP PRESS

The power of Blogging - at 00.28 this morning I received an inviation to attend this meeting. This is not fair and I really dont know if I can rearrange my day and to travel and get there and maybe not have any opportunity to say my piece.  I have written to the organisers find out the date of the next meeitng. And of course to give a presentation

Helen

Vernon Coaker made a presentation  at the “Tackling drugs reducing crime” conference in Nottingham this week.

He said :

“Greater access to treatment and more effective treatment has not only delivered results for individuals, it has also benefited society and is helping to break the cycle between drug misuse and offending. And those offenders who enter drug treatment through the Criminal Justice System – through, yes, a degree of coercion – do as well as those who enter treatment completely voluntarily. So I hope we can now all accept that what matters is what happens when people get into treatment rather than how they get there.”

Do people who are forced into drug treatment do as well as those who have made the decisions that it it what they want?  Not according to Mark Eaton, quoted in Centre for policy Studies “2008 Drug Strategy - The Continuing Nationalisation of addiction“.

The real business of this strategy is about spending something like £4 billion of public money over the next decade on drug treatment. Now, the point about that is that this strategy was actually written after the Treasury last year agreed its funding for all of this, based on the same targets as the old strategy. So frankly, whatever the press release says, we can be confident that this new plan will be very similar to that old one, based primarily on measuring how many people are signed up for treatment, and the problem with that is it doesn’t tell you whether treatment is actually doing any good. If you remember, last October on the Today programme, we revealed some figures which showed that of the 180,000-odd people who were signed up for treatment, 20,000 never actually had any treatment, 80,000 didn’t complete their treatment, and just 5000, less than 3%, left the government programme free of illegal drugs. Now, since that report, one academic in the drugs world said it was, ‘like a rocket fired into the English drug treatment structure, an Emperor’s New Clothes moment’.

In my opinion engagement is esential for change.  If people have no intention of giving up drugs how can the treatment work?  I would like to see the evidence that those who are forced to have treatment do as well as those who chose to have it.

Vernon Coaker also talked about agencies working together:

” I wanted to say how proud I think we should be of those achievements and the investment that has made them happen. They would not have happened without the commitment of front line staff such as police officers, drugs workers, probation and prison staff and many, many other agencies. I want to thank the many people in this room who have been part of that success both here in Nottinghamshire and also nationally.”
And about  working with communities :

“Harnessing local participation provides quality intelligence and a better understanding of local concerns; and, just as importantly, it can provide a hostile environment for drug dealers and other criminals. And if that results in some more appropriate role models for our young people, then we will truly have made progress.”

But true partnership is for everybody - he talks about tackling drugs without any reference to engaging drug users themselves.   Why should he be listened to if he does not show that he is listening to others?  Drug users ar just as much vulnerable to local crime as everybody else.  Partnership working engages everyone - it is not about us and them.

Brown, in his poorly briefed statement, wants to go against the recommendations of the government appointed experts if they want it to stay at C.  Did he really think that the recommendations would be any different from what  they were 2 years ago?

I sincerely hope that the ACMD makes recommendations based on harm reduction and engagement. Transform has made some predictions about the outcomes.  IMHO central to any recommendations is that issues of risk about cannabis use are health risks,  and people should be made aware of them. Punishing users does not engage. The government is not suggesting that alcohol should be banned because it is being misused. 

I stand by my resolve not to comment on research papers that I have not read, so I have nothing to say on the one that claims that rates of schizophrenia are going down,  apparently based on data from GP practices.  Other than if this is right it’s good news - schizophrenia is a horrible  illness, not least because of the stigma that sufferers and their families have to put up with.  I just hope that the paper makes clear any limitations, and breaks down what is meant by schizophrenia and psychosis. There is a big difference between mild and transient and longterm and treatment resistent. And the patients  themselves - I don’t know if any of the 193 gp practices are in areas of high black and ethnic minority poputations such as south east london (and probably to raise issues about discrimination in mental health services would be beyond its remit)  Or if the study made allowances for the homeless mentally ill who are less likely to be registered with a G.P.. And of course I hope it discusses cause and effect - why are rates  going down ?  Would they  go down even more if there were less misuse of drugs? 

And I also  hope, that the ACMD is not making one piece of research central to its recommendations when in fact it has been reviewing a vast amount of evidence.  My concern  is that focussing on one paper can make people complacent about the mental health and other risks in spite of evidence. 

I’ve not done any research but my feelings are that the reporting about cannabis and its relative safety and risks has improved and there is an increase of a pragmatic, considered reporting .  But there are still the cannabis is completely harmless/harmful brigades.  And I have been trying hard to contact Debra Bell whose organisation “Talking about Cannabis”  has an aim  “to provide and stimulate debate on cannabis education, prevention and treatment”.  Her lack of response to my emails suggests limited commitment to debate.

The BBC is reporting that the ACMD is going to recommend that cannabis should not be moved to Class B.  I’m glad - I dont beleive that the classification A B or C gives out any information about the specific risks of its use.

 So how should messages of potential risk,  particularly risks of mental illness for young and vulnerable people, be “sent”?

I support the approach of RETHINK   - “The Government to deliver on the massive public education programme promised in 2006 and stop being distracted by the reclassification issue.”

But more I would like campaigns about harm minimisation  be led by adult cannabis  users.  Why - because they are more likely to be believed than governments. I dont think many adults - whether cannabis users or not - want  children and teens to use it. We should be working together to discourage them from doing so.  And support those with a mental illness who want to give up or cut down their cannabis use.

 Sadly, I suspect that the concept of harm minimisation is too complicated for many journalists and they will report the decision to leave it at C as an encouragement to use it. It is not.

No longer On the BBC I player but available here.

Comments welcome

This feedback is from my notes. Any gaps and there are plenty - please look at the research if you can find it (rather than newsaper reports which are likely to be biased) . Some of the research papers might not be the exact ones they were refering to - I’m just looking on the web and finding the nearest available.

1. Welcome from Sir Malcome Rawlins, chair of ACMD

I missed this but apparently he said said he had received a letter of reassurance from the Home Secretary after reports that she was prepared to disregard the committee’s recommendations.”I will be reading a letter from the Home Secretary that I received yesterday, basically saying that the Government has an open mind.”

Asked if he had been reassured by the pledges in Ms Smith’s letter, Sir Michael said: “Absolutely, yes.”  (  Mental Health  Foundation   )

 SESSION 1 - CANNABIS POTENCY AND BEHAVIOUR

2.  Dr Mike White (FSS) “THC content of seized cannabis and cannabis content of reefer cigarettes

3.  David Potter (GW Pharmaceuticals) “THC content of UK Cannabis”

His powerpoint presentation was very similar to this one which  I found googling.

Rising potency of street seizures of cannabis

 Have a look at slides 16-23 - CBD and THC

 4.  Dr Les King “Potency and UK market share of cannabis products”

He started by criticising the press for misquoting the findings of studies on strength.

Current Home Office summary will be completed in late March 2008 . In 2002 Sinsimmilla was 15% of the market, now it is 70-80%

5.  Marije Wouters (Uni of Amsterdam) “Cannabis and smoking behaviour”

Ive found several research papers with her name on but cant find this one. Findings were of three cluster “types”  

Cluster 1- Stongest high - mainly young males

Cluster 2 - Consistent high - moderate user group

Cluster 3 - Steady quantity  - these aged 40+

Cluster 1 were found to have the greatest risk of dependence

SESSION 2 - CANNABIS AND POTENTIAL MENTAL HEALTH RISKS

6. Prof Glyn Lewis (Academic Unit of Psychiatry; Bristol University) “Cannabis Psychosis and depression

Looked at longitudinal studies .Talked about how the reseach was miquoted in the Mail which said that here is psychosis risk in one joint, which was a misquote.

 He talked less about cannabis and  depression - said there is less evidence and less conclusive

 Conclusion from longitudinal studies : There is evidence that cannabis can lead to psychotic symptoms.  Though one cannot be certain that the relationhsip is causal, there is now sufficient evidence to warn people that cannabis use could increase the risk of psychotic illness.

In answer to a question from ACMD member re doubling risk. He said if your risk is low doubling it is  still not a  great risk but if your risk is high - you’ve got a first degree relative who has schizophrenia  - then doubling the risk makes the risk very big.

In response to another question he said the longitudinal stidies did not look at potency, they asked people if they used cannabis.

Dr Paul Morrison (dept of Psychological Medicine, King’s college London) “The acute effects fo THC and CBD”

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The Advisory Council on the Misuse of Drugs will be meeting on 5th February 2008. It’s a public meeting and I will be attending.

What will the government do with its recommendation, whatever it is?  Gordon Brown seems to have already made up his mind that a move to Class B will help the problems of inappropriate and children’s use.   Where is the evidence for this?

Engagement is the key. Call it harm reduction, harm minimisation, but messages about risk have to be within a context and accepting that people take drugs for reasons.  And when things go wrong its a health issue, not a reason for punishment. My concern is that increasing punishment for cannabis use  is alienating and causes understandable resentment.  Putting people on the defensive is not a way to support sensible use.