ACMD 2

The ACMD (UK's Advisory Council on the Misuse of Drugs) is the government's statutory committee, which as the name suggests advises Ministers on illicit drug matters. It has a long and mostly distinguished history of providing top quality, objective and science-based views on illicit drugs, or on drugs which are thought to be risky and government thinks may need to be legislated against. Arguably its greatest day was its delivery of two reports in the mid-eighties on AIDS and drug misuse. If you can't be bothered to read these landmark reports then all you need to know is that the key point was that AIDS was/is more dangerous to individuals and society than drug misuse. The reports ushered in officially sanctioned harm-reduction measures such as needle exchange schemes, easy and free distribution of condoms and a huge drive to encourage drug users, especially injectors in to contact with specialist services. The result was a tiny rate of HIV infection amongst English and Welsh users (Scotland and NI went their own way) at around 2% compared with rates of up to 70% + in other countries.

But in the latter part of last year it reached a low point when it produced a report on Cannabis arguing that the drug should not be re-upgraded to Class B under the 1971 Misuse of Drugs Act. It had been downgraded to C, the least dangerous category a few years before and use had declined. The ACMD argued that upgrading did not reflect its real risks (low compared to other illicit drugs) and would result in an increased attractiveness to potential users.

Unfortunately, the Prime Minister, a puritan wishing to flash his hard-man credentials and desperate to shore up a sinking premiership decided before the report emerged that it - the drug would be classified as a 'B'. This was a decision almost without precedent; minister(s) deciding on a view and action in advance of their own adviser's consideration. The ACMD disagreed, said 'no' to a regrade. The chairman of the committee was sacked for saying at a scientific lecture that cannabis was not as dangerous as horse-riding. And everyone wondered what the point of all advisory committees might be in the future.

Of course ministers are not obliged to agree with advisory committees' views, they have to take many other issues in to account when deciding on policy. But they chose to disagree about the science saying that Cannabis was a more dangerous drug than the committee thought it was. Had they come out and said, well, it does cause distress to a small number of people so on balance to avoid that we'll upgrade it; most people might not have agreed but would have taken the point. By choosing to argue the science rather than wider issues they shot themselves and the committee in the foot(s).

Now the sacked ACMD chairman, the wonderfully named psychiatrist, Professor David Nutt has set up his own independent ACMD whilst the actual one has a new chairman. The last thing drugs policy needs is yet another committee/pressure group/advisory council and no one will believe that future actual ACMD reports are a) truly independent of government pressure and b) paid any attention to by ministers. A sad decline from the brilliance and bravado of the AIDS reports.

Back again with added Morphine

I haven't posted for a long time. Mostly because I've been very ill and then recovering for almost a year and was obviously unwell - in retrospect, for some time before acute illness set in. Friends, family and colleagues tell me I look better now than I have done in two years. So that's why I haven't posted for some time. Too toxic and messed up for a year or so before the acute illness and convalescing after.

When I was very ill and in hospital, for reasons I won't go in to I suffered absolutely agonising pain and after 2 shots of pethidine and various oral painkillers which had no effect I requested, and was given intravenous (iv) morphine. The Professor of Surgery looking after me told me that the pain I was feeling was up there equivalent to that suffered during child-birth, heart attack or from kidney stones. Ouch.

Well Sister Morphine's gentle caress did the business. Although the drip ran constantly I could supplement the regular dose with self-administered extra if I needed it - which I did. I didn't find the drug induced euphoria but it did stop me feeling the pain. Although I knew the pain was still there, frankly I didn't care as long as it just stopped hurting. After twenty-four hours the cause of my pain had rested, thanks to Sister M and I only needed one dose of oral morphine after coming off the drip. Then I could cope on ordinary paracetamol-based analgesia.

This was all very interesting from a professional point of view as I had never been on the receiving end of pure pharmaceutical morphine before then. My wife tells me I did blather on for a bit whilst on the drip but subjectively I felt calm and lucid. Also very interesting was the wildly differing attitude of the various nurses taking care of me whilst I was mainlining (in a good way) that fine chemical. One or two of the nurses (all qualified I might add) freaked and kept checking on me every five minutes and ticked me off for self administering. I discovered that despite a limiter I could repeat self-administer after every seven minutes, so I just kept banging away until the pain stopped - much to these nurses' consternation. Other staff were much more relaxed and encouraged me - one even saying that, 'we really need to get on top of this (the pain)'. So from this highly unscientific study it seems that some nurses are terrified of morphine and it being controlled by the patient, whilst others, rightly in my view, see it as the nurses and patients friend.