Britain's drug policy focuses on abusers already receiving treatment, rather than recreational users.
We need an honest dialogue in this country that accepts that drugs can be incredibly dangerous but also that there are ways that people can use them that moderate their risk of harm. We need to start being able to help people do that in ways that are not hypocritical or driven by the tiny proportion of people that are in treatment. I work with that minority, and for those people drug use is not a choice. Patients in drug clinics do not use heroin for pleasure, yet the majority of people who use drugs do use them for pleasure. We can help those people make smart decisions.
In the past, the national guidelines have been along the lines of "don't take them, they're harmful – they kill you". It would be really nice to start a narrative with users that gave them information about drugs that was more meaningful. The government must have the information it needs to make guidelines, and its communications department must ensure that drug users are given information that is meaningful. But the elephant in the room is the truth that it's pleasure that drives drug use – guidelines that fail to acknowledge this will mean people will not pay attention to them.
This year the Global Drug Survey came up with guidelines for the safer use of eight drug groups, including cannabis and MDMA. Essentially, these are the strategies you can take that will reduce your risk. One of the fundamental problems with guidelines on drugs is the widely variable purity of drugs. If we take MDMA, for example, you might have guidelines that say that one pill of 75mg of MDMA taken less than monthly is associated with a very low risk of long-term harm, and in terms of short-term risk – unless you were one of those incredibly unlucky people who have a very unusual reaction – would be associated with a very low risk. As you increase the frequency of MDMA use to every two weeks, you start to increase the negative effects and the risk of longer-term effects increases.
It's as simple as "more drugs, more often, more harm". At some level the guidelines would be like cigarette health warnings, in that there's no level of drug use that is probably without risk at all, but there is a level at which – if you stuck to it – your risk in the long term would be very slim. Of course, we would also need to highlight the contextual factors around drug use that also increase risk, such as avoiding driving, whether users are taking medication, and avoiding drinking excess alcohol. The government doesn't do this very well at the moment.
I think that the drug-using population is ready for this, and the internet means that you can get the information out; a perfect storm of interesting information and the means of mass communication. One real problem is that drug policy has to match a country's culture. There's something about the UK in terms of our capacity to understand moderation. Maybe it's because we're such an intolerant society that we've never been able to educate around moderation.
Adam Winstock, founder of the Global Drug Survey, is a senior lecturer at King's College London and a consultant psychiatrist and addiction medicine specialist for the NHS. He was talking to Mark Townsend
