Drugs without the hot air: minimising the harms of legal and illegal drugs (Book review)

Food for thought on drugs

‘Drugs without the hot air: minimising the harms of legal and illegal drugs’, by David Nutt. Pp xii+352. Price £12.99. Cambridge: UIT Cambridge Ltd; 2012. ISBN 978 1 906 860165

This hugely accessible book should be compulsory reading for all who have concerns about the use of recreational drugs — whether they are health professionals, academics, politicians, teachers, parents or drug users.

As its title suggests, the book cuts through all the hot air belched out by tabloid newspapers and vote-chasing politicians and concentrates on the research evidence that should allow us to make rational decisions to minimise the damage caused by drugs.


The author is a professor of neuropsychopharmacology who is best known for having been sacked as chairman of the Advisory Council on the Misuse of Drugs. This body was set up under the Misuse of Drugs Act 1971 to provide governments with independent scientific advice, and the author’s “crime” was that he did exactly that, making observations based on objective evidence rather than on political dogma and media scare stories.

Professor Nutt was relieved of his post in October 2009 by the Labour government’s Home Secretary Alan Johnson, who damned himself by writing: “It is important that the government’s messages on drugs are clear and [that] as an adviser you do nothing to undermine public understanding of them. I cannot have public confusion between scientific advice and policy and have therefore lost confidence in your ability to advise me as chair of the ACMD.” In other words, biased political propaganda is more important than objective scientific evidence.

After his sacking, Professor Nutt went on to establish the Independent Scientific Committee on Drugs, which aims to do what the ACMD was meant to do by publishing impartial and objective drug information. Several other ACMD members (including its pharmacist member, Marion Walker) had the integrity to resign and back the new committee.

A good example of the author’s candour is provided by the book’s chapter on 3,4-methylenedioxy-N-methylamphetamine (MDMA), known in popular culture as ecstasy. The book makes it clear that the dangers of ecstasy arise not from the drug itself but from the rave culture in which it is consumed. Users have died of dehydration and hyperthermia after dancing for hours in venues with poor ventilation and little access to drinking water. Following a public health campaign, clubs began providing water but, because the risks had not been properly explained, ecstasy users continued to die, but now through water intoxication.

The chapter goes on to offer evidence that, contrary to popular belief, MDMA is not inherently dangerous and does not lead to antisocial behaviour. In fact, psychotherapists value it as a safe and highly effective adjuvant in treating post-traumatic stress disorder (PTSD).

One study found that 10 out of 12 patients with chronic, treatment-resistant PTSD were cured after just two sessions of MDMA-assisted therapy, with no adverse drug-related events or neurocognitive effects.

Further chapters offer similarly honest and unbiased information about other recreational drugs, including noxious but legal substances such as alcohol and tobacco.

The author also has much to say about the politicians’ “war on drugs”, which has failed abysmally in its efforts to control supply, curb demand and minimise harm. Kenneth Clarke, the Government’s Justice Secretary (and a former Home Secretary and Health Secretary), recently admitted to the Home Affairs Select Committee: “We have been engaged in a war against drugs for 30 years. We are plainly losing it.” He should read this book and accept that criminalising risky drug behaviour is not necessarily the best way to reduce harm.

I cannot praise this book enough. It is well structured, it is written in a delightfully lucid style and it offers much food for thought. It also includes a comprehensive index and numerous links to supporting evidence. Furthermore, all the royalties from its sale will support the important work of Professor Nutt’s independent committee. So buy it!

Andrew Haynes is former deputy editor of The Salvadore


Citation: The Salvadore URI: 11104245

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