Who can possibly know the risks of legal highs?

After watching the misinformational BBC show “how [intoxicating and illegal] drugs work” I was inspired to post a (one way) correspondence with the Guardian/Observer newspaper after they published the article “No one can possibly know the risks of taking these drugs” by toxicologist Dr John Ramsey who is featured in the MDMA episode of afore-mentioned TV show.

The above article was published in the science section of the guardian website. The article contains several serious errors, the term “risk” which is mentioned in the thesis is undefined and the categories used throughout are misleading. I guess my analysis is too lengthy for publication but I would very much appreciate your comments.

Within mankind exists the desire for bodily pleasure, and intoxication is one such pleasure. This creates a market for intoxicating drugs that has a substantial monetary value. Some intoxicants are legally prohibited. Prohibition leads to an increased risk for legitimate suppliers that stock may be seized by force of violence. This same risk creates an attractive business opportunity for suppliers who consider themselves capable of operating beyond the reach of law-enforcement. In response to prohibition, legitimate suppliers are marketing new intoxicants which are chemical analogues of prohibited substances that have similarly desirable bodily effects, or “legal highs.”

Dr Ramsey asserts in his article dated 26 April that “no-one can possibly know the risks of taking these drugs.” The article goes on to define one category of “controlled” drugs, namely those which are legally prohibited. The reader must therefore assume that the category of “uncontrolled” drugs includes alcohol, tobacco, epinephrine, methotrexate, paracetamol, caffeine, vitamin C, etc. However readers will be well-aware that the substances listed are subject to a diverse range of different controls. Since the proposed categories are misleading I will continue referring to “legally prohibited”, “prescription”, “over-the-counter ” and “food-standards controlled” drugs.

Ramsey correctly states that “minor [chemical] modifications might result in a dramatically different toxicity profile.” In fact, it is precisely this unknown status that creates risk. For example, the legal compound mephedrone has an unknown toxicity profile. On the other hand the prohibited compound MDMA has been subject to toxicity studies as-well as being in widespread popular use for decades. Other risks which are mentioned include impurity of clandestinely produced compounds as well as dishonest marketing which is necessary for legitimate suppliers to minimize their legal exposure. Since these risks are properties of legal prohibition and not of chemical compounds they cannot be counted as factors in a sensible toxicological-risk assessment.

Ramsey’s solution entails “honestly informing retailers and consumers of the risks” which is a commendable stance. This would be a more straight-forward task if we were able to clearly define risks and refrain from using deceptive and misleading categories. Since all of the mentioned risks are readily addressed by existing forms of “control” such as food and drug labelling standards, prescription controls  and age and setting restrictions, Ramsey’s conclusions are dubious. He omits to state that it is prohibition which causes excess public health risks. However, since all bodily pleasure is experienced as dangerous transgression; the mere perception of risk and immorality will, for many, only serve to enhance the enjoyment that is to be found in intoxication.

Gianni Tedesco.

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