In the UK, drug policy is one of the least modified legislative agendas for 50 years. Today’s drug laws look almost exactly as they did in 1971, with the passing of the Misuse of Drugs Act. As many readers will know, there is precious little empirical support to justify the continuation of a prohibitionist approach to drugs: Britain has broken its own record for numbers of drug-related deaths, for five years in a row. Drug dealers – gifted a multi-billion-pound trade by laws forbidding legitimate, regulated supply – vie for increased market share by ever-increasing levels of violence, and now by exploiting vulnerable children in County Lines.
Meanwhile, jurisdictions across the world are experimenting with a host of different policies: a regulated cannabis market, wholesale decriminalisation, overdose prevention sites. A well-regulated cannabis market has been shown to wither a significant income source for organised criminal gangs, reduce prevalence of use among teenagers, and provide significant revenues to the public purse. Decriminalising drug use as part of an initiative to reorient drug policy around health can decrease drug-related harms and deaths, alongside overall drug use. The introduction of overdose prevention sites (supervised facilities where injecting drug users can receive clean needles to take their own drugs) facilitates, rather than delaying, entry into rehabilitation and treatment programmes. It also reduces street injecting and the associated littering, and leads to net savings by decreasing the incidence of HIV, hepatitis C, and other costly health complications.
These are all successful, evidence-based initiatives, qualities that politicians frequently claim to prize highly. Those who work in drug policy reform have long since learned that to take such posturing at face-value, is, of course, a recipe for disappointment.
Whilst a disappointing lack of engagement from politicians is certainly part of the explanation, it may be that we — the reformers — have been guilty of poor tactics and strategy when it comes to political lobbying. This should not be so surprising. A community that supports evidence-based policy is likely to be one that is habituated, if not explicitly trained, to present the best, most sensible explanation of the data available. It is natural that such thinkers would gravitate towards envisioning what a rational drug policy, in its totality, would look like.
But even the most honest and uncynical democratic politician cannot afford to think in these terms. A solid evidence base does not always confer sufficient protection for a politician to take up a cause. Harm-reducing, compassionate, and cost-saving as the reforms outlined above might be, they are nonetheless bogged down in clashes of values in significantly contested political spaces: personal responsibility and desert, vice, law and order, the direction of limited state funds, and the largely misplaced fear of increased drug use. These are all arguments that can and eventually will be won. But until drug policy becomes a significant electoral issue, taking a progressive stance on any of these issues will be seen as a risk of alienating voters, at least as much as a chance to attract them.
Maximising our chances of successful reform will depend on deeply considering the perspectives of politicians. For them, those voters who distrust, fear, or hate drugs that happen to be illegal, and the people who use them, are, nonetheless, still voters. As such they must still be factored into a politician’s electoral calculus. They are still constituents who might, in constituency surgeries, local newspapers, or Twitter spats, rage that their MP is making things easier for drug dealers, or is risking kids getting hooked on heroin. Rightly or wrongly, politicians cannot completely discount this group. If we want to see politicians taking up evidence-based positions on drugs, we should begin by building support in Westminster for changes in the law that almost none of the electorate would oppose, regardless of their political values or perceptions about drugs. We should be concentrating our firepower on policy changes which any mainstream politician would be unafraid to explain and defend on The Today Programme or The Andrew Neil Show.
A prime candidate would be to reschedule psilocybin, a psychedelic compound found in magic mushrooms. This has the perfect combination of excellent empirical support with little or no political risk. It is a change that a wide coalition of parliamentarians could support, without an undue sense of risk towards their electoral majorities.
For a decade now, psychiatric studies have been uncovering ever-more data about the potential of psilocybin-assisted psychotherapy to treat mood and addictive disorders. Two sessions can offer relief to patients who have suffered from severe, treatment-resistant depression for decades, after finding no benefit from multiple antidepressants or talk therapies. It outperforms any available treatment in supporting the long-term cessation of tobacco, which kills five million a year. The evidence from these studies is clear enough to say: psilocybin-assisted therapy will play some role in mental health treatment in the coming years. The question is now, how big a role will it play?
Currently, the answer to that question is being held up in Westminster. Since psilocybin is in Schedule 1 of the Misuse of Drugs Regulations, scientists wishing to undertake research with psilocybin, by and large, cannot. The bureaucratic and financial hurdles imposed by the Home Office on those seeking to research Schedule 1 drugs are significant enough to exclude all but a tiny number of scientists. Schedule 2 drugs — including cocaine and heroin — can be stored and supplied in any hospital or university unproblematically. But to do the same with psilocybin mushrooms – non-toxic, non-addictive, and associated with the lowest emergency treatment-seeking of any recreational drug – requires special licensing associated with a host of restrictive, onerous, and expensive demands.
Properly framed, moving psilocybin to Schedule 2 is the UK’s best in-road towards evidence-responsive drug policy. Although psilocybin is relatively unknown, it is thereby relatively free of taboo, having largely evaded the hyperbolic and polarising reporting that has befallen cannabis of late. Psilocybin was completely legal in the UK, in the form of truffles, as recently as 2005. Meanwhile, there has been no major pharmacological development in psychiatry for thirty years, but some four million people in the UK suffer from depression or anxiety. By cutting the red tape that is slowing research, rescheduling psilocybin is perhaps the only credible policy response to the mental health crisis that costs nothing.
Moving the compound to Schedule 2 will significantly ease the burden on scientists wishing to perform research with psilocybin. Alongside its major centres of psilocybin expertise at KCL and Imperial College London, the UK would have the world’s friendliest regulatory environment for such research, allowing us to cement a position as global leaders in a paradigm-shifting new health treatment.
The reason that psilocybin rescheduling is the lowest of the low-hanging fruit, is that, on the record, a politician can not only cite the therapeutic evidence, but defend themselves against the accusation that they are being soft on drugs by explaining that they are proposing psilocybin be controlled as tightly as heroin and cocaine. This line of defence makes it considerably more straightforward to market their position as ‘supportive of science and industry.’
‘Supportive of science and industry’ is, still, a value position. But there are no points for politicians to score by declaring themselves as against science and industry, in the way that some see points in standing against the removal of criminal penalties for drug possession.
Calls for decriminalisation, overdose prevention sites, and the like are all worthy. They are all supported by the evidence. And the fight will not be over until they are secured. But British drugs policy is not, yet, evidence-based. Inviting politicians to wade into controversial clashes of values which risk alienating their constituency is to expect them to behave in a most un-politician-like manner, no matter how ill-founded the controversy. Calling for psilocybin rescheduling is an invitation for politicians to signal their support for evidence-responsive drug policies, without requiring that they make value claims that could lose them votes.
As reformers, we should consider psilocybin the vanguard.
Eddie Jacobs is Visiting Research Associate at the Centre for Affective Disorders, KCL. He previously supported the Beckley Foundation’s Psychedelic Science and Policy Programmes as Science Officer.
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The views expressed in this piece may reflect those of the author but do not express the views of Volteface as an organisation.