Lessons from the mephedrone ban

On 17 March I was giving a lecture in Barcelona when I received a call from CNN. They wanted my reactions to the international press conference that the Lincolnshire police were holding on the deaths of two young men that they claimed had taken mephedrone (the new synthetic drug also known as "meow meow" or "M-cat"). At that point I realised that all sense had left the ongoing debate on the question of the harms and control of this drug.

Why were the police holding a press conference when they had no idea if the men had taken any drugs? Why implicate mephedrone when the only established facts were that deaths occurred in the context of a heavy alcohol binge that went on into the early hours of the morning? As a stimulant, mephedrone is likely to reduce not increase the risk of alcohol-related respiratory depression (suppression of breathing). There was little evidence at the time of serious harms from mephedrone use, despite it having become almost as widely used as MDMA (ecstasy). Moreover, the earlier epidemic overdose use in Israel had not revealed significant harms and few if any mortalities.

The "media madness" that followed the Scunthorpe event probably tipped the balance in the decision to ban mephedrone which was enacted by a depleted ACMD in an intemperate and rushed manner, and which lead to the resignation of several more members and a coruscating editorial in the Lancet.

It has been revealed today that my suspicions were correct – there was no evidence that either of the two had taken mephedrone. It appears they took some other sedative drug – probably methadone – which is highly dangerous in combination with high levels of alcohol.

It is probably too late now to reverse the government decision to make mephedrone Class B but we do need to learn the lessons from the debacle of its being banned on limited evidence and media hysteria. The first lesson is that the police and other public bodies should not make pronouncements and certainly not hold press conferences on mere conjecture or hearsay; the public interest is not served by inciting media attention in this way. In addition the media should apply some traditional journalistic principles such as evidence collecting and testing and allow the scientific process to take place before claiming harms of drugs, especially new legal highs.

There are lessons for government and their advisers too. They should have the courage to resist media hysteria and let the truth drive decision-making. Moreover there should be proper research investment in the science of new drugs. Quite frankly, it is an insult to the country that the ACMD report on mephedrone didn't have some basic pharmacological facts about the drug, even though it had been under review since last summer and the data could have been obtained within a few days or weeks at little expense.

What we now require is a guaranteed minimum set of core pharmacological and behavioural data to be acquired for any new drug that is being considered for classification and control in the UK, before a decision to ban it is made. The new Independent Scientific Committee on Drugs (ISCD) is currently developing a set of guidelines for this that we hope the government will endorse.

The whole mephedrone debacle illustrates what has been known for many years – there is a real need for a new approach to the drug laws. The 1971 MD Act is 40 years old, and in its current classification system is fatally flawed and not fit for purpose. In this new world where drugs may be invented one day and sold over the internet the next, there needs to be a fundamental revision or better still a completely new approach to drug classification.

Finally there is a personal lesson from the Scunthorpe deaths to young people who drink and take drugs. Alcohol itself is very toxic (killing by acute poisoning, hundreds of young people each year through respiratory failure) and these actions are magnified when in combination with other drugs that suppress breathing such as opiates (heroin, morphine, methadone) and GHB/GBL. If in doubt, don't drink and drug.

David Nutt @'The Guardian'