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Help me in my ambition to be uncontroversial

David Nutt      

6th November 2013

I’m very grateful for having been awarded the John Maddox prize. The award has caused me to reflect on the role of science in the public discourse, and evidence in politics, to ask what Standing up for Science means.

When I am invited to talk on the radio or in a debate, sometimes it seems as if I am there to represent one pole of a dichotomised debate. This isn’t always a comfortable position for a scientist to be. There are a few topics where I am happy to be contentious, but more typically I find that there is no relation between the statements I think are radical and those that actually provoke controversy. I can’t complain if people disagree with a moral or political stance, but I worry when it is factual statements about the harms of drugs or the efficacy of policy that are received as controversial by interviewers and listeners. It’s controversial to point out that the risks of some Class A drugs, such as LSD and ecstasy, are simply not comparable to those of heroin or methamphetamine. It’s controversial to suggest that “sending messages” by toughening classification has no pronounced or predictable effects on the prevalence of drugs like cannabis or ketamine. It is controversial to think that interventions that result in a fall in the numbers using a particular drug cannot be assumed to be successful in reducing net harm. This phenomenon, where truth is taboo, is the hallmark of topics where progress is needed in improving public understanding.

Drug science happens to be the field in which I do most of my work, but the change I’m hopeful of seeing would necessarily be wider-reaching. Improved public literacy in critical and scientific thinking is a desirable end in itself, but I think that the benefits could be quite profound, as any rewards attached to mythmaking by politicians and journalists recede, and the costs of misrepresenting science grow. Those who stand up for science risk being misconstrued as advocating for something akin to a scientific dictatorship, where their advice is never challenged. Actually, my vision for the role of evidence in the political debate is quite different; what I would like is a shared understanding about when any views or feelings have an equal claim to be considered, in contrast to questions of fact, things that can be framed and tested as scientific hypotheses. How much more productive might these discussion be if we could start from a consensus reality, and a shared assumption that any intervention we should make should have real-world effects? This was summed up by Dr Ben Goldacre on a science comedy programme this year (18.40). He said “It would have been nice to see politicians say ‘Look, I understand [what the evidence shows about the relative dangers of drugs], … but I just think, regardless of the real world impact, I just want drugs to be illegal. I just feel, morally, it’s just nice that the country sends out a message, just says this stuff is wrong, and actually I don’t care if the impact of that is to increase the total amount of harm.”

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