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(wootton report) HALLUCINOGENS SUB-COMMITTEE Report on Cannabis To: The Advisory Committee on Drug Dependence SECTION 1 INTRODUCTION Appointment 1. At your third meeting, on the 7th April 1967, you appointed us as a Sub-Committee to examine the question of misuse of cannabis and Lysergic Acid Diethylamide (L.S.D.) in the United Kingdom, and problems arising. You invited us in particular to review available evidence on the pharmacological, clinical, pathological, social and legal aspects of these drugs. We have held seventeen meetings and now have pleasure in submitting our first report, which deals with the problems of cannabis. Procedure 2. Our first enquiries were proceeding without publicity into the pharmacological and medical aspects when other developments gave our study new and much increased significance. An advertisement in The Times on the 24th July 1967 represented that the long-asserted dangers of cannabis were exaggerated and that the related law was socially damaging, if not unworkable. This was followed by a wave of debate about these issues in Parliament, the Press and elsewhere, and reports of enquiries e.g. by the National Council for Civil Liberties (1). This publicity made more explicit the nature of some current "protest" about official policy on drugs; defined more clearly some of the main issues in our study; and led us to give greater attention to the legal aspects of the problem. Government spokesmen made it clear that any future development of policy on cannabis would have to take account of the Advisory Committee’s report. Accordingly, we decided to give first priority to presenting our views on cannabis. 3. At the first meeting of the Sub-Committee we invited Dr. C. R. B. Joyce, Head of the Department of Pharmacology, London Hospital Medical College, to serve as a co-opted member for this study. We are especially grateful for all thc help he has given to us. 4 We are also greatly indebted to Sir Aubrey Lewis. Emeritus Professor of Psychiatry, University of London, for his special contribution to our work. At an early stage of our enquiry we were informed that he had begun a survey of the salient international clinical literature on cannabis and L.S.D., and was willing to place this at our disposal when completed. We were glad to co-opt him to the Sub-Committee, and we have made extensive use of his advice as well as his material, which, with his agreement, we reproduce as Appendix I to this report. International Background 5. Cannabis is a substance of many varieties, each differing in potency, and all widely used throughout the world. Its active principles have not been exhaustively investigated, and are not fully understood. The literature is vast and contradictory. International discussion and decision-making have been handicapped by inexact or inadequate information. No previous attempt has been made to evaluate United Kingdom experience of this substance, or to compare that experience with that of other countries. United Kingdom adherence to the 1925 Geneva Convention (2) which first placed Indian hemp under international control, was undertaken when this country had no experience of its effects. 6. In 1961 new restrictions (3) on cannabis and cannabis resin were introduced by the Single Convention on Narcotic Drugs, designed to impose much the same controls on production and distribution of these substances as are applicable to opium and other drugs, and to bring to an end the non-medical use-of the drug in certain Eastern countries. In addition, these drugs were separately scheduled (4) with others of special danger such as heroin, because in the opinion of the World Health Organisation none of these drugs had an irreplaceable therapeutic value. 7. Since 1961 W.H.O. has introduced a new concept and terminology of "drug dependence" in place of the terms "addiction" and "habituation". Drug dependence, both physical and psychological, is presented as the interaction of three factors: the host (the individual), the agent (the drug), and the environment (society). Each dependence-producing drug demonstrates that interaction in its own way, varying with the characteristics of the individual and of the society in which he is placed (the W.H.O. appraisal of cannabis-type dependence is given in Appendix 3). As new criteria for judgment about drugs have been offered by W H O. new patterns of drug use have appeared. Even the term "narcotic" has been losing its identity, and there has been an understandable public tendency to try to simplify the classification of drugs, notwithstanding W.H.O. insistence on the individual character of the dependence produced by particular drugs. Lay opinion has readily recognised cannabis as "soft" in its own parlance, and found it difficult to understand why it is aligned with the opiates in the Single Convention, and in United Kingdom law. Ambit of Sub-Committee’s Study of Cannabis 8. Against this background our study has been focussed on three controversial topics: the effects of cannabis in different cultures, including its possible therapeutic use: the place of cannabis in the current United Kingdom drug "scene"; and the existing provisions relating to this drug in the Dangerous Drugs Acts . 9. Inevitably when the subject of study is an illegal activity, it is not easy to obtain reliable information or unbiased comment. Nevertheless, in the light of the evidence we received, we concluded that there was sufficient information available on which to reach a provisional judgment of the effects of cannabis in different cultures, and to form a reasonably clear picture of the use of cannabis in the United Kingdom. 10. To obtain first-hand evidence about the use and effects of cannabis in the United Kingdom we issued, by notice in the Press, a general invitation to people who might wish to express views to submit written evidence. This drew a very small response. We also invited a number of individuals who were known to be concerned with our problems to give oral evidence. The names of these witnesses are listed in Appendix 4. We are grateful for the help that they gave us. 11. Throughout our study we have borne in mind that the use of cannabis is a world-wide problem, about which the international authorities have repeatedly expressed concern. We strongly support the principle of international collaboration against the misuse of drugs, and accept that international control must be based on a consensus of world opinion. At the same time we have thought it right not to restrict the scope of our review by consideration of external obligations. The United Kingdom drug problem is primarily for this country to resolve. It is entirely consistent with the W.H.O. concept of drug dependence to try to evaluate national factors bearing upon any particular drug problem. In the case of the United Kingdom and cannabis it is even more important to do so because evidence of the wider use of cannabis has come to notice so recently along with evidence of increased use of other drugs. In this respect the Single Convention has not been an obstacle to a wide-ranging review. Parties to the Convention have discretion to determine the stringency of penalties appropriate to particular drugs; and, in relation to drugs listed in the Fourth Schedule, they have discretion to adopt such additional measures of control as are necessary in "the prevailing conditions of the country". 12. It hardly need saying that the law alone cannot dispose of the problem of cannabis, or any other form of drug-taking. When the Interdepartmental Committee on Drug Addiction (The Brain Committee) reported in 1961 they felt able to say that the incidence of addiction to, and trafficking in, manufactured drugs was very small: "the cause for this seems to lie largely in social attitudes, to the observance of the law in general and to the taking of dangerous drugs in particular, coupled with the systematic enforcement of the Dangerous Drugs Act 1951 and its Regulations". The position today is very different. Convictions for drug offences have recently shown a sharp increase; many courts are faced for the first time with the task of deciding how to deal with the trafficker and the drug user; some immigrants from countries more familiar with cannabis-use have had to adjust to United Kingdom attitudes; and the task of the police has been growing more onerous, particularly in enforcing the law against young drug-takers without disruptive effect on the wider fabric of society. When drug misuse spreads, it becomes more difficult to strike the right balance between preventive, penal and remedial measures so as to prevent some individuals, for whom these measures are provided, being hurt by them rather than helped. We think that it may be helpful to state our own basic point of view Philosophy of Control 13. The great majority of the restrictions currently imposed upon an individual’s freedom in this country are defended on the ground that they are necessary for the safety or well-being of others. Although there may be differences of opinion as to how far such restrictions may legitimately be carried, at least it is clear that the law which requires a landowner to obtain the approval of the local authority before he can erect a building upon his own property is not designed in the interests of his personal convenience; nor does anyone suppose that the law which fixes the maximum concentration of alcohol in the blood with which it is permissible to drive a motor vehicle is primarily intended to protect the drunken driver from himself. 14. Much more controversial, however, is the question whether, and if so, how far, it is justifiable for the law to restrict a man’s freedom in what is presumed of be his own interest. On that issue there is considerable support today for J. S. Mill’s dictum that "the only purpose for which power can rightly be exercised over any member of a civilized community against his will is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant". It was indeed, on this very ground that the Wolfenden Committee put forward a recommendation, which Parliament subsequently accepted, that homosexual acts committed in private between two consenting adults should no longer be criminal; and it can be argued that by similar reasoning the use or sale of drugs in general, and of cannabis in particular, ought not to be the subject of criminal proceedings. Adult men and women, it is said, ought to be free to make their own decisions, in accordance with their personal tastes, and their own moral judgments, as to what substances they think it proper to consume. Added weight is, moreover, given to this argument by the multiplicity of restrictions on individual liberty which in any complex modern society are incontestably necessary for the common good. The greater the number and variety of unavoidable limitations on personal freedom, the more pressing, it may be said, is the urgency of preserving freedom of choice hl what are matters of purely individual concern. 15.While we appreciate the force of this argument, it has to be recognized that no hard and fast line can be drawn between actions that are purely self-regarding, and those that involve wider social consequences. If, generally speaking, every one is entitled to decide for himself what he will eat, drink, or smoke, the fact remains that those who indulge in gross intemperance of almost any kind will nearly always become a burden to their families, the public authorities or both. Indeed, examples of actions which never in any circumstances involve social repercussions are by no means easy to find. Nor can it be said that any consistent principle dictates the occasions on which the law at present intervenes to protect the individual from himself. Suicidal attempts at immediate and total self-destruction are not criminal; yet he who shortens his expectation of life by misusing heroin is liable to prosecution. Again, anyone over the age of 16 is entitled to ride a motor bicycle, although the statistics of self-destruction thereby (5) bear eloquent testimony to the lethal character of these machines. 16. Every proposal to restrict the freedom of the individual in his own supposed interests must, therefore, be decided on merits, in the light of the probable severity Of any damage that he may inflict upon himself, and of the risk that in damaging himself he may also involuntarily be the cause of injury to others. 17. In addition, account must be taken of public attitudes. It is clear that interest in mood-altering drugs has much increased in the past few years. Explanations of this phenomenon can only be speculative. To some extent it could not unreasonably be ascribed to growing disenchantment with the highly competitive and threatening nature of contemporary society, or to the destruction of the natural environment. Again, it is notable that some of those who use drugs such as cannabis or L.S.D. appear to be searching for spiritual experience. They speak of "new levels of consciousness" and of "the heightening of sensual, visual and musical experience" in terms reminiscent of those employed by mystics. The students of the epidemiology of crowd behaviour will, moreover be alive to the tendency of any new fashion. whether in contemporary speech, modes of recreation or forms of consumption, to spread throughout the community. In particular, a fashion that is illegal may be particularly tempting when the dangers are not clear. 18. Laws which seek to control the personal consumption of individuals are notoriously hard to enforce. We have to recognize that there comes a point at which public pressures become so powerful that it is idle to keep up attempts to resist them, the classic example in this context being the American prohibition of the consumption of alcohol. On the question whether this point has already been reached, or is likely to be reached in the near future, in relation to cannabis, differing opinions have been expressed to us. In any case. however. prohibition of the consumption of a substance which has become the normal accompaniment of social intercourse in all social classes must involve significantly more public disturbance than the continuance of a ban on the use of a drug which. in this country, is not, and never has been, in general use.
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