Tuesday 8 March 2011

David Nutt shows his true colours

David Nutt by name, temperance nut by nature

One of the most important factors that brought about Prohibition in America was something called Scientific Temperance Instruction. Without it, Prohibition would have been "practically impossible" according to the Anti-Saloon League's chief tactician, Ernest Cherrington.

Scientific Temperance Instruction (STI)  was the brainchild of a prohibitionist zealot named Mary Hunt, who realised in the 1870s that Prohibition would takes decades to achieve. Playing the long game, Hunt believed that if children were indoctrinated with extreme anti-alcohol views in school they would become “trained haters of alcohol" who would one day "pour a Niagara of ballots upon the saloon.” This policy was adopted by the Woman's Christian Temperance Union in 1880 and through relentless lobbying, they succeeded in having mandatory STI in almost every school in America.

These campaigners wanted to move from temperance (ie. moderation) to total abstinence. To do this, they had to convince people that:

(a) alcohol could be fatal even in small doses
(b) alcohol was a poison
(c) alcohol had no medicinal benefits
(d) alcohol was instantly addictive

These were the four central messages in STI and they were hammered into school children for decades.

The problem was that science did not agree with any of these claims. Alcohol could be a poison, of course, but the dose makes the poison. Alcoholic drinks cannot, by any normal definition, be described as inherently poisonous (alas, the same could not be said of the moonshine that came with Prohibition).

It was certainly not true to say alcohol was fatal in small doses, nor that it was instantly addictive, nor that it had no medical benefits. To get round this problem, Mary Hunt began creating her own text-books and eventually got herself into a position whereby she effectively had a veto over which physiology text-books reached American class-rooms. Authors either had to rewrite their books to demonise alcohol or face being black-listed.

As would be discovered after her death, Hunt was a crook and a fraud. She used her power of veto to demand bribes from publishers and stashed away royalties in a secret 'charity' which paid her mortgage. More importantly, the text-books she presided over were full of junk science. When a distinguished committee of academics investigated them in 1903, they found that she had misrepresented the views of scientists and fabricated quotes from the leading figures in the field. If she could not misquote a leading scientist, she would pretend that any old quack who agreed with her was a 'leading authority'. Her books completely ignored the medical benefits of alcohol and used fictitious horror stories to terrify children into believing that total abstinence was the only way to avoid the perils of alcohol.

One STI text-book, for example, told the story of a boy who “once drank whisky from a flask he had found and died in a few hours.” Another insisted that alcohol burns the flesh from the throat leaving it bare and raw. Above all, STI hammered home the message that fermentation turned food into a poison which could never be consumed safely. “This alcohol is poisonous,” read one text-book. “It is in its nature, even in small quantities, to harm any one who drinks it.”

The committee found that Scientific Temperance Instruction was “neither scientific, nor temperate, nor instructive.” They concluded that:

“The text-books are written with a deliberate purpose to frighten the children, the younger the better, so thoroughly that they will avoid all contact with alcohol.”

All of this is well documented. STI has gone down in history as a prime example of fanatics infiltrating the educational system for political ends. But what else could the prohibitionists do? If they accepted the real scientific evidence, they would have to accept that alcohol—as everyone knew—was dangerous in excess but benign, indeed healthy, in moderation.

I was reminded of STI today when I read a staggering article by David Nutt in The Guardian, in which he repeated all the lies about alcohol that were popularised by Mary Hunt in the 19th century.

The myth of a safe level of drinking is a powerful claim. It is one that many health professionals appear to believe in and that the alcohol industry uses to defend its strategy of making the drug readily available at low prices. However, the claim is wrong and the supporting evidence flawed.

There is no safe dose of alcohol for these reasons:

First we have the poison claim:

• Alcohol is a toxin that kills cells such as microorganisms, which is why we use it to preserve food and sterilise skin, needles etc.

The dose maketh the poison, David. This is the same kind of deliberate attempt to scare and deceive that leads fanatics to say that e-cigarettes contains a product that is used in anti-freeze or that secondhand smoke contains a chemical that is used in car batteries. It is deceit without having to tell a lie. They know, or at least they bloody well should know, that the levels are far too low to conceivably cause harm to man or beast, but they say it any way because, frankly, they are not the most honest of people and they know most people will interpret this information as intended (ie. wrongly).

Alcohol kills humans too. A dose only four times as high as the amount that would make blood levels exceed drink-driving limits in the UK can kill.

In some rare instances, perhaps. But people dying from excessive drinking is hardly proof that there is "no safe dose of alcohol."

Then we have the claim of instant addiction:

• Although most people do not become addicted to alcohol on their first drink, a small proportion do.

Evidence please.

As a clinical psychiatrist who has worked with alcoholics for more than 30 years, I have seen many people who have experienced a strong liking of alcohol from their very first exposure and then gone on to become addicted to it.

As opposed to people who have experienced a strong dislike of alcohol and then become addicted to it? As opposed to people who have never drunk alcohol but become addicted to it? What kind of nonsense is this? Obviously alcoholics started drinking at some point and later became addicted. That is hardly proof that people become addicted on their first drink—a claim for which there is no serious evidence whatsoever.

We cannot at present predict who these people will be, so any exposure to alcohol runs the risk of producing addiction in some users.

That is self-evident but, again, you have not supported your original argument. You're also assuming that alcoholism is the fault of the alcohol itself whereas most experts believe that alcoholism is a psychological disorder which could just as easily manifest itself in drug addiction or any other compulsive behaviour. Since most people do not become addicted to alcohol, let alone on their first sip, the consensus view seems more likely to be correct.

Then we have the no medicinal benefit claim:

• The supposed cardiovascular benefits of a low level of alcohol intake in some middle-aged men cannot be taken as proof that alcohol is beneficial. To do that one would need a randomised trial where part of this group drink no alcohol, others drink in small amounts and others more heavily. Until this experiment has been done we don't have proof that alcohol has health benefits.

This is a phony argument. We have masses of studies which have compared non-drinkers to light drinkers, and light drinkers to heavy drinkers (and not just for "some middle-aged men"). Virtually every single study has come to the same conclusion—that alcohol use reduces heart disease risk. A recent review of 31 studies in the British Medical Journal showed this very clearly.

Click, as ever, to enlarge. Everything to the left of the bold line is a reduction in risk. 29 of the 31 studies showed a reduction in risk, with 18 achieving statistical significance.

We all know that correlation doesn't equal causation but if we're going to treat these data skeptically, we need to have some alternative explanations for what is behind these findings if the obvious conclusion is to be rejected. Nutt has got nothing. Instead, he plays the Nirvana fallacy card. Since no epidemiological study is ever perfect, he wants us to ignore all the evidence until science can come up with an experiment that meets his criteria of 'proof'.

That will never happen. He knows perfectly well that a randomised study of the kind he demands could never be performed. It would require forcing a random selection of people to drink specified amounts of alcohol for decades. What he's doing here is no different to what the tobacco industry did when they said there was no absolute proof that smoking caused lung cancer. He's picking at one possible, but minor, flaw in the epidemiological evidence and demanding an impossible degree of proof without acknowledging the weight of evidence that already exists. It's a classic obfuscation tactic used by—for want of a better word—denialists.

• For all other diseases associated with alcohol there is no evidence of any benefit of low alcohol intake – the risks of accidents, cancer, ulcers etc rise inexorably with intake.

Have the studies that showed these inexorable rises been carried out under Nutt's exacting conditions? Of course not. They were normal epidemiological studies, but since they support his position he asks no questions of them. Nor does he mention that the cancers alcohol is associated with (primarily oral, throat and liver) are much rarer than diseases of the heart.

And here comes another rhetorical device favoured by those deep in denial...

A recent example of where an epidemiological association was found not to be true when tested properly was hormone replacement therapy. Population observations suggested that HRT was beneficial for post-menopausal women, but when controlled trials were conducted it was found to cause more harm than good.

This is such a tired and cheap trick. You pick one example of a study that later turned out to be incorrect and then imply that a totally unconnected body of evidence must also be wrong. It is a deliberate attempt to conflate preliminary studies that turn out to be wrong (as preliminary studies often are) with a body of evidence that consistently produces the same statistically significant results over many decades across large and diverse populations. This trick is usually associated with homeopaths, charlatans and assorted loonies who live by the mantra that "science doesn't know everything" (and, therefore, convince themselves that science knows nothing and they know it all).

We must not allow apologists for this toxic industry to pull the wool over our eyes with their myth of a safe alcohol dose, however appealing it might be to all us so-called "safe" drinkers.

His mouth is starting to froth a little now, I think. This appeal against industry is a familiar one these days for all sorts of single-issue campaigners. It was familiar in the nineteenth century too, with prohibitionists blaming their every set back on the 'liquor trust'. It was hokum then and it's hokum now. The scientific evidence that shows that alcohol is safely consumed by the vast majority of drinkers has not been manufactured by the drinks industry (or their "apologists"), nor has the evidence showing that alcohol has many medical benefits. It's based on science which is as reliable as epidemiology can get. Never perfect, I agree, but a damn sight more impressive than the muddled-thinking and innuendo that Nutt relies on.

Nutt finishes off by quoting JFK's famous speech in which he said a myth is more dangerous than a lie (prohibitionists used to quote Lincoln out of context when he was dead as well). Seriously, how dare this guy accuse other people of peddling myths when he has nothing to offer but lies, distortions and fallacious arguments? There is scarcely a grain of truth in Nutt's whole article, but there is much that is designed to mislead (successfully, judging by some of the comments).

David Nutt was briefly regarded as a heroic maverick a couple of years ago when he was sacked for his 'brave stance' on drugs. Like Brendan O'Neil and the Pub Curmudgeon, this blog warned at the time that his talk about drugs being less harmful than alcohol was not rooted in a desire to see a more liberal drugs policy but to see a more draconian alcohol policy. He has since proven us spectacularly correct but this new outburst plumbs new depths.

The stoners and alleged liberals who worship this guy need to wake up to the fact that he's just an old-fashioned temperance zealot who's finding it more and more difficult to cloak his hatred of alcohol in the language of science. One wonders how long it will be before he starts preaching in the street. As he unravels before our eyes, it seems less remarkable that the last government dispensed with his services than that they ever hired him in the first place.


Anonymous said...

Started a thread about this over on Bad Science.
Would you mind awfully, if I borrowed this post and reprinted it over there (with linky of course)?

You have summed up my thoughts on this matter better than I could have done.

Also, I have tried in the past to pull the wool from over the heads of cannabis users on the forum THC Talk who seem to regard this fellow as some kind of Demi-God.
I've recognised for some time that he is not some great Liberal, more a case of looking along the scaffold and asking to make sure everyones noose is tight enough.

Bald headed John.

Christopher Snowdon said...

Hi John,

I'm more of a JREF man myself but go for it!


Frank Davis said...

"pour a Niagara of ballets upon the saloon.”

Yeah, lots of dancing girls would do it!

Christopher Snowdon said...

Whoops. Duly corrected.

Anonymous said...

This is 'ad hominem', but I do not mean it to be so.
I wonder if Mr Nutt is trying to re-ingratiate himself? That might be true, but one might ask with whom he is trying to re-integrate?

Suppose that we say that anti-tobacco has more or less run its course. What is the next big thing? Is it not anti-alcohol? Divide et impera!

I firmly believe that MPs are clever. They would not have become MPs if they were not clever. But what do I mean by 'clever'?

Clever could mean getting rid of aircraft carriers to save money. Brilliant idea! Saves billions! Right, OK...but where are you going to get your skilled seaborne pilots from if you have no seaborne aircraft? Mr Clever will say that there is no need for seaborne pilots if there is no need for seaborne aircraft - until the need actually arises. At which point Mr Clever will quietly disappear - only to emerge later with some other clever idea.

Is that not what is wrong with politicians? And is not this trait just what ASH et al are exploiting?

Off topic, but I actually think that a politician has actually come up with a good idea. Duncan Smith's idea of a universal state pension is a good idea. However, as usual, the devil will be in the detail. In this case, the detail will be: 'At what age will this benefit be payable?' Also, one might ask: 'what would be the case in respect of immigrants?'

Thus, this really good idea is also subject to the limitations of 'cleverness'.

Could this simple idea still work? I believe so. A person bred and born in this country is fully entitled; an immigrant is only entitled for as long as he has lived here. If his income is less than the pension, then rules would have to be made to allow him a living income. Oddly, enough, that is not as difficult a problem as it may seem. This is all 'off topic', I suppose. And yet it shows the difference between 'clever' and 'thought through'.

Everything coming from ASH and co is clever. That is all. It is has not yet been observed that the stuff emanating from ASH is, in fact, persecution.

Anonymous said...

I will say again, PERSECUTION.

manwiddicombe said...

I think you have overlooked one really rather relevant piece of information that could effect how you view his article.


Anonymous said...

I heard Nutt talking to Iain Dale on LBC recently talking about the billions that drinking costs to the tax payer and posing the question "Why should non-drinkers pay for ...". That is the first time I have been aware of some one trying to create the identity of "non-drinkers" other than for the sake of argument.

Curmudgeon said...

I've written about this on my own blog and put a link back to your excellent and thorough demolition of Nutt's nonsense.

Anonymous said...

Got to admit you Nutt critics were right all along. He did a feature a feature on synthetic alcohol (see above) on TV. Perhaps he's aiming to be a one man Pfizer - so long as synthetic alcohol gets an easier ride than ecigs.

PeterJ said...

Your piece of history reminded me that something similar was happening here in the early 1960s, when a representative of the Band of Hope and Temperance Union came into our class at school and got us all to write an essay on 'The Effects of Alcohol on the Human Body'. Of course, this was based on Nutt-style nonsense told us beforehand.

I got a Certificate of Special Merit for my essay, which I later put up on the wall alongside the beermats in my student house.

It was saddening to find some commenters on the Guardian piece still backing Nutt as a brave supporter of drug legalisation, alongside some of the usual anti-alchohol extremists.

Drinks Industry said...

In the Uk there is an increasing number of laws and procedures coming in to place to halt the effect of alcohol and tabacco use. It's good to see an international perspective of the issue!