Wednesday, 22 July 2015

Drugs, harm and sceptical conservatism

I do occasionally stop thinking about the concept of evidence-based policy, but at the moment I seem to keep coming back to it.

With a certain arrogance, my aim in setting up this blog was to contribute to an open and honest debate on various policy issues, but particularly those relating to drugs and alcohol.

Regular readers will know that I don’t have much time for the idea that there is a single unquestionably ‘right’ answer to any policy problem, as every decision is necessarily a compromise.  I’m more interested in ensuring that when we’re making those compromises we’re going into them with our eyes open.

On the walk to work last Friday morning I was thinking about NPSs (novel psychoactive substances or ‘legal highs’) and nudging – and, oddly, but not unusually, sceptical conservatism.

My thought was that both nudging and this form of conservatism are based on a view of the world as being irrational, but functional.  It’s just that where sceptical conservatism thinks our ostensibly ‘irrational’ society has huge strengths, nudgers want to change our actions to make them more ‘rational’.

But what’s that got to do with NPS?

Well, I don’t think there’s any serious argument that our overarching policy approach to intoxicating substances is ‘rational’ – though perhaps that would be an oxymoron in any case.  Certainly there’s an inconsistency laid bare by the new Psychoactive Substances Bill in relation to caffeine, alcohol, nicotine and certain other substances.

As I’ve written before, I was optimistic that NPS and e-cigs might disrupt the status quo and get people to question current arrangements.  Others were more sceptical – and possibly more accurate.

But here’s the link between conservatism and nudging.  There are serious ethical debates around nudging, based on the fact that it operates on your unconscious ‘thinking’ – System 1.  But we are able to override this system (to some extent) with conscious thought (System 2).

So what if a ‘nudge’ lost (some of) its effectiveness if its aims and methods were broadcast?

That is, what if you told everyone that you were placing the doughnuts in a particular location in the cafĂ© in order to reduce their consumption – and telling people this meant they didn’t react to that move?  The whole approach potentially depends on us being in blissful ignorance.

And it’s the same with sceptical conservatism.  Society is too complex for us to understand, and it works reasonably well.  We shouldn’t think too hard about how it’s working and try to tweak things to make them more rational – that way lie the horrors of the French Revolution.

But then what’s all this irrationality and unconscious stuff got to do with NPS?

Well, as I said before, there’s a view that our drug policy isn’t strictly ‘rational’, but it isn’t disastrous, and a complete revamp would be hugely risky.  Alcohol and tobacco might not be so different from banned substances in terms of their pharmacology, but their unique histories mean they’re understood quite differently, so it could be argued that the ‘irrationality’ is perfectly ‘rational’ given the irrational place we find ourselves in.

I’d suggest that the Psychoactive Substances Bill is an attempt to support the status quo, and there’s no mention of ‘harm’ because to frame the debate in this way would highlight the inconsistency of this current approach.

So this is where sceptical conservatism, nudging and drug policy interact: we don’t talk about the irrationality of policy for fear that would destroy the illusion – and if we thought too carefully about alcohol and drugs, maybe the (arguably) functional arrangement we currently have would fall apart.

So is it possible that one way to keep harm from drugs down is to not talk about harm?  And is that a policy compromise worth making?