Can We Ever Replace Alcohol?
BROOKE GLADSTONE: This is On the Media. I’m Brooke Gladstone. We’ve spent this hour considering how alcohol has been folded into just about every facet of American life, church, leisure, creation, celebration, recreation, anguish and remorse. How can we escape its baleful impact? Even when it’s not literally in us, it’s still of us and all around us. Our friends across the pond struggle with the same questions. Experts estimate that over the next five years, 63,000 people will die from heavy drinking in England.
But David Nutt, a neuropsychopharmacologist at Imperial College London, may have found an antidote. He’s developed a less addictive, less toxic drink that produces a gentle high. For years, he helped steer England’s drug policy as a top government advisor, but that relationship was fraught.
DAVID NUTT: During my time, we made ketamine illegal, we made GHB illegal, we made crystal meth more illegal. But when we said things like, well, okay, so now there are drugs which should be made less illegal because they’re not as harmful as we used to think, drugs like cannabis, the penalty should be reduced, the government was not remotely interested. And I just carried on arguing that case and they carried on getting angry with me, and eventually they sacked me.
BROOKE GLADSTONE: You said that any drug less dangerous than alcohol should be available legally, right?
DAVID NUTT: I don’t think I said that while I was working for them.
[BROOKE LAUGHS]
But I’ve certainly said it subsequently. [LAUGHS]
While I was there, the terms I made to take on the job were that we had to start doing things properly, that we had to have some criteria for assessing harm. And over the next nine years, I developed actually two separate scales of harm. The first was a 9-point scale. But then after publishing that, I was approached by experts and they encouraged us to set up what’s called the MCDA approach, Multicriteria Decision Analysis approach. And that project ended up telling us that there were 16 harms that those can do, 9 harms to the user and 7 harms to society.
But as we were doing that, of course, we were applying those criteria to ongoing assessment. And during that time, we revisited ecstasy. It’s not as harmful as crack cocaine, it’s not as harmful as crystal meth, so it shouldn’t be a Class A drug. It should be Class B.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: And the government said, no, no, no, no, we daren’t change it because the newspapers won’t like it. And then we said cannabis should stay as a Class C drug; it’s definitely less harmful than Class B drugs. And the government said, no, we don’t like that, the newspapers want it to be Class B. And, in the end, we just had this continual tension between what politicians wanted and what the science was telling us.
BROOKE GLADSTONE: So, after you were fired, you released a study that asserted alcohol was actually the most dangerous drug in the UK, more dangerous than heroin or cocaine, even.
DAVID NUTT: Yes, after being sacked, I then did the study where we used the 16 parameters of harm and we then applied them to 20 drugs. So that particular study, published in The Lancet in 2010, showed that alcohol was the most harmful drug in the UK because the harm to other people was vast.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: Things like traffic accidents, like costs to the Health Service, the cost of policing, the lost productivity from hangovers, the, the child abuse, spousal abuse, etc. Alcohol, because of its pervasive use and its disinhibiting effects, is an enormously damaging drug to society. It’s not the most harmful drug to the user. I think crack, crystal heroin were the most dangerous drugs to the users.
BROOKE GLADSTONE: Mm-hmm. [AFFIRMATIVE]
DAVID NUTT: But alcohol, because of its prevalence of use, was the most harmful drug overall.
BROOKE GLADSTONE: So tell me about the range of feedback you got from other scientists and from the government.
DAVID NUTT: Of the 110,000 medical papers published in the last 10 years, the paper itself is in the top .3% of all citations, so it’s massively cited by other scientists. And, actually, we replicated it with a separate group of scientists in Europe and they came out with almost the rankings, so we’re pretty sure it’s right.
BROOKE GLADSTONE: So why do you think that alcohol and illegal drugs are treated so differently?
DAVID NUTT: Well, because the drinks industry watched how the tobacco industry made a hash of it by claiming that nicotine wasn’t addictive and then got really steamrollered when it turned out it was lying. So the drinks industry doesn’t say alcohol is not addictive. “Use responsibly,” it says. It’s avoided confrontation with scientists.
The second thing it’s done is it lobbies ferociously. It’s managed to put huge amounts of money into the pockets of politicians and it dishes dirt on other drugs, like cannabis, so that it doesn’t have any competition in the marketplace.
BROOKE GLADSTONE: So how would you change the rules about drugs and alcohol to put them more in line with science?
DAVID NUTT: I’ll start with what I would do based on what we know from other countries works. So, for instance, we know that now in your country, some of your states and in the Netherlands and Uruguay, the regulated cannabis market works, it’s safe, it doesn’t cause massive social harm, etc. So I would bring cannabis out of the illegal realm. That’s the first thing I’d do. The second thing I would do is I’d actually decriminalize personal possession of all drugs.
BROOKE GLADSTONE: All drugs?
DAVID NUTT: All drugs, and let me explain why. Personal possession, right? Ninety percent of people who are caught with drugs in their possession for personal use, their lives will be more affected by the criminal sanction than they will be harmed by the drug. And for the 10% who are actually addicted to the drug, then they’ve got an illness and putting them in prison or giving them a criminal sanction because they’re ill, it seems particularly inhumane.
And we know that decriminalizing possession, which is what the Portuguese have done, has huge economic benefits because if you treat people who use drugs as ill, rather than as criminals, you save a lot of money. And there’s another hidden benefit, which is that if you give someone a criminal record for drug possession, there’s very little else they can do in life but deal drugs. So you create an underclass, and, and underclasses live on crime and drugs.
In the 15 years since they decriminalized drug possession in Portugal, deaths from heroin have fallen to one-third of what they were before. Because people are in treatment, the number of users has gone down and, therefore, the number of deaths has gone down.
BROOKE GLADSTONE: Mmm.
DAVID NUTT: In the same 15 years in Britain, heroin deaths have gone up by a third. So we’re trying to do what Americans do, which is to criminalize our way out of the problem, and all we do is create more deaths.
BROOKE GLADSTONE: A couple of years back, you went on the BBC and proposed creating something totally new, a safe alcohol, alcosynth. Why?
DAVID NUTT: Most of my professional career, I have been involved in trying to reduce the harms of alcohol. Back in the late ‘70s, ‘80s, I kind of developed an antidote to alcohol. I could sober up rats that were very drunk. But then about 10 years ago, I realized whatever you did, you could never get rid of the intrinsic harms of alcohol because it’s metabolized to acetaldehyde, and acetaldehyde is a toxic substance.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: You know, whatever we do, if I can sober people up, the acetaldehyde is still pickling their liver. If I stop them from having hangovers, the acetaldehyde is still damaging their brain. Having spent 30 years looking at the pharmacology of alcohol, I realized there were substances out there that actually could replicate some of the positive effects of alcohol but be much, much less harmful.
BROOKE GLADSTONE: So what kind of reaction did you get to your announcement?
DAVID NUTT: I got some newspapers called me, you know, the Nutty Professor and other people saying, you know, this is a fantastic vision. The problem is I didn’t get any money. You can’t get money from governments to do this. There are 4 million premature deaths a year from alcohol. If we switched everyone to alcosynth, we’d save more people dying than eliminating malaria, tuberculosis and meningitis in the world. So it would be a massive health benefit but it’s just too left field for governments to invest. So I’m looking for private investors.
BROOKE GLADSTONE: You know, the way we respond to alcohol is so subjective. Some of us get happy. Some of us get hostile. Do you know how people would react to alcosynth?
DAVID NUTT: Well, we’ve tested it on fair numbers of people and most people get relaxed and happy. Yeah, there will always be some individuals who will have idiosyncratic reactions. You can’t avoid that. But the good thing is it’s a lot safer. You can’t overdose on it. It’s not going to kill you. I mean, we lose 3 young people a week in Britain from alcohol poisoning. In the States, you must probably lose 30 or 40. So we can put ourselves in a position where we do have a massive, massive reduction in harm.
BROOKE GLADSTONE: Some of your colleagues, when you made the announcement, dismissed the idea as just scientifically infeasible.
DAVID NUTT: they’re wrong. We’ve tested it and we have a number of substances which are enjoyed as much as a glass or two of wine. You know, we -- you’re not going to get completely out of head on it. People who want to be completely blasted aren’t going to go for this but people who would want to have a mellow pleasant sociable evening with their friends are.
BROOKE GLADSTONE: What if you take too much?
DAVID NUTT: Yeah, well, very cleverly, we’ve worked out how to plateau out the effect, so if you take too much you’re just wasting your money because the effect doesn’t go on, unlike with alcohol, which just builds up and builds up ‘til it kills you.
I expect there are a lot of people out there who would quite like the pleasurable effects of alcohol but they don’t want the calories, which, of course, are huge in alcohol. Our drink has a very few calories. But also, they don’t want to damage their body or put their body at risk. So I think the population will be very welcoming of this.
BROOKE GLADSTONE: How does it taste?
DAVID NUTT: It tastes like whatever you want to put it in, so you choose your favorite cocktail and we put it in there. It’s a mixer.
BROOKE GLADSTONE: You said that we have a hostility toward drug innovation. Why do you think so? I mean, isn’t there money in this?
DAVID NUTT: I mean, the drinks industry knows it’s going to come but it’s going to fight tooth and nail to stop it.
BROOKE GLADSTONE: Until it starts producing it.
DAVID NUTT: Exactly. It’s just like the E-cigarettes. Once they realized that people want safer cigarettes, the industry will then switch.
I don’t know if you saw a couple of weeks ago that Corona, the people that make Mexican beer, Corona --
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: -- they took out a 200-million-pound share of a cannabis company in Canada with a view to making cannabis drinks. So I think that the alcohol industry realizes the future is going to be much more complex.
BROOKE GLADSTONE: So how many evenings have you spent by the fire with a nice hot alcosynth toddy?
DAVID NUTT: I prefer it with ice in it but quite a few. I never thought about it. It probably would go into a nice glass of hot milk, as well.
BROOKE GLADSTONE: Do you really think that this is going to work? You say that in a couple of months there’ll be a patent out there. Do you think this will actually get to market?
DAVID NUTT: Yes, it will.
BROOKE GLADSTONE: You do.
DAVID NUTT: It will do in various interesting places like, for instance, the Middle East, where alcohol is forbidden.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: A huge, huge market there. China, half of all the alcohol sales in the world are in China. The Chinese government is desperate. We’re working with the Chinese government at present, trying to work out ways in which we could minimize the damage to the Chinese economy about drinking. There are smart places out there that would accept this enthusiastically, I’m certain.
BROOKE GLADSTONE: What about UK and the States?
DAVID NUTT: I think UK is really -- we’re very backward, but I think the US, with your more rational approach in many states to recreational cannabis, there’s no conceivable reason, well, intellectual reason why you wouldn’t then support a safer alcohol would you. I mean, you’ve been rational about cannabis. Maybe you’ll be rational about this.
[MUSIC UP & UNDER]
BROOKE GLADSTONE: David, thank you very much.
DAVID NUTT: It’s been an absolutely pleasure. Thank you.
BROOKE GLADSTONE: David Nutt is the director of the Neuropsychopharmacology Unit in the Division of Brain Sciences at Imperial College London.
This week’s show was pitched to us by Mary Harris and Christopher Johnson from WNYC’s health desk. On the Media is produced by Alana Casanova—Burgess, Jesse Brenneman, Micah Loewinger and Leah Feder. We had more help from Jon Hanrahan, Isaac Naple and Philip Yiannopoulos. Our technical director is Jennifer Munson. Our engineer this week was Sam Bair.
Thanks also to Andy Lanset, head of the WNYC Archives.
Katya Rogers is our executive producer. On the Media is a production of WNYC Studios. Bob Garfield will be back next week. I’m Brooke Gladstone.
BROOKE GLADSTONE: This is On the Media. I’m Brooke Gladstone. We’ve spent this hour considering how alcohol has been folded into just about every facet of American life, church, leisure, creation, celebration, recreation, anguish and remorse. How can we escape its baleful impact? Even when it’s not literally in us, it’s still of us and all around us. Our friends across the pond struggle with the same questions. Experts estimate that over the next five years, 63,000 people will die from heavy drinking in England.
But David Nutt, a neuropsychopharmacologist at Imperial College London, may have found an antidote. He’s developed a less addictive, less toxic drink that produces a gentle high. For years, he helped steer England’s drug policy as a top government advisor, but that relationship was fraught.
DAVID NUTT: During my time, we made ketamine illegal, we made GHB illegal, we made crystal meth more illegal. But when we said things like, well, okay, so now there are drugs which should be made less illegal because they’re not as harmful as we used to think, drugs like cannabis, the penalty should be reduced, the government was not remotely interested. And I just carried on arguing that case and they carried on getting angry with me, and eventually they sacked me.
BROOKE GLADSTONE: You said that any drug less dangerous than alcohol should be available legally, right?
DAVID NUTT: I don’t think I said that while I was working for them.
[BROOKE LAUGHS]
But I’ve certainly said it subsequently. [LAUGHS]
While I was there, the terms I made to take on the job were that we had to start doing things properly, that we had to have some criteria for assessing harm. And over the next nine years, I developed actually two separate scales of harm. The first was a 9-point scale. But then after publishing that, I was approached by experts and they encouraged us to set up what’s called the MCDA approach, Multicriteria Decision Analysis approach. And that project ended up telling us that there were 16 harms that those can do, 9 harms to the user and 7 harms to society.
But as we were doing that, of course, we were applying those criteria to ongoing assessment. And during that time, we revisited ecstasy. It’s not as harmful as crack cocaine, it’s not as harmful as crystal meth, so it shouldn’t be a Class A drug. It should be Class B.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: And the government said, no, no, no, no, we daren’t change it because the newspapers won’t like it. And then we said cannabis should stay as a Class C drug; it’s definitely less harmful than Class B drugs. And the government said, no, we don’t like that, the newspapers want it to be Class B. And, in the end, we just had this continual tension between what politicians wanted and what the science was telling us.
BROOKE GLADSTONE: So, after you were fired, you released a study that asserted alcohol was actually the most dangerous drug in the UK, more dangerous than heroin or cocaine, even.
DAVID NUTT: Yes, after being sacked, I then did the study where we used the 16 parameters of harm and we then applied them to 20 drugs. So that particular study, published in The Lancet in 2010, showed that alcohol was the most harmful drug in the UK because the harm to other people was vast.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: Things like traffic accidents, like costs to the Health Service, the cost of policing, the lost productivity from hangovers, the, the child abuse, spousal abuse, etc. Alcohol, because of its pervasive use and its disinhibiting effects, is an enormously damaging drug to society. It’s not the most harmful drug to the user. I think crack, crystal heroin were the most dangerous drugs to the users.
BROOKE GLADSTONE: Mm-hmm. [AFFIRMATIVE]
DAVID NUTT: But alcohol, because of its prevalence of use, was the most harmful drug overall.
BROOKE GLADSTONE: So tell me about the range of feedback you got from other scientists and from the government.
DAVID NUTT: Of the 110,000 medical papers published in the last 10 years, the paper itself is in the top .3% of all citations, so it’s massively cited by other scientists. And, actually, we replicated it with a separate group of scientists in Europe and they came out with almost the rankings, so we’re pretty sure it’s right.
BROOKE GLADSTONE: So why do you think that alcohol and illegal drugs are treated so differently?
DAVID NUTT: Well, because the drinks industry watched how the tobacco industry made a hash of it by claiming that nicotine wasn’t addictive and then got really steamrollered when it turned out it was lying. So the drinks industry doesn’t say alcohol is not addictive. “Use responsibly,” it says. It’s avoided confrontation with scientists.
The second thing it’s done is it lobbies ferociously. It’s managed to put huge amounts of money into the pockets of politicians and it dishes dirt on other drugs, like cannabis, so that it doesn’t have any competition in the marketplace.
BROOKE GLADSTONE: So how would you change the rules about drugs and alcohol to put them more in line with science?
DAVID NUTT: I’ll start with what I would do based on what we know from other countries works. So, for instance, we know that now in your country, some of your states and in the Netherlands and Uruguay, the regulated cannabis market works, it’s safe, it doesn’t cause massive social harm, etc. So I would bring cannabis out of the illegal realm. That’s the first thing I’d do. The second thing I would do is I’d actually decriminalize personal possession of all drugs.
BROOKE GLADSTONE: All drugs?
DAVID NUTT: All drugs, and let me explain why. Personal possession, right? Ninety percent of people who are caught with drugs in their possession for personal use, their lives will be more affected by the criminal sanction than they will be harmed by the drug. And for the 10% who are actually addicted to the drug, then they’ve got an illness and putting them in prison or giving them a criminal sanction because they’re ill, it seems particularly inhumane.
And we know that decriminalizing possession, which is what the Portuguese have done, has huge economic benefits because if you treat people who use drugs as ill, rather than as criminals, you save a lot of money. And there’s another hidden benefit, which is that if you give someone a criminal record for drug possession, there’s very little else they can do in life but deal drugs. So you create an underclass, and, and underclasses live on crime and drugs.
In the 15 years since they decriminalized drug possession in Portugal, deaths from heroin have fallen to one-third of what they were before. Because people are in treatment, the number of users has gone down and, therefore, the number of deaths has gone down.
BROOKE GLADSTONE: Mmm.
DAVID NUTT: In the same 15 years in Britain, heroin deaths have gone up by a third. So we’re trying to do what Americans do, which is to criminalize our way out of the problem, and all we do is create more deaths.
BROOKE GLADSTONE: A couple of years back, you went on the BBC and proposed creating something totally new, a safe alcohol, alcosynth. Why?
DAVID NUTT: Most of my professional career, I have been involved in trying to reduce the harms of alcohol. Back in the late ‘70s, ‘80s, I kind of developed an antidote to alcohol. I could sober up rats that were very drunk. But then about 10 years ago, I realized whatever you did, you could never get rid of the intrinsic harms of alcohol because it’s metabolized to acetaldehyde, and acetaldehyde is a toxic substance.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: You know, whatever we do, if I can sober people up, the acetaldehyde is still pickling their liver. If I stop them from having hangovers, the acetaldehyde is still damaging their brain. Having spent 30 years looking at the pharmacology of alcohol, I realized there were substances out there that actually could replicate some of the positive effects of alcohol but be much, much less harmful.
BROOKE GLADSTONE: So what kind of reaction did you get to your announcement?
DAVID NUTT: I got some newspapers called me, you know, the Nutty Professor and other people saying, you know, this is a fantastic vision. The problem is I didn’t get any money. You can’t get money from governments to do this. There are 4 million premature deaths a year from alcohol. If we switched everyone to alcosynth, we’d save more people dying than eliminating malaria, tuberculosis and meningitis in the world. So it would be a massive health benefit but it’s just too left field for governments to invest. So I’m looking for private investors.
BROOKE GLADSTONE: You know, the way we respond to alcohol is so subjective. Some of us get happy. Some of us get hostile. Do you know how people would react to alcosynth?
DAVID NUTT: Well, we’ve tested it on fair numbers of people and most people get relaxed and happy. Yeah, there will always be some individuals who will have idiosyncratic reactions. You can’t avoid that. But the good thing is it’s a lot safer. You can’t overdose on it. It’s not going to kill you. I mean, we lose 3 young people a week in Britain from alcohol poisoning. In the States, you must probably lose 30 or 40. So we can put ourselves in a position where we do have a massive, massive reduction in harm.
BROOKE GLADSTONE: Some of your colleagues, when you made the announcement, dismissed the idea as just scientifically infeasible.
DAVID NUTT: they’re wrong. We’ve tested it and we have a number of substances which are enjoyed as much as a glass or two of wine. You know, we -- you’re not going to get completely out of head on it. People who want to be completely blasted aren’t going to go for this but people who would want to have a mellow pleasant sociable evening with their friends are.
BROOKE GLADSTONE: What if you take too much?
DAVID NUTT: Yeah, well, very cleverly, we’ve worked out how to plateau out the effect, so if you take too much you’re just wasting your money because the effect doesn’t go on, unlike with alcohol, which just builds up and builds up ‘til it kills you.
I expect there are a lot of people out there who would quite like the pleasurable effects of alcohol but they don’t want the calories, which, of course, are huge in alcohol. Our drink has a very few calories. But also, they don’t want to damage their body or put their body at risk. So I think the population will be very welcoming of this.
BROOKE GLADSTONE: How does it taste?
DAVID NUTT: It tastes like whatever you want to put it in, so you choose your favorite cocktail and we put it in there. It’s a mixer.
BROOKE GLADSTONE: You said that we have a hostility toward drug innovation. Why do you think so? I mean, isn’t there money in this?
DAVID NUTT: I mean, the drinks industry knows it’s going to come but it’s going to fight tooth and nail to stop it.
BROOKE GLADSTONE: Until it starts producing it.
DAVID NUTT: Exactly. It’s just like the E-cigarettes. Once they realized that people want safer cigarettes, the industry will then switch.
I don’t know if you saw a couple of weeks ago that Corona, the people that make Mexican beer, Corona --
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: -- they took out a 200-million-pound share of a cannabis company in Canada with a view to making cannabis drinks. So I think that the alcohol industry realizes the future is going to be much more complex.
BROOKE GLADSTONE: So how many evenings have you spent by the fire with a nice hot alcosynth toddy?
DAVID NUTT: I prefer it with ice in it but quite a few. I never thought about it. It probably would go into a nice glass of hot milk, as well.
BROOKE GLADSTONE: Do you really think that this is going to work? You say that in a couple of months there’ll be a patent out there. Do you think this will actually get to market?
DAVID NUTT: Yes, it will.
BROOKE GLADSTONE: You do.
DAVID NUTT: It will do in various interesting places like, for instance, the Middle East, where alcohol is forbidden.
BROOKE GLADSTONE: Mm-hmm.
DAVID NUTT: A huge, huge market there. China, half of all the alcohol sales in the world are in China. The Chinese government is desperate. We’re working with the Chinese government at present, trying to work out ways in which we could minimize the damage to the Chinese economy about drinking. There are smart places out there that would accept this enthusiastically, I’m certain.
BROOKE GLADSTONE: What about UK and the States?
DAVID NUTT: I think UK is really -- we’re very backward, but I think the US, with your more rational approach in many states to recreational cannabis, there’s no conceivable reason, well, intellectual reason why you wouldn’t then support a safer alcohol would you. I mean, you’ve been rational about cannabis. Maybe you’ll be rational about this.
[MUSIC UP & UNDER]
BROOKE GLADSTONE: David, thank you very much.
DAVID NUTT: It’s been an absolutely pleasure. Thank you.
BROOKE GLADSTONE: David Nutt is the director of the Neuropsychopharmacology Unit in the Division of Brain Sciences at Imperial College London.
This week’s show was pitched to us by Mary Harris and Christopher Johnson from WNYC’s health desk. On the Media is produced by Alana Casanova—Burgess, Jesse Brenneman, Micah Loewinger and Leah Feder. We had more help from Jon Hanrahan, Isaac Naple and Philip Yiannopoulos. Our technical director is Jennifer Munson. Our engineer this week was Sam Bair.
Thanks also to Andy Lancet, head of the WNYC Archives.
Katya Rogers is our executive producer. On the Media is a production of WNYC Studios. Bob Garfield will be back next week. I’m Brooke Gladstone.