David Nutt

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This article is about the neuropsychopharmacologist. For the publisher, see David Nutt (publisher).
David John Nutt
Picture of David Nutt

David Nutt during a presentation in Oslo, May 22nd 2013.
Born (1951-04-16) 16 April 1951
Institutions Imperial College London
University of Cambridge
University of Oxford
University of Bristol
Guy's Hospital
Advisory Council on the Misuse of Drugs (ACMD)
Independent Scientific Committee on Drugs (ISCD)
Alma mater Downing College, Cambridge
Thesis The effect of convulsions and drugs on seizure susceptibility in rats (1982)
Known for Equasy controversy[3]
Website
drugscience.org.uk
David Nutt's voice
from the BBC programme The Life Scientific (BBC Radio 4), 18 Sep 2012[4]

David John Nutt (born 16 April 1951) DM FRCP FRCPsych FMedSci is a British psychiatrist and neuropsychopharmacologist specialising in the research of drugs that affect the brain and conditions such as addiction, anxiety and sleep.[5] He was until 2009 a professor at the University of Bristol heading their Psychopharmacology Unit.[6] Since then he has been the Edmond J Safra chair in Neuropsychopharmacology at Imperial College, London.[7] Nutt was a member of the Committee on Safety of Medicines, and was President of the European College of Neuropsychopharmacology.[8][9][10]

Career summary and research

Nutt completed his secondary education at Bristol Grammar School and then studied medicine at Downing College, Cambridge, graduating in 1972. In 1975, he completed his clinical training at Guy's Hospital.[11]

He worked as a clinical scientist at the Radcliffe Infirmary from 1978 to 1982 where he carried out important basic research into the function of the benzodiazepine receptor/GABA ionophore complex, the long term effects of BZ agonist treatment and kindling with BZ partial inverse agonists. This work culminated in a ground-breaking paper in Nature (journal) in 1982[12] which described the concept of inverse agonism (using his preferred term, 'contragonism') for the first time. From 1983 to 1985, he lectured in psychiatry at the University of Oxford. In 1986, he was the Fogarty visiting scientist at the National Institute on Alcohol Abuse and Alcoholism in Bethesda, MD, just outside of Washington, D.C. Returning to the UK in 1988, he joined the University of Bristol as director of the Psychopharmacology Unit. In 2009, he then established the Department of Neuropsychopharmacology and Molecular Imaging at Imperial College, London, taking a new chair endowed by the Edmond J Safra Philanthropic Foundation.[11] He is an editor of the Journal of Psychopharmacology.[13]

His current research focuses on brain circuits and receptors in anxiety and addiction, and on the pharmacology of sleep. This involves the study of GABA receptors, using labelled subtypes of GABA 5, and serotonin, or 5-HT, receptors. Type 1 5-HT receptors seem to be especially important in depression and the action of anti-depressants.[6]

In 2007 Nutt published a controversial study on the harms of drug use in The Lancet.[1] Eventually, this led to his sacking from his position in the Advisory Council on the Misuse of Drugs (ACMD); see government positions below. Subsequently, Nutt and a number of his colleagues who had subsequently resigned from the ACMD founded the Independent Scientific Committee on Drugs.[14]

A summary of the results from Nutt's 2010 paper in The Lancet

In November 2010, Nutt published another study in The Lancet, co-authored with Les King and Lawrence Phillips on behalf of this independent Committee. This ranked the harm done to user and society by a range of drugs.[15] Owing in part to criticism over the arbitrary weighting of the factors in the 2007 study,[14][16] the new study employed a multi-criteria decision analysis procedure and found that alcohol is more harmful to society than both heroin and crack, while heroin, crack and methylamphetamine (crystal meth) were the most harmful drugs to individuals.[15] Nutt has also written about this topic in newspapers for the general public,[17] sometimes leading to public disagreements with other researchers.[18]

A synthetic alcohol substitute based on benzodiazepines, proposed for alcoholic beverages which give the drinker the effects of drunkenness without many of the risks of alcohol, is currently being developed by a team at Imperial College London under the leadership of Nutt.[19]

Government positions

Professor Nutt worked as an advisor to the Ministry of Defence, Department of Health and the Home Office.[11]

He served on the Committee on Safety of Medicines where he participated in an enquiry into the use of SSRI anti-depressants in 2003. His participation was criticised as, owing to his financial interest in GlaxoSmithKline, he had to withdraw from discussions of the drug Seroxat.[20] In January 2008 he was appointed as the chairman of the Advisory Council on the Misuse of Drugs (ACMD), having previously been Chair of the Technical Committee of the ACMD for seven years.[5]

A figure using data from a paper in the journal, The Lancet ranking the relative negative effects of different drugs. The paper was written by Nutt and included in his controversial lecture[1][2]

As ACMD chairman Nutt repeatedly clashed with government ministers over issues of drug harm and classification. In January 2009 he published in the Journal of Psychopharmacology an editorial ('Equasy – An overlooked addiction with implications for the current debate on drug harms') in which the risks associated with horse riding (1 serious adverse event every ~350 exposures) were compared to those of taking ecstasy (1 serious adverse event every ~10,000 exposures).[3] In February 2009 he was criticised by Home Secretary Jacqui Smith for stating in the paper that the drug ecstasy was statistically no more dangerous than an addiction to horse-riding.[21] Speaking to the Daily Telegraph, Nutt said that the point was "to get people to understand that drug harm can be equal to harms in other parts of life". Jacqui Smith claimed to be "surprised and profoundly disappointed" by the remarks, and added: "I'm sure most people would simply not accept the link that he makes up in his article between horse riding and illegal drug taking". She also insisted that he apologise for his comments, and asked him to apologise also to 'the families of the victims of ecstasy'.[22]

The issue of the mismatch between lawmakers' classification of recreational drugs, in particular that of cannabis, and scientific measures of their harmfulness surfaced again in October 2009, after the publication of a pamphlet[23] containing a lecture Nutt had given to the Centre for Crime and Justice Studies at King's College London in July 2009. In this, Nutt repeated his familiar view that illicit drugs should be classified according to the actual evidence of the harm they cause, and presented an analysis in which nine 'parameters of harm' (grouped as 'physical harm', 'dependence', 'and 'social harms') revealed alcohol and tobacco to be more harmful than LSD, ecstasy and cannabis. In this ranking, alcohol came fifth behind heroin, cocaine, barbiturates and methadone, and tobacco ranked ninth, ahead of cannabis, LSD and ecstasy, he said. In this classification, alcohol and tobacco appeared as Class B drugs, and cannabis was placed at the top of Class C. Nutt also argued that taking cannabis created only a "relatively small risk" of psychotic illness,[24] and that "the obscenity of hunting down low-level cannabis users to protect them is beyond absurd".[25] Nutt objected to the recent re-upgrading (after 5 years) of cannabis from a Class C drug back to a Class B drug (and thus again on a par with amphetamines), considering it politically motivated rather than scientifically justified.[2] In October 2009 Nutt had a public disagreement with psychiatrist Robin Murray in the pages of The Guardian about the dangers of cannabis in triggering psychosis.[18]

Dismissal

Following the release of this pamphlet, Nutt was dismissed from his ACMD position by the Home Secretary, Alan Johnson. Explaining his dismissal of Nutt, Alan Johnson wrote in a letter to The Guardian, that "He was asked to go because he cannot be both a government adviser and a campaigner against government policy. [...] As for his comments about horse riding being more dangerous than ecstasy, which you quote with such reverence, it is of course a political rather than a scientific point."[26] Responding in The Times, Professor Nutt said: "I gave a lecture on the assessment of drug harms and how these relate to the legislation controlling drugs. According to Alan Johnson, the Home Secretary, some contents of this lecture meant I had crossed the line from science to policy and so he sacked me. I do not know which comments were beyond the line or, indeed, where the line was [...]"[27]

In the wake of Nutt's dismissal, Dr Les King, a part-time advisor to the Department of Health, and the senior chemist on the ACMD, resigned from the body.[28] His resignation was soon followed by that of Marion Walker, Clinical Director of Berkshire Healthcare NHS Foundation Trust's substance misuse service, and the Royal Pharmaceutical Society's representative on the ACMD.[29]

The Guardian revealed that Alan Johnson ordered what was described as a 'snap review' of the 40-strong ACMD in October 2009. This, it was said, would assess whether the body is "discharging the functions" that it was set up to deliver and decide if it still represented value for money for the public. The review is to be conducted by David Omand.[30] Within hours of that announcement, an article was published online by The Times arguing that Nutt's controversial lecture actually conformed to government guidelines throughout.[31] This issue was further publicised a week later when Liberal Democrat science spokesman Dr Evan Harris, MP, attacked the Home Secretary for apparently having misled Parliament and the country in his original statement about Nutt's dismissal.[32]

John Beddington, the Chief Scientific Adviser to the UK Government stated that he agreed with the views of Professor Nutt on cannabis. When asked if he agreed whether cannabis was less harmful than cigarettes and alcohol, he replied: "I think the scientific evidence is absolutely clear cut. I would agree with it."[33] A few days later, it was revealed that a leaked email from the government's Science Minister Lord Drayson was quoted as saying Mr Johnson's decision to dismiss Nutt without consulting him was a "big mistake" that left him "pretty appalled".[34]

On 4 November, the BBC reported that Nutt had financial backing to create a new independent drug research body if the ACMD was disbanded or proved incapable of functioning.[35] This new body, The Independent Scientific Committee on Drugs, was launched in January 2010. On 11 November, after a meeting between ACMD and Alan Johnson, three other scientists tendered their resignations, Dr Simon Campbell, a chemist, psychologist Dr John Marsden and scientific consultant Ian Ragan.[36]

In an 11 November 2009 editorial in The Lancet, Nutt explicitly attributed his dismissal to a conflict between government and science, and reiterated that "I have repeatedly stated [cannabis] is not safe, but that the idea that you can reduce use through raising the classification in the Misuse of Drugs Act from class C to class B—where it had previously been placed, but thus now increasing the maximum penalty for possession for personal use to 5 years in prison—is implausible."[37] In a rejoinder, William Cullerne Bown of Research Fortnight pointed out that the framing of science vs. government was misleading because the weighting of the factors in Nutt's 2007 Lancet paper was arbitrary, and consequently that there was no scientific answer to ranking drugs.[38] In reply, Nutt admitted the limitations of the original study, and wrote that ACMD was in the process of devising a multicriteria decision-making approach when he was dismissed. Nutt reiterated that "The repeated claims by Gordon Brown's government that it had scientific evidence that trumped that of the ACMD and the acknowledgment that it was only interested in scientific evidence that supported its political aims was a cynical misuse of scientific evidence that breached the principles of the 1971 Act and was insulting to Council." Nutt announced that he and number of colleagues that had resigned from the ACMD had set up an Independent Scientific Committee on Drugs.[14]

A subsequent review of policy drafted by Lord Drayson[14] essentially reaffirmed that the scientific advisers to the government can be dismissed under similar circumstances: "Government and its scientific advisers should not act to undermine mutual trust."[39] This clause was kept despite protest from Sense About Science, Campaign for Science and Engineering, and liberal-democrat MP Evan Harris; according to Lord Drayson, the clause was requested by John Beddington, the Chief Scientific Adviser to the UK Government.[40] Les Iversen was announced as the successor of Nutt as the chair of the ACMD in January 2010.[41]

Honours

He is a Fellow of the Royal College of Physicians, Royal College of Psychiatrists and the Academy of Medical Sciences. He holds visiting professorships in Australia, New Zealand and the Netherlands. He is a past president of the British Association of Psychopharmacology and of the European College of Neuropsychopharmacology.[11] He is currently the president of the British Neuroscience Association and vice-president of the European Brain Council. He was the recipient of the 2013 John Maddox Prize [42] for promoting sound science and evidence on a matter of public interest, whilst facing difficulty or hostility in doing so.

Publications

Articles

for example:

Books

  • David J. Nutt (2012). Drugs Without the Hot Air: Minimising the Harms of Legal and Illegal Drugs. Cambridge: UIT. ISBN 1-906860-16-5. 

Medical and Science

Pharmacotherapy

  • David J. Nutt, Roni Shiloh, Stryjer Rafael, Abraham Weizman (2005). Essentials in Clinical Psychiatric Pharmacotherapy, Second Edition. London ; New York: Taylor & Francis. ISBN 0-415-39983-1.  1st ed(2001):ISBN 1-84184-092-0.
  • David J. Nutt, Roni Shiloh, Rafael Stryjer, Abraham Weizman (2006). Atlas of Psychiatric Pharmacotherapy, Second Edition. New York: Taylor & Francis. ISBN 1-84184-281-8.  1st ed(1999):ISBN 1-85317-630-3.
  • David J. Nutt, Adam Doble, Ian L. Martin (2001). Calming the brain: benzodiazepines and related drugs from laboratory to clinic. London: Martin Dunitz. ISBN 1-84184-052-1. 
  • David J. Nutt, Mike Briley (2000). Anxiolytics. Basel etc.: Birkhäuser Verlag. ISBN 3-7643-6032-1. 
  • David J. Nutt, Wallace B. Mendelson (1995). Hypnotics and Anxiolytics. London: Bailliere Tindall. ISBN 0-7020-1955-0. 

Brain Science

  • David J. Nutt, Martin Sarter, Richard G. Lister (1995). Benzodiazepine receptor inverse agonists. New York: Wiley-Liss. ISBN 0-471-56173-8. 

Addiction and associated disorder

Anxiety disorders

  • David J. Nutt, James C. Ballenger (2003). Anxiety disorders. Oxford: Blackwell Science. ISBN 0-632-05938-9. 
  • David J. Nutt, Eric J.L. Griez, Carlo Faravelli, Joseph Zohar (2001). Anxiety disorders: an introduction to clinical management and research. New York: Wiley. doi:10.1002/0470846437. ISBN 0-471-97873-6. 
  • David J. Nutt, Spilios Argyropoulos, Adrian Feeney (2002). Anxiety Disorders Comorbid with Depression: Panic Disorder and Agoraphobia. London: Martin Dunitz. ISBN 1-84184-049-1. 
  • David J. Nutt, Karl Rickels, Dan J. Stein (2002). Generalised Anxiety Disorder: Symptomatology, Pathogenesis and Management. London: Martin Dunitz. ISBN 1-84184-131-5. 
  • David J. Nutt, Spilios Argyropoulos, Sam Forshall (2001). Generalized Anxiety Disorder: Diagnosis, Treatment and Its Relationship to Other Anxiety Disorders, 3rd edition. London: Martin Dunitz. ISBN 1-84184-135-8.  1st ed(1998):ISBN 1-85317-659-1 .
  • David J. Nutt, Spilios Argyropoulos, Sean Hood (2000). Clinician's manual on anxiety disorders and comorbid depression. London: Science Press. ISBN 1-85873-397-9. 

Other disorders

Sleep and connected disorder

References

  1. ↑ 1.0 1.1 Nutt, D.; King, L. A.; Saulsbury, W.; Blakemore, C. (2007). "Development of a rational scale to assess the harm of drugs of potential misuse". The Lancet 369 (9566): 1047–1053. doi:10.1016/S0140-6736(07)60464-4. PMID 17382831. 
  2. ↑ 2.0 2.1 Dominic Casciani (30 October 2009). Profile: Professor David Nutt. BBC 
  3. ↑ 3.0 3.1 Nutt, D. (2008). "Equasy -- an overlooked addiction with implications for the current debate on drug harms". Journal of Psychopharmacology 23 (1): 3–5. doi:10.1177/0269881108099672. PMID 19158127. 
  4. ↑ "David Nutt". Life Scientific. 18 Sep 2012. BBC Radio 4. http://www.bbc.co.uk/programmes/b01mqp1c. Retrieved 2014-01-18.
  5. ↑ 5.0 5.1 Science and Technology Select Committee (18 July 2006). Drug classification: making a hash of it?. House of Commons. p. Ev 1. Retrieved 11 October 2008 
  6. ↑ 6.0 6.1 Professor David Nutt. University of Bristol 
  7. ↑ College Directory. Imperial College 
  8. ↑ "David J Nutt". The Royal Institution. Retrieved 11 August 2009. 
  9. ↑ List of publications from Microsoft Academic Search
  10. ↑ http://downloads.bbc.co.uk/podcasts/radio4/tls/tls_20120918-0930a.mp3 David Nutt on The Life Scientific with Jim Al-Khalili, September 2012, BBC Radio 4
  11. ↑ 11.0 11.1 11.2 11.3 Lucy Goodchild (8 January 2009). Addiction, anxiety and Alzheimer's disease tackled by new Chair at Imperial College. Imperial College, London 
  12. ↑ Nutt, D. J.; Cowen, P. J.; Little, H. J. (1982). "Unusual interactions of benzodiazepine receptor antagonists". Nature 295 (5848): 436–438. doi:10.1038/295436a0. PMID 6276771. 
  13. ↑ "Editor - David J Nutt". SAGE. Retrieved 3 November 2009. 
  14. ↑ 14.0 14.1 14.2 14.3 Nutt, D. (2010). "Nutt damage – Author's reply". The Lancet 375 (9716): 724–724. doi:10.1016/S0140-6736(10)60302-9. 
  15. ↑ 15.0 15.1 Nutt, D. J.; King, L. A.; Phillips, L. D. (2010). "Drug harms in the UK: a multicriteria decision analysis". The Lancet 376 (9752): 1558–1565. doi:10.1016/S0140-6736(10)61462-6. PMID 21036393. Lay summary – BBC (1 November 2010). 
  16. ↑ Tim Locke (1 Nov 2010) Alcohol more harmful than crack or heroin: Study. Former government drugs advisor Professor David Nutt produces new measures on the way drugs and alcohol cause harm, WebMD Health News
  17. ↑ "The best scientific advice on drugs (written by David Nutt)". London: The Guardian. 15 January 2010. Retrieved 2 April 2010.  Unknown parameter |unused_data= ignored (help)
  18. ↑ 18.0 18.1 Robin Murray, A clear danger from cannabis, The Guardian, 29 Oct 2009 replying to David Nutt The cannabis conundrum, The Guardian, 29 Oct 2009
  19. ↑ "Ex drugs tsar creates synthetic alcohol that gives buzz without the hangover". The Mail Online. Retrieved 10 June 2013. 
  20. ↑ Sarah Boseley (17 March 2003). Drugs inquiry thrown into doubt over members' links with manufacturers. London: The Guardian 
  21. ↑ Christopher Hope (9 Feb 2009). Home Office's drugs adviser apologises for saying ecstasy is no more dangerous than riding a horse. London: The Daily Telegraph 
  22. ↑ Hope, Christopher (9 February 2009). "Home Office's drugs adviser apologises for saying ecstasy is no more dangerous than riding a horse The Government's chief drugs adviser has been ordered to apologise by the Home Secretary for saying that taking ecstasy was no worse than riding a horse". The Daily Telegraph (London). Retrieved 1 May 2010. 
  23. ↑ David Nutt's pamphlet 'Estimating drug harms: a risky business?'
  24. ↑ Jones, Sam; Robert Booth (1 November 2009). "David Nutt's sacking provokes mass revolt against Alan Johnson". London: The Guardian. Retrieved 3 November 2009. 
  25. ↑ Vuillamy, Ed (24 July 2011). "Richard Nixon's 'war on drugs' began 40 years ago, and the battle is still raging". London: The Guardian. Retrieved 24 July 2011. 
  26. ↑ Johnson, Alan (2 November 2009). "Why Professor David Nutt was shown the door". London: The Guardian. Retrieved 3 November 2009. 
  27. ↑ Nutt, David (2 November 2009). "Penalties for drug use must reflect harm". London: The Times. Retrieved 3 November 2009. 
  28. ↑ "Government drugs adviser resigns". BBC News. 1 November 2009. Retrieved 3 November 2009. 
  29. ↑ "Second drugs adviser quits post". BBC News. 1 November 2009. Retrieved 3 November 2009. 
  30. ↑ Travis, Alan; Deborah Summers (2 November 2009). "Alan Johnson orders swift review of drugs advice body". London: The Guardian. Retrieved 3 November 2009. 
  31. ↑ Henderson, Mark (2 November 2009). "David Nutt's controversial lecture conformed to government guidelines". The Times. Retrieved 8 September 2011. 
  32. ↑ "Johnson 'misled MPs over adviser'". BBC News. 8 November 2009. Retrieved 10 November 2009. 
  33. ↑ Ghosh, Pallab (3 November 2009). "Science chief backs cannabis view". BBC News. Retrieved 3 November 2009. 
  34. ↑ "Minister 'backs adviser autonomy'". BBC News. 6 November 2009. Retrieved 10 November 2009. 
  35. ↑ "Nutt vows to set up new drug body". BBC News. 4 November 2009. Retrieved 10 November 2009. 
  36. ↑ "Three more drugs advisers resign". BBC News. 10 November 2009. Retrieved 10 November 2009. 
  37. ↑ Nutt, D. (2009). "Government vs science over drug and alcohol policy". The Lancet 374 (9703): 1731–1733. doi:10.1016/S0140-6736(09)61956-5. 
  38. ↑ Bown, W. C. (2010). "Nutt damage". The Lancet 375 (9716): 723–724. doi:10.1016/S0140-6736(10)60301-7. 
  39. ↑ http://www.bis.gov.uk/go-science/principles-of-scientific-advice-to-government
  40. ↑ Nick Dusic (24 Mar 2010) Principles of Scientific Advice, Campaign for Science and Engineering
  41. ↑ New drugs chief Les Iversen said cannabis 'safer' BBC News 13 January 2010
  42. ↑ https://www.youtube.com/watch?v=tDFvaQq_YBs

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