Executive summary
Alfie Dingley, is believed to be the only boy in Britain and one of only nine boys in the world with an extremely rare medical condition known as PCDH19 (Oppenheim, 2018). This form of epilepsy disrupts the cells in his brain resulting in aggressive seizures, behavioural problems and cognitive and sensory delays (Epilepsy Foundation, 2018). |
Cannabis-based medication, prescribed and administered to Alfie Dingley, by a paediatric neurologist in the Netherlands, has been proven to significantly relieve Alfie Dingley's symptoms because it reduces the number, severity and duration of seizures, improving the overall quality of his life (End Our Pain, 2018).
However, cannabis is a Schedule 1 drug and for this reason it cannot be practically prescribed, administered or supplied to the public because it is illegal under UK law (Legislation.gov.uk, 2018a and Oppenheim, 2018). The Home Office can grant medical cannabis licences for research purposes, but it cannot grant medical licences for personal use (Legislation.gov.uk, 2018b and Oppenheim, 2018).
On 20th March 2018, the government set a ground breaking precedent and announced it would be issuing, the first of its kind in the UK, a personal medical cannabis licence for Alfie Dingley (Penning, ITV News, 2018).
This report will critically explore the reasons behind the government's radical change in drug-based policy. It will do this by initially providing some historical and global context to the emergence of drug regulation for the purpose of demonstrating how the current legal and regulatory framework in the UK came into force.
Introduction
The primary objective behind the enactment of drug-based policy in the United Kingdom such as the Misuse of Drugs Act 1971 (Legislation.gov.uk, 2018a) and the amended update, the Misuse of Drugs Regulations 2001 (Legislation.gov.uk, 2018b), according to the Government is to control the use and distribution of ‘dangerous and harmful’ drugs, with the aim of preventing drug misuse (Law Teacher, 2018).
In practice the enactment of black letter law in the form of the act and regulation listed above, produces unintended consequences which have negative impacts within societies. because they create and/or exacerbate multiple social harms (Hillyard and Tombs 2007). Expertise can be used to contest and influence drug-based policy because it evidences how the policies in place to control and prevent drug misuse paradoxically in particular cases cause ‘danger and harm’.
One such highly publicised case, where the UK policies around the Misuse of Drugs, have caused harm instead of preventing harm is that of Alfie Dingley. For this reason this report has constructed a case study around Alfie Dingley's injustice (End Our Pain, 2018). What this will illustrate is how the harms caused to Alfie are a direct result of the prohibition and illegal status constructed by the enactment of the above mentioned drug-based polices.
A critical evaluation of this case study will clearly illustrate how public consensus/pressure influenced the government into making a ground breaking decision to grant Alfie Dingley a medical cannabis licence based on compassion. This precedent goes against the current drug-based policy in the United Kingdom evidencing why drug policy reform is now pertinent.
Historical use of cannabis
The medical use of cannabis dates back to 4000 BC and the first written accounts can be traced back to the ancient Greeks. In the nineteenth century cannabis was used throughout Europe and was recommended for various conditions ranging from: insomnia, migraine, neuropathic and musculoskeletal pain and to aid childbirth (All-Party Parliamentary Group, 2016). Cannabis can therefore be described as an active concept because taken for granted traditional understandings have faded from view and have been replaced with contemporary understandings. These understandings result from cultural, moral and political discourse shifts, which can be guided by drug-based research.
Globalisation of cannabis
In the early twentieth century, many drugs including cannabis were passed from country to country with minimal interference from authorities. Many drugs such as cannabis were freely available in over-the-counter pharmaceutical preparations. In the United Kingdom cannabis remained clinically available until 1971. Prior to this period the national legal control of drugs was minimal and consumption was primarily a matter of personal choice. What this demonstrates is that taken for granted understandings of cannabis and cannabis usage are historically and geographically contingent.
The emergence of drug/cannabis regulation
The United States have always been at the forefront of all legislation to restrict the international drugs trade throughout the twentieth century and its justification for drug reform has always been self-serving. Justification included:
In the latter part of the twentieth century ex-President Nixon declared a 'war on drugs' in an attempt to control and regulate the illegal drug trade. However the reasons behind this government initiative have always been highly contested. Two opposing reasons include:
Following ex-President Nixon's war on drugs declaration, the UK government swiftly enacted the Misuse of Drugs Act 1971. This reveals that policy is socially constructed. Social constructionism takes the view that all knowledge is situated historically, socially and culturally, and can change over time and place. Therefore, for social constructionists, the meanings given to things are not universal, and there is no single truth.
Informing the publics of Alfie Dingley's injustice
In February 2018, the Independent (2018) published an article entitled 'Government refuses medical cannabis to six-year-old boy who had 3,000 seizures in a year'. It challenged the 'expertise' of the government. Such expertise is gifted by way of virtue because society recognises it as an expert. Hence it has the power to enact policy which prohibits behaviours and actions of its citizens (Sternberg and Horvath, 1998). Oppenheim (2018) positioned the government as an institution that is insensitive, uncaring and unwilling to act to prevent Alfie Dingley from suffering unnecessarily as a result of the prohibitions constructed by the Misuse of Drugs Act 1971 and the amended update, the Misuse of Drugs Regulations 2001.
Oppenheim (2018) did this through the following statements made within the article:
In contrast, it presents Alfie Dingley's mother, Hannah Deacon as being, a caring and concerned mother, who wants the best for Alfie and her family. 'Expertise' is part of a perception process and therefore experts are those whom are recognised by society. Consequently, people such as Hannah Deacon are gifted by virtue of being labelled as such (Sternberg and Horvath, 1998).
Oppenheim (2018) on behalf of the Independent recognised Hannah Deacon as an 'expert' through the following statements:
On this occasion the Independent has positioned itself on the side of, supporting and campaigning, for the issue of a medical cannabis licence for Alfie. It is important to make clear that the Independent's stance around cannabis usage and other drugs is fluid and shifts over time.
This newspaper like many others including: The Guardian and The Mail to list but two, present a skewed picture of the harms of drugs. They do this by sensationalising headlines, claiming misleading and untrue causal associations, not always present accurate representational data, over reporting and creating self-fulfilling moral panics (Cohen, 1972).
The Independent used its media platform/power to inform its readers (publics) that the government needs to make an exception to the law, under the grounds of extenuating circumstances and should issue a medical cannabis licence to a six year old boy (Jacobs et al.,1999). What this reveals is how and why social attitudes/opinions about the usage of cannabis are embroiled within social, cultural, moral and political discourse.
Influencing the publics to mobilise on behalf of Alfie Dingley
In order to prove to the UK government that a medical cannabis licence would improve the quality of Alfie's life, Hannah Deacon and her husband Drew Dingley moved their family to Holland from September 2017 - January 2018 (End Our Pain website, 2018). They gave their consent for a neurologist (in the Netherlands) to treat Alfie's medical condition with cannabis-based medication (End Our Pain, 2018).
As a result, an experiment was conducted which established the relationship between one set of factors and another. The independent variable was manipulated and Alfie Dingley's condition was treated with three drops of cannabis-based medication per day. The dependent variables these being: the number, severity and duration of seizures were then measured (End Our Pain, 2018). Such an experimental approach enabled a comparison to be made between Alfie's condition being treated in the UK by steroids and his condition being treated in the Netherlands with cannabis oil (End Our Pain, 2018). The tables below provide the comparison:
However, cannabis is a Schedule 1 drug and for this reason it cannot be practically prescribed, administered or supplied to the public because it is illegal under UK law (Legislation.gov.uk, 2018a and Oppenheim, 2018). The Home Office can grant medical cannabis licences for research purposes, but it cannot grant medical licences for personal use (Legislation.gov.uk, 2018b and Oppenheim, 2018).
On 20th March 2018, the government set a ground breaking precedent and announced it would be issuing, the first of its kind in the UK, a personal medical cannabis licence for Alfie Dingley (Penning, ITV News, 2018).
This report will critically explore the reasons behind the government's radical change in drug-based policy. It will do this by initially providing some historical and global context to the emergence of drug regulation for the purpose of demonstrating how the current legal and regulatory framework in the UK came into force.
Introduction
The primary objective behind the enactment of drug-based policy in the United Kingdom such as the Misuse of Drugs Act 1971 (Legislation.gov.uk, 2018a) and the amended update, the Misuse of Drugs Regulations 2001 (Legislation.gov.uk, 2018b), according to the Government is to control the use and distribution of ‘dangerous and harmful’ drugs, with the aim of preventing drug misuse (Law Teacher, 2018).
In practice the enactment of black letter law in the form of the act and regulation listed above, produces unintended consequences which have negative impacts within societies. because they create and/or exacerbate multiple social harms (Hillyard and Tombs 2007). Expertise can be used to contest and influence drug-based policy because it evidences how the policies in place to control and prevent drug misuse paradoxically in particular cases cause ‘danger and harm’.
One such highly publicised case, where the UK policies around the Misuse of Drugs, have caused harm instead of preventing harm is that of Alfie Dingley. For this reason this report has constructed a case study around Alfie Dingley's injustice (End Our Pain, 2018). What this will illustrate is how the harms caused to Alfie are a direct result of the prohibition and illegal status constructed by the enactment of the above mentioned drug-based polices.
A critical evaluation of this case study will clearly illustrate how public consensus/pressure influenced the government into making a ground breaking decision to grant Alfie Dingley a medical cannabis licence based on compassion. This precedent goes against the current drug-based policy in the United Kingdom evidencing why drug policy reform is now pertinent.
Historical use of cannabis
The medical use of cannabis dates back to 4000 BC and the first written accounts can be traced back to the ancient Greeks. In the nineteenth century cannabis was used throughout Europe and was recommended for various conditions ranging from: insomnia, migraine, neuropathic and musculoskeletal pain and to aid childbirth (All-Party Parliamentary Group, 2016). Cannabis can therefore be described as an active concept because taken for granted traditional understandings have faded from view and have been replaced with contemporary understandings. These understandings result from cultural, moral and political discourse shifts, which can be guided by drug-based research.
Globalisation of cannabis
In the early twentieth century, many drugs including cannabis were passed from country to country with minimal interference from authorities. Many drugs such as cannabis were freely available in over-the-counter pharmaceutical preparations. In the United Kingdom cannabis remained clinically available until 1971. Prior to this period the national legal control of drugs was minimal and consumption was primarily a matter of personal choice. What this demonstrates is that taken for granted understandings of cannabis and cannabis usage are historically and geographically contingent.
The emergence of drug/cannabis regulation
The United States have always been at the forefront of all legislation to restrict the international drugs trade throughout the twentieth century and its justification for drug reform has always been self-serving. Justification included:
- Restriction of the drug trade that was dominated by the European colonial powers.
- Favourably improve Chinese–American economic relations and China’s trade with the United States (Belenko, 2000).
In the latter part of the twentieth century ex-President Nixon declared a 'war on drugs' in an attempt to control and regulate the illegal drug trade. However the reasons behind this government initiative have always been highly contested. Two opposing reasons include:
- Drug addiction destroys lives, destroys families, and destroys communities, we are still not moving fast enough to meet the problem in an effective way (Nixon, 1971).
- The war on drugs initiative helped ex-President Nixon keep his job, by getting rid of his two enemies: the antiwar left and black people, it did this by getting the public to associate the hippies with marijuana and blacks with heroin (Ehrlichman, 1994, cited in Lopez, 2016).
Following ex-President Nixon's war on drugs declaration, the UK government swiftly enacted the Misuse of Drugs Act 1971. This reveals that policy is socially constructed. Social constructionism takes the view that all knowledge is situated historically, socially and culturally, and can change over time and place. Therefore, for social constructionists, the meanings given to things are not universal, and there is no single truth.
Informing the publics of Alfie Dingley's injustice
In February 2018, the Independent (2018) published an article entitled 'Government refuses medical cannabis to six-year-old boy who had 3,000 seizures in a year'. It challenged the 'expertise' of the government. Such expertise is gifted by way of virtue because society recognises it as an expert. Hence it has the power to enact policy which prohibits behaviours and actions of its citizens (Sternberg and Horvath, 1998). Oppenheim (2018) positioned the government as an institution that is insensitive, uncaring and unwilling to act to prevent Alfie Dingley from suffering unnecessarily as a result of the prohibitions constructed by the Misuse of Drugs Act 1971 and the amended update, the Misuse of Drugs Regulations 2001.
Oppenheim (2018) did this through the following statements made within the article:
- A six-year-old boy has been denied a request for medical cannabis licence by the Government.
- The Home Office has denied the family's request for medical cannabis oil.
- The Home Office would not issue a licence to enable the personal consumption of a Schedule 1 drug (Oppenheim, 2018).
In contrast, it presents Alfie Dingley's mother, Hannah Deacon as being, a caring and concerned mother, who wants the best for Alfie and her family. 'Expertise' is part of a perception process and therefore experts are those whom are recognised by society. Consequently, people such as Hannah Deacon are gifted by virtue of being labelled as such (Sternberg and Horvath, 1998).
Oppenheim (2018) on behalf of the Independent recognised Hannah Deacon as an 'expert' through the following statements:
- He deserves to have a wonderful life of joy, not pain he currently faces.
- You've got to fight for your kids; I want to know that I've done everything I can.
- We want our baby back; we want to give Alfie the chance of a happy life which he massively deserves (Oppenheim, 2018).
On this occasion the Independent has positioned itself on the side of, supporting and campaigning, for the issue of a medical cannabis licence for Alfie. It is important to make clear that the Independent's stance around cannabis usage and other drugs is fluid and shifts over time.
This newspaper like many others including: The Guardian and The Mail to list but two, present a skewed picture of the harms of drugs. They do this by sensationalising headlines, claiming misleading and untrue causal associations, not always present accurate representational data, over reporting and creating self-fulfilling moral panics (Cohen, 1972).
- Researchers expect London to be named as a city where cocaine is delivered faster than pizza (Dearden, 2018).
- Super strong cannabis is responsible for a quarter of new psychosis cases (Bingham, Dominczak and Turner, 2015).
- Clever teenagers most at risk of 'skunk' psychosis as cannabis expert reveals super-strong strain is linked to permanent schizophrenia (Adams, 2015).
The Independent used its media platform/power to inform its readers (publics) that the government needs to make an exception to the law, under the grounds of extenuating circumstances and should issue a medical cannabis licence to a six year old boy (Jacobs et al.,1999). What this reveals is how and why social attitudes/opinions about the usage of cannabis are embroiled within social, cultural, moral and political discourse.
Influencing the publics to mobilise on behalf of Alfie Dingley
In order to prove to the UK government that a medical cannabis licence would improve the quality of Alfie's life, Hannah Deacon and her husband Drew Dingley moved their family to Holland from September 2017 - January 2018 (End Our Pain website, 2018). They gave their consent for a neurologist (in the Netherlands) to treat Alfie's medical condition with cannabis-based medication (End Our Pain, 2018).
As a result, an experiment was conducted which established the relationship between one set of factors and another. The independent variable was manipulated and Alfie Dingley's condition was treated with three drops of cannabis-based medication per day. The dependent variables these being: the number, severity and duration of seizures were then measured (End Our Pain, 2018). Such an experimental approach enabled a comparison to be made between Alfie's condition being treated in the UK by steroids and his condition being treated in the Netherlands with cannabis oil (End Our Pain, 2018). The tables below provide the comparison:
The comparison tables demonstrate the benefits to Alfie's quality of life when taking cannabis medication. Equally it illustrates the harm caused to Alfie through traditional UK treatments. Being able to measure and compare the harm caused to Alfie reveals a correlation because the harm: number, severity and duration of seizures, is evidently reduced when taking cannabis-based medication. The data provides the publics with an accurate representation of why the current UK legislation on cannabis and taken for granted (mis)understandings need to be contested (End Our Pain, 2018).
Making a difference Alfie Dingley gets justice
On 20th March 2018, Hannah Deacon, Drew Dingley, Alfie's Hope campaigners and supporters of Alfie Dingley’s plight including celebrity Sir Patrick Stewart made their way to Downing Street (ITV News, 2018). The purpose being, to hand over a petition signed by 370,000 campaigners/supporters demanding that the Home Office/Government issue a medical (personal) cannabis licence to Alfie Dingley (ITV News, 2018). The family were invited into Downing Street and met with the Prime Minster Theresa May and the former Home Office Minster and MP Sir Mike Penning (ITV News, 2018). Following this, in a ground breaking precedent Sir Mike Penning announced that the government had decided to issue Alfie Dingley a licence for the medical (personal) consumption of the controlled drug cannabis under compassionate grounds (ITV News, 2018).
- "Alfie's a one off child. He's a remarkable child. He's one of only seven children like him in the world. And so the licence will be issued to Alfie and that's the right thing to do" (Penning, ITV News, 2018).
According to Mackenzie the British Government is well aware of the controversy linked to medicinal cannabis (ITV, News, 2018). This is because the government has helped to maintain this controversy through constructing and maintaining drug-based moral panics as exemplified:
- Those who produce and those who sell drugs are waging war against the young people of all our countries (Thatcher, 1989).
- We must protect our country, our people, our economy, our way of life (Blair, 2001).
It can be claimed that the 'expertise' of 370,000 publics who signed the petition, together with the celebrity 'expertise' of: Sir Patrick Stewart and Joanna Lumley (Lumley, 2018) and the expertise of media outlets such as the Independent (Oppenheim, 2018) pressured the Government to concede on this issue. Moreover this unified voice of expertise, gave their permission for the Government to issue a medical cannabis licence for Alfie Dingley, as a one off special compassionate case.
Ironically, in issuing this licence the government are in violation of the Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 2001 (Legislation.gov.uk, 2018a and Legislation.gov.uk, 2018b) because all amendments/changes to a law have to go through a policy process (Parliament.uk, 2018).
According to the All-Party Parliamentary Group (2016), many countries across the world have altered their subject positions and have constructed polices which allow for the lawful access to medical cannabis as evidenced in the table below:
''12 EU countries, numerous US states, Canada and Israel all allow under medical supervision licensed use of cannabis''(Dear, BBC News, 2018)
The information clearly highlights how countries are now recognising expertise drug-based research, which is valid and reliable and demonstrates that cannabis offers health benefits to a range of conditions.
Yet, the British Government have not responded to the United Nations request to enact drug policies that comply with the drugs policy reform principles as listed below, which were set out at the United Nations General Assembly Special Session in 2016:
- Evidence-based drugs policy.
- Policy that genuinely promotes the health and welfare of mankind driven by human rights and public health values.
- Flexibility for Member States to develop drug policy within the UN Conventions (All-Party Parliamentary Group, 2016).
What this illustrates is that since April 2016 the UK government ignored the advancing expertise (knowledge and understanding) of academics who provided a sound evidence base for the legalisation of cannabis for medical/personal use (All-Party Parliamentary Group, 2016).
This makes visible that the harms inflicted to Alfie Dingley during April 2016 - March 2018, could have been prevented if the UK Government had enacted new legislation and licensing regulations around the three principles set out in the United Nations General Assembly Special Session. Although the British government has issued a medical cannabis licence for Alfie Dingley, the UK drug-based policy is lagging behind others countries and needs to be reformed.
Conclusion
The UK government implemented a top-down approach to enact the Misuse of Drugs Act 1971 and the amended update, the Misuse of Drugs Regulations 2001. These policies were enacted to combat social problems linked to recreational drug-usage. The government was able to enact such polices because of 'expertise' that is gifted to it by way of virtue (Sternberg and Horvath, 1998).
This created a dilemma because Alfie Dingley is an exceptional child with a rare medical condition and the drug-based laws in the UK inadvertently caused him harm. These harms were measured and validated when he was taken to Holland by his parents (Epilepsy Foundation, 2018 and End Our Pain, 2018).
Under section 30 of the Misuse of Drugs Regulations 2001 the Home Office can issue a medical based licence for research purposes. However, the Home Office/Government cannot legally issue a medical licence for the personal consumption of cannabis because cannabis is listed as a Schedule 1 drug. Issuing a personal consumption licence is in violation of the Misuse of Drugs Regulations 2001. All citizens of the United Kingdom are subject to these laws without exception, including members of parliament/government (Legislation.gov.uk, 2018b).
The UK Government failed to comply with its United Nations obligations as agreed at the United Nations General Assembly Special Session in 2016 (All-Party Parliamentary Group, 2016). The choice the UK government made, not to amend drug-based legislation and licencing following academics expertise, led to Alfie Dingley's continued suffering from April 2016 – March 2018 (End Our Pain, 2018).
It is pertinent that the government call upon expertise of academics and enact new policy. This policy should move away from the policies implemented in the UK as a direct result of ex-President Nixon's 1970s war on drugs initiative (All-Party Parliamentary Group, 2016 and History.com, 2018).
Recommendations
- Alfie Dingley's licence must be regularly checked to ensure it continues to be the best option for his specific condition.
- The government must comply with the three principles agreed at the United Nations and reform drug based policy.
- The government must call upon academic expertise to reform drug-based policy which should endeavour to encompass twenty-first century contemporary understandings.
- The government must urgently update drug-based policy to incorporate a compassionate element because as the law stands the government is in violation of the Misuse of Drugs Regulations 2001.
- The British government must ensure children and adults in the United Kingdom are issued with a medical cannabis licence to alleviate chronic pain and debilitating illnesses.
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Please cite this article as:
Hartles, S (2018) Is it time for the UK government to decriminalise the use of cannabis ? [Online] Available at https://sharonhartles.weebly.com/is-it-time-for-the-uk-government-to-decriminalise-the-use-of-cannabis.html (Accessed)
ATTRIBUTION
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© Sharon Hartles 2022.