Mattha Busby interview

Torrin Wilkins: Welcome to the conversation. My first question is what made you such a strong advocate for reforming drug laws? I have read your new book and your articles about drug laws. Why did you decide to publish a book on the issue?

Mattha Busby: To be honest, I feel like my reporting and the facts pretty much do the talking. The book is more like a history of drug policy and an appraisal of the different models that are in place, both contemporaneously and historically. Drugs have affected my life tremendously, including through serious addiction in my family, so simply seeing and chatting with people who have dependencies on the streets, living in Bethnal Green, growing up in Bletchley, and these people, lovely souls, all of them, have seemingly received little useful help. I have had my issues with alcohol and drugs, nothing approaching dependency, but some significant issues. Although with drugs, my experiences have been largely positive, I have also ended up in some pretty difficult places.

I think there is a lack of education about drugs and alcohol, along with practical help throughout society in the UK. Ultimately, I was approached by the publisher because I reported on drug policy. My wish is that it is an objective, balanced book that helps raise awareness of the awful situation that many people around the world still find themselves in,  persecuted for trafficking, using drugs, and it is almost always people who are marginalised who feel the brunt of these regressive policies.

I am happy with the book. It is a poppy product. It is not a big book; it is about 20,000 words, but it has about 150 photos. The publishers did an amazing job of putting it together. It is a great little thing for the coffee table. I guess I hope this interview leads to a commission for my magnum opus.

Torrin Wilkins: Well, maybe. In terms of drug policy and where we go next, the UK at the moment seems to have published a report which almost leads to a decriminalisation, interestingly. I was wondering whether you were more in favour of the legalisation of some drugs, decriminalisation as they have in Portugal, which is more focused on removing laws for carrying small quantities and trying to get people out of drug addiction. I was wondering whether you have any preference towards either of those, or whether there is another way that you think we can do it?

Mattha Busby: Yes, it is interesting. I woke up this morning, checked Twitter and spoke with a friend, and the government released this white paper today. It is just putting a small flag in the sand, but a lot can happen from here. It signals a continued shift away from imprisonment and the blanket criminalised approach, despite some fundamentally regressive elements, like drug testing people to make sure they are staying abstinent according to the terms of a court order.

The government seems to be catching up with the number of police forces that have introduced various decriminalisation models for certain possession and use offences across the UK, seven or eight police forces led the way. It seems like these policies appear to be bearing fruit. If you are not locking people up, it is going to reduce the rate of people going in and out of prison. Many people are coming around to the reality that prison is often a crime school.

There are other promising projects underway, state-provided heroin assisted treatment in Middlesbrough and Bristol, the first long-term licence for a service to attest to the purity of drugs, and deliver harm reduction was recently announced. There is plenty of movement, but the two main parties do not consider it a vote-winner. I mentioned this the other day, it brings me back to this Gramscian idea of passive revolution, where political change is veiled in doublespeak and relatively unannounced, even when it is significant, but it is so gradual and slow that it is quite difficult for the average person to identify.

On the wider point about legalisation and decriminalisation, it is not just in the UK where, in the political sphere and the public sphere, drug policy is increasingly being seen as a health and not a criminal issue,  even though on this white paper, it is still going to be like these special courts, and it is still a criminal justice approach. It just adds more barriers to someone going to prison and follows the trend that has been in place for a while.

About 500 first offenders were imprisoned in 2020, which is still a significant number,  but it is a massive fall. In Portugal, the death and HIV infection rate fell very swiftly when drugs were decriminalised and treatment provision was massively expanded in 2001. The outreach work is bold. I have seen photos of these kinds of aquatic exercises for people in treatment that look thoroughly relaxing. People are going to marginalised parts of the country to offer help. The architect of the plan said that the main thing was removing the stigma; when you do that, people are not afraid to ask for help. If there is an overdose in a place where people are using drugs, they can call the ambulance, and, likely, the cops are not going to come unless there is some wider crime that they are investigating.

However, decriminalisation does not solve the issue of the market. There is widespread concern that authority figures in Portugal, the police and the military, are involved to some degree with the drug trade because there is still that demand and decriminalisation just does not take the billions out of the hands of the criminals.

Torrin Wilkins: To ask the opposite question, why then do you think that drugs being illegal in the so-called “war on drugs”,  why do you think it failed? Why do you think keeping drugs illegal is not the right route?

Mattha Busby: Historically, humans, and indeed some other animals, have an insatiable desire to explore altered states of consciousness. When cannabis, mushrooms, opium, and coca grow so abundantly all over the world, then you cannot make something illegal and expect that to stop people from experimenting, working and abusing these plants,  unless you have an authoritarian approach, as in some countries, like the Philippines and other countries in Southeast Asia, people still use drugs there. In a nutshell, that is the answer to the question. Just like using alcohol, you cannot alter human nature with mere laws. 

Torrin Wilkins: Something else you wrote about last year was drug consumption rooms, which goes more along the lines of ensuring that people do use drugs but do so safely. It has taken off in Scotland, but I think it still has quite a way to go in England to pick up that popular support. This is a policy that really should be up and running in as many areas as possible. Do you think there is a way we can speed it up? Why do you think that drug consumption rooms are so important?

Mattha Busby: I think the situation is more acute in Scotland; drug death rates are the highest in Europe by quite some distance. Concerning some of my friends, the campaigning in England has been comparatively mild, given that the activist Peter Krykant set up an arguably illegal, supervised drug consumption van, right on the streets of Glasgow. It is a desperately needed service, and he demonstrated the political point with incredible bravery.                                            

It seems that a bid now to install these permanent facilities in three Scottish cities is going to be accepted because the issue has just become so serious that the governing Scottish National Party simply had to hold up their progressive credentials on the one hand. I am sure it also came from a good place, but I think they are in a very difficult situation. It is a good issue for them because the drug policy is not devolved, and Westminster ultimately has the power.

I think the Daily Record got on board in a way that the newspapers in England have not regarding significant drug policy reform. The Times put out an editorial once,  a very strong stance they took, but I do not think it has been so sustained. From an editorial perspective, newspapers across the board have covered some important issues on drug policy very well. There has not been that same sustained editorial stance that the Daily Record took. There is pressure for drug consumption rooms in England from significant quarters, 13 Members of Parliament, and seven police and crime commissioners wrote to the then Home Secretary in 2019, a letter I covered for The Guardian, calling for them, saying the international evidence is clear.

There are about 100 of these drug consumption rooms around the world, in 16 or so countries, thousands of injections and drug use have been recorded, observed and supervised. There has never been a recorded death because if you do have supervision, someone has the overdose antidote naloxone, and simply, if the person is throwing up, they just make sure they do not choke on their vomit.

It seems the evidence is clear. I visited a facility in Denmark for The Guardian in 2018, and we did a very interesting piece covering the amazing work that they are doing there. It seems that it is a bit of a step too far, at the moment, for the authorities in England, even though we have these heroin assisted treatment facilities.

There was a Public Health England report a year or two ago. In the first version that they published, it was a bit more sympathetic towards DCRs, but then it got taken down and put up again a few weeks later, a bit toned down. It is just difficult when the standard of evidence that you need for certain policy changes, especially when the bar seems to be much higher on controversial issues. It is difficult to do some of this research to the highest standard possible when there is no funding, partly because there is no profit motive. These charities are doing it on a bootstrap, and it seems to me that the accumulation of evidence is very impressive.

Torrin Wilkins: For the last part of this interview, I am going to move on to drug use for medical purposes, because that has also been something in England that has been a very large and long-standing debate. One of the things that has been debated relatively recently is medical cannabis. Originally, it was available on prescription, and it was just seen as a very big win. Then after that, it turned out to be very difficult for people to access it. Especially for people with epilepsy, it has been very difficult for families to get hold of medical cannabis. Do you think that may have been a political stunt rather than a major change? How easy would it be to make that more accessible?

Mattha Busby: Certainly, I think medical cannabis was legalised to kill the story that was getting increasingly embarrassing to the government. Billy Caldwell was in the hospital after his medicine was confiscated. It was a very effective piece of campaigning that illustrated how archaic, in a way, the drug laws were in that specific case. Who could deny an eight-year-old boy who is having dozens of serious seizures every day unless he has a couple of drops of cannabis? Maybe he will be a little bit high,  but it is not like he is walking down the street of Kingston, Jamaica, with a big doobie in his mouth. Even if he was, as long as he is not harming anyone else, the cannabis has hopefully come from an ethical source,  then what difference does it make to the vast majority of people’s lives?

I guess what has happened is that no new NHS prescriptions have been given. Since this legalisation, a couple have been previously on a compassionate, really exceptional basis. About 10,000 prescriptions in total, I am sure that some people have had more than one prescription, have been issued privately since November 2018, according to one campaigner. About 15 clinics are growing around the country to supply the demand. Police chiefs support this CanCard scheme used by about 50,000 people to ensure that medical users are entitled to carry legal market cannabis. But privately, you can get supplies for a month for around £300. It is just for the specialist oils that the epileptic children need; it is way more. It is a really difficult situation for them. The idea that they have been legalised,  I presume, was not just to give more business to private clinics. It was to put it through the NHS because most families cannot afford to spend a few thousand pounds a month, even £300 a month, especially considering that they have added outgoings for having a child with such a serious disability.

I think it is like a combination of these rigid guidelines set by the healthcare watchdog, NICE, and the British Paediatric Neurological Association. There are rumours of doctors coming under pressure, and a lot of these guys and women in these positions would have also been there 20 years ago, when these Reefer Madness narratives were not as challenged as they are being quite convincingly today.

I feel like there remains a lot of resistance in the medical establishment, but as the evidence continues to grow, and even if it is anecdotal, I feel like the adherence to these kinds of tropes and views is going to continue to wilt.

Torrin Wilkins: So, my final question is carrying on with that theme of looking at using drugs more for medical use. One other is psychedelics being used for the treatment of post-traumatic stress disorder, PTSD. Still, there has been this unwillingness and pushback on actually using it, simply because it is seen as a drug. That one I found surprising just because, given the fact that it often ends up getting used on ex-military people, it is almost surprising that it would get pushback. How do we get past that resistance? It seems strange to even see it there.

Mattha Busby: For me, it is quite remarkable. Some of these arguments say to use another drug to treat addiction or these sorts of things. Morphine is a drug, and antidepressants are drugs. All of these pills that are prescribed are also consciousness-altering. Veterans are the front line of the changes in the US, and I understand that within 24 months, it is expected that MDMA and psilocybin will be approved by the FDA for PTSD and depression, respectively. I guess a classic countercultural refrain has been that perhaps psychedelics were prohibited because the US establishment and others around the world who followed in tandem were afraid that they might cause people to become more rebellious and fuss, increasing pressure on the status quo to make some changes.

I feel maybe it is not as clear-cut as I think it is; I think it is more than President Nixon, who declared war on drugs. The hippies,  the nascent hippie movement, then, were very anti-Vietnam War. Especially at that time, the idea that you would recreatively take something that could, in some cases, send you pretty loopy, but obviously, the vast majority of usages were responsible,  maybe did not seem so at the time,  but I would be surprised if most people were just taking them like lunatics. It is possible. I think he was just seeking to crush opposition to the Vietnam War, and it was a good stick to beat them with. So, it is collateral damage in a way. 

This is the same thing today as regulators grapple with these questions, like psychedelics do not fit into this allopathic pharmaceutical model. They will need to come alongside therapy preparation before, and integration afterwards. Nor do their seemingly manifold benefits fit into this rationalist worldview that is often tinged by a disconnection with nature and a scepticism of the potentially healing power of simple plants.

The knowledge of indigenous cultures, we in the West have become very ostracised from. If ever we were more connected with them in some ways, perhaps through our traditions. These medicine people were also persecuted through witch hunts,  the Inquisition, and Roman attacks on the Druids.

It is a positive moment; research has been unshackled. Still, now sceptics justifiably point to the fact that most of the research on each specific drug is only tested on hundreds of people, not thousands. I think that is a significant point, also explained by the fact that big pharmaceutical companies have not got behind it. It is mainly smaller organisations that are funding these studies, which does explain the scope of them to some extent. I think there are questions for other organisations to answer about some of the sizes of the studies. I think these drugs, or plants, carry great healing potential. It is not a minute too late in this mental health crisis, and the growing realisation that some of our current drugs that are widely prescribed are not fit for purpose.

Nothing survives in human consciousness for this long if it was useless; some of these plant medicines are psychedelics that have been used for thousands of years. Today, all sorts of people are using psychedelics. Chris Martin, the Coldplay frontman, came out saying they helped him reconcile his view on the world. Justin Bieber is wearing shroomy necklaces. Other pop stars like Jaden Smith, are saying how amazing everything is on magic mushrooms. Half of Hollywood has done Ayahuasca and DMT. There is this Michael Pollan Netflix series out at the moment and it is difficult to keep up with it. It is only over the last three or four years that the Overton window has shifted in step with some of the research, which has been very impressive. These stories of people like the veterans who had crippling PTSD, and now suddenly can enjoy their lives. They still face challenges, but they are not experiencing these crippling and destructive symptoms. 

It seems to me, as people will find out on this Netflix documentary, which I have not watched yet, that psychedelics can go to the root of people’s trauma and suffering in a way that I do not think current Western medicines can. People can undergo therapy and do different forms of meditation and exercise. You can take a shortcut with these psychedelics, and then these other practices can help people integrate their experiences.

The question now is access and method of delivery because, currently, psychedelic therapy, where it is permitted, is generally the preserve of wealthy Westerners, which is a shame. There are economic factors. If there is no state support for these treatments, that will continue.

In Oregon,  which is rolling out psilocybin therapy next year, there may be some spots for people on low incomes, but broadly speaking, in keeping with the US healthcare model, it is going to be paid for and whether people’s insurance packages cover it remains to be seen. I think it would take some time.

Torrin Wilkins: Well, thank you for that answer. And also, just thank you for coming to the conversation.

Mattha Busby: Thank you for having me on. It has been good to chat with you. We are in a really interesting moment right now. As I said, three years ago, when I was approached to do this book, it was still in some aspects a taboo topic, legalising drugs and I think we should not rush to do anything, and everything has to be very carefully considered; significant safeguards need to be in place. I do not think we should have a retail market for all drugs. Indeed, I think that the safeguards on alcohol use should be much stronger, such as in places like Quebec and Canada, where spirits are only sold in a small number of government stores that are only open at certain times. We should go even further than that. There should be far more readily available treatment and harm reduction advice for alcohol and drugs as soon as possible, because people just do not have the information, whether they are legal or illegal, which is a terrible shame. That lack of information, that lack of education, is in large part driving a lot of this, along with other factors.

Torrin Wilkins: It is true. It feels like the end of the Netflix series. Their point was that we should take drugs seriously. If you do legalise them, the biggest thing is to make sure that it is not just used as a recreational thing, which seems to be the phrase now. The ending of the series was about using it for a purpose. Most of the series is going around and looking at Native Americans and how they use drugs, and how it is used in therapy. It feels very similar to that in the sense of, yes, it can be legalised, but it is always good to have purposes that are good for us as well as just simply saying that it is legal now.

Mattha Busby: When the West first discovered tobacco, these chaps and these Native American communities were not walking around chain-smoking. It was the ceremonial use of tobacco on a relatively limited number of occasions.

There is a lot we can learn also about the use of alcohol, and we need to be careful. Just look at the opioid crisis in the US. Pharmaceutical companies had carte blanche to sell these addictive painkillers through pharmacies across the country. Look what is happening now. Some of these drugs that are currently illegal might even be more addictive than opioids. We need to be careful. This is not an argument not to change things, because it is even more dangerous to just uphold the status quo.

Torrin Wilkins: Very much so. Well, I think we can leave it there. Unless there is anything else you want to say at the end?

Mattha Busby: No, I think that is a good way to round it off. As I say, I just want to let the facts do the talking. If I can be a medium for some of those on both sides, some of the issues that are also arising regarding the use of drugs in therapy and elsewhere, then I am happy to be that messenger, from an unbiased perspective.

Torrin Wilkins: Well, as I said, thank you for coming on. And it has been great.

Mattha Busby: Cheers. Thanks, Torrin.

Note: This interview has been edited for grammar, clarity, and flow. The original recording is the final and definitive version.