Alcohol, tobacco among riskiest drugs

This paper is getting a lot of attention. It is thoughtful and provocative, It would be nice if it provoked some thoughtful dialogue, but I suspect that is hoping for too much. Any DF staff interested in a copy of the paper should ask me for one.

New "landmark" research finds that alcohol and tobacco are more dangerous than some illegal drugs like marijuana or Ecstasy and should be classified as such in legal systems, according to a new British study.

In research published Friday in The Lancet magazine, Professor David Nutt of Britain's Bristol University and colleagues proposed a new framework for the classification of harmful substances, based on the actual risks posed to society. Their ranking listed alcohol and tobacco among the top 10 most dangerous substances.

Nutt and colleagues used three factors to determine the harm associated with any drug: the physical harm to the user, the drug's potential for addiction and the impact on society of drug use. The researchers asked two groups of experts — psychiatrists specializing in addiction and legal or police officials with scientific or medical expertise — to assign scores to 20 different drugs, including heroin, cocaine, Ecstasy, amphetamines and LSD.

Nutt and his colleagues then calculated the drugs' overall rankings. In the end, the experts agreed with each other — but not with the existing British classification of dangerous substances.

Heroin and cocaine were ranked most dangerous, followed by barbiturates and street methadone. Alcohol was the fifth-most harmful drug and tobacco the ninth most harmful. Cannabis came in 11th, and near the bottom of the list was Ecstasy.

‘Current drug system is ill thought-out’
According to existing British and U.S. drug policy, alcohol and tobacco are legal, while cannabis and Ecstasy are both illegal. Previous reports, including a study from a parliamentary committee last year, have questioned the scientific rationale for Britain's drug classification system.

"The current drug system is ill thought-out and arbitrary," said Nutt, referring to the United Kingdom's practice of assigning drugs to three distinct divisions, ostensibly based on the drugs' potential for harm. "The exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary," write Nutt and his colleagues in The Lancet.

Tobacco causes 40 percent of all hospital illnesses, while alcohol is blamed for more than half of all visits to hospital emergency rooms. The substances also harm society in other ways, damaging families and occupying police services.

Here's the complete list of drugs assessed in the paper. I'm a little surprised that solvents are so low.

Research recently published in the medical journal The Lancet rates the most dangerous drugs (starting with the worst) as follows:

1. Heroin

2. Cocaine

3. Barbiturates

4. Street methadone

5. Alcohol

6. Ketamine

7. Benzodiazepines

8. Amphetamine

9. Tobacco

10. Buprenorphine

11. Cannabis

12. Solvents

13. 4-MTA

14. LSD

15. Methylphenidate

16. Anabolic steroids

17. GHB

18. Ecstasy

19. Alkyl nitrates

20. Khat