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This article is from the WebMD News Archive

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 UK Health News
Medically Reviewed by Dr Roger Henderson
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1st November 2010 -- Alcohol is more harmful than crack or heroin, according to a new study by a former government drugs advisor and other experts.

Professor David Nutt, from Imperial College London, Dr Leslie King, adviser to the European Monitoring Centre for Drugs and Drug Addiction and Dr Lawrence Phillips, London School of Economics and Political Science are publishing their research to coincide with a major summit on drugs being held in London: “Drug science and drug policy: Building a consensus”.

Measuring harm

Drugs can cause harm in many ways, but measuring harm is not easy.

Nutt and colleagues last attempted to give scores to drugs in 2007. They used nine criteria, from the harm caused to an individual to social and health care costs.

However, concerns were voiced about the choice of the nine criteria and a lack of weight given to each of them.

This time they used a system called the multicriteria decision analysis MCDA approach. In the past this has been used to assess issues around the disposal of nuclear waste.

In the new analysis, nine scores are about the harms that a drug causes to an individual and seven are about the harm to others.

Drugs were scored with points out of 100, where zero meant no harm caused.

The scores were then weighted to make sure different drugs and their harms could be compared on a similar scale.

The results

The study appears in an article published Online First today and will be printed in a future Lancet.

The ‘overall harm’ league table was headed by alcohol with an overall harm score of 72, followed by:

  • heroin 55
  • crack 54
  • crystal meth 33
  • cocaine 27
  • tobacco 26
  • amphetamine/speed 23
  • cannabis 20
  • GHB 18
  • benzodiazepines eg valium 15
  • ketamine 15
  • methadone 14
  • mephedrone 13
  • butane 10
  • khat 9
  • ecstacy 9
  • anabolic steroids 9
  • LSD 7
  • buprenorphine 6
  • mushrooms 5.

Heroin, crack and crystal meth were the most harmful drugs to the individual.

Alcohol, heroin and crack were the most harmful to others.

Further analysis showed alcohol is almost three times as harmful as cocaine or tobacco.

Compared with mephedrone, one of the UK’s most recently banned drugs, alcohol is more than five-times more harmful. Mephedrone was formerly known as a ‘legal high’ before being made a class B illegal drug in April.

What it means

The authors say there is almost no relation between their results and the current UK drug classification system under the UK Misuse of Drugs Act.

In a news release, Professor Nutt says: "What a new classification system might look like would depend on what set of harms-to self or others-you are trying to reduce. But if you take overall harm, then alcohol, heroin and crack are clearly more harmful than all others so perhaps drugs with a score of 40 or more could be class A; 39 to 20 class B; 19-10 class C and 10 or under class D."

The authors say that aggressively targeting alcohol harm is “a valid and necessary public health strategy."

Not definitive

Other experts who have reviewed the new study point out issues with it. The ‘weight’ given to different drugs and harm is based on opinion - and not all experts agree with each other.

The study doesn’t address what happens when people abuse more than one drug - including drinking alcohol alongside illegal drugs.

Reviewed on October 31, 2010

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