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Thread: Alcohol 'more harmful than heroin' says Prof David Nutt

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    Default Alcohol 'more harmful than heroin' says Prof David Nutt

    Alcohol 'more harmful than heroin' says Prof David Nutt

    Alcohol is more harmful than heroin or crack, according to a study published in medical journal the Lancet.

    The report is co-authored by Professor David Nutt, the former UK chief drugs adviser who was sacked by the government in October 2009.

    It ranks 20 drugs on 16 measures of harm to users and to wider society.

    Tobacco and cocaine are judged to be equally harmful, while ecstasy and LSD are among the least damaging.

    Prof Nutt refused to leave the drugs debate when he was sacked from his official post by the former Labour Home Secretary, Alan Johnson.

    He went on to form the Independent Scientific Committee on Drugs, a body which aims to investigate the drug issue without any political interference.

    One of its other members is Dr Les King, another former government advisor who quit over Prof Nutt's treatment.

    Classification system

    Members of the group, joined by two other experts, scored each drug for harms including mental and physical damage, addiction, crime and costs to the economy and communities.

    The modelling exercise concluded that heroin, crack and methylamphetamine were the most harmful drugs to individuals, but alcohol, heroin and crack cocaine were the most harmful to others.

    When the scores for both types of harm were added together, alcohol emerged as the most harmful drug, followed by heroin and crack.

    The findings run contrary to the government's long-established drug classification system, but the paper's authors argue that their system - based on the consensus of experts - provides an accurate assessment of harm for policy makers.

    "Our findings lend support to previous work in the UK and the Netherlands, confirming that the present drug classification systems have little relation to the evidence of harm," the paper says.

    "They also accord with the conclusions of previous expert reports that aggressively targeting alcohol harms is a valid and necessary public health strategy."

    In 2007, Prof Nutt and colleagues undertook a limited attempt to create a harm ranking system, sparking controversy over the criteria and the findings.

    Legal high

    The new more complex system ranked alcohol three times more harmful as cocaine or tobacco. Ecstasy was ranked as causing one-eighth the harm of alcohol.

    It also contradicted the Home Office's decision to make so-called legal high mephedrone a Class B drug, saying that alcohol was five times more harmful. The rankings have been published to coincide with a conference on drugs policy, organised by Prof Nutt's committee.

    Prof Nutt said: "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."

    The Lancet paper written by Prof Nutt, Dr King and Dr Lawrence Phillips, does not examine the harm caused to users by taking more than one drug at a time.
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    Drugs debate hots up

    Mark Easton | 00:00 UK time, Monday, 1 November 2010

    Today sees the publication of two pieces of scientific research that threaten to destabilise further the orthodoxy on drug policy in Britain.

    One says our classification system of illicit substances is basically hopeless. The other says that decriminalising illicit drugs may be quite a good idea.

    Tomorrow, of course, Californians vote on whether to legalise marijuana.

    It is almost exactly a year since this blog revealed that Professor David Nutt had been sacked from his position as chair of the Advisory Council on the Misuse of Drugs (ACMD) by the then Home Secretary Alan Johnson.

    His dismissal, for allegedly "campaigning" against government drugs policy, prompted a show-down between scientists and ministers which saw a further seven council members resign.

    A number of those experts went on to found their own Independent Scientific Committee on Drugs, operating, as they put it, "free from the constraints of policy-making and politics".

    Today an ISCD paper entitled Drug Harms in the UK: A Multicriteria Decision Analysis is published in the Lancet. Its title may not be overly exciting but its findings are bound to cause an almighty stir.

    The headline is that, on the basis of new analysis assessing the relative harms of different legal and illegal drugs to the user and wider society, "alcohol was the most harmful drug (overall harm score 72), with heroin (55) and crack (54) in second and third places".



    So, Professor Nutt, shown the door by ministers after suggesting ecstasy is less dangerous than horse-riding, now says booze is more harmful than smack. It won't go down well at the Fox and Hounds.

    The professor helped produce an earlier version of what is called a "harm matrix" of drugs. As today's paper puts it, that "provoked major interest and public debate, although it raised concerns about the choice of the nine criteria and the absence of any differential weighting of them". So the ISCD has returned to the fray with what is called multi-criteria decision analysis.



    This approach includes 16 criteria including a drug's affects on users' physical and mental health, social harms including crime, "family adversities" and environmental damage, economic costs and "international damage".

    The scientists, based on their expert knowledge, score a substance on each category from zero to 100.



    The problem remains, however, of how much weight to give each of these categories. "The weighting process is necessarily based on judgement, so it is best done by a group of experts working to consensus," the report authors say.

    "Extensive sensitivity analyses on the weights showed that this model is very stable; large changes, or combinations of modest changes, are needed to drive substantial shifts in the overall rankings of the drugs."
    What emerges is a ranking of drugs at complete odds with the official Home Office classification system.

    The fact that alcohol emerges as the most harmful drug leads the authors to conclude that "aggressively targeting alcohol harms is a valid and necessary public health strategy" but its place at the head of the table also suggests a legal status in stark contrast to the much less harmful effect of Class A drugs including ecstasy and LSD.

    It is also notable that cocaine and tobacco emerge with very similar rankings in terms of harm.

    "Our findings lend support to previous work in the UK and the Netherlands, confirming that the present drug classification systems have little relation to the evidence of harm," they say.

    Also published today is another peer-reviewed paper assessing the effect of Portugal's decision to decriminalise all illicit drugs. You may recall I visited the country last year to report on a policy introduced in 2001.

    Since then there has been a dispute as to how effective the new arrangements have been. I have seen all kinds of pretty half-baked analysis attempting to prove that the policy is either the silver bullet to drug abuse or that it has been a health and crime disaster.

    Well, this new report looks at the arguments of both sides and attempts to provide a critical analysis of what has happened and concludes that "contrary to predictions, the Portuguese decriminalization did not lead to major increases in drug use. Indeed, evidence indicates reductions in problematic use, drug-related harms and criminal justice overcrowding."

    The report goes on to point out that "such affects can be observed when decriminalising all illicit drugs. This is important, as decriminalisation is commonly restricted to cannabis alone".

    The Home Office has not yet responded to the new study but drugs minister James Brokenshire recently told the House of Commons "[O]n the specific point about the Portuguese model, we are against that proposal."
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    This shouldn't surprise anybody.

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    It really all depends on how you're using it. Do we really think that having a beer every day is more harmful than taking a couple hits of crack every day?

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    Quote Originally Posted by Soten View Post
    It really all depends on how you're using it. Do we really think that having a beer every day is more harmful than taking a couple hits of crack every day?
    Of course not. But the damage to the brain which alcohol causes is often neglected.
    Not forgetting the social miseries caused by alcohol...
    The governments need that alco tax money, though...

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    Quote Originally Posted by Motörhead Remember Me View Post
    Of course not. But the damage to the brain which alcohol causes is often neglected.
    Not forgetting the social miseries caused by alcohol...
    The governments need that alco tax money, though...
    Regarding alcohol, I'm not in the dark about these things, but crack wreaks havoc in the black community and I can't imagine what it would be like if people did as much heroin as they drink. Plenty of social miseries would be/are created by drugs like crack and heroin. Probably more so than alcohol, but alcohol use is FAR more common.

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    Quote Originally Posted by Soten View Post
    Regarding alcohol, I'm not in the dark about these things, but crack wreaks havoc in the black community and I can't imagine what it would be like if people did as much heroin as they drink. Plenty of social miseries would be/are created by drugs like crack and heroin. Probably more so than alcohol, but alcohol use is FAR more common.
    Moderation with everything is the key in harm reduction, and so is the opposite (excess = damage). If you compare one failed life due to alcohol with one failed life due to heroin, the result is equally devastating.
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    Quote Originally Posted by Loki View Post
    Moderation with everything is the key in harm reduction, and so is the opposite (excess = damage). If you compare one failed life due to alcohol with one failed life due to heroin, the result is equally devastating.
    True.

    But the numbers of life's that have been devastated by alcohol greatly exceed heroin.

    Isn't that what the professor is really aiming at?

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    If everyone went bars to shoot up I am sure heroin would rank a lot higher than alcohol on his little charts. Apart from well, they may just stay still high than falling about everywhere pissed.

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    Quote Originally Posted by Loki View Post
    Moderation with everything is the key in harm reduction, and so is the opposite (excess = damage). If you compare one failed life due to alcohol with one failed life due to heroin, the result is equally devastating.
    Aye, but (and this is the reason I'll never support legalization of these two), is it even possible for there to be moderate users of crack and heroin? There are many recreational users of drugs which are currently illegal who lead very successful lives and are no more impacted by their drug use than is a moderate drinker by his couple of daily beers. But do you ever see that with these two drugs?

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