The largest ever study in to drug harms places alcohol in the top four (1 Viewer)

[Graney]

[h=4]Article focus[/h]

• To produce an expert-based consensus on the relative harms posed by 19 commonly used legal and illegal substances.

[h=4]Key messages[/h]

• The legality of a substance is not correlated with its perceived harm. There is no stepped ‘A, B, C’ distinction in harm evident.

[h=4]Strengths and limitations of this study[/h]

• This is largest known addiction experts survey of substance-related harm. Observer bias cannot be excluded The availability and cost of substances was not taken into account.
  
  

Conclusions The harm rankings of 19 commonly used substances did not match the A, B, C classification under the Misuse of Drugs Act. The legality of a substance of misuse is not correlated with its perceived harm. These results could inform any legal review of drug misuse and help shape public health policy and practice.

http://bmjopen.bmj.com/content/2/4/e000774.full

 

[funkshen]

and yet, besides the status of cannabis, nothing is going to change

i also wonder how the scoring is affected by the poor quality of illicit (e.g. snorting binding agents, no more rat poison/PMMA/speed in your ecstasy, levamisole in your cocaine)

 

[U MAD BRO]

what about weed?

 

[Azure]

what about weed?

It's there on the end.

 

[funkshen]

It's there on the end.

no, that's cannabis. i wanna know about weed

 

[iSplicer]

Is the 'score' (y-axis logarithmic)? You can't tell me heroin is 57% more harmful than grass.

 

[seanieg89]

Is the 'score' (y-axis logarithmic)? You can't tell me heroin is 57% more harmful than grass.

Or only fractionally more harmful than alcohol!

 

[Azure]

no, that's cannabis. i wanna know about weed

I didn't even realize they were separate things (noob).

 

[funkshen]

Is the 'score' (y-axis logarithmic)? You can't tell me heroin is 57% more harmful than grass.

read the report bro


Design Structured questionnaire with nine scored categories of harm for 19 different commonly used substances.

...

Addiction specialists and psychiatrists working with substance misuse across Scotland were approached to complete the questionnaire, on the basis of their clinical experience and expertise.

 

[Graney]

Is the 'score' (y-axis logarithmic)? You can't tell me heroin is 57% more harmful than grass.

"Participants were asked to score each substance for each of the nine parameters, using a 4-point scale, with 0 being no risk, 1 some risk, 2 moderate risk and 3 extreme risk"

Yeah it's not a linear scale, it's unclear to read, it's only useful to place substances in a ranking order but doesn't accurately gauge the distance between each substance,

 

[kaz1]

I didn't even realize they were separate things (noob).

They're not.

 

[funkshen]

"Participants were asked to score each substance for each of the nine parameters, using a 4-point scale, with 0 being no risk, 1 some risk, 2 moderate risk and 3 extreme risk"

Yeah it's not a linear scale, it's unclear to read, it's only useful to place substances in a ranking order but doesn't accurately gauge the distance between each substance,

what are your thoughts on the methodology? it's self-reported and purely qualitative, so imho it's not the kind of study that could really shake the foundations of the discourse on drug illegality/classification. on the other hand, it is solid evidence of expert experience and opinion.

 

[Graney]

what are your thoughts on the methodology? it's self-reported and purely qualitative, so imho it's not the kind of study that could really shake the foundations of the discourse on drug illegality/classification. on the other hand, it is solid evidence of expert experience and opinion.

Qualitative research is what it is, it's not really a suitable question for a randomised controlled trial because unfortunately we can't dope up people with illicit drugs, and even if we could, it wouldn't be valid to extrapolate results taken in a clinical setting to how people use drugs in the real social world.

It's basically the same as two previous studies performed by Nutt, so not really groundbreaking, but it confirms the validity of those results.

Most of the experts in this sample work with addictions, so they're more exposed to drugs of addiction, and probably have little exposure to some of the drugs listed in this study. Like, cannabis was rated more dangerous in Nutt's study which surveyed toxicologists and pharmacists, rather than addiction specialists, the toxicologists etc are probably more exposed to the amount of research into cannabis and mental health, whereas cannabis isn't bread and butter work for people managing addictions.

The graphs are poorly constructed, the names change on different graphs, tobacco is use on some and nicotine on others, mushrooms on some and mag(ic mushrooms) on others, coke vs cocaine.

I thought solvents included things like sniffing petrol, which causes acute brain damage rapidly, I would have thought that would top the list.

 

[funkshen]

neither the study nor the Nutt article they cite define solvents. also, Nutt (2007) seems to distinguish alkyl nitrates (poppers) from inhaled solvents. so i can only assume inhaled solvents refers to mostly petroleum products, and i would have imagined their harm factor would be much higher.

 

[Lolsmith]

alcohol more social harm than meth and crack

yes this is good

 

[abbeyroad]

will you turn into hitler if you combined alcohol, heroin and meth???

 

[funkshen]

i always have a good time on meth

 

[soloooooo]

Those graphs are hard to read. I find it difficult to believe that alcohol and nicotine are so much more harmful than LSD, ecstasy and pot.

 

[townie]

Those graphs are hard to read. I find it difficult to believe that alcohol and nicotine are so much more harmful than LSD, ecstasy and pot.

Why? As somebody who has used all these substances I would say it matches well to my experiences. I've only ever once called in sick because I smoked too much weed, but I've called in sick many times because of a hangover. Smoking and tobacco costs me infinitely more than the other three combined. I've never done something I've regretted on ecstasy (indeed I've had some of my best nights) I only wish I could say the same for alcohol.

 

[abbeyroad]

what about meth