From The Times
March 23, 2007
Alcohol and tobacco cause more harm than Ecstasy, study claims
Alcohol and tobacco are more harmful than illegal drugs such as cannabis and Ecstasy, according to a new drug classification system set out by scientists.
A study published today in The Lancet rates alcohol as only slightly less dangerous than Class A drugs such as heroin and cocaine.
The new system ranks drugs according to the estimated harm they cause, rather than by the current A, B, and C divisions. Tobacco appears in the top half of a league table of 20 legal and illegal substances, well above the Class A drug Ecstasy, possession of which can result in a seven-year jail sentence.
LSD, another Class A drug, is also considered relatively safe despite its powerful hallucino-genic properties.
Cannabis, recently downgraded to Class C, occupies a middle position. It is rated more dangerous than Ecstasy, LSD and the dancefloor drug GHB, but less harmful than tobacco.
The drugs were rated according to their potential to cause physical harm to the user, addictiveness and other harmful effects and social costs.
The result has little in common with the classifications under the Misuse of Drugs Act. Heroin, cocaine, barbiturates, street methadone and alcohol were judged the top five most harmful drugs. Ketamine, which was unclassified at the time of the study but since made Class C, was rated sixth.
The authors, David Nutt, of the University of Bristol, and Colin Blakemore, head of the Medical Research Council, said that the high scores for alcohol and tobacco reflected their prevalance and current legal status compared with more illicit drugs. The two legal substances together account for 90 per cent of “drug-related” deaths in the UK, they said.
Other drugs evaluated in the project included solvents, anabolic steroids and qat.
Two panels of experts — including psychiatrists, chemists, pharmacologists, lawyers and police officers — were asked to rate each drug on a scale for the three major categories of harm. Each category was split into three sub-components.
Acute and chronic illnesses associated with a drug were considered, and also whether it could be taken intravenously, creating additional risks such as infections caused by sharing needles. Wider social harm covered consequences of intoxication such as violence and road accidents, damage to family and social life and the costs to systems of healthcare, social care and police.
The likelihood of misuse or abuse because of the pleasure caused by a drug and its propensity to cause psychological or physical dependence was also taken into account.
The current legal classification is supposed to relate to the harm and risk of each drug, but the authors of the study in the medical journal say that the regulations “evolved in an unsystematic way . . . with seemingly little scientific basis”.
Professor Nutt, lead author on the paper, said that isolated cases of unpleasant and unpredictable responses to drugs such as Ecstasy had been allowed to dictate policy. “A more scientific view is that these risks have to be assessed against their effect on the whole population,” he added.
The scientists said they were not pressing the Government to adopt the new system, but hoped it would spark a debate that could lead to reforms.
“Drug misuse and abuse are major health problems,” Professor Nutt said. “Our methodology offers a systematic framework and process that could be used to assess the harm of current and future drugs of abuse.” Professor Blakemore added: “Drug policy is primarily aimed at reducing the harm to users, their families and society. But at present there is no rational, evidence-based method for assessing the harm of drugs. We have tried to develop such a method.”
Campaigners said yesterday that the Government had reneged on promises of a review. Martin Barnes, of the charity Drugscope, said: “Last summer the Home Secretary, John Reid, said that he no longer intended to go ahead with the review of classification proposed by his predecessor in the context of debate about the status of cannabis. This paper builds on the conclusions of previous studies that we need a more general review of the Act. It is important that we open up the debate which the Government seems intent on closing.”
The Home Office Minister Vernon Coaker said that the Government had “no intention of reviewing the drug classification system”. He added: “Our priority is harm-reduction, and we focus on enforcement, education and treatment.”
Vices that cost nation billions
— Health, social and crime cost of drug misuse is put at £10 billion to £16 billion a year
— Alcohol is involved in more than half of all A&E visits Smoking beyond the age of 30 cuts life expectancy by up to ten years on average
— Tobacco is estimated to cause up to 40 per cent of all hospital illness
— A quarter of adults are “binge drinkers”, consuming at least double the recommended limit a day
Sources: The Lancet, Department of Health, RSA
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