Alcohol the most harmful drug

January 01, 0001

Alcohol the most harmful drug

Proper assessment of the harms caused by the misuse of drugs can inform policy makers in health, policing, and social care. The researchers from the UK and Portugal aimed to apply multicriteria decision analysis (MCDA) modelling to a range of drug harms in the UK. Members of the Independent Scientific Committee on Drugs, including two invited specialists, met in a 1-day interactive workshop to score 20 drugs on 16 criteria: nine related to the harms that a drug produces in the individual and seven to the harms to others. Drugs were scored out of 100 points, and the criteria were weighted to indicate their relative importance.

MCDA modelling showed that heroin, crack cocaine, and metamfetamine were the most harmful drugs to individuals (part scores 34, 37, and 32, respectively), whereas alcohol, heroin, and crack cocaine were the most harmful to others (46, 21, and 17, respectively). Overall, alcohol was the most harmful drug (overall harm score 72), with heroin (55) and crack cocaine (54) in second and third places.

The researchers concluded: "These findings lend support to previous work assessing drug harms, and show how the improved scoring and weighting approach of MCDA increases the differentiation between the most and least harmful drugs. However, the findings correlate poorly with present UK drug classification, which is not based simply on considerations of harm."

Alcohol problems also appear to be on the increase.

For the full abstract, click here.

The Lancet published online 1 November 2010
© 2010 Elsevier Ltd
Drug harms in the UK: a multicriteria decision analysis. David J Nutt, Leslie A King, Lawrence D Phillips on behalf of the Independent Scientific Committee on Drugs. Correspondence to: David Nutt:

Category: Z. Social Problems. Keywords: drugs, harm, multicriteria decision analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 26 November 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.