The 20 most harmful drugs ranked
(approx 5 minute read)
Former chief drug adviser to the government Professor David Nutt wrote a book titled: Drugs Without The Hot Air, Making Sense Of Legal And Illegal Drugs. In it, he ranks the 20 most harmful drugs. You might be surprised by what is considered the most harmful.
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Professor Nutt is a neuropsychopharmacologist specialising in the research of drugs that affect the brain and conditions such as addiction, anxiety and sleep.
He has had top roles at University of Bristol, Imperial College London and was President of the European College of Neuropsychopharmacology.
The reason for giving background here is to show he’s a serious professor with a serious background and has operated in some seriously serious positions.
However, in 2009, Professor Nutt was asked to resign from his role as the government’s chief drug adviser (he occupied a number of roles for the government between 1998 to 2009) after his claims that ecstasy and LSD were less dangerous than alcohol.
So how did Professor Nutt go about ranking the drugs?
16 different sorts of harm caused by drugs
Firstly he looked at the different sorts of harm caused by drugs looking at harm to self and harm to others.
Harm to Self: Assessing the Physical and Mental Effects
Drug-specific mortality: Death from poisoning. Measured by comparing the amount needed to give a psychoactive effect and the amount that would be fatal.
Drug-related mortality: Includes death from chronic illness caused by drug taking or drug-related activities e.g. dangerous driving under alcohol
Drug-specific harm: Physical damage (short of death) caused by a drug e.g. tobacco-related lung disease
Drug-related harm: Damage (short of death) from drug-related activities e.g. road traffic accident
Dependance: Addiction
Drug-specific impairment of mental functioning: How being intoxicated on the drug impairs judgement e.g. drunk or drugged driving
Drug-related impairment of mental functioning: Psychological effects that continue once the drug has left the body e.g heavy use of some drugs is associated with depression, memory loss or increased depression
Loss of tangibles: Losing your job, your income, your possessions
Loss of relationships: People might lose friends or family because of behaviour
Harm to Others: Exploring the societal impact of drug abuse
Injury: Being under the influence and harming someone else
Crime: Committing crime to fund a drug habit or while under the influence e.g vandalism
Economic cost: Cost to health service, police service or work days lost due to recovery
Impact on family life: Because drugs can fuck families up
International damage: People killed by drug trade, carbon emissions and other environmental impacts
Environmental damage: Drug production can pollute areas, used needles can make local parks a no-go area and noisy and aggressive behaviour can become an issue
Decline in reputation of the community: Heavy drug use can stigmatise social groups and turn areas into no-go zones
Harm to the user is considered purely on an individual level. Harm to others is considered on a population level i.e. given the total levels of consumption of X drug in this country how much harm does each drug produce to society.
The panel
It was like the Avengers of drug related knowledge: five addiction experts, two experts in drug issues relating to young people, two chemists and five other experts from a range of backgrounds. We won’t name them here, but rest assured they all know their stuff (read chapter three if you don’t believe).
Ranking the Drugs: Insights from Professor David Nutt
Understandably, this was quite the process. Men’s Mental Fitness has attempted to summarise.
Multi-criteria decision analysis was used to create the final rankings
Based on the panels’ expertise and experience, the drugs were rated out of 100 according to each of the 16 criteria listed above (e.g heroin was given 100 for drug-related mortality, smoking 90, mushrooms one, LSD zero)
Where available, compared scores with official statistics on drug related deaths
All 16 scales weighted against one another
Detailed rankings of most harmful drugs
Alcohol ranked as the fourth most harmful drug to the user and most harmful to others - making it top overall. Over half its score came from economic cost, injury, family fall-outs and crime.
Drug
What is it?
Overall harm (out of 100)
1. Alcohol: Drinks of different strength - 72
2. Heroin: Brown solid, smoked or injected - 55
3. Crack: Smokable crystal form of cocaine - 54
4. Methylamphetamine: Smokable crystal form of amphetamine - 35
5. Cocaine: Powder usually snorted - 27
6. Tobacco: Smoked in cigarettes - 26
7. Amphetamine: Pills or powder mostly taken by clubbers - 23
8. Cannabis: Solid resin or leaves of plant, smoked or eaten - 20
9. GHB: Powder dissolved in liquid, similar effects to alcohol - 19
10. Benzodiazepines: Type of sleeping pill - 15
11. Ketamine: Powder snorted or liquid inject, popular with clubbers - 15
12. Methadone: Pharmacological substitute for heroin, usually drunk as liquid - 14
13. Mephedrone: Pills or powder popular with clubbers - 13
14. Butane: Gas that can be inhaled - 11
15. Anabolic Steroids: Drug to build muscle mass - 10
16. Ecstasy: Pills or powder containing MDMA that produce feelings or energy and euphoria, popular with clubbers - 9
17. Khat: A leaf which is chewed - 9
18. LSD: Liquid that in small doses causes psychedelic experiences - 7
19. Buprenorphine: Pharmacological substitute for heroin - 7
20. Mushrooms: Eaten whole or brewed as tea, causes psychedelic experiences - 6
Limitations and considerations: Examining the study's findings
Professor Nutt did highlight a lack of objective data in many areas and that the group rating approach is best for now.
He also acknowledged they only scored drugs based on harm - and that all drugs have benefits too (at least initially) otherwise no one would take them.
And Professor Nutt suggests most people are poly-drug users and the study only considered the impact of substances on their own e.g. some drugs are more dangerous as a combination e.g. alcohol with GHB.
It’s worth noting….
The same study was then repeated by 30 European experts from 20 different countries. While they changed every one of the 16 harm rankings and every one of the ratings, the final result was almost identical to the UK scoring.