Following on from the work of David Nutt and others - originally for the government’s own advisory panel - is another paper trying to compare the harms of different drugs. As with previous papers, and available at the British Medical Journal, this one’s not good news for our current classification system or the distinction between legal and illegal drugs.
One of the strengths of this study is the large number of experts involved. Two hundred and ninety-two addiction multidisciplinary experts across Scotland were involved making it the largest national panel to be involved in this type of study. [Addiction community psychiatric nurses were the largest group, making up 46% of the experts]
The main result is that heroin, crack cocaine, crystal meth, alcohol and cocaine were in the top five places for all  categories of harm, with LSD, ecstasy, methylphenidate, magic mushrooms and cannabis in the bottom five places for all categories of harm. The hierarchy of harm when judged by the experts did not correlate with the hierarchy used currently by the Misuse of Drugs Act.
This study demonstrates, similar to both of Nutt’s studies, that the legality of a substance does not reflect its potential for harm.
The burgeoning evidence of the harm caused by tobacco and alcohol would also suggest that from a scientific perspective these drugs are currently misclassified and that a new method for ranking drug harm, which could guide policies and public health strategies, is required, with many in the scientific and medical community feeling that this should be separated from the criminal justice system and associated penalties.
Any new system would also have to address the issue of personal choice and responsibility in using substances and examine the context in which they are being used. Increasing public awareness of the potential for harm of all the drugs examined whether legal or illegal and finding ways of reducing the demand for psychoactive substances should be the focus rather than imposing harsh penalties for their use.
These methods of comparing harms aren’t perfect. One issue with this paper is that there’s no distinction between harms intrinsic to the drug and additional harm caused by prohibition. Whatever you think of legalisation, a regulated market certainly wouldn’t see heroin contaminated with anthrax, for example.
But these methods are certainly better than the politics and misinformed hysteria that have created the UK’s classification system.
Hopefully this and further improvements will help lead to a more sensible system, but it’s clear that there are also individual reclassifications that could help. The ACMD might next year recommend that Ketamine should be moved up to Class B. Based on this paper, that might be reasonable. But it may also be an opportunity to change - or at least discuss - other classifications, especially those of ecstasy and cannabis (in both cases Labour ignored ACMD advice), as well as LSD and magic mushrooms.
This is not entirely academic. Assuming some people listen to advice from the Home Office, information not based in fact promotes poor decisions and is a danger to people’s health. Think of the children…