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The former U.K. drug czar has published a study damning alcohol as a more dangerous drug than heroin or crack cocaine and urged governments to radically readjust their targets in the fight on narcotics.
Prof. David Nutt, head of the Independent Scientific Committee on Drugs, published his comparison in the medical journal, Lancet.
One Canadian expert said the study should prompt a new discussion about the dangers of alcohol abuse and a “more rational” consideration of our overall drug policy.
Nutt’s study weighs the danger of a drug based on a 16-point checklist – nine factors relating to harm to the user, and seven more measuring harm to others. Effects measured range from death to loss of mental functioning to crime to failed relationships.
The checklist produces a score out of 100 – the higher the score, the greater the danger.
Overall, alcohol scored a 72 on Nutt’s measure, well ahead of heroin (55) and crack (54).
In order of personal risk, the worst offenders were heroin, crack and crystal methamphetamine. The worst narcotics in terms of their effect on others were, in order, alcohol, heroin and crack.
“We need to rethink how we deal with drugs in light of these findings,” Nutt told the Guardian.
Nutt, a psychiatrist and neuropyschopharmacologist, has become a lightning rod in Britain’s drug wars. He was fired as chair of the government’s Advisory Council on Misuse of Drugs after his advice to lower the party-drug ecstasy from its classification as a class “A” drug – along with heroin and crack – was ignored. He also disagreed with the government’s decision to raise cannabis from class “C” to “B.”
Nutt argued that the government was making decisions on drug classifications using political, rather than scientific, criteria.
Nutt has argued in the past that tobacco and alcohol are a greater danger to society than marijuana or LSD.
One of Nutt’s co-authors said that the takeaway from the study was not that alcohol should be banned.
“We cannot return to the days of prohibition,” said Leslie King, an adviser to the European Monitoring Centre for Drugs. “Alcohol is too embedded in our culture and it won't go away.”
Instead, King called for a redistribution of resources away from illegal drugs to fight the problem of alcoholism.
“Once you look into the science … you will see that alcohol is currently doing the most harm in our societies,” said Dr. Jurgen Rehm, a senior scientist at Toronto’s Centre for Addiction and Mental Health who has done similar research in Canada. “We need to go over the arsenal of alcohol-control policies, and examine them rationally on what they can do for Canada.”
Rehm was one of the authors of a 2006 study that posited that the per capita cost to Canadian society of tobacco ($541) and alcohol ($463) far outweighs that of illegal drugs ($262).
Amongst Rehm’s advice – increase taxes on booze, revisit alcohol advertising and its “enticement” to minors and expand efforts at harm reduction. Rehm referenced a CAMH study on simple measures to reduce alcohol-related violence at bars as just one example.
He also suggests that Canada reconsider its policies on illegal drugs. He cited California’s sweeping Proposition 19 to legalize many marijuana-related activities as one example that such a discussion north of the border “is inevitable.”
“We need to come up with a way where we no longer criminalize the user for certain drugs, but where we try to reduce the risk to the user and to society as a whole,” Rehm said.
“Of course, we don’t want syringes in front of our schools … but we have to come up with a more rational discussion.”
Nutt’s List of Overall Harm
Alcohol (72)
Heroin (55)
Crack (54)
Crystal Meth (33)
Cocaine (27)
Tobacco (26)
Amphetamines (Speed) – (23)
Cannabis (20)
GHB (18)
Benzodiazapines (15)
Ketamine (15)
Methadone (13)
Butane (10)
Qat (9)
Ecstasy (9)
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Alcohol Use and Health
There are approximately 79,000 deaths attributable to excessive alcohol use each year in the United States.1 This makes excessive alcohol use the 3rd leading lifestyle-related cause of death for the nation.2 Additionally, excessive alcohol use is responsible for 2.3 million years of potential life lost (YPLL) annually, or an average of about 30 years of potential life lost for each death. In the single year 2005, there were more than 1.6 million hospitalizations3 and more than 4 million emergency room visits4 for alcohol-related conditions....
Immediate Health Risks
Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These immediate effects are most often the result of binge drinking and include the following—
Unintentional injuries, including traffic injuries, falls, drownings, burns, and unintentional firearm injuries.7
Violence, including intimate partner violence and child maltreatment. About 35% of victims report that offenders are under the influence of alcohol.8 Alcohol use is also associated with 2 out of 3 incidents of intimate partner violence.8 Studies have also shown that alcohol is a leading factor in child maltreatment and neglect cases, and is the most frequent substance abused among these parents.9
Risky sexual behaviors, including unprotected sex, sex with multiple partners, and increased risk of sexual assault. These behaviors can result in unintended pregnancy or sexually transmitted diseases.10, 11
Miscarriage and stillbirth among pregnant women, and a combination of physical and mental birth defects among children that last throughout life.12, 13
Alcohol poisoning, a medical emergency that results from high blood alcohol levels that suppress the central nervous system and can cause loss of consciousness, low blood pressure and body temperature, coma, respiratory depression, or death.14
Long-Term Health Risks
Over time, excessive alcohol use can lead to the development of chronic diseases, neurological impairments and social problems. These include but are not limited to—
Neurological problems, including dementia, stroke and neuropathy.15, 16
Cardiovascular problems, including myocardial infarction, cardiomyopathy, atrial fibrillation and hypertension.17
Psychiatric problems, including depression, anxiety, and suicide.18
Social problems, including unemployment, lost productivity, and family problems.19, 20
Cancer of the mouth, throat, esophagus, liver, colon, and breast.21 In general, the risk of cancer increases with increasing amounts of alcohol.
Liver diseases, including—
Alcoholic hepatitis.
Cirrhosis, which is among the 15 leading causes of all deaths in the United States.22
Among persons with Hepatitis C virus, worsening of liver function and interference with medications used to treat this condition.23
Other gastrointestinal problems, including pancreatitis and gastritis.
http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm$1:
For example, in the mid-1990s, the World Health Organization commissioned a team of experts to compare the health and societal consequences of marijuana use compared to other drugs, including alcohol, nicotine, and opiates. After quantifying the harms associated with both drugs, the researchers concluded: "Overall, most of these risks (associated with marijuana) are small to moderate in size. In aggregate they are unlikely to produce public health problems comparable in scale to those currently produced by alcohol and tobacco On existing patterns of use, cannabis poses a much less serious public health problem than is currently posed by alcohol and tobacco in Western societies."