The British Medical Journal on 27th of July 2012 published an extensive study scaling the harm caused to ones self and to others due to substance use. The study looked at the 19 most commonly used drugs both legal and illicit. Heroin was ranked at number 1 whilst Alcohol sat in 4th place and cannabis came bottom being deemed least harmful in all 3 tables.
The Paper titled “Quantifying the RR of harm to self and others from substance misuse: results from a survey of clinical experts across Scotland.” published in the BMJ by a collective of 6 research bodies, five from the UK and one from our common wealth cousins in New Zealand who also operate under a policy of prohibition like ours – The Misuse of Drugs Act. This study was carried out by 292 clinical experts.
- 1NHS Lothian, Edinburgh, UK
- 2NHS Lanarkshire, Hairmyres Hospital, Glasgow, UK
- 3Maori Mental Health, Otahuhu, Auckland, New Zealand
- 4Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- 5NHS Forth Valley, Falkirk, UK
- 6NHS Grampian, Aberdeen, UK
The first thing to take note of here is the number of NHS contributors there are, which have also got “mental health” and “psychiatry” in their names. Let’s start off by remembering that cannabis is a Class B drug and the Governments continuously reinforced standard line is “cannabis is toxic, harmful to yourself and others and leads to serious mental health problems.” Here we have Harm to self and other (as in the study) and links to mental health (as per the researchers credentials).
The aim of the study is transparent as you could get
“To produce an expert consensus hierarchy of harm to self and others from legal and illegal substance use.”
This is actually something we have seen before produced by Prof. David Nutt who chaired the ACMD before being dismissed of his voluntary duties after doing so. His graph clearly pointed out that Alcohol was much more harmful than cannabis and ecstasy, the later of which he famously and politically controversially made the statement that it was statistically more harmful to go horse-riding. Apparently the scientific evidence did not interest the Home secretary Alan Johnson. Prof. Nutt has gone on to form the ISCD that has produced a second version of the chart. Not much difference.
The 2012 version of the study carried out by the NHS again has a very straight answer concerning the results about this study. This is black and white.
Results There was no stepped categorical distinction in harm between the different legal and illegal substances. Heroin was viewed as the most harmful, and cannabis the least harmful of the substances studied. Alcohol was ranked as the fourth most harmful substance, with alcohol, nicotine and volatile solvents being viewed as more harmful than some class A drugs.
Alcohol a very legally available drug, considered by many now to be over advertised to youth and studies are backing this up also is being highlighted as health risk in relation to the title of the study, harm to self and to others. In Prof. David Nutt‘s appearance to give oral evidence to the Home Affairs Select Committee reviewing the current Governments Drug Policy he argued the point that alcohol does increase domestic violence, and that is part of the nature of alcohol. In 2008 the Government released a paper detailing the extent of what they called “An alcohol Epidemic”, however it uses the excuse of tradition to keep it well out of arms reach of the MDA’71. At the same sitting, Nutt also said “maybe it was time the Government got their hand dirty and started regulating cannabis”, this is certainly what the Chillian Premier is considering.
Conclusions The harm rankings of 19 commonly used substances did not match the A, B, C classification under the Misuse of Drugs Act. The legality of a substance of misuse is not correlated with its perceived harm. These results could inform any legal review of drug misuse and help shape public health policy and practice.
Could they scream it any louder?
Cannabis is the least harmful drug out of 19 legally available over the counter drugs, prescription drugs, and recreational drugs. Cannabis is safer than the drug given to children at an alarmingly hight rate, Ritalin. It may or may not surprise some people that in America where they have Medical Marijuana laws in a growing number of states (now standing at 17+Washington DC) parents and child physicians are dropping the pharma pills for their children and replacing it with small doses of cannabis infused food called edibles. This is the same for ADD, ADHD, Asperhger Syndrome, Autism and then even on to illnesses like Epilepsy. This should be listened to much more by the Home Office who are restricting this treatment from patients who are desperate for another option, the Home Office that licenses GW Pharmaceuticals to grow 300 tonnes a year, but more less that 1,500 patients can benefit from a watered down version of it in Sativex at 1000 x the price.
Out of two smoked drugs up there out nicotine and cannabis, the legally available and one wouldn’t get you arrested if you were caught walking around with it in your pocket by the police, it wouldn’t get you a criminal record and a set of fines, travel restrictions imposed, the stigma of having a criminal record and the loss of job and education prospects. Being caught with the least harmful one will though.
Alcohol costs the taxpayer £19 billion a year to enforce in courts and police time, public clean ups and repairs, and cost to the NHS which is around £7 billion alone according to the NHS Alcohol Statistics of 2011 paper.
Also to note, Mushrooms that were banned without any cause in a scandal rush in 2005 also ranked second least harmful in the table just above cannabis in the combined harm table. There are many drugs that were not included that do more harm than cannabis to individuals but in no way harm others such as over the counter pain killers and aspirins that cause a number of digestive and liver problems with prolonged use. Mixing alcohol with aspirins increases the rise of intestinal bleeding and bowel cancer, not that you get this kind of health warning for these two very available and advertised drugs. Social acceptability has nothing to do with the actual harms.
This paper published in the British Medical Journal indicates without a shadow of a doubt that if there was to be a shift around in the classification system that currently sees cannabis sit at C and alcohol excluded, we would instead see something the reverse of this. What a Misuse of Drugs Act needs to have a distinction between use and misuse, or state what they mean by harms. Most people who consume cannabis do so without causing a problem to anyone else, most of those times a problem is caused though it is when they are stopped by the police or have their homes raided. This causes a problem for everyone else because they are paying £500 million a year for it out of their taxes. The NHS are quite clearly not having problems with cannabis as they are with other drugs as the three published tables indicate.