If someone asked you to bet on which drug is actually the most harmful, which one would you pick?

Fentanyl, a drug 50 to 100 times more potent than morphine – so powerful, even, that it can cause an overdose in a single breath? Or crack cocaine, with nasty side effects that include paranoia, organ failure, seizure, and death?

The correct answer is neither of the above. According to a paper recently published in the Journal of Psychopharmacology, the most harmful drug is alcohol.

A team of 25 experts came to this conclusion after scoring 22 drugs on 16 criteria, using a scale of 0 to 100. In this case, 0 represented “no harm” and 100 signified “most harm”. The analysis was based on a similar study conducted in the UK in 2010 but had been adapted for an Australian context.

As with the original study, nine criteria were based on harms to the drug user. Think: drug-specific mortality, dependence, drug-related impairment of mental functioning, and loss of relationships. While the remaining seven were based on harms to others. For example, injury, crime, economic cost, and community. The criteria were then weighted to produce a final score.

The analysis found that the drug most harmful to the individual was fentanyl, with a part score of 50 (out of 50). The runner-up was heroin (45), followed by alcohol (41), crystal meth (24), and tobacco, or cigarettes (14).

But when harm to others was factored in, the list changed. Alcohol came top (combined score 77), followed by crystal meth (66), heroin (58), fentanyl (51), and tobacco (32). Straddling the bottom was kava (combined score 3), e-cigs (3), LSD and mushrooms (5), antipsychotics (7), and ecstasy (7).

Interestingly, both UK and Australian studies found alcohol to be the most harmful drug. In this study, it scored especially high on the criteria of economic cost, family adversity, injury, drug-related morbidity, and drug-specific morbidity. (Read more…)

Re-post from IFL Science!, by Rosie McCall, May 15, 2019