Which are the most harmful drugs?

Drug Policy Question of the Week – 12-18-10

As answered by Mary Jane Borden, Editor of Drug War Facts for the Drug Truth Network on 12-18-10. http://www.drugtruth.net/cms/node/3189

Question of the Week: Which are the most harmful drugs?

Title 21, Chapter 13, Section 812 of the U.S. Code contains the Controlled Substances Act of 1970 that established five drug “schedules” presumably based on harm. Schedule I are said to the most dangerous. The other four schedules suggest gradually less harm. The United Kingdom has a similar classification system using the letters A, B, and C. Neither includes alcohol or tobacco.

Several studies have compared the harms of various drugs. A famous New York Times article from 1994 looked at nicotine, heroin, cocaine, alcohol, cocaine, and marijuana and found heroin to be the most dangerous, followed closely by alcohol. Cannabis and caffeine were deemed to be least dangerous.

The American Scientist magazine analyzed drug dependence and concluded,

“Heroin and methamphetamine are the most addictive … Cocaine, pentobarbital, nicotine and alcohol are next, followed by marijuana and possibly caffeine. Some hallucinogens—notably LSD, mescaline and psilocybin—have little or no potential for creating dependence.”

A similar analysis recently appeared in the British medical journal, The Lancet that found,

“… heroin, crack cocaine, and metamfetamine were the most harmful drugs to individuals, whereas alcohol, heroin, and crack cocaine were the most harmful to others.”

A table from another Lancet analysis now appears on Drug War Facts. This study ranked 20 drugs by physical-, dependence-, and socially-related harms. The table also shows their legal classifications in the U.K. and U.S.

Of the top five drugs rated as most harmful, only one – heroin – is a Schedule I drug in the U.S. Of the nine drugs that had ranking among the least harmful, four including cannabis are Schedule I.

These facts and others like them can be found in the Crime and Addictive Properties of Drugs chapters of Drug War Facts at http://www.drugwarfacts.org.

Questions concerning these or other facts concerning drug policy can be e-mailed to mjborden@drugwarfacts.org

These facts and others like them can be found in the Crime and Addictive Properties of Popular Drugs chapters of Drug War Facts at http://www.drugwarfacts.org.
Drug Rankings by Harm
Substance Physical Harm Dependence Social Harm UK Class US Schedule
Heroin 2.78 3.00 2.54 A I
Cocaine 2.33 2.39 2.17 A II
Barbiturates 2.23 2.01 2.00 B III
Street Methadone 1.86 2.08 1.87 A II
Alcohol 1.40 1.93 2.21 n/s n/s
Ketamine 2.00 1.54 1.69 C III
Benzodiazepines 1.63 1.83 1.65 C IV
Amphetamine 1.81 1.67 1.50 A II
Tobacco 1.24 2.21 1.42 n/s n/s
Buprenorphine 1.60 1.64 1.49 C III
Cannabis 0.99 1.51 1.50 B I
Solvents 1.28 1.01 1.52 n/s n/s
4-MTA 1.44 1.30 1.06 A n/s
LSD 1.13 1.23 1.32 A I
Methylphenidate 1.32 1.25 0.97 B II
Anabolic steroids 1.45 0.88 1.13 C III
GHB 0.86 1.19 1.30 C I
Ecstasy 1.05 1.13 1.09 A I
Alkyl nitrites 0.93 0.87 0.97 n/s n/s
Khat 0.50 1.04 0.85 C I

– United Kingdom drug classes were initially assigned based on Table 2 in The Lancet report. However, since then, two drugs have been reclassified:
– Methamphetamine was moved from class B to class A in 2006.
– Although Cannabis was downgraded from class B to class C in 2004, it was subsequently upgraded to class B in 2009.
– “n/s” = no scheduling

A printer-ready “From the Chapters of Drug War Facts” fact sheet in PDF format can be found at: http://drugwarfacts.org/cms/files/Drug-Rankings-by-Harm.pdf