Comments on This Week on Drugs

that chart seems rather strange:
eg- meth is only slightly worse than tobacco??
extacy is better for you than weed? (or less bad)

(I better put my bong away and take some e after work i guess)

and what exactly do the numbers mean, ie what is a "3"?

You can get the full article with free registration here from The Lancet. Their methodology looks pretty sound to me.

It depends on what you mean by "dangerous" Certainly Meth is much more dangerous to an individual then tobacco. You would have to be an idiot to think otherwise. However if you add the factors this study does, like damage to society, etc, then it makes sense.

The Lancet study is crap. (Yes, I did read it. And yes, I am a scientist.)

One humongous problem is that they never clarify whether they consider harms in toto, or per user, or per use. In the BBC interview, one author points out that the UK sees ~50 deaths/year from alcohol poisoning but only ~10 deaths/year from ecstacy, citing this as evidence of misplaced priorities in drug policy. But presumably there are many more than 5 times as many alcohol users than ecstacy users, so these statistics could actually be used to support the notion that ecstacy is more dangerous than alcohol.

Another humongous problem is that they undertake no sensitivity analysis. If they weight the categories differently, how do the rankings change? And, returning to the previous point, how do the rankings change with normalized harms? Are there any weightings and normalizations that reproduce or nearly reproduce the current legal classifications? They don't even mention these issues.

It's sad to see the Lancet, which is good journal that would demand much more rigor from any study purporting to answer a clinical question, publish something like this, which has about as much objective content as an web poll.

plus (earlier posts seem to have been erased), this is a UK study. I'm not sure this all translates quite so directly to the US for determining relative dangerousness.

Well, if all you are doing is comparing the actual harm caused by the pharmacolgical properties of the substances themselves, then yes a UK study is directly comparable to the US (or anywhere else).

And yes, methamphetamine would certainly rank lower than tobacco. Contrary to media demonizing and urban legend, pharmaceutical meth is quite safe and not inherently harmful.

Similarly, heroin would rank below either alcohol or tobacco. I attended a presentation earlier this year by Martin Schecter of the long running Vancouver Injection Drug User Study and he made the point that if you look at the harm associated with heroin use, virtually all of of the popularly perceived harm comes from the drug's legal status. In other words, the harm is primarly sociological, not pharmacological.

oops...hit post too quick...

So yes, the fact that they include social harms as well as a couple of other dubious factors (such as possibility of intravenous use?!), means this study needs to be evaluated carefully when applying to other countries.

It also lends to a certain crap factor as David Wright notes.

If they wanted to call attention to failures of current legal classification schemes, they should have stuck with a pure pharmacological/physiological comparison.

Gee, poppers are not as bad as I thought they would be.