Alcohol, tobacco worse than pot, ecstasy

[Tars]

From a CBC review of an article in "The Lancet" (British journal of medicine):

https://www.cbc.ca/health/story/2007...l-tobacco.html



New landmark research concludes that alcohol and tobacco are more dangerous than some illegal drugs like marijuana or ecstasy and should be classified as such in legal systems, according to a new British study. In research published Friday in The Lancet, Professor David Nutt of Britain's Bristol University and colleagues proposed a new framework for the classification of harmful substances, based on the actual risks posed to society. Their ranking listed alcohol and tobacco among the top 10 most dangerous substances.

'The exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary.'— Study's authors

Nutt and colleagues used three factors to determine the harm associated with any drug: the physical harm to the user, the drug's potential for addiction, and the impact on society of the drug's use. The researchers asked two groups of experts — psychiatrists specializing in addiction and legal or police officials with scientific or medical expertise — to assign scores to 20 different drugs, including heroin, cocaine, ecstasy, amphetamines, and LSD.

Nutt and his colleagues then calculated the drugs' overall rankings. In the end, the experts agreed with each other, but not with the existing British classification of dangerous substances. Heroin and cocaine were ranked most dangerous, followed by barbiturates and street methadone. Alcohol was the fifth-most harmful drug and tobacco the ninth most harmful. Cannabis came in 11th, and near the bottom of the list was ecstasy.

According to existing British and U.S. drug policy, alcohol and tobacco are legal, while cannabis and ecstasy are both illegal. Previous reports, including a study from a British parliamentary committee last year, have questioned the scientific rationale for Britain's drug classification system.
"The current drug system is ill thought-out and arbitrary," said Nutt, referring to the United Kingdom's practice of assigning drugs to three distinct divisions, ostensibly based on the drugs' potential for harm. "The exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary," write Nutt and his colleagues in The Lancet.

Classification debate

Tobacco causes 40 per cent of all hospital illnesses, while alcohol is blamed for more than half of all visits to hospital emergency rooms. The substances also harm society in other ways, damaging families and occupying police services. Nutt hopes that the research will provoke debate within the U.K. and beyond about how drugs — including socially acceptable drugs such as alcohol — should be regulated. While different countries use different markers to classify dangerous drugs, none use a system like the one proposed by Nutt's study, which he hopes could serve as a framework for international authorities.

"This is a landmark paper," said Dr. Leslie Iversen, professor of pharmacology at Oxford University. Iversen was not connected to the research. "It is the first real step towards an evidence-based classification of drugs." He added that, based on the paper's results, alcohol and tobacco could not reasonably be excluded. "The rankings also suggest the need for better regulation of the more harmful drugs that are currently legal, i.e. tobacco and alcohol," wrote Wayne Hall, of the University of Queensland in Brisbane, Australia, in an accompanying Lancet commentary. Hall was not involved with Nutt's paper.

While experts agreed that criminalizing alcohol and tobacco would be challenging, they said that governments should review the penalties imposed for drug abuse and try to make them more reflective of the actual risks and damages involved. Nutt called for more education so that people were aware of the risks of various drugs. "All drugs are dangerous," he said. "Even the ones people know and love and use every day."

[Braggi]

Thanks for sharing that article Tars.

It's about time "the people" learned what the failed "War on (some) Drugs" is really about.* Expert testimony carries a lot of weight and this study shows where the dangers lie and the dangers of the lies.



*The Law Enforcement Growth Industry and the Prison Industrial Political Complex

[Dixon]

Thanks for sharing this info, Tars.

Although many will find this study's findings shockingly "liberal", I must insist that it is conservatively biased. Note that those who rated dangerousness of the drugs were only two groups: "...psychiatrists specializing in addiction and legal or police officials with scientific or medical expertise". Both of these groups will tend to be biased in the direction of maximizing the dangers of drugs that happen to be illegal while minimizing the dangers of those that are legal.

Psychiatrists specializing in addiction will be biased against illegal drugs to the extent that people who don't really have a drug problem are forced into "treatment" due to having been busted with illegal drugs. The psychiatrist in such a situation will tend to exaggerate the dangers of the drug in order to see the client as having a problem; otherwise the psychiatrist would have to admit to participating in oppression by pathologizing non-abusive drug use.

Similarly, legal and police officials will tend to be biased against illegal drugs so that they don't have to feel bad about busting or prosecuting people for drugs that are actually safer than the tobacco and alcohol they themselves use. If your job requires you to bust pot dealers, you're gonna want to see pot as a bad thing, or else you'll feel bad about persecuting people for dealing it.

I'd love to find out how many of these "experts" are themselves users of tobacco and/or alcohol, thus further biasing their responses.

The study would have been more valid had they balanced out this conservative bias by including proponents of drug legalization, such as NORML (National Association for the Reform of Marijuana Laws). Better yet, instead of asking shrinks who make their $ from drug "treatment" and cops who make their $ from criminalization of certain drugs, why didn't they ask the real experts: medical researchers, and perhaps insurance companies who do lots of research on the comparative risks of various things in order to set their prices?

When tobacco, one of the most addictive of all drugs, which kills over a million people a year globally, including thousands of innocent victims of passive smoking, is rated only two notches more dangerous than marijuana, which is less addictive than coffee and has never been shown to cause a single death during several millennia of worldwide use, something is seriously wrong.

When heroin, which is less addictive than tobacco and less likely to kill or sicken a user, is rated more dangerous, something is wrong. Note that some drug problems, such as accidental overdose, are caused by the illegality of the drug more than by any inherent danger of the drug itself. If drugs like heroin were legal, accidental overdose would disappear overnight because potency would be standardized and clearly marked on the package. Also, less junkies would get sick and die if they could legally get clean needles. I'd bet that this study didn't correct for the degree to which the dangers of illegal drugs are caused by the illegality rather than the drug itself.

So, this study is a step in the right direction, but a flawed one. Bottom line: The illegal drugs in general (especially cannabis) are probably safer than this study indicates, and tobacco and alcohol are probably more dangerous than the study indicates.

Don't bogart that joint;

Dixon

[Clancy]

New landmark research concludes that alcohol and tobacco are more dangerous than some illegal drugs like marijuana or ecstasy and should be classified as such in legal systems, according to a new British study.

I doubt it will impact public perception a whit. The facts have been known for years;

Annual Causes of Death in the United States

Tobacco 435,000
Poor Diet and Physical Inactivity 365,000
Alcohol 85,000
Microbial Agents 75,000
Toxic Agents 55,000
Motor Vehicle Crashes 26,347
Adverse Reactions to Prescription Drugs 32,000
Suicide 30,622
Incidents Involving Firearms 29,000
Homicide 20,300
Sexual Behaviors 20,000
All Illicit Drug Use, Direct and Indirect 17,000
Non-Steroidal Anti-Inflammatory Drugs Such As Aspirin 7,600
Marijuana 0

From
https://www.drugwarfacts.org/causes.htm

[Braggi]

Thanks for sharing this info, Tars.



Psychiatrists specializing in addiction will be biased against illegal drugs to the extent that people who don't really have a drug problem are forced into "treatment" due to having been busted with illegal drugs. The psychiatrist in such a situation will tend to exaggerate the dangers of the drug in order to see the client as having a problem; otherwise the psychiatrist would have to admit to participating in oppression by pathologizing non-abusive drug use.


Dixon

Oh boy! Dixon, you claim to work in mental health and you say this? I personally know dozens of psychiartists and NONE of them fit that description. I've NEVER known a psychiatrist to "force" someone into "treatment" for drug use. Even pathological drug use. That's just nonsense. It's usually courts and social workers that make that kind of thing happen.

That statement reeks of the notion that doctors are out there creating lots of new diseases so they can label healthy people "patients" so they have more work to do. More nonsense. Most doctors in all fields are so overloaded with work I'm shocked more of them don't go off the deep end. I guess a lot of them actually do. They are going back to school to become stockbrokers and lawyers where they can make some money and work a 40 hour week.

FWIW, there are now very few psychiatrists even involved in actual treatment for drug problems. The bean counters at HMOs and other insurance companies have decided cheaper people can be used for such things. Actually, a lot of insurance companies won't even pay for drug dependancy treatment any more.

Overall, Dixon, I agree with your criticisms of the study. It's still a step in the right direction though.

[Dixon]

Oh boy! Dixon, you claim to work in mental health and you say this? I personally know dozens of psychiartists and NONE of them fit that description. I've NEVER known a psychiatrist to "force" someone into "treatment" for drug use. Even pathological drug use. That's just nonsense. It's usually courts and social workers that make that kind of thing happen.

Braggi;

I think we can clear up this misunderstanding easily. Go back and look at what I wrote more carefully and you'll see that you misread it. I didn't say nor imply that psychiatrists are forcing people into drug treatment. I fully agree with you that it's courts and social workers who do that. Do you see that now?

My point was that once someone who doesn't really have a drug problem (i.e., they're using some drug non-abusively) is forced into treatment by our misguided "justice" system, whoever makes their money by delivering such "treatment" will want to feel that the client really has a problem, rather than acknowledging that they are "treating" a non-problem, which is, after all, ludicrous, oppressive, and wasteful of tax monies. This conflict of interest will tend to make drug treatment practitioners, psychiatrists included, avoid unpleasant cognitive dissonance by exaggerating the dangers of the drugs they're "treating" people for, which will disproportionately be the drugs that happen to be illegal in this culture. At the very least, since tobacco addicts will usually be underrepresented among the clientele of "drug" treatment practitioners (note that most people are in denial that tobacco is even a drug), such practitioners will tend to underestimate the harmfulness of tobacco as compared to other drugs.

And, I reiterate, the fact that the study under discussion had all of the assessment of comparative drugs' harmfulness done by two groups both of which have a conflict of interest (shrinks specializing in drug treatment and cops or others in the legal system) is a SERIOUS flaw in the study--a flaw which presumably biased the conclusion against illegal drugs and in favor of legal ones, especially tobacco.

I hope that clears it up.

Regards;

Dixon

[Braggi]

Braggi;

{snip}
My point was that once someone who doesn't really have a drug problem (i.e., they're using some drug non-abusively) is forced into treatment by our misguided "justice" system, whoever makes their money by delivering such "treatment" will want to feel that the client really has a problem, rather than acknowledging that they are "treating" a non-problem, which is, after all, ludicrous, oppressive, and wasteful of tax monies. This conflict of interest will tend to make drug treatment practitioners, psychiatrists included, avoid unpleasant cognitive dissonance by exaggerating the dangers of the drugs they're "treating" people for, which will disproportionately be the drugs that happen to be illegal in this culture.

{big snip}
I hope that clears it up.
Regards;
Dixon

Well, no, it doesn't. But first let me say thanks for that excellent post on mental illness. You're spot on there. But this is something else.

First: drug companies don't generally make money treating drug addicts (or rarely). Most shrinks won't prescribe anything to an addict that's actively using. That's real bad practice. Only the dimwits at [one certain hospital in Sonoma County] would prescribe, for instance, benzos to addicts. Most psychiatrists won't prescribe even to addicts who are clean. And I reiterate, few psychiatrists in this day and age are even allowed by their gatekeepers to treat addictions, even though they usually get more training in that department and have more understanding of it (since they are, by definition, Medical Doctors) than any other kind of care provider.

My point is, quite in opposition to yours, that psychiatrists have little to gain by calling casual drug use a mental illness. Many other "professionals" have a different relationship with "drug problem" treatments and they pathologize like crazy. Got it. Just not shrinks. Shrinks tend to pathologize other things, but that's a different topic. And as you state above, most of that is justified.

There is also a significant difference between drug use and abuse. Most psychiatrists are equipped to make that distinction. Most "drug counselers" and law enforcement types define any use of illegal substances as abuse so there you have it.

Dixon, we agree on almost everything and I really appreciate reading your posts. Perhaps this is a small issue to the Wacco community but I'm a bit sensitive about it since so much of my personal circle is made up of psychiatrists. {There, I've beaten that dead horse to smithereens and don't I feel better!}

[Dixon]

Braggi;

Thanks for your kind words.

I'm gonna give this dead horse just one more swift kick.

While there may be some individual exceptions, this applies to every group of human beings: where there is some conflict of interest, there will tend to be certain predictable biases. (See my previous posts for explication of the nature of these conflicts of interest vis-a-vis drug treatment). Psychiatrists being human, this applies to them, and it is no insult to them to say so. Even if you believe that shrinks are less disposed to such bias than other folks, the principle still holds, and since both groups used as raters in the study are subject to such bias, the validity of the study is compromised.

I know and like quite a few shrinks myself, and this is not an insult to shrinks, just an observation about universal human nature re: certain biasing factors that are relevant to research design.

Regards;

Dixon

[don]

Hey Dixon

You might like this quote from Anais Nin:

"We don't see things as they are, we see things as we are."

Cheers
don

Braggi;

Thanks for your kind words.

I'm gonna give this dead horse just one more swift kick.

While there may be some individual exceptions, this applies to every group of human beings: where there is some conflict of interest, there will tend to be certain predictable biases. (See my previous posts for explication of the nature of these conflicts of interest vis-a-vis drug treatment). Psychiatrists being human, this applies to them, and it is no insult to them to say so. Even if you believe that shrinks are less disposed to such bias than other folks, the principle still holds, and since both groups used as raters in the study are subject to such bias, the validity of the study is compromised.

I know and like quite a few shrinks myself, and this is not an insult to shrinks, just an observation about universal human nature re: certain biasing factors that are relevant to research design.

Regards;

Dixon