Today’s paper, published by the respected Lancet medical journal, will be seen as a challenge to the government to take on the fraught issue of the relative harms of legal and illegal drugs, which proved politically damaging to Labour.
Nutt was sacked last year by the home secretary at the time, Alan Johnson, for challenging ministers’ refusal to take the advice of the official Advisory Council on the Misuse of Drugs, which he chaired. The committee wanted cannabis to remain a class C drug and for ecstasy to be downgraded from class A, arguing that these were less harmful than other drugs. Nutt claimed scientific evidence was overruled for political reasons.
The new paper updates a study carried out by Nutt and others in 2007, which was also published by the Lancet and triggered debate for suggesting that legally available alcohol and tobacco were more dangerous than cannabis and LSD.
Today’s study offers a more complex analysis that seeks to address the 2007 criticisms. It examines nine categories of harm that drugs can do to the individual “from death to damage to mental functioning and loss of relationships” and seven types of harm to others. The maximum possible harm score was 100 and the minimum zero.
Overall, alcohol scored 72 – against 55 for heroin and 54 for crack. The most dangerous drugs to their individual users were ranked as heroin, crack and then crystal meth. The most harmful to others were alcohol, heroin and crack in that order.
Nutt told the Guardian the drug classification system needed radical change. “The Misuse of Drugs Act is past its sell-by date and needs to be redone,” he said. “We need to rethink how we deal with drugs in the light of these new findings.”
For overall harm, the other drugs examined ranked as follows: crystal meth (33), cocaine (27), tobacco (26), amphetamine/speed (23), cannabis (20), GHB (18), benzodiazepines (15), ketamine (15), methadone (13), butane (10), qat (9), ecstasy (9), anabolic steroids (9), LSD (7), buprenorphine (6) and magic mushrooms (5).
The authors write: “Our findings lend support to previous work in the UK and the Netherlands, confirming that the present drug classification systems have little relation to the evidence of harm. They also accord with the conclusions of previous expert reports that aggressively targeting alcohol harm is a valid and necessary public health strategy.”
Nutt told the Lancet a new classification system “would depend on what set of harms ‘to self or others’ you are trying to reduce”. He added: “But if you take overall harm, then alcohol, heroin and crack are clearly more harmful than all others, so perhaps drugs with a score of 40 or more could be class A; 39 to 20 class B; 19-10 class C and 10 or under class D.” This would result in tobacco being labelled a class B drug alongside cocaine. Cannabis would also just make class B, rather than class C. Ecstasy and LSD would end up in the lowest drug category, D.