Tuesday, September 24, 2013

24/9/2013: Public Health, and Legal v Illegal Drugs...

In light of the Government push for stricter tobacco regulations while happily cheering the Arthur Day and providing support for the drink celebrations across the country, here's an interesting 2010 study (full citation at the bottom of the post) of the effects of various drugs in terms of causing various types of individual (user) and common (social) harm. Note: I have no objection to the idea that taken in moderation, alcohol is hardly harmful to anyone involved. Then again, I have possibly an objection as to what constitutes moderation in the case of Arthur Day level of booze consumption in Ireland…

Background: "Proper assessment of the harms caused by the misuse of drugs can inform policy makers in health, policing, and social care. We aimed to apply multi-criteria decision analysis (MCDA) modelling to a range of drug harms in the UK."

Method: "Members of the Independent Scientific Committee on Drugs, including two invited specialists, met in a 1-day interactive workshop to score 20 drugs on 16 criteria: nine related to the harms that a drug produces in the individual and seven to the harms to others. Drugs were scored out of 100 points, and the criteria were weighted to indicate their relative importance."

Findings: "MCDA modelling showed that heroin, crack cocaine, and metamfetamine were the most harmful drugs to individuals (part scores 34, 37, and 32, respectively), whereas alcohol, heroin, and crack cocaine were the most harmful to others (46, 21, and 17, respectively). Overall, alcohol was the most harmful drug (overall harm score 72), with heroin (55) and crack cocaine (54) in second and third places."

Interpretation: "These findings lend support to previous work assessing drug harms, and show how the improved scoring and weighting approach of MCDA increases the differentiation between the most and least harmful drugs. However, the findings correlate poorly with present UK drug classification, which is not based simply on considerations of harm."

And here are some charts (you can click on each chart to open a larger image)

Methodological tree used in assessment:

Overall results along two main branches of the methodological tree:

Two-dimensional positioning of the two main branches scores:

Lastly, all 16 criteria mapped:

As I quipped on twitter earlier this week, maybe before introducing plain packaging laws for tobacco products we should introduce blank labels for alcohol too? After all, if restricting the former is about public and personal health, restricting the latter at least as much would make sense. Not that I subscribe to the idea that the former is any good of a policy tool... just pointing the inherent contradiction in Government's strategies to deliver improvements in public health...

Study link: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61462-6/abstract

Citation: Nutt, David J, King, Leslie A and Phillips, Lawrence D. (2010) Drug harms in the UK: a multicriteria decision analysis. The Lancet, 376 (9752). pp. 1558-1565. ISSN 0140-6736

Note: I wrote about research on links between alcohol and mortality here (see bottom of the post).

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