David Nutt's drug rankings

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David Nutt's drug rankings

Postby apeman5291 » Mon Nov 02, 2009 10:35 pm UTC

David Nutt (recently fired for his statements about cannabis) and his colleagues published their research in the Lancet rating the 20 most dangerous drugs. Here is a summary that you don't have to sign up for.

Here's the list, from most dangerous to least dangerous:
Spoiler:
Nutt wrote:
  1. Heroin
  2. Cocaine
  3. Barbituates
  4. Street methadone
  5. Alcohol
  6. Ketamine
  7. Benzodiazepines
  8. Amphetamine
  9. Tobacco
  10. Buprenorphine
  11. Cannabis
  12. Solvents
  13. 4-MTA
  14. LSD
  15. Methylphenidate
  16. Anabolic Steroids
  17. GHB
  18. Ecstasy
  19. Alkyl Nitrates
  20. Khat


I'm not that surprised by the results, actually. I knew that heroin and cocaine are dangerous, and I've always thought that tobacco and alcohol get it too easy. It's also nice to see cannabis below #10.

EDIT: changed title.
Last edited by apeman5291 on Tue Nov 03, 2009 12:52 am UTC, edited 1 time in total.
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Re: David Nutt's 20 most dangerous drugs

Postby kingofdreams » Mon Nov 02, 2009 10:39 pm UTC

MDMA at 18, LSD at 14, cannabis at 11, this list confuses the shit out of me
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Re: David Nutt's 20 most dangerous drugs

Postby sje46 » Mon Nov 02, 2009 10:41 pm UTC

LSD and marijuana are more dangerous than Ecstasy? Doesn't Ecstasy mess up your brain a little? Doesn't it cause chronic depression? I'm surprised that LSD is ranked so high. You can't overdose on it and you can't get physically addicted.
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Re: David Nutt's 20 most dangerous drugs

Postby Izawwlgood » Mon Nov 02, 2009 10:42 pm UTC

I'm surprised to see Ecstacy and LSD so far apart, but admittedly don't know much about the physiological differences between the two.

Also, I linked around a bit but couldn't find the criteria they base this ranking on. "Harmful" to user? To someone drugged? To someone habitually using, vs. one time using? Habit forming?
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Re: David Nutt's 20 most dangerous drugs

Postby apeman5291 » Mon Nov 02, 2009 10:50 pm UTC

Izawwlgood wrote:I linked around a bit but couldn't find the criteria they base this ranking on. "Harmful" to user? To someone drugged? To someone habitually using, vs. one time using? Habit forming?


According to the full text, the harmfulness index is based upon 3 criteria: Physical, Dependence, and Social.
Physical
Assessment of the propensity of a drug to cause physical harm—ie, damage to organs or systems—involves a systematic consideration of the safety margin of the drug in terms of its acute toxicity, as well as its likelihood to produce health problems in the long term. The effect of a drug on physiological functions—eg, respiratory and cardiac—is a major determinant of physical harm. The route of administration is also relevant to the assessment of harm. Drugs that can be taken intravenously—eg, heroin—carry a high risk of causing sudden death from respiratory depression, and therefore score highly on any metric of acute harm. Tobacco and alcohol have a high propensity to cause illness and death as a result of chronic use. Recently published evidence shows that long-term cigarette smoking reduces life expectancy, on average, by 10 years. Tobacco and alcohol together account for about 90% of all drug-related deaths in the UK.
Dependence
This dimension of harm involves interdependent elements—the pleasurable effects of the drug and its propensity to produce dependent behaviour. Highly pleasurable drugs such as opioids and cocaine are commonly abused, and the street value of drugs is generally determined by their pleasurable potential. Drug-induced pleasure has two components—the initial, rapid effect (colloquially known as the rush) and the euphoria that follows this, often extending over several hours (the high). The faster the drug enters the brain the stronger the rush, which is why there is a drive to formulate street drugs in ways that allow them to be injected intravenously or smoked: in both cases, effects on the brain can occur within 30 seconds. Heroin, crack cocaine, tobacco (nicotine), and cannabis (tetrahydrocannabinol) are all taken by one or other of these rapid routes. Absorption through the nasal mucosa, as with powdered cocaine, is also surprisingly rapid. Taking the same drugs by mouth, so that they are only slowly absorbed into the body, generally has a less powerful pleasurable effect, although it can be longer lasting.
Social
Drugs harm society in several ways—eg, through the various effects of intoxication, through damaging family and social life, and through the costs to systems of health care, social care, and police. Drugs that lead to intense intoxication are associated with huge costs in terms of accidental damage to the user, to others, and to property. Alcohol intoxication, for instance, often leads to violent behaviour and is a common cause of car and other accidents. Many drugs cause major damage to the family, either because of the effect of intoxication or because they distort the motivations of users, taking them away from their families and into drug-related activities, including crime.


I'm just gonna edit the full text into the OP for convenience.
EDIT: Nevermind, too long.
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Re: David Nutt's 20 most dangerous drugs

Postby iop » Mon Nov 02, 2009 11:01 pm UTC

I am skeptical concerning their assessment of the relative harm of tobacco and alcohol. One reason we know the long-term effects of these so well (which, in turn, gives them among the top three scores for chronic effects) is because there are so many people who consume both, have no confounding problems, and do not incur any legal risk talking about the consumption. Furthermore, the other reason alcohol and tobacco score so high is because of the high social costs, which are not normalized by the number of regular consumers.

Other than problems with n, I think the study looks fairly reasonable, and is at least a good basis for discussion.

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Re: David Nutt's 20 most dangerous drugs

Postby The Reaper » Mon Nov 02, 2009 11:05 pm UTC

post a link to the full pdf maybe? megaupload or something? That would be awesome.

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Re: David Nutt's 20 most dangerous drugs

Postby kingofdreams » Mon Nov 02, 2009 11:17 pm UTC

I know opinion is infinitly divided on mdma, for some reason its impossible to get a credible conclusive statement form anyone, and its demonized incredibly but damn. I always considered lsd to be relatively benign as well
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Re: David Nutt's 20 most dangerous drugs

Postby TheSkyMovesSideways » Mon Nov 02, 2009 11:23 pm UTC

11. Cannabis
12. Solvents

Really? :shock:
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Re: David Nutt's 20 most dangerous drugs

Postby Telchar » Tue Nov 03, 2009 12:12 am UTC

LSD seems ranked really high. No physical addiciton, no known lethal dose etc....


I guess it stands under the social impact of

"through the various effects of intoxication, through damaging family and social life, and through the costs to systems of health care, social care, and police."

But most drugs would have the same social affect with a few notable exceptions.
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Re: David Nutt's 20 most dangerous drugs

Postby TheAmazingRando » Tue Nov 03, 2009 12:31 am UTC

I'm surprised Ecstasy is so low. I've only taken it once, but for about 5 seconds coming down I felt intensely suicidal, something I can imagine could manifest much worse in people with a history of depression. Also, I felt pretty significant short term memory problems for about a week after.

LSD may be high just because of the possibility of flashbacks/PTSD, psychedelics don't do a lot of physical stuff but they can be pretty taxing mentally, I can easily imagine a bad trip being permanently scarring. Though psilocybin could do the same, and that isn't even on the list. That being said, when I've been around people on LSD they didn't seem to be in any danger to themselves or others.

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Re: David Nutt's 20 most dangerous drugs

Postby The Reaper » Tue Nov 03, 2009 12:34 am UTC

TheAmazingRando wrote:I'm surprised Ecstasy is so low. I've only taken it once, but for about 5 seconds coming down I felt intensely suicidal, something I can imagine could manifest much worse in people with a history of depression. Also, I felt pretty significant short term memory problems for about a week after.

LSD may be high just because of the possibility of flashbacks/PTSD, psychedelics don't do a lot of physical stuff but they can be pretty taxing mentally, I can easily imagine a bad trip being permanently scarring. That being said, when I've been around people on LSD they didn't seem to be in any danger to themselves or others. Though psilocybin could do the same, and that isn't even on the list.

With X, it also has to do with how you take it. You can generally smooth it out by not taking a large dose straight off the bat. The feeling of depression isn't for everyone. Alot of people just feel... blank? i guess is the way to describe it. Not happy, but not sad? Introspective? something. Does interesting things for people with bad ADD and ADHD as well. :3 As far as short term memory problems, hmm, havn't heard that one personally, but I spose it can happen.

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Re: David Nutt's 20 most dangerous drugs

Postby apeman5291 » Tue Nov 03, 2009 12:38 am UTC

The Reaper wrote:post a link to the full pdf maybe? megaupload or something? That would be awesome.

I posted the link to the full publication, but you have to sign up to the site (for free, no strings attached). It's an HTML doc with lots of interactive charts and such, so I can't think of any other way to see it.

iop wrote:I am skeptical concerning their assessment of the relative harm of tobacco and alcohol. One reason we know the long-term effects of these so well (which, in turn, gives them among the top three scores for chronic effects) is because there are so many people who consume both, have no confounding problems, and do not incur any legal risk talking about the consumption. Furthermore, the other reason alcohol and tobacco score so high is because of the high social costs, which are not normalized by the number of regular consumers.

Other than problems with n, I think the study looks fairly reasonable, and is at least a good basis for discussion.

This section sheds some insight into the comparison:
[The experts] were asked to assess 14 compounds—heroin, cocaine, alcohol, barbiturates, amphetamine, methadone, benzodiazepines, solvents, buprenorphine, tobacco, ecstasy, cannabis, LSD, and steroids. Tobacco and alcohol were included because their extensive use has provided reliable data on their risks and harms, providing familiar benchmarks against which the absolute harms of other drugs can be judged. However, direct comparison of the scores for tobacco and alcohol with those of the other drugs is not possible since the fact that they are legal could affect their harms in various ways, especially through easier availability.
So I guess the proper way to read this list is to use alcohol at #5 and tobacco at #9 as fixed reference points, meaning that only 4 of the drugs evaluated were found to be more harmful than both, while 11 were found to be less harmful than both. Still, regarding sample size, I think a more scientific approach would be useful for a better comparison. Maybe with n volunteers for each drug, with similar backgrounds of drug use, and close supervision in a controlled observation environment during the experimental period.
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Re: David Nutt's 20 most dangerous drugs

Postby psychosomaticism » Tue Nov 03, 2009 12:41 am UTC

Solvents are not harmless. In fact, I'd probably put them as the worst on there. They're usually flammable, can cause permanent brain damage and hypoxia, and have an extremely short half-life of metabolism that they're used a lot at once, thus aggravating the above.

Same with amphetamines; they can cause long-lasting or permanent dopamine transporter and neuronal branching damage, and there have been studies that indicate cognitive effects after 7 years abstinence.

A lot of the things that get a worse rap than they deserve are there because they have bad societal connotations. Not to say that the lifestyles associated with the drugs are any less harmful; I'm sure alcohol would be worse were it illegal and sold illicitly.

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Re: David Nutt's 20 most dangerous drugs

Postby Texas_Ben » Tue Nov 03, 2009 1:27 am UTC

psychosomaticism wrote:Not to say that the lifestyles associated with the drugs are any less harmful; I'm sure alcohol would be worse were it illegal and sold illicitly.


History proves you correct.

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Re: David Nutt's drug rankings

Postby Marbas » Tue Nov 03, 2009 2:05 am UTC

Same with amphetamines; they can cause long-lasting or permanent dopamine transporter and neuronal branching damage, and there have been studies that indicate cognitive effects after 7 years abstinence.


Blort blort blort. MDMA is not your friend if you have test within a week. In fact, I think that list seriously under ranked it. IIRC it causes a drop in verbal memory for about a week. And that's not all.

http://cat.inist.fr/?aModele=afficheN&cpsidt=955237
http://brain.oxfordjournals.org/cgi/con ... 31/11/2936
http://www.maps.org/research/mdma/litup ... 001-2.html

Important bit from the MAPS study.

roblem/No Problem comparisons - Everyday Life Events and Psychological Function - "Problem" ecstasy users reported more cognitive failures than "no problem" users (no information on comparisons between ecstasy users and non-users on this measure). Cognitive Function - RT - "Problem" ecstasy users had slower reaction times than non-users. Executive Function - "No problem" ecstasy users had longer planning time than either non-users or "problem" ecstasy users ("no problem" users > non-users, "problem" users). Memory - Both "problem" and "no problem" users had lower scores on the spatial working memory test


http://www.mdma.net/toxicity/residual.html


Etc.

I don't care if it doesn't kill you, it definitely should not be as low as 18.

And Solvents, at twelve? Are you fucking kidding me?
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Re: David Nutt's drug rankings

Postby apeman5291 » Tue Nov 03, 2009 2:24 am UTC

Marbas wrote:And Solvents, at twelve? Are you fucking kidding me?

Are you saying they should be ranked closer to 1 or 20?
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Re: David Nutt's drug rankings

Postby Marbas » Tue Nov 03, 2009 3:18 am UTC

Are you saying they should be ranked closer to 1 or 20?


Put them closer to 1. Like, a lot closer. Psychosomatism covered it pretty well. Solvents are very nasty. They're probably one of the worst ways to get high. It's basically deliberately inducing hypoxia to cause an endorphin rush. And, depending on the solvent used, one of the easiest ways on that list to kill yourself or cause permanent damage.
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Re: David Nutt's drug rankings

Postby LuNatic » Tue Nov 03, 2009 8:23 am UTC

11. Cannabis
18. Ecstasy


You have to be freaking kidding me. When was the last time someone OD'd on Cannabis?
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Re: David Nutt's drug rankings

Postby Dr.Robert » Tue Nov 03, 2009 8:37 am UTC

LuNatic wrote:
11. Cannabis
18. Ecstasy


You have to be freaking kidding me. When was the last time someone OD'd on Cannabis?


Yeah, this is ridiculous.

Actually, a lot of this list is pretty ridiculous.

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Re: David Nutt's drug rankings

Postby Kizor » Tue Nov 03, 2009 9:10 am UTC

Any idea why PCP's not on the list? Its users have been known to murder other people to eat their lungs, consume eyes, and other such fun things. Presumably it's not (directly) that physically destructive nor all that addicting, but I'd like to see the details on its social effects and how those are quantified.

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Re: David Nutt's drug rankings

Postby the_bandersnatch » Tue Nov 03, 2009 9:50 am UTC

Kizor wrote:Any idea why PCP's not on the list? Its users have been known to murder other people to eat their lungs, consume eyes, and other such fun things. Presumably it's not (directly) that physically destructive nor all that addicting, but I'd like to see the details on its social effects and how those are quantified.


It's a UK study and PCP is relatively unknown here, so probably why it has not been included. All the others on the list are at least somewhat in common usage.
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Re: David Nutt's drug rankings

Postby dedalus » Tue Nov 03, 2009 11:20 am UTC

What would everyone elses top 20 list be? Just curious.

I really don't think Alcohol should rate higher then Tobacco and Amphetamines. Ice is deadly.
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Re: David Nutt's drug rankings

Postby Goldstein » Tue Nov 03, 2009 11:25 am UTC

WoW didn't even make the list. You're out of touch, Nutt.

I have this friend, I.. I don't even see him any more.

There is something a bit unnerving about this list, though. When looking at it, I can't help but think "Well I'm on alcohol now, maybe I should downgrade. If I give up drinking and start on LSD, I'll be better off."
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Re: David Nutt's drug rankings

Postby The Reaper » Tue Nov 03, 2009 12:33 pm UTC

dedalus wrote:What would everyone elses top 20 list be? Just curious.

I really don't think Alcohol should rate higher then Tobacco and Amphetamines. Ice is deadly.

I don't know. Look at how many teenagers think getting pissfaced is awesome.

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Re: David Nutt's drug rankings

Postby Zamfir » Tue Nov 03, 2009 12:36 pm UTC

dedalus wrote:What would everyone elses top 20 list be? Just curious.

I don't think this is meant as a "top 20", more as an "Put 20 common drugs into a ranking order".

I can see good reasons to put cannabis higher than MDMA. Not because a single dose of cannabis is worse than a single dose of ecstasy, but because people are much more prone to become large scale abusers of cannabis. I have known enough people who started to smoke canabis every morning and saw the rest of their days disappear around them. Ecstasy abuse is much more concentrated on parties, in the weekends. Some people are completely out of their minds for several evenings in the weekend, but they usually function reasonably well during the week.

And the connection between parties and ecstasy seems to make it easier to stop with serious abuse. People start going to different events, with a slightly different crowd, and the use diminishes a lot. Cannabis abuse on the other hand can become a very individual thing, and if people lose friends around them some only smoke more. That's a much harder trap to escape from.

It's like the difference between lonely drinkers and social alcoholics. People who drink too much in groups can do a lot of damage to themselves and others while drunk, but it keeps mostly limited to the drunk periods. People who drink by themselves can easily get in a spiral where the drinking causes the problems the escape by drinking more.

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Re: David Nutt's drug rankings

Postby Zamfir » Tue Nov 03, 2009 12:36 pm UTC

dedalus wrote:What would everyone elses top 20 list be? Just curious.

I don't think this is meant as a "top 20", more as an "Put 20 common drugs into a ranking order".

I can see good reasons to put cannabis higher than MDMA. Not because a single dose of cannabis is worse than a single dose of ecstasy, but because people are much more prone to become large scale abusers of cannabis. I have known enough people who started to smoke canabis every morning and saw the rest of their days disappear around them. Ecstasy abuse is much more concentrated on parties, in the weekends. Some people are completely out of their minds for several evenings in the weekend, but they usually function reasonably well during the week.

And the connection between parties and ecstasy seems to make it easier to stop with serious abuse. People start going to different events, with a slightly different crowd, and the use diminishes a lot. Cannabis abuse on the other hand can become a very individual thing, and if people lose friends around them some only smoke more. That's a much harder trap to escape from.

It's like the difference between lonely drinkers and social alcoholics. People who drink too much in groups can do a lot of damage to themselves and others while drunk, but it keeps mostly limited to the drunk periods. People who drink by themselves can easily get in a spiral where the drinking causes the problems they escape from by drinking more.

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Re: David Nutt's drug rankings

Postby dedalus » Tue Nov 03, 2009 1:27 pm UTC

I guess the problem with the order is that rather then staying to a topic like 'highest cause of health issues and death in society' (alcohol/cigarettes) or 'most dangerous to health' (probably solvents really), it seems to be adding everything up together and trying to weight fairly unrelated issues together. So the main question out of this is 'what do you want us to do with it', because I think that legalising all drugs lower on the list then alcohol is a bad idea, and I'm not sure whether he's intending that we ban alcohol/nicotine.
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Re: David Nutt's drug rankings

Postby Sharlos » Tue Nov 03, 2009 1:34 pm UTC

It would be more useful if he gave separate lists for the 3 criteria he judged them on as social issues have little to do with the drugs themselves.

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Re: David Nutt's drug rankings

Postby CivilDefense700 » Tue Nov 03, 2009 1:49 pm UTC

Cannabis is more dangerous than inhaling solvent fumes? ? ?

Do they not have any idea how much damage inhaling ether or petroleum distillates until you pass out does to your brain cells?
Was their study of cannabis just talking to a stoner and saying "oh yea, listen to that guy, he's got major brain damage."

And that study probably doesn't include burns or deaths from idiots accidentally igniting the fumes while trying to get high.

Can we revoke their license to do science? Although I wouldn't call a study that plays to political pressure good science.
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Re: David Nutt's drug rankings

Postby Decker » Tue Nov 03, 2009 1:54 pm UTC

On why LSD is so high up there.

This is just what I've heard, so don't take it to mean I've done any research or anything, but my aunt who worked as a nurse has told me stories of people who take LSD once and it pretty much fucks them up for life. One girl wanted to write a letter home, proceeds to make few circles on a piece of paper and gives it to my aunt to mail. She cried.
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Re: David Nutt's drug rankings

Postby Ixtellor » Tue Nov 03, 2009 2:14 pm UTC

1) Ectasy. I don't use illegal drugs and have not for a very very long time. But if you must use drugs, I highly recommend Ectasy. Drink lots of water and you will be fine.

2) Cannabis - add up all the habitual users of solvents you know, then add up all the habitual users of cannibis you know.
I don't believe the drug itself harms you, but chronic cannabis is going to turn you into a sad person. "Wake and Bake" is not a positive way to live your life and is going to have ramifcations in your work, private, and interpersonal lives.
I have never once known, or heard about a person who woke up in the morning and thought taking Ectasy would be a great idea. My freshman year of college was very very wild with lots of alcohol and drug use. An entire dorm room floor of guys would 'party' on a daily basis. Come sophmore year, every single pot smoker had dropped/failed out. Cannabis has a bad habit of turning people into everyday users.

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Re: David Nutt's drug rankings

Postby Zamfir » Tue Nov 03, 2009 2:48 pm UTC

Ixtellor wrote:2) Cannabis - add up all the habitual users of solvents you know, then add up all the habitual users of cannibis you know.

Exactly. If you never sniffed solvents, go ahead and try it a few time, just for the experience. It gives you a nice rush for a few seconds, and if you find the right solvent, you even feel nice a bit longer. But it stinks, leaves you with a headache, and really isn't much fun at all. You're not going to become an addict easily, unless you are a slum-dweller who needs very hard to escape life and can't afford anything else.

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Re: David Nutt's drug rankings

Postby Izawwlgood » Tue Nov 03, 2009 3:22 pm UTC

Decker wrote:stories of people who take LSD once and it pretty much fucks them up for life


I'm fairly confident that A) these stories are bullshit, and B) they are referencing people with way way more life issues to begin with. For example, I wouldn't suggest a soldier with PTSD drop acid and sit in a dark room by themselves.

Solvent usage is also physically far worse then marijuana.
Ixtellor wrote:Cannabis has a bad habit of turning people into everyday users.


I'd agree, but still find the placement of 'badness' to be odd. I'm sort of shocked that GHB is placed below LSD.
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Re: David Nutt's drug rankings

Postby apeman5291 » Tue Nov 03, 2009 4:23 pm UTC

Sharlos wrote:It would be more useful if he gave separate lists for the 3 criteria he judged them on as social issues have little to do with the drugs themselves.

The chart of their results and calculations is in the study:

I think the problem with the Physical Harm category is that there's a separate score for intravenous harm. Drugs that you don't inject get a zero in that category figured into their average, making them seem less harmful (Note: even though Alcohol's intravenous score says NA, its average indicates a 0 in the calculation). If the drugs with zeros instead got an N/A in that category and it wasn't factored into the average, the following list would come out (ranked by that one category):
Spoiler:
  1. Heroin
  2. Cocaine
  3. Barbiturates
  4. Alcohol
  5. 4-MTA (tied with Alcohol)
  6. Ketamine
  7. Tobacco
  8. Solvents (tied with Tobacco)
  9. Street methadone
  10. Amphetamine
  11. Benzodiazepines
  12. Ecstasy
  13. Buprenorphine (tied with Ecstasy)
  14. Cannabis
  15. Anabolic Steroids
  16. Methylphenidate
  17. GHB
  18. LSD
  19. Alkyl nitrites
  20. Khat
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Re: David Nutt's drug rankings

Postby LuNatic » Wed Nov 04, 2009 4:08 am UTC

apeman5291 wrote:If the drugs with zeros instead got an N/A in that category and it wasn't factored into the average, the following list would come out (ranked by that one category):
Spoiler:
  1. Heroin
  2. Cocaine
  3. Barbiturates
  4. Alcohol
  5. 4-MTA (tied with Alcohol)
  6. Ketamine
  7. Tobacco
  8. Solvents (tied with Tobacco)
  9. Street methadone
  10. Amphetamine
  11. Benzodiazepines
  12. Ecstasy
  13. Buprenorphine (tied with Ecstasy)
  14. Cannabis
  15. Anabolic Steroids
  16. Methylphenidate
  17. GHB
  18. LSD
  19. Alkyl nitrites
  20. Khat


That's certainly a better list. I still think amphetamines and E are too low, with tobacco too high though. How much of the negative health effects of smoking are actually due to tobacco anyway? I always thought it was the nicotine and tar and other chemicals they put in that killed you.
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Re: David Nutt's drug rankings

Postby Marbas » Wed Nov 04, 2009 4:26 am UTC

I'm fairly confident that A) these stories are bullshit


Naah. LSD can cause some really nasty psychotic breaks that lead to chronic psychosis in a really small proportion of the population. I think it's like 8 out of 10,000 or something for psychologically healthy people.
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Re: David Nutt's drug rankings

Postby dedalus » Wed Nov 04, 2009 7:28 am UTC

LSD side effects are like a reverse lottery: chances of getting them are minute, but if you get a bad one, you're fucked.
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Re: David Nutt's drug rankings

Postby TheAmazingRando » Wed Nov 04, 2009 7:47 am UTC

Assuming those numbers are accurate, the odds of psychosis induced by LSD are an order of magnitude less than the odds of being schizophrenic. I've heard it suggested that LSD (or, really, any particularly strong psychological experience) can act as a trigger for latent schizophrenia, which often doesn't manifest itself until early adulthood, which is when many people first start experimenting with drugs. My father's uncle was a paranoid schizophrenic (hearing voices, paranoid delusions, dozens of detailed notebooks full of complicated math and formal logic and philosophy and kaballah and hermeticism and numerology and pure nonsense trying to prove some cosmic truth) and his situation didn't really develop until after he got into psychedelics in college. They weren't the cause, but they may very well have triggered it.

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Re: David Nutt's drug rankings

Postby Dr.Robert » Wed Nov 04, 2009 8:11 am UTC

dedalus wrote:LSD side effects are like a reverse lottery: chances of getting them are minute, but if you get a bad one, you're fucked.


A bad one, as in a bad trip? Or do you mean that people who are predisposed to psychosis who take LSD are sure to have those symptoms appear? What if someone predisposed to psychosis has an extremely good trip?

wiki says --
Spoiler:
"In most cases, the psychosis-like reaction is of short duration, but in other cases it may be chronic. It is difficult to determine whether LSD itself induces these reactions or if it triggers latent conditions that would have manifested themselves otherwise. The similarities of time course and outcomes between putatively LSD-precipitated and other psychoses suggests that the two types of syndromes are not different and that LSD may have been a nonspecific trigger. Several studies have tried to estimate the prevalence of LSD-induced prolonged psychosis (0.8 in 1,000 volunteers and 1.8 in 1,000 psychotherapy patients in Cohen 1960;[57] 9 per 1,000 psychotherapy patients (of which 2/3's recovered) in Melleson 1971[58]), but they were unable to compare the rate of psychosis in these volunteers and patients with the rate of psychosis found in other groups of research volunteers or in other methods of psychological treatment like psychoanalysis. In fact, subsequent mental disturbances may be falsely attributed to LSD like a Chinese girl in a control group (taking water she thought contained LSD) who believed that LSD made her paraplegic."


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