
A new study suggests alcohol is more harmful than heroin or crack - cammsaul
http://www.economist.com/blogs/dailychart/2010/11/drugs_cause_most_harm
======
sk5t
This seems to me like a really simple-minded article--who is surprised that
the most available, legal, inexpensive, socially-acceptable drug has the
largest impact? By this measure walking down a flight of stairs is more
dangerous than mountain climbing.

~~~
fennecfoxen
Are stairs more dangerous? No. Is the sum of all accidents on the stairs more
costly to society than all accidents mountain-climbing? Probably.

There's a reason the occasional mandatory workplace-safety education sessions
you have around your office focus on things like ladders and picking up
packages: people actually _do_ those things.

Postscript: Also, auto accidents cause kill more people in the US than
terrorism. :P

~~~
ams6110
Funny you should mention workplace safety.. where I work there is a campaign
to have people take the stairs instead of the elevators, a typically busybody
approach to improving employee fitness. However an employee is far more likely
sustain an injury by using the stairs compared to riding in an elevator, and
particularly as they were encouraged by the employer to do so, they would have
a pretty clear worker's compensation claim.

~~~
molecule
> However an employee is far more likely sustain an injury by using the stairs
> compared to riding in an elevator, and particularly as they were encouraged
> by the employer to do so, they would have a pretty clear worker's
> compensation claim.

With or without encouragement by their employer, they would have a pretty
clear worker's comp claim, as the injury is "in the course of employment."

Also, I would imagine that the company promoting usage of stairs has had an
actuary do the cost-benefit analysis of the potential health-care savings
versus the potential worker's-comp payouts.

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aresant
From the original study:

"Many of the harms of drugs are affected by their availability and legal
status, which varies across countries, so our results are not necessarily
applicable to countries with very different legal and cultural attitudes to
drugs." (1)

And I'm still confused - are they weighting for per-user, or overall?

Under a per-user model this is interesting.

Under an "overall" model this is obvious (legality of alcohol)

Since neither the linked article or the original study make this clear, I'm
voting by clicking "flag"

(1) Source: [http://www.chanvre-info.ch/info/en/IMG/pdf/drug-harms-in-
the...](http://www.chanvre-info.ch/info/en/IMG/pdf/drug-harms-in-the-uk-a-
multicriteria-decision-analysis-1.pdf)

~~~
shantanubala
Unfortunately, it seems that it's an "overall" model -- see under "Study
Design" in the "Methods" section of the paper.

There are "individual harms" that take account the harm done to the user
himself or herself.

But, "the extent of individual harm is shown by the criteria listed as to
others take account indirectly _of the number of users_ "

(emphasis mine)

Unfortunately, parts of the study are well-thought, but others, not so much.

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pervycreeper
>to rank 20 drugs (legal and illegal) on 16 measures of harm to the user and
to wider society, such as damage to health, drug dependency, economic costs
and crime

What I don't understand about these studies is what mathematical basis they
use for comparing the relative impact of these various factors. I would assume
that these would all be completely different, and as a consequence,
incommensurable. However, studies like this seem to have found appropriate
relative weights for these factors, and were able to add them all together. I
would be interested in knowing if it's really possible to do this without
producing a figure that's totally bogus, and if so, how.

~~~
themgt
They explained it pretty simply - they asked the experts in the field to rate
the harm on various factors, and they aggregated and compared those ratings.

Drugs and the harm they cause to an individual and others is highly subjective
and contextualized within a culture/society. There is not going to be some
math formula to give you the answer.

If you wanted to know the best web application framework to build your next
REST API, would you build a mathematical theory for deducing it, or find out
what the relevant experts in the field think?

~~~
phren0logy
>Drugs and the harm they cause to an individual and others is highly
subjective and contextualized within a culture/society. There is not going to
be some math formula to give you the answer.

I disagree. I am a psychiatrist and participated in some clinical research.
Step 0 is quantifying. It's not always perfect, but if you don't know what you
are measuring, your measurements are useless.

~~~
themgt
The fact that you can quantify a thing by a given metric doesn't change the
subjectivity of the choice. You can measure the amount a drug causes the
average user to miss work, or die sooner, or number of missing teeth, or
anything, but any combination of these will still always be: a) missing other
relevant metrics b) representative of one perspective on what is valuable to
measure, and what constitutes harm

The idea that any one set of metrics and measurements have more intrinsic
truth-value than simply aggregating the internal mental weights of all the
relevant experts in the field is just like, your opinion man.

If you want to present an alternate, mathematical model for drug harm and
explain and argue for the validity of the choices you make for how to measure
harm and how the data was gathered over what time period, etc etc - no one's
stopping you.

------
Alex3917
tl;dr If you want to be healthier, switch from drinking wine to huffing
butane.

I've posted this before, but since I can't seem to find it in the search I'll
just copy paste the explanation of why this is propaganda rather than science:

\- The full methodology isn't actually published anywhere.

\- The rankings are created by combining a lot of different factors that don't
have anything to do with each other, e.g. by combining harm to the user with
harm to society. This means that drugs like coffee end up being more dangerous
than drugs like heroin, simply because more people use coffee than heroin so
the total social costs are greater.

\- The harms for drugs are measured as they are typically used, rather than
correcting for things like differences in demographic and route of
administration. This leads to drugs like heroin looking more dangerous than
they are, because people who have drug abuse problems tend to gravitate toward
drugs like heroin. (Whereas people who use, say, Khat tend not to be the worst
of the worst as drug abusers go.) This is especially problematic since how
drugs are typically used depends on the laws that exist to encourage or
discourage their use. E.g. when drugs like tobacco and coffee used to be
illegal, they were used more similarly to how crack and heroin are typically
used today. So the idea of using these rankings, which are meaningless to
begin with, as an argument for setting public policy is completely
nonsensical.

\- The harms of the drugs caused by prohibition are not accounted for. (E.g.
they are counting people using dirty needles and impure/unknown/fake drugs as
being a harm that stems from heroin, but they aren't counting using dirty
needles and fake Starbucks as being a harm that stems from drinking coffee.)

-The way they assess the harms is by doing a survey of mainly psychiatrists and just asking their opinion. It's not scientific at all. If the people they were asking for their opinions were experts this wouldn't be scientific, but the people they're asking aren't even experts.

-The idea that some drugs are more harmful than others is anti-scientific to begin with, since the dosage makes the poison. E.g. there is no way to say whether weed or heroin is more harmful, since it's all about patterns of usage. Same for the idea that some drugs are more addictive than others.

\- They're not accounting for the benefits of drug use, only the harms.

~~~
piokoch
The absurdity of that "research" can't be explained better.

In fact the study ommits the most dangerous drugs, that is those which are
used to fight cancer. They are very, very dangerous... and so what.

------
andyl
I grew up in a drinking culture, and damn we loved to party. Nothing was
funnier than a drunk friend doing something stupid.

Twenty five years later: four of my school friends are dead from alcohol. Fuck
- that kind of takes the fun out of it - I loved those people.

Most people can handle drugs and alcohol just fine. But a lot of people can't.

~~~
aswanson
Wow. How old were they when they died, and what were their drinking habits
like throughout the years, if you don't mind sharing. If you don't feel like
providing the details, understood.

~~~
andyl
My friends died in their late thirties / early forties. I don't know all the
details. One guy's liver gave out - another got into pills and I'm not sure
what else. I don't know what killed the others, just that alcohol was
contributor.

Stories like these are not uncommon. CDC says alcohol kills 80K people
annually.

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JVIDEL
I always wondered why alcohol didn't get the same restrictions that cigarettes
got: sure you can still buy marlboros anywhere, they are not banned and the
police wont throw you in a cell for carrying a pack, but ads for tobacco are
seriously curtailed if not outright forbidden in most places and the boxes
themselves are full of health warnings.

Why don't do the same with alcohol? Where I live ads for beer, wine and other
drinks are literally EVERYWHERE, and the way the ads are made is plain
manipulative, something even Don Draper would consider _going too far_. It
doesn't takes a psychologist to see alcohol ads much like the cigarettes go
for the exact opposite of what an addict's life is like, and just like
marlboro told men they could be cowboys and go into adventures beer ads say
you can party hard 24/7 and nail all the chicks you want/see by being pissing-
in-your-pants drunk.

Ironically the most realistic beer ad I ever saw was Pißwasser's in GTAIV.

~~~
aswanson
_beer ads say you can party hard 24/7 and nail all the chicks you want/see by
being pissing-in-your-pants drunk_

Hilarious. This was been the exact opposite of my experience in my younger
days. If anything, alcohol tipped the odds against me in situations, in sober
retrospect , would have went my way had I not been drinking. They should use
celibate monasteries as a backdrop for alcohol ads.

~~~
aswanson
Too late to edit: The grammatical errors in the parent post may lead one to
think that I was inebriated prior to typing. I assure you this was totally due
to poor editing rather than alcohol. :)

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hluska
I think that this chart (sourced from Figure 4) is rather telling. I changed
the order to reflect the cumulative weight of each of the factors, then added
in whether the study considers each item to be a harm to others, or a harm to
the user.

Economic cost (CW 12·8) - others

Injury (CW 11·5) - others

Crime (CW 10·2) - others

Family adversities (CW 8·9) - others

Drug-related mortality (CW 6·4) - users

Dependence (CW 5·7) - users

Drug-specific impairment of mental functioning (CW 5·7) - users

Drug-related impairment of mental functioning (CW 5·7) - users

Drug-specific mortality (CW 5·1) - users

Loss of tangibles (CW 4·5) - users

Loss of relationships (CW 4·5) - users

Drug-specific damage (CW 4·1) - users

Drug-related damage (CW 4·1) - users

Environmental damage (CW 3·8) - others

International damage (CW 3·8) - others

Community (CW 3·2) - others

------
kghose
Expanding on an point by grimtrigger, is this related to damage per user, or
overall damage? If governments no longer controlled heroin, and the number of
users spiked to be the same as the number of users of alcohol would the graphs
change.

I suspect that because of dependency, strong drugs would still lead to
increases in crime, since they would still cost something, and their users
would still not be in a position to productively earn to feed their habit
especially as they got deeper into the addiction.

~~~
MacsHeadroom
You suspect wrong on both accounts. Many governments have legalized Heroine.
Doing so has always lead to marked decreases in use. Lower use means lower
demand means less drug related crime.

Additionally, when money saved on drug enforcement is appropriated for needle
exchanges and rehab centers, the price of a days worth of heroin drops to 0
for the user. Areas with decriminalized heroin and needle exchanges see the
greatest reduction in use and drug related crime.

~~~
alexanderRohde
" Many governments have legalized Heroine. Doing so has always lead to marked
decreases in use." Source?

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grimtrigger
Is this chart adjusted for number of users? For example if not a single person
in the UK used alcohol, would it drop to the bottom of the list?

If not, it makes very little intuitive sense.

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jlgreco
Where does the societal harm from anabolic steroids come from? Is it because
anabolic steroids have an illegal black market? Why don't LSD and mushrooms
have that same black market induced societal harm then?

And how does harm to self from anabolic steroids come under harm to self from
cannibis? Has anyone ever killed their liver with cannibis? Anabolic steroids
can do that, and much more, to your body.

This whole thing seems very bullshitty to me.

~~~
codesuela
> This whole thing seems very bullshitty to me.

I agree however

> Has anyone ever killed their liver with cannibis?

Liver damage from steroid abuse only applies to use of oral steroids. And even
that is "only" comparable to drinking alcohol. Looking as to how professional
bodybuilders utilizing steroids tend to lead a vastly more healthy lifestyle
(diet, workout) than most people it'd assume it somewhat reduces overall
health risk. Assuming the fictional situation where I would have to pick
between option

a) a friend starting to use steroids, cleaning up his diet and working out
most days of the week

or b) smoke pot every day, play video games and eat Ben and Jerrys

I would pick option a) by a wide margin.

Personally I have smoked pot in the past and while casually smoking a little
weed is all good and fun (like having a few beers), repated use has a
zombifying effect on me which is very strong. For me it's as if my whole brain
is slowed down. I've seem people who still get along just fine smoking pot
regularly but I've also seem people whose personal development just completely
stopped and their social life is centered around smoking bud as the result of
regular pot use. I am all for legalization but don't make the mistake of
assuming that just because delta 9 THC is a chemical that occurs in a plant it
is a drug without any negative consequences or addiction potential for anyone.

~~~
jlgreco
Certainly steroids can be used safely, and to be clear, I think that the
healthy lifestles lived by users of steroids should more than make up for any
aggragate negative impact steroid use may have. I fully support the use of
anabolic steroids, they are a-okay in my book.

However to say that pot can be dangerous because it's users often adopt fatass
lifestyles seems a bit disingenious. You could similarly start attributing
sports injuries to anabolic steroids _(clearly sporting injuries would never
catch up with fatass injuries, but anyway..)_ , though that would be similarly
disingenious. I think the only reasonable way to compare the drugs is to
compare the harm that the substances themselves are capable of inflicting when
taken in dosages that are logistically feasible.

In your fictional situation I think I would choose the unstated option _c)
clean up my diet, smoke pot occasionally, and go to the gym almost every day._
Hmm.. come to think of it, that is already what I chose...

~~~
codesuela
> However to say that pot can be dangerous because it's users often adopt
> fatass lifestyles seems a bit disingenious. You could similarly start
> attributing sports injuries to anabolic steroids, though that would be
> similarly disingenious.

yes, you are completely right. I just wanted to make the point that you
shouldn't promote THC as a completely harmeless wonderdrug without potential
to worsen your life. I wrongfully assumed that you might fall into this camp.

> In your fictional situation I think I would choose the unstated option c)
> clean up my diet, smoke pot occasionally, and go to the gym almost every
> day. Hmm.. come to think of it, that is already what I chose...

sounds like a reasonable choice :) more power to you

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mattangriffel
Wait, how is methamphetamine use not harmful to others? Doesn't
methamphetamine use specifically lead to erratic behavior?

~~~
MacsHeadroom
Very very rarely. For most methamphetamine users, you can't even tell when
they're using.

Markedly different from alcohol, which frequently causes erratic and even
extremely dangerous behaviour.

------
D9u
I dare say that alcohol is more harmful than Americans' owning assault rifles.
Thus, by extrapolation, the gun-control proponents should also be clamoring
for increased control of alcohol if they were truly concerned about
"protecting the children."

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nbdbvcrea
Pdf: [http://www.chanvre-info.ch/info/en/IMG/pdf/drug-harms-in-
the...](http://www.chanvre-info.ch/info/en/IMG/pdf/drug-harms-in-the-uk-a-
multicriteria-decision-analysis-1.pdf)

------
NatW
Reading the study, this poll/index-based study actually did rank Crack Cocaine
more harmful than Alcohol in terms of "harm to others". On that axis, they
claim the worst in terms of "harm to others are, in order: 1. Crack Cocaine,
2. Heroin, 3. Metamfetamine and 4. Alcohol.

Alcohol ranked #1 in terms of "harm to yourself". In order for "harm to
yourself" they found: 1. Alcohol, 2. Heroin, 3. Crack Cocaine.

There are many issues with this study, obviously. Dosages / use can
significantly differ between drugs, etc.

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afterburner
So why is cannabis so high? Especially "to others". Why did researchers rank
it so high, so often? I have to wonder what the "harm" was that they were
thinking of so frequently.

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bcoates
Given that we've established that this study is invalid as a matter of
methodology, are there any _legitmate_ attempts to compare harm caused by
various drugs? A graph like this would be really interesting if it were backed
by actual evidence.

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alexanderRohde
So, despite the title, this is not new at all (2010). On an unrelated note
it's very shoddy speculation, not based on life outcomes of alcohol users
versus crack users or anything remotely meaningful.

------
standeven
"A new study..."

"Nov 2nd 2010"

