Drugs

Alcohol, tobacco make top 10 list of risky drugs

New "landmark" research finds 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 magazine, 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.

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 drug 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.

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.

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"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.

Tobacco causes 40 percent 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.

This is how the Lancet study ranked the drugs:

1. Heroin
2. Cocaine
3. Barbiturates
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

Speaking as an expert on the subject having tried almost every drug available in the Sixties, I concur with these findings. Of the drugs on that list, I've taken heroine, cocaine, barbiturates, alcohol, benzodiazepines, (such as Valium, Halcion, Ativan etc) amphetamines, tobacco, cannabis, methylphenidate, (known as Ritalin which is prescribed for hyperactive kids) and alkyl nitrates (known as "poppers.") I've also taken drugs not on that list like opium, mescaline, magic mushrooms and MDA.

The first drug that I ever took was alcohol. I don't remember the exact age when I first tasted it but I do remember not liking it much. I was maybe ten or so when I was allowed to drink my first glass of wine. I disliked it so much that I would not drink wine for years after that. Of course it was not a good wine - just some cheap plonk that my Mom drank. I much preferred my Dad's choice of poison, brandy and coke - probably because it was sweeter - and used to sneak a sip from his glass now and then. As I got older, I was allowed to have a small glass of port or sweet sherry on holidays.

I never smoked as a kid. Both my parents did as did all of their friends and relatives. I loathed cigarets. To me they stank and I was never tempted until the night after I got my results from my first year of pharmacy school. I had passed with flying colors. That night I went out to celebrate with my friends in pharmacy school. They all smoked. I was 19 and it was just before Christmas in December of 1966. (The school year ends in December in South Africa.) That was the first time that I got drunk and the next thing I was accepting cigarets from my friends and feeling very grown-up and sophisticated.

That Christmas Eve I got drunk with my Dad for the first time. He was so proud of me for having having passed my exams. We were sitting on the steps leading from the kitchen door to the backyard drinking brandy and coke. I asked him for one of his cigarets. "Now you're a man," he said to me adding, "but you better start buying your own." A week later, on New Year's Eve, he died of a massive heart attack and hemorrhagic stroke brought about by too much booze and smoking. He was 57.

A few days later my friends decided to take me out to a movie to cheer me up. They had all taken some Ritalin to make them high and they gave me some too and we went to see "It's a Mad, Mad, Mad World." The Ritalin made me edgy and irritable and I could not concentrate on the movie. Later they started using amphetamines instead of Ritalin and of course I tried that too. I was hooked. I loved the rush of energy and how "speed" made my mind whirl with thoughts. I would party from Friday night till Sunday night and I began to drink like a fish.

The ampehtamines prevented me from sleeping properly so my friends advised me to take barbiturates to sleep. We all worked in drugstores part-time so getting drugs was easy. I spent the next two years addicted to amphetamines and barbiturates until one day I realized that the drugs were making me sick. I stopped cold-turkey and then really became sick. For two weeks I lay in bed sweating and vomitting until I de-toxed. Later I read that barbiturate withdrawal is just as bad as heroine withdrawal.

When I was 21, I went to live in the UK. There I discovered hashish. By now booze was beginning to give me terrible hangovers and hashish did not. I stopped drinking and did not touch alcohol again for about ten years. During those ten years I tried every hippie drug available: LSD, mescaline, magic mushrooms. I loved them all. Unlike booze, they made me feel alert and alive. I also tried cocaine but knew from the first sniff that it was addictive and deadly. Also I did not like cocaine users - they all seemed to be crazed megalomaniacs. I preferred potheads and trippers - they were nutty but mostly easy-going.

One day a friend of mine in London, "Peter," brought some heroine that he had gotten from an American. Peter and I had taken LSD together several time. He did not like LSD as it gave him horrible hallucinations and scared the hell out of him. We took the heroine. Peter was in heaven. He loved the euphoria. Meantime it made me itch and feel nauseous and it gave me horrible hallucinations. I hated it. Peter went on to become a heroine addict and, 40 years later he still is. He was one of the "lucky" ones who could function on heroine. He went on to become a famous dress-designer in spite of being addicted to heroine.

LSD and the other psychedelics showed me that "getting high" was probably all "in the mind." When I was 23 I stopped taking all drugs and started reading as much as I could about the ancient Eastern religions that promised "bliss." Buddhism called it "nirvana." Hinduism called it all sorts of things like "moksha" (liberation) and "satchitanand" (pure blissful consciousness.) This led me to a Hindu guru who taught raja yoga which is the original yoga from which all others came. I eventually broke from the guru but I still kept on doing raja yoga and I've been doing it for the past 34 years. "Getting high" on yoga is not as easy as doing drugs but at least it isn't making me sick or killing me.

There is no doubt in my mind that alcohol and tobacco were my "gateway" drugs. I still enjoy alcohol in moderation mostly in the form of wine with dinner ever since I discovered fine wines about 20 years ago. But I've seen more damage done by booze than any other drug except maybe crack cocaine and the latest killer drug, methamphetamine.

In my mind, the worst sin that I have ever committed was to start smoking. 30 odd years of smoking damaged my lungs, heart and arteries. We are not meant to inhale smoke into our lungs and that goes double for pot. Eating pot in brownies or drinking it as tea are a lot less dangerous than booze but smoking it does more damage to the lungs than cigarets.

I'm not suggesting that booze and tobacco be prohibited. Prohibition does not work. It doesn't work for the illicit drugs either. I don't know what the solution is but it would help if we were more honest about them and classify booze and tobacco with the other drugs.

Update

From the American Scientist: The Toxicity of Recreational Drugs

The Shuar tribes in Ecuador have for centuries used native plants to induce religious intoxication and to discipline recalcitrant children. By comparison, most North Americans know little about the mood-altering potential of the wild vegetation around them. And those who think they know something on this subject are often dangerously ignorant. Over a three-week period in 1983, for example, 22 Marines wanting to get high were hospitalized because they ate too many seeds of the jimsonweed plant (Datura stramonium), which they found growing wild near their base, Camp Pendleton in southern California.

A dozen seeds of jimsonweed contain about 1 gram of atropine, 10 grams of which can cause nausea, severe agitation, dilation of pupils, hallucinations, headache and delirium. Tribal groups in South America refer to datura plants as the "evil eagles." Of approximately 150 hallucinogenic plants that are routinely consumed around the world, those with atropine have the most pernicious reputation—something these Marines discovered the hard way.

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The most toxic recreational drugs, such as GHB (gamma-hydroxybutyrate) and heroin, have a lethal dose less than 10 times their typical effective dose. The largest cluster of substances has a lethal dose that is 10 to 20 times the effective dose: These include cocaine, MDMA (methylenedioxymethamphetamine, often called "ecstasy") and alcohol. A less toxic group of substances, requiring 20 to 80 times the effective dose to cause death, include Rohypnol (flunitrazepam or "roofies") and mescaline (peyote cactus). The least physiologically toxic substances, those requiring 100 to 1,000 times the effective dose to cause death, include psilocybin mushrooms and marijuana, when ingested. I've found no published cases in the English language that document deaths from smoked marijuana, so the actual lethal dose is a mystery. My surmise is that smoking marijuana is more risky than eating it but still safer than getting drunk.

Alcohol thus ranks at the dangerous end of the toxicity spectrum. So despite the fact that about 75 percent of all adults in the United States enjoy an occasional drink, it must be remembered that alcohol is quite toxic. Indeed, if alcohol were a newly formulated beverage, its high toxicity and addiction potential would surely prevent it from being marketed as a food or drug. This conclusion runs counter to the common view that one's own use of alcohol is harmless.