Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 369 (9566), 1047-53

Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse

Affiliations
Review

Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse

David Nutt et al. Lancet.

Abstract

Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.

Comment in

Similar articles

  • Harms Associated With Psychoactive Substances: Findings of the UK National Drug Survey
    CJ Morgan et al. J Psychopharmacol 24 (2), 147-53. PMID 19939875.
    Nutt and colleagues' 'rational' scale to assess the harms of commonly used drugs was based on ratings by a panel of experts. This survey aimed to assess drug users' views …
  • European Rating of Drug Harms
    J van Amsterdam et al. J Psychopharmacol 29 (6), 655-60. PMID 25922421.
    The outcome of this study shows that the previous national rankings based on the relative harms of different drugs are endorsed throughout the EU. The results indicates t …
  • Harms and Benefits Associated With Psychoactive Drugs: Findings of an International Survey of Active Drug Users
    CJ Morgan et al. J Psychopharmacol 27 (6), 497-506. PMID 23438502.
    There have been several recent efforts in the UK and the Netherlands to describe the harms of psychoactive substances based on ratings of either experts or drug users. Th …
  • Psychoactive Drug Abuse in Older Adults
    L Simoni-Wastila et al. Am J Geriatr Pharmacother 4 (4), 380-94. PMID 17296542. - Review
    Psychoactive medications with abuse potential are used by at least 1 in 4 older adults, and such use is likely to grow as the population ages. The treatment of disorders …
  • Managing Misuse of Novel Psychoactive Substances
    D Solomon et al. Nurs Times 110 (22), 12-5. PMID 24984370. - Review
    Misuse of novel psychoactive substances, also known as legal highs, is growing in the UK. These substances include more than 200 psychoactive chemicals and are associated …
See all similar articles

Cited by 167 PubMed Central articles

See all "Cited by" articles

MeSH terms

LinkOut - more resources

Feedback