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Drug harms in the UK: a multicriteria decision analysis : The Lancet

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The Lancet, Early Online Publication, 1 November
2010doi:10.1016/S0140-6736(10)61462-6Cite or Link Using DOIDrug harms in the UK:
a multicriteria decision analysis
Original Text
Prof David J Nutt FMedSci a , Leslie A King PhD b, Lawrence D Phillips PhD c, on

behalf of the Independent Scientific Committee on Drugs


Summary
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 multicriteria
decision analysis (MCDA) modelling to a range of drug harms in the UK.
Methods
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.
Funding
Centre for Crime and Justice Studies (UK).
a Neuropsychopharmacology Unit, Imperial College, London, UK
b UK Expert Adviser to the European Monitoring Centre for Drugs and Drug
Addiction (EMCDDA), Lisbon, Portugal
c Department of Management, London School of Economics and Political Science,
London, UK
Correspondence to: Prof David J Nutt, Neuropsychopharmacology Unit, Imperial
College London, Burlington-Danes Building, Hammersmith Hospital, Du Cane Road,
London W12 0NN, UK
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