Drug Rating

Question 1

Are drug ratings reasonable?

Answer 1

No, its more about pushing a political agenda than informing the public about risks associated with specific drugs.

Question 2

Does a high rating mean high risk?

Answer 2

Not necessarily, Alcohol has a very high risk and isn’t even classified since it’s not an illegal substance. LSD (Class A) can cause almost no harm and Cannabis (Class B) is much less harmful than Alcohol. But Heroin and Methamphetamine (both Class A) both have high risks.

Question 3

Nutt’s sixteen different sorts of harm - SELF

Answer 3

1. Drug-specific mortality - death due to drug toxicity
2. Drug-related mortality - terminal illness due to drug use
3. Drug-specific harm - due to drug toxicity
4. Drug-related harm - due to drug effects
5. Dependence - duh.
6. Drug-specific impairment of mental functioning - during drug use
7. Drug-related impairment of mental functioning - after drug use
8. Loss of tangibles - i.e. job, income, possessions
9. Loss of relationships

Question 4

Nutt’s sixteen different sorts of harm - OTHERS

Answer 4

10. Injury - injure others
11. Crime - either acquisitive (to get more drug) or due to drug (impairment)
12. Economic cost - work days lost
13. Impact on family life
14. International damage - war on drugs, drug rings
15. Environmental damage - planes used for drug trafficking
16. Decline in reputation of the community - ghettos i.e. crack in US

Question 5

What is harm?

Answer 5

• difference between harm to self and society

- physical or mental damage

Question 6

Best method to assess harm

Answer 6

Multi-criteria decision analysis (MCDA), criteria are compared with each other to assess relative importance

Question 7

How did Nutt and Co. rate?

Answer 7

First searched for a drug with score 100 and then drug with score 0; ranked the other drugs accordingly

Question 8

Most Harmful drugs

Answer 8

Alcohol (72), Heroin (55), Crack (54)

Question 9

Least Harmful drugs

Answer 9

Ecstasy and Khat (9), LSD (7), Shrooms (6)

Question 10

Are Prescription drugs harmful?

Answer 10

Yes, users may take too many or become dependent

Question 11

Most commonly abused prescription drugs

Answer 11

Benzodiazepines (Xanax, Tavor), Painkillers (Codeine, morphine, oxycodone), and stimulants (Ritalin)

Question 12

Benzodiazepines

Answer 12

• anxiolytic
• increases effect only of existing GABA, does not stimulate release
• OD may lead to respiratory depression
• rarely fatal, only poly drug use increases risk (especially sedatives i.e. alcohol)
• causes severe withdrawal symptoms

Question 13

Antidepressants/SSRIs

Answer 13

• Selective serotonin reuptake inhibitors
• block reuptake of serotonin into its nerve terminals thus serotonin levels rise slowly
• most common anti-depressant (Citalopram, “Prozac”)

Question 14

Antidrepressants/SSRIs - Dependence

Answer 14

1. Relapse: first episode returns
2. Recurrence: new episode of illness begins after full recovery - SSRIs can prevent this if treatment is continued
3. Rebound: discontinuing medication worsens condition - with SSRIs less likely the longer the patient has been taking them
4. Discontinuation syndrome: different from withdrawal, characterized by nausea, dizziness, lethargy; peaks after 2-5 days then disappear

Question 15

Painkillers

Answer 15

• Paracetamol, Aspirin, Ibuprofen, Codeine
• high efficacy -> higher dependence rate
• medical context (unpleasant) protects patients against addicition
• too many or too often leads to sensitization to pain and chronic headaches

Question 16

LD50 (Median lethal dose)

Answer 16

Amount of an ingested substance that kills 50% of a test sample, expressed in mg/kg (i.e. regular dose Ecstasy 1-1.5g/kg)

Question 17

Median effective dose

Answer 17

Amount of substance that produces beneficial effects in 50% of a test sample

Question 18

LD50 Ranges

Answer 18

1. less than 10 times (of the effective dose): Heroin, GHB
2. 10 to 20 times: largest cluster, MDMA, cocaine, alcohol
3. 20 to 80 times: less toxic, Rohypnol (roofies), mescaline (peyote cactus)
4. 100 to 1000 times: psilocybin, marijuana (when ingested)

Question 19

Why alcohol is conceived as less dangerous

Answer 19

1. positive experience = lower level of perceived danger
2. high perceived sense of control = reduces fear
3. no media coverage of deaths

Question 20

Other ways to die from recreational drugs

Answer 20

• no rest periods = drug levels in blood still high, no recovery time
• Capture ratio: what portion of people who sample a particular substance become physiologically or psychologically dependent

Question 21

Harms and benefits associated with psychoactive drugs - Implications (How to find out motivation behind use? Are the official drug classifications appropriate?)

Answer 21

• if we understand the perceived benefits we may learn about the motivation behind their use
• lack of correlation between users’ rating and official drug classifications = current policy does not influence useage

Question 22

Harms and benefits associated with psychoactive drugs - Conclusion (What to consider to make drug users more informed?)

Answer 22

Important to consider both the perceived consequences and motivations for drug use to better inform govt. policies and educational programmes.