Drug Rating Flashcards
Are drug ratings reasonable?
No, its more about pushing a political agenda than informing the public about risks associated with specific drugs.
Does a high rating mean high risk?
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.
Nutt’s sixteen different sorts of harm - SELF
- Drug-specific mortality - death due to drug toxicity
- Drug-related mortality - terminal illness due to drug use
- Drug-specific harm - due to drug toxicity
- Drug-related harm - due to drug effects
- Dependence - duh.
- Drug-specific impairment of mental functioning - during drug use
- Drug-related impairment of mental functioning - after drug use
- Loss of tangibles - i.e. job, income, possessions
- Loss of relationships
Nutt’s sixteen different sorts of harm - OTHERS
- Injury - injure others
- Crime - either acquisitive (to get more drug) or due to drug (impairment)
- Economic cost - work days lost
- Impact on family life
- International damage - war on drugs, drug rings
- Environmental damage - planes used for drug trafficking
- Decline in reputation of the community - ghettos i.e. crack in US
What is harm?
- difference between harm to self and society
- physical or mental damage
Best method to assess harm
Multi-criteria decision analysis (MCDA), criteria are compared with each other to assess relative importance
How did Nutt and Co. rate?
First searched for a drug with score 100 and then drug with score 0; ranked the other drugs accordingly
Most Harmful drugs
Alcohol (72), Heroin (55), Crack (54)
Least Harmful drugs
Ecstasy and Khat (9), LSD (7), Shrooms (6)
Are Prescription drugs harmful?
Yes, users may take too many or become dependent
Most commonly abused prescription drugs
Benzodiazepines (Xanax, Tavor), Painkillers (Codeine, morphine, oxycodone), and stimulants (Ritalin)
Benzodiazepines
- 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
Antidepressants/SSRIs
- Selective serotonin reuptake inhibitors
- block reuptake of serotonin into its nerve terminals thus serotonin levels rise slowly
- most common anti-depressant (Citalopram, “Prozac”)
Antidrepressants/SSRIs - Dependence
- Relapse: first episode returns
- Recurrence: new episode of illness begins after full recovery - SSRIs can prevent this if treatment is continued
- Rebound: discontinuing medication worsens condition - with SSRIs less likely the longer the patient has been taking them
- Discontinuation syndrome: different from withdrawal, characterized by nausea, dizziness, lethargy; peaks after 2-5 days then disappear
Painkillers
- 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
LD50 (Median lethal dose)
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)
Median effective dose
Amount of substance that produces beneficial effects in 50% of a test sample
LD50 Ranges
- less than 10 times (of the effective dose): Heroin, GHB
- 10 to 20 times: largest cluster, MDMA, cocaine, alcohol
- 20 to 80 times: less toxic, Rohypnol (roofies), mescaline (peyote cactus)
- 100 to 1000 times: psilocybin, marijuana (when ingested)
Why alcohol is conceived as less dangerous
- positive experience = lower level of perceived danger
- high perceived sense of control = reduces fear
- no media coverage of deaths
Other ways to die from recreational drugs
- 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
Harms and benefits associated with psychoactive drugs - Implications (How to find out motivation behind use? Are the official drug classifications appropriate?)
- 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
Harms and benefits associated with psychoactive drugs - Conclusion (What to consider to make drug users more informed?)
Important to consider both the perceived consequences and motivations for drug use to better inform govt. policies and educational programmes.
