A new drug classification system that relates more closely to harm, has been proposed in the latest issue of The Lancet. The article follows hot on the heels of the RSA Drugs Commission recommendations on rethinking drugs policy, earlier this month. Authors Professor David Nutt, Leslie King, William Saulsbury and Professor Colin Blakemore challenge the current classification system, set by the Misuse of Drugs Act 1971, as being based on methodology that is not transparent which, they say, ‘reduces confidence in their accuracy and undermines health education messages’. The authors recommend a new system based on ‘fact and scientific knowledge’. Three factors would be used to determine a drug’s harm: the physical harm to the user; its tendency to induce dependence; and its effect on families, communities and society – which included damage from drug-induced crime. When graded by panels of experts using the new system, 20 drugs were given scores for their overall harm rating. While heroin and cocaine were still at the top of the table, the exercise turned many current perceptions on their head by moving alcohol and tobacco towards the top of the table, above cannabis and ecstasy. Commenting on their findings, the authors say they saw no clear distinction between socially acceptable and illicit substances. Hoping that public debate on illegal drug use would take account of the appearance of alcohol and tobacco in the upper ranking of harm, they say that replacing prejudice with the new form of assessment could ‘help society to engage in a more rational debate about the relative risks and harms of drugs.’ Development of a rational scale to assess the harm of drugs of potential misuse’ is published in The Lancet, vol 369, no 9566.

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