Ranking on harmful drugs

Surfing on the "Economist" I stumbled across an article concerning the classification of how harmful drugs are. The ranking shows that alcohol is seen as the most harmful drug in the UK followed by heroin, crack cocaine and methamphetamine. It is a graph that I have seen before and is also been used in arguments concerning legalization and drug classification.

The article mentioned that the ranking is done by "drug harm experts". And this is something that made me look more critically at the ranking First of all, who are these "drug harm experts" and secondly, in what way have they ranked these drugs? I went to the source of the article, which is the Lancet and the article can be found here. (I had to sign up to be able to view the whole article). 

I found out that the group of "drug harm experts" were members of the Independent Scientific Committee on Drugs and two invited specialists with knowledge in legal highs. I could not find how many people were in this group.

The analysis was done in a 1 day session where everyone discussed and ranked 20 drugs in accordance to 16 different criteria that had been decided upon earlier. Below are the 16 different criteria that is taken from the Lancet article.

Panel 1

Evaluation criteria and their definitions

Drug-specific mortality

Intrinsic lethality of the drug expressed as ratio of lethal dose and standard dose (for adults)

Drug-related mortality

The extent to which life is shortened by the use of the drug (excludes drug-specific mortality)—eg, road traffic accidents, lung cancers, HIV, suicide

Drug-specific damage

Drug-specific damage to physical health—eg, cirrhosis, seizures, strokes, cardiomyopathy, stomach ulcers

Drug-related damage

Drug-related damage to physical health, including consequences of, for example, sexual unwanted activities and self-harm, blood-borne viruses, emphysema, and damage from cutting agents

Dependence

The extent to which a drug creates a propensity or urge to continue to use despite adverse consequences (ICD 10 or DSM IV)

Drug-specific impairment of mental functioning

Drug-specific impairment of mental functioning—eg, amfetamine-induced psychosis, ketamine intoxication

Drug-related impairment of mental functioning

Drug-related impairment of mental functioning—eg, mood disorders secondary to drug-user's lifestyle or drug use

Loss of tangibles

Extent of loss of tangible things (eg, income, housing, job, educational achievements, criminal record, imprisonment)

Loss of relationships

Extent of loss of relationship with family and friends

Injury

Extent to which the use of a drug increases the chance of injuries to others both directly and indirectly—eg, violence (including domestic violence), traffic accident, fetal harm, drug waste, secondary transmission of blood-borne viruses

Crime

Extent to which the use of a drug involves or leads to an increase in volume of acquisitive crime (beyond the use-of-drug act) directly or indirectly (at the population level, not the individual level)

Environmental damage

Extent to which the use and production of a drug causes environmental damage locally—eg, toxic waste from amfetamine factories, discarded needles

Family adversities

Extent to which the use of a drug causes family adversities—eg, family breakdown, economic wellbeing, emotional wellbeing, future prospects of children, child neglect

International damage

Extent to which the use of a drug in the UK contributes to damage internationally—eg, deforestation, destabilisation of countries, international crime, new markets

Economic cost

Extent to which the use of a drug causes direct costs to the country (eg, health care, police, prisons, social services, customs, insurance, crime) and indirect costs (eg, loss of productivity, absenteeism)

Community

Extent to which the use of a drug creates decline in social cohesion and decline in the reputation of the community

ICD 10=International Classification of Diseases, tenth revision. DSM IV=Diagnostic and Statistical Manual of Mental Disorders, fourth revision.

I am sure that these experts all have great knowledge of drugs and have read a lot of the different effects drugs have on people. But I am sceptical that they have all the numbers memorised to be able to make correct assesments within one day. What I wonder is, is it really possible to do enough research and discussion in one day to rank 20 drugs on one criteria, let alone 16?