Alcohol Is the Most Harmful Drug

When Harms to Self and Others Are Taken Into Account

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Alcohol Is a Dangerous Drug. © Getty Images

Alcohol is the world's most dangerous drug when you consider the harm it does to drinkers, their friends, and families and to society in general. The harm that alcohol does exceeds the dangers of even heroin and crack cocaine when the overall danger to the user and others is taken into account.

This is the conclusion of a panel of British experts that assessed and ranked the harm caused by 20 different drugs, both legal and illegal.

Members of Britain's Independent Scientific Committee on Drugs (ISCD) and two specialists from the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) carefully assessed the harm caused by each drug in 16 separate categories.

Ranking the Harm Drugs Do

The scientists ranked each drug on a scale of 0 to 100 in nine areas related to the harm that the drugs do to the individual and seven categories of harm they do to others. They looked at the physical, psychological and social harm the drugs do to life expectancy, health risks, dependence, mental functioning, loss of tangibles, loss of relationships, crime, costs to society, family adversities and other factors.

By applying a multicriteria decision analysis to each drug and then weighing which harms are more important than others, the scientists were able to give each drug a score that could be compared and combined across all 16 criteria.

The Damage Done by Drugs

Some of the harms to the user the panel looked at included:

  • Drug-specific death
  • Drug-related death
  • Damage to health
  • Drug dependence
  • Loss of relationships

Some of the harms to others that were considered included:

  • Crime
  • Environmental damage
  • Family conflict
  • International damage
  • Economic cost
  • Damage to community cohesion

The panel's analysis showed that heroin, crack cocaine and methamphetamine were the most harmful drugs to the individual user, while alcohol, heroin, and crack were the most harmful to others. When the two areas of harm were combined, the overall most harmful drugs were alcohol, heroin and crack cocaine.

The Most Harmful Drugs

Here are the scores each drug received for overall harm caused on a scale of 0 to 100:

Legal Drugs Do Much Harm

The ISCD panel, chaired by Professor David Nutt, concluded that the current drug classification systems do not take into account the actual harms done by various drugs and have little relation to that harm caused.

"It is intriguing to note that the two legal drugs assessed -- alcohol and tobacco -- score in the upper segment of the ranking scale, indicating that legal drugs cause at least as much harm as do illegal substances," Nutt said.

Nutt said public health strategies need to be adjusted to aggressively target the harm that alcohol does. It's a valid and necessary step, he said.


Nutt DJ, et al, "Drug harms in the UK: a multicriteria decision analysis," The Lancet. November 1, 2010.

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