What Would Society Look Like If Drug Laws Reflected Drug Harm?

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The definition of a drug is any chemical substance that has a biological effect on the thing taking it. Coffee beans have caffeine; coffee beans are a food; if you take caffeine out of coffee beans and take it directly it becomes a drug. Many, many drugs are legal. More than you think. “Taking drugs” can be as simple as taking Vitamin C supplements.

Some drugs are illegal to possess because lawmakers have deemed them too harmful for an individual, or society, or both. Examples include amphetamine, ecstasy, anabolic steroids, cocaine, heroin, LSD, and so on. These are the “drugs” referred to in “doing drugs” although this is an extremely misleading phrase.

So let’s say you don’t take the law at face value, and you could determine exactly how harmful these drugs really are, then adjust the laws according to that. How would you do it?

Alcohol is the standard by which drug harm is judged, because alcohol is legal nearly everywhere and most people are okay with that. If alcohol is legal, and drug laws are based on the harm of a drug, and a given drug is equally harmful or less harmful than alcohol, then that drug should have equal legality or more when compared to alcohol.

In “Development of a rational scale to assess the harm of drugs of potential misuse”, 2007 study by Nutt et al. published in The Lancet, the authors developed a nine-category matrix of harm that would allow evidence-based assessment of how harmful, really, these illicit drugs are. The categories include physical harm to the individual when used (1) acutely, (2) chronically, or (3) intravenously; capacity of the drug to cultivate dependence via (4) intensity of pleasure, via (5) psychological mechanism, or via (6) physiological mechanism; and capacity of the drug to harm society via (7) intoxication, via (8) social harms like infections, and via (9) health care costs.

I have several friends who would probably say anything if it meant getting weed legal everywhere. You may think the authors are like my friends and pulling this nine-category scale out of their ass. They’re not, and you can know this because this is what they had to say:

The UK Medicines and Healthcare Regulatory Authority, in common with similar bodies in Europe, the USA, and elsewhere, has well-established methods to assess the safety of medicinal drugs, which can be used as the basis of this element of risk appraisal. Indeed several drugs of abuse have licensed indications in medicine and will therefore have had such appraisals, albeit, in most cases, many years ago.

To reiterate: the same methods used to assess the safety of medicinal drugs in the United States and the UK are the basis for the methods in this study.

The study’s authors convened experts in chemistry, pharmacology, forensic science, psychiatry and other disciplines to survey what they thought about the harm in these areas. After evaluating the results, the authors conclude that “the results of this study do not provide justification for the sharp A, B, or C divisions of the current classifications in the UK Misuse of Drugs Act.” (The drug classification system in the UK Misuse of Drugs Act is similar to the drug scheduling system in the United States that you may be familiar with.)

Drug laws do not reflect drug harm. That is not just me speculating; the question has been analyzed using methodology better than what you or I have and the authors responsible for the analysis have drawn that conclusion.

Here’s what’s contrary to layperson views, and existing drug laws, about the results:

In terms of the larger social harm category, the intoxication rating of alcohol was higher than every other drug except barbiturates. The social harm (e.g. infection, misc. economic harm) subcategory rating of alcohol was higher than every other drug except cocaine and heroin. The health care costs of alcohol were above every other drug except cocaine, tobacco, and heroin.

In terms of physical harm and dependence, you can quickly assess the results via this graph:

Physical harm in the above graph was determined by averaging acute harm, chronic harm, and intravenous harm. When intravenous harm ratings were not available, only acute and chronic harm were averaged.

I am going to assume that alcohol will stay legal. I am also going to assume that most of the population is okay with alcohol’s legality.

If drug laws were based on the actual harm of a drug, then every drug as harmful as alcohol or less should be as legal as alcohol or less.

So if society’s drug laws were re-structured to reflect actual drug harm:

Drugs in red (more harmful than alcohol) would be either illegal or legal, but more restricted than alcohol. This includes cocaine, heroin, and barbiturates.

Drugs in orange (around as harmful as alcohol) would be at least as legal/restricted as alcohol. So methadone, benzodiazepines, buprenorphine, amphetamine, ketamine, 4-MTA and cannabis would be legal and contain similar restrictions to alcohol.

Drugs in yellow (substantially less harmful than alcohol) would not only be legal, but less restricted than alcohol. Methylphenidate, ecstasy, LSD, GHB, solvents, khat, alkyl nitrites, and anabolic steroids would be legal and less restricted than alcohol.

I’m sure you know a lot of people who want weed to be legal. But how many people do you know who say “we should legalize methadone / benzodiazepines / buprenorphine, amphetamine / ketamine / 4-MTA in addition to weed, and we should make methylphenidate / ecstasy / LSD / GHB / solvents / khat / alkyl nitrites and anabolic steroids even more legal than alcohol”? I’m guessing not many.

But if drug laws are to reflect the harm of those drugs, that’s the kind of legalization push we should be making.