Safest intoxicant: alcohol or cannabis

.

 

 

Department of Health’s Dangerousness of Drugs:

Table 15: Hall et al (1999) assessment of comparative adverse effects for heavy users of the most harmful form of alcohol, nicotine, opiates and cannabis.

 

Cannabis

Alcohol

Tobacco

Heroin

Traffic and other accidents

*

**

 

*

Violence and suicide

 

**

   

Overdose death

 

*

 

**

HIV and liver infections

 

*

 

**

Liver cirrhosis

 

**

   

Heart disease

 

*

**

 

Respiratory disease

*

 

**

 

Cancer

*

*

**

 

Mental illness

*

**

   

Dependence/addiction

**

**

**

**

Lasting effects on the foetus

*

**

*

*

 

In Table 16 below, the lower the score, the greater the likelihood comparatively (ie 1 is the most likely to lead to this problem and 4 the least).

Table 16: Comparative ratings of the dependence potential of cannabis, alcohol, tobacco and heroin (Hall et al, 1999).

 

Cannabis

Alcohol

Tobacco

Heroin

Presence and severity of withdrawal symptoms

4

1

3

2

Reinforcement: Capacity to get users to use again and again

4

2

3

1

Tolerance: How much more needed by a regular user for the same effect

4

3

2

1

Dependence: Difficulty quitting and avoiding relapse: perceived need to use

4

3

1

2

Intoxication: Impairment of motor abilities, distortion of thinking and mood

3

1

4

2

 

Table 18: Number of deaths where target substance mentioned on death certificate. Source: Office for National Statistics database on drug related deaths.

SUBSTANCE ANNUAL NUMBER DEATHS 1997
ALCOHOL 28,000 (over 3000 cases alcohol specified on death certificate)
AMPHETAMINES 40
BENZODIAZEPINES temazepam 104; diazepam 122; nitrazepam 14
CANNABIS 13
COCAINE HYDROCHLORIDE 38
FREE BASE COCAINE -
AMPHETAMINE TYPE (ecstasy) 11
HALLUCINOGENS 1
VOLATILE SUBSTANCES 78
TOBACCO 120,000
HEROIN 255
METHADONE 421

 

 

 

Advisory Council on the Misuse of Drugs - The classification of cannabis under the Misuse of Drugs Act 1971

 

4.3.5 Unlike sedative intoxicants such as alcohol, cannabis does not cause respiratory depression or suppress the gag reflex even when extremely intoxicated.

4.3.6 Cannabis differs from alcohol, however, in one major respect: it seems not to increase risk-taking behaviour. This may explain why it appears to play a smaller role than alcohol in road traffic accidents. … cannabis rarely contributes to violence either to others or to oneself, whereas alcohol use is a major factor in deliberate self-harm, domestic accidents and violence.

4.4.1 In general cannabis users smoke fewer cigarettes per day than tobacco smokers and most give up in their 30s, so limiting the long-term exposure that we now know is the critical factor in cigarette-induced lung cancer.

4.4.5 It is possible to rank the risks of dependence of abused drugs with heroin and crack cocaine the worst and cannabis generally at, or near, the bottom (and well below nicotine and alcohol).

4.5.1 Tobacco smoking and alcohol use are significant causes of harm to the unborn child. Cannabis may also increase the risk of minor birth defects and abortion but the effect is small.

4.5.2 There is some evidence that smoking cannabis during pregnancy may produce subtle alterations in neuropsychological performance of the child that persists into later life. This effect is similar to that of tobacco smoking and may be due to the actions of tobacco smoke rather than to cannabis per se.

4.5.3 Taken together this data suggest that cannabis use in pregnancy is not safe but that it is probably no more dangerous to the foetus than either alcohol or tobacco.

4.6.3 Interestingly, other studies have found that the use of alcohol and tobacco in early teens (and especially in pre-adolescents) appears to be associated with the later use of many drugs including cannabis.

4.6.4 Despite all these caveats, it is likely that cannabis use (and that of alcohol or tobacco) has an effect on later Class A drug use.

4.7.1 Cannabis appears not to make as major a contribution to road traffic or other accidents as alcohol.

5.1 The high use of cannabis is not associated with major health problems for the individual or society.

5.2 The occasional use of cannabis is only rarely associated with significant problems in otherwise healthy individuals. These harmful effects of cannabis, however, are very substantially less than those associated with similar use of other drugs, such as amphetamines, which (like cannabis) are currently classified as Class B.

5.4 Regular heavy use of cannabis can result in dependence, but its dependence potential is substantially less than that of other Class B drugs such as amphetamines or, indeed, that of tobacco or alcohol.

5.5 It is not possible to state, with certainty, whether or not cannabis use predisposes to dependence on Class A drugs such as heroin or crack cocaine. Nevertheless the risks (if any) are small and less than those associated with the use of tobacco or alcohol.

6.1 Cannabis is not a harmless substance and its use unquestionably poses risks both to individual health and to society.

6.2 Cannabis, however, is less harmful than other substances (amphetamines, barbiturates, codeine-like compounds) within Class B of Schedule 2 to the Misuse of Drugs Act 1971. The continuing juxtaposition of cannabis with these more harmful Class B drugs erroneously (and dangerously) suggests that their harmful effects are equivalent. This may lead to the belief, amongst cannabis users, that if they have had no harmful effects from cannabis then other Class B substances will be equally safe.

6.3 The Council therefore recommends the reclassification of all cannabis preparations to Class C under the Misuse of Drugs Act 1971.