David Nutt, the former Labour government drugs advisor who now heads the Independent Scientific Committee on Drugs, is not suggesting that the harm from drinking a glass of wine at dinner is greater than spending the night in a heroin shooting gallery.
What Nutt says he's trying to do is open up a new discussion on policy regarding all drugs -- legal and illegal -- based on the total harm they do to the user and to others, rather than on the basis of politics or habits.
Nutt was forced out of office after this study, which he co-authored, indicated alcohol and tobacco were nearly as physically damaging as cocaine and heroin. (Illustration from Wikipedia.)
The latest study offers 16 criteria for analysis, ranging from personal illness and mortality to the economic cost and harm done to families. From the accumulation of all this damage, his group gives alcohol a score of 72, against scores of 55 and 54 for crack cocaine and heroin.
The big differences lie in the economic cost of the drug, the cost to families, and injuries associated with the drug's use.
The report also looked at Portugal, which decriminalized all illicit drugs in 2001, concluding "evidence indicates reductions in problematic use, drug-related harms and criminal justice overcrowding." In other words decriminalization did not make Portugal a nation of drug addicts.
Nutt believes it's not the legal status of specific substances that makes them harmful, but their social acceptance within society. The report recommends that money be shifted from the fight against illegal drugs to reducing tolerance for legal ones.
One of the study's authors, Leslie King, put it this way. "What governments decide is illegal is not always based on science."
Another way to put it is that drug policy includes more than whether a drug is legal or illegal, even how high the penalty for possession is.
It reminds me of something I wrote years ago concerning Seth Godin's book "Permission Marketing." Just as there are levels of permission below that of a transaction, there are policy levers extending beyond the simple legal status of a substance.
Tobacco, for instance, is legal, but we spend a lot of money warning people away from it. Much of the money spent against cocaine, which Nutt's study calls equally damaging, is focused on law enforcement, and some of the damage results directly from that legal sanction.
Depoliticizing our discussion of drug policy might be welcome, but even looking at Nutt's results it's hard to see that happening. There are many variables, perhaps too many to get good data.
Still, it's a subject worthy of further discussion, whether or not Californians decide to start the experiment tomorrow by making marijuana legal.
Psychoactives will always be with us, and minimizing their total cost is in everyone's best interests.