Development of a rational scale to assess the harm of drugs of potential misuse

Nutt, David; King, Leslie A.; Saulsbury, William; Blakemore, Colin

doi:10.1016/s0140-6736(07)60464-4

Cited by 1,048 publications

(735 citation statements)

References 12 publications

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“…Moreover, cocaine is the primary illegal drug responsible (European Monitoring Centre for Drugs and Drug Addiction, 2012) for drug-dependence treatment in North and South America (United Nations Office on Drugs and Crime, 2011). Cocaine is classified as a highly addictive drug (Nutt et al 2007) and it is estimated that 5-6% of users will meet dependence criteria within the first year of use and around 21% by the age of 45 years (Wagner & Anthony, 2007). The health risks associated with cocaine abuse include severe medical complications, such as cardiovascular or respiratory incidences, and a number of psychiatric disorders (Buttner, 2012).…”

Section: Introductionmentioning

confidence: 99%

Altered social and non-social decision-making in recreational and dependent cocaine users

et al. 2013

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Background Maladaptive decision-making is assumed to be a core feature of cocaine addiction. Indeed, numerous studies have reported deficits in non-social decision-making tasks and reward-related impulsivity in dependent cocaine users. However, social decision-making has not been examined in cocaine users yet. Moreover, it is unknown if even recreational and non-dependent cocaine use is linked to decisionmaking deficits. Therefore, we investigated whether recreational and dependent cocaine users exhibit alterations in social and non-social decision-making. Method The performance of healthy controls (n = 68), recreational cocaine users (n = 68) and dependent cocaine users (n = 30) in classical decision-making paradigms (Iowa Gambling Task, Delay Discounting) and in social interaction paradigms (Distribution Game, Dictator Game) was assessed. Results Decisions in the social interaction tasks of both cocaine user groups were more self-serving compared with controls as cocaine users preferred higher monetary payoffs for themselves. In the Iowa Gambling Task, only dependent cocaine users were more likely to choose disadvantageous card decks, reflecting worse decision-making. They were also more likely to choose immediate smaller rewards over larger delayed rewards in the Delay Discounting task. Conclusions Our results imply that both recreational and dependent cocaine users are more concerned with their own monetary gain when interacting with another person. Furthermore, primarily dependent cocaine users are less foresighted and more impulsive regarding immediate reward. Overall, social interaction deficits are already present in recreational users, while non-social decision-making deficits occur predominantly in dependent cocaine users. Thus, social interaction training and cognitive remediation strategies may improve treatment success and quality of life in cocaine dependence.

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Section: Introductionmentioning

confidence: 99%

Altered social and non-social decision-making in recreational and dependent cocaine users

et al. 2013

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“…Captagon ® was first synthesized in 1961 for the treatment of hyperactivity, depression and narcolepsy [2]. It metabolizes to form two active stimulant drugs-amphetamine and theophylline [3,4]. Fenethylline was controlled in 1981 as a Schedule 1 substance and currently does not have an accepted medical use in the United States.…”

Section: Neil Mckeganey and Christopher Russellmentioning

confidence: 99%

“…The paper published by Nutt and colleagues, on the basis of their assessment, formed part of Public Health England's recent conclusion that electronic cigarettes were 95% less harmful than combustible tobacco [2]. The method that Nutt and colleagues used in this study was a continuation of earlier work, in which they had used the approach of Multi-Criterion Decision Analysis (a form of Delphi technique in which the views of key experts on a given topic are collected and assessed) to rank the relative harm of a range of legal and illegal drugs [3]. This earlier work on legal and illegal drugs was published in the Lancet medical journal and drew both widespread attention and critical comment [4][5][6][7].…”

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confidence: 99%

Tobacco control research: a tale of two Delphi groups

McKeganey¹,

Russell²

2016

Addiction

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“…While public attitudes to drugs are fairly closely aligned with the scientific evidence about relative harms (Pearson and Shiner, 2002), they are also shaped by less rational taboos and stigmas. In particular, the public seem reluctant to accept evidence that cannabis and ecstasy are less harmful than alcohol (Nutt et al, 2007): more respondents considered cannabis and ecstasy use to be 'very unsafe' than getting drunk; and more considered it acceptable to get drunk occasionally than to use cannabis or ecstasy. (Parker et al, 2002;Shiner, 2009;Aldridge et al, 2011).…”

Section: Where's the Harm? Prevalence And Public Opinionmentioning

confidence: 99%

Drug use and social control: The negotiation of moral ambivalence

Shiner

Winstock

2015

Social Science & Medicine

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Illicit drugs occupy an ambivalent position in late modern society; one that revolves around the twin themes of pleasure and disapproval. Drawing on Freudian psychoanalysis and Eliasian sociology this article considers how people, particularly those who use drugs, negotiate such ambivalence.Patterns of drug use and associated attitudes are examined on the basis of the Crime Survey for England and Wales and a specialist survey of largely recreational drug users in the United Kingdom. Although illicit drugs have become increasingly familiar, their use is still widely thought to be harmful and morally dubious, creating a series of challenges for those who engage in such behaviour. Ambivalence among drug users is evident in an awareness of potential costs as well as benefits; a tendency to avoid more harmful substances; a general emphasis on moderation; and a desire to use less. Building on previous work, which highlights the role of neutralisations in sustaining drug using behaviour, particular attention is paid to users' judgements about how their levels of consumption compare with other users. The analysis identifies a tendency among users to downplay their relative levels of use, which, it is argued, serves to shield them from some of the imperatives that may lead to decisions to cut down. As such, normalisation is said to be an intrapersonal as well inter-personal process. The article concludes by discussing the potential of webbased personalised feedback as a harm reduction approach.

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Development of a rational scale to assess the harm of drugs of potential misuse

Cited by 1,048 publications

References 12 publications

Altered social and non-social decision-making in recreational and dependent cocaine users

Altered social and non-social decision-making in recreational and dependent cocaine users

Tobacco control research: a tale of two Delphi groups

Drug use and social control: The negotiation of moral ambivalence

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