Drug harms in the UK: a multicriteria decision analysis

Nutt, David; King, Leslie A.; Phillips, Lawrence D.

doi:10.1016/s0140-6736(10)61462-6

Cited by 1,268 publications

(1,006 citation statements)

References 9 publications

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“…A serious adverse event is defined as a reaction that results in death, is life threatening, results in prolonged hospitalisation or persistent or significant disability. The absence of this so far is consistent with research using psilocybin in healthy volunteers (Studerus et al, 2011), pre-prohibition research with LSD and mescaline (Cohen, 1960), modern population level data on recreational use of psilocybin mushrooms and other psychedelics Hendricks et al, 2014Hendricks et al, , 2015Johansen and Krebs, 2015;Krebs and Johansen, 2013a;Nutt et al, 2010;Walsh et al, 2016) and toxicology work (Gable, 2004). However, modern trials with psilocybin are notable for not collecting adverse event data systematically in a manner that allows aggregated analyses.…”

Section: Safetymentioning

confidence: 53%

Psychiatry & the psychedelic drugs. Past, present & future

2018

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a b s t r a c tThe classical psychedelic drugs, including psilocybin, lysergic acid diethylamide and mescaline, were used extensively in psychiatry before they were placed in Schedule I of the UN Convention on Drugs in 1967. Experimentation and clinical trials undertaken prior to legal sanction suggest that they are not helpful for those with established psychotic disorders and should be avoided in those liable to develop them. However, those with so-called 'psychoneurotic' disorders sometimes benefited considerably from their tendency to 'loosen' otherwise fixed, maladaptive patterns of cognition and behaviour, particularly when given in a supportive, therapeutic setting. Pre-prohibition studies in this area were sub-optimal, although a recent systematic review in unipolar mood disorder and a meta-analysis in alcoholism have both suggested efficacy. The incidence of serious adverse events appears to be low. Since 2006, there have been several pilot trials and randomised controlled trials using psychedelics (mostly psilocybin) in various non-psychotic psychiatric disorders. These have provided encouraging results that provide initial evidence of safety and efficacy, however the regulatory and legal hurdles to licensing psychedelics as medicines are formidable. This paper summarises clinical trials using psychedelics pre and post prohibition, discusses the methodological challenges of performing good quality trials in this area and considers a strategic approach to the legal and regulatory barriers to licensing psychedelics as a treatment in mainstream psychiatry.

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Section: Safetymentioning

confidence: 53%

Psychiatry & the psychedelic drugs. Past, present & future

2018

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“…The result of this expert consultation process is a table of 20 legal and illegal drugs ranked according to harms, showing enormous differences (4). Another approach is to include user opinions besides experts to determine harms, resulting in a surprising coincidence between the two (5). And a recent model uses the margin of exposure approach MOE (ratio between medium lethal dose in animal experiments and estimated human intake) for determining the mortality risks of substances (6).…”

Section: Summary Statementmentioning

confidence: 99%

Which policy for new psychoactive drugs?

Uchtenhagen

2016

Addiction

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“…In other words, substances with greater harm potential should be regulated more than substances with lesser harm potential. Obviously, less regulation of psychoactive substances may lead to their greater availability, and therefore greater harm (as evidenced for alcohol [4] and prescription opioids [5]; for Canada see [6]), but there are differences in the pharmacological and toxicological properties of the substances [7,8]. An important epidemiological indicator in this regard would be harm per user or harm per heavy user [9], which would also suggest cannabis as having lesser harm potential than alcohol, tobacco or prescription opioids in Canada.…”

Section: On the Relationship Between Epidemiology And Policymentioning

confidence: 99%

On the relationship between epidemiology and policy

et al. 2016

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K the knowledge base into consideration. For instance, there is far more accumulated evidence on alcohol and chronic disease risks [14,15] than similar evidence on cannabis [16]. This is due, in part, to the greater availability of alcohol, and thus data could be integrated more easily into large medical cohort studies. This situation will improve with a more evidence-based approach to drug policies in the future. Therefore, policies can, by no means, be derived exclusively from epidemiological results per se, but should be informed by such results. Declaration of interestsNone.

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Drug harms in the UK: a multicriteria decision analysis

Cited by 1,268 publications

References 9 publications

Psychiatry & the psychedelic drugs. Past, present & future

Psychiatry & the psychedelic drugs. Past, present & future

Which policy for new psychoactive drugs?

On the relationship between epidemiology and policy

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