A study examining how expert assessments of drug-related harms compare to U.S. drug policy, revealing significant discrepancies between federal drug classifications and evidence-based evaluations of public health and social harms.
Notable Findings
- The most harmful drugs were fentanyl, methamphetamine, crack, heroin, and alcohol.
- The least harmful drugs were psychedelics: MDMA/Ecstasy, ketamine, ayahuasca, LSD, and mushrooms.
- The largest contributors to harm were economic costs and drug-specific mortality.
- Legal consequences were also ranked relatively high. Only one Schedule I drug, heroin, was in the top five most harmful.
- Cannabis ranked in the middle for relative harm, and four of the five least harmful drugs were Schedule I.
- With the exception of cannabis, all drugs were rated as more harmful to people who use them than to others.
- There was a weak association between drug harms as classified by the CSA and how our experts defined the harm of each drug.
Study Overview
United States drug policy is primarily based on the Controlled Substances Act of 1970 and largely contradicts scientific evidence about how to mitigate drugs’ harms. The mismatch between drug harms and policy exists partly because expert knowledge has not been fully considered with national drug policy decisions. Our study leveraged this knowledge by having 17 experts on drug use, including three individuals with lived experiences, rate drug harms across 18 criteria consisting of health and social impacts to people who use drugs and their families, communities, and society. These included legal consequences of drug use, and how these follow people as they attempt to gain important resources such as housing and employment. Nineteen drugs were scored by their relative harm for each criterion.
Recommendations
- Instead of a punitive approach, a public health approach to drug use should be prioritized. This would save lives and promote wellness of people who use drugs. It would also help society through reduced economic costs, family adversities, and acquisitive crime.
- Strategies should be introduced to reduce demand for alcohol, similar to those that have been successfully used with tobacco. Strategies should include TV advertising bans, higher prices, and reduced availability.
- Since psychedelics scored the lowest in harm and there is mounting evidence that they have therapeutic benefits, they should be removed from Schedule I to make it easier to conduct important research.
About the Researcher
- Michael Broman, PhD is an Assistant Professor at the College of Social Work at The Ohio State University and is a Faculty Affiliate for both the Center for Psychedelic Drug Research and Education (CPDRE) and the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery
- Alan K. Davis, PhD is an Associate Professor at the College of Social Work at The Ohio State University and the Director of CPDRE
- Stacey Armstrong, PhD, is the Associate Director at CPDRE at The Ohio State University
- Adam Levin, MD is a Post-Doctoral Scholar at CPDRE at The Ohio State University
- Kaltum Ahmed is a PhD Student at the College of Social Work at The Ohio State University
- Gustavo A. Angarita, MD, MHS is an Assistant Professor of Psychiatry at the School of Medicine at Yale University and is the Associate Director of Clinical Affairs at the Clinical Neuroscience Research Unit at the Connecticut Mental Health Center
- Brooke J. Arterberry, PhD is a Research Investigator at the Survey Research Center at the Institute for Social Research at the University of Michigan
- Cecilia Bergeria, PhD is an Associate Professor in the Department of Psychiatry and Behavioral Sciences in the School of Medicine at Johns Hopkins University
- Mitch Earleywine, PhD is a Professor in the Department of Psychology at the University at Albany
- Kathryn S. Gex, PhD is an Assistant Professor at the College of Medicine at the Medical University of South Carolina
- Tom Gregoire, PhD, MSW is an Associate Professor and Dean Emeritus at the College of Social Work at The Ohio State University
- Jamey J. Lister, PhD, MSW is an Associate Professor at the School of Social Work at Rutgers University
- David S. Mathai, MD is a Resident Physician in the Menninger Department of Psychiatry and Behavioral Sciences at the Baylor College of Medicine
- Nicky J. Mehtani, MD, MPH is an Assistant Professor of Medicine in the Division of General Internal Medicine at the School of Medicine at the University of California, San Francisco
- Nathan Menke, MD, PhD is a Clinical Assistant Professor of Psychiatry at the University of Michigan Medical School
- Charles D. Nichols, PhD is a Professor at the School of Medicine at the Louisiana State University Health Sciences Center
- Hillary Shaub, LISW-S is a Social Worker at CPDRE at The Ohio State University
- Alayna P. Tackett, PhD is an Associate Professor and Pediatric Psychologist in the Division of Medical Oncology at the College of Medicine at The Ohio State University
- Brandon Weiss, PhD is an Assistant Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine working in the Center for Psychedelic and Consciousness Research
- Nefize Yalin is a Researcher at the Centre for Affective Disorders in the Department of Psychological Medicine at the Institute of Psychology, Psychiatry, and Neurosciences at King’s College London
- Lawrence D. Phillips, PhD is Emeritus Professor at The London School of Economics and Political Science and is the Director of the Decision Capability Group.
Contact information: Mike Broman at broman.6@osu.edu
