Should the use of some drugs be criminalized? Are legal drugs and prescription drugs safer than illicit drugs? Will decriminalizing drugs increase usage? There are many misconceptions about drugs. Fortunately there is also a lot of research to guide your answers.
Relative Harms of Drugs
A psychoactive drug is a chemical substance that changes brain function and results in alterations in perception, mood, or consciousness. Examples of psychoactive drugs and their legal status are illustrated below:
|marijuana (soon)||benzodiazepines||ecstasy (MDMA)|
|anti-anxiety medications||synthetic cannabinoids|
|marijuana (not for long)|
Our bodies do not know the legal status of a drug. If it is a psychoactive drug, there is a risk of addiction. The risk of addiction depends on the age of the person consuming the drug and the drug being used. For example, with respect to marijuana estimates of the rates of addiction are as high as 5%-9% for an adult and 17% for an adolescent.
Hallucinogens like LSD, mescaline (peyote) or mushrooms are not usually addicting.
It would be logical to assume that legal drugs are the drugs that cause the least amount of harm, followed by prescription drugs and then illegal drugs. This is not the case. For example, oxycodone has many similarities to heroin. Most importantly, alcohol is a drug that has become normalized in our society and according to a study of the relative harms of 20 of the most commonly used drugs alcohol causes the greatest amount of harm once you combine harm to self and harm to others. Marijuana (cannabis) ranks eighth on the list. According to the World Health Organization (WHO) 5.9% of all deaths worldwide in 2012 were attributable to alcohol consumption.
Wood E, McKinnon M, Strang R, Kendall PR. Improving community health and safety in Canada through evidence-based policies on illegal drugs. Open Medicine. 2012;6(1):e35-e40.
It must be noted that this analysis was done prior to the introduction into the illegal market of more toxic drugs like fentanyl and carfentanil, both synthetic opioids which are much more powerful than morphine. These drugs are being laced in to other drugs. North America is in the midst of an opioid overdose epidemic. It has never been more dangerous to use illegal drugs. Both persons struggling with addiction and recreational users of illegal drugs are at risk. Persons who use drugs do not know if what they are purchasing is the drug that they believe they have purchased. Due to this epidemic, Ottawa Public Health has prepared information for parents on what they need to know about opioids.
Societal Costs of Different Drugs
A report by the Canadian Centre on Substance Use and Addiction (CCSA) on Comparing the Perceived Seriousness and Actual Costs of Substance Abuse in Canada found that Canadians perceived that illegal drug misuse was a more serious problem than alcohol misuse. However, in 2002 direct alcohol-related health care costs ($3,306.2 million) were nearly three times as high as for all illicit drugs, excluding marijuana (cannabis) ($1,061.6 million), and over 45 times higher than the direct health care costs of marijuana ($73 million).
This misperception of the relative costs of alcohol and illegal drugs contributes to the discrimination and stigma faced by those who choose to use illegal substances rather than alcohol.
The report concludes:
“At this point it may be useful to consider what could be done to correct the misperceptions documented above. Just as the wide dissemination of evidence on the health risks of tobacco changed the public’s perceptions of smoking, a concerted and sustained effort is necessary to correct misperception of the relative risks and costs associated with alcohol and other drug abuse. These efforts could take many forms, but one of the most effective would be for experts from the public health and addictions fields to actively respond in the media to better inform the public about the true nature of these risks. This could take the form of op-ed articles in major newspapers or respectful letters to the editor providing direct responses to media reports that misrepresent the true nature and relative significance of the risks of various substances. As well, messaging on the relative risks of various substances should be actively incorporated into the design and delivery of prevention programs across Canada so that, over time, the public becomes better informed about the relative seriousness of substance abuse behaviours.”
Effects of Different Drugs
The National Institute on Drug Abuse (NIDA) has an easy to read list of drug facts for the most commonly used drugs of abuse, including their effects on the body. They also have a more detailed list of drugs facts.