Drugs—without the hot air: minimising the harms of legal and illegal drugs

A book club discussion of David Nutt's 'Drugs – without the hot air' recounts how the author, a neuropsychopharmacologist, was dismissed as chair of the UK Advisory Council on the Misuse of Drugs after comparing the harms of horse-riding to those of ecstasy and cannabis. He then formed the Independent Scientific Committee on Drugs, which systematically evaluated and ranked drug harms using a multidomain framework. The ranking showed little relationship between legal drug classes and harm levels: alcohol was ranked most harmful, while several Class A drugs including ecstasy and psychedelics ranked at the opposite end.

Study at a glance

Abstract

In the wake of recent changes to legislation on cannabinoid prescribing we decided to discuss Drugs – without the hot air 1 (figure 1) for the latest Edinburgh Neurology Book Club. Written by David Nutt, Professor of Neuropsychopharmacology, this book provides his account of how he became the ‘scientist who was sacked’ by the UK Home Secretary, after comparing the risks of harm from horse-riding with those from taking ecstasy and cannabis. Following his dismissal as the chair of the Advisory Council on the Misuse of Drugs, he formed the Independent Scientific Committee on Drugs, which then systematically evaluated and ranked harm caused by drugs using a multidomain framework. Perhaps unsurprisingly, there was little relationship between legal classes and the position drugs were ranked, with alcohol ranked most harmful, while several class A drugs including ecstasy and psychedelics ranked at the opposite end. The book delved into this process and …