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Many people say that most illegal drugs are dangerous.

Others say that meth is more dangerous than heroin and cocaine and alcohol and nicotine is about as dangerous as those.

And others say that heroin and cocaine are the most dangerous and the rest aren't as dangerous. For example, some people write how safe ecstasy (XTC), ganja (i.e. cannabis), kratom, LSD, and DMT are.

I would like a table that lists:

  1. Drug
  2. Death per user
  3. Addiction level. How many that have used it, used it in last 1 week, for example, and how often
  4. Other adverse effects
  5. Harm to society

Are there some tables for that somewhere?

I saw some graphs like that. But it's very unclear.

  • 3
    Why is this getting posted in politics rather than somewhere more appropriate like health or biology? – Denis de Bernardy Mar 15 '18 at 12:08
  • I will migrate the question on Health.SE. They should be more qualified to answer questions about the health risks of recreational drug use. – Philipp Mar 15 '18 at 12:27
  • I think the best you're going to get are the graphs by Nutt. – faustus Mar 15 '18 at 13:57
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    Much of the reason illegal drugs are dangerous is because of inconsistent and unknown dosages and purity, so any such table would be largely contrived. For example, heroin is often cut with fentanyl these days, which is vastly more potent. A slight measurement error and what appears to be a safe dose is an instantly fatal dose. So how do you compare heroin to other drugs when it depends on the batch of heroin? The same is true for all the other illegal drugs. They're manufactured by criminal amateurs using crude methods and can randomly be anywhere between ineffective and deadly. – Carey Gregory Mar 15 '18 at 14:09
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These tables you wish for are not quite exactly in the format you would seem to like them and as far as I know not available for a "global every substance we know" analysis. It is also quite difficult to compare all of them in one metric alone since these drugs are sometimes quite incomparable.

General harmful results involving a certain drug

Most of the following tables and graphics are attempting to aggregate and integrate many aspects of "harm" involving a drug can cause. "Involving" a drug here includes any harm resulting from societal or legal troubles and other consequences. That is largely due to the legal or illegal status of a drug. In the case of clean cannabis (i.e. unadulterated, uncontaminated etc.) the direct physical harm from the drug itself, while not completely without possible dangers, is close to zero for the very vast majority of adult people without pre-existing conditions that would increase their vulnerability.

Since this data is based on the official statistics from countries waging the war on drugs, sometimes these statistics are a bit skewed. For example, if an autopsy reveals any casualty had consumed cannabis this is recorded as cannabis being involved in the death (and then sometimes sloppily even reported as "causing") even if the drug itself cannot and did not cause the death. These cases are for example resulting from accidents in traffic even if it entirely the fault of an entirely sober driver.

When interpreting the data, these intentional skewing by the authorities has to be taken into account.

But some very thorough studies on general harm were done, like these one for the UK:

Psychoactive drugs of misuse: rationalising the irrational (The Lancet Volume 369, No. 9566, p972, 24 March 2007)

Drug harms in the UK: a multicriteria decision analysis (The Lancet Volume 376, No. 9752, p1558–1565, 6 November 2010) These findings lend support to previous work assessing drug harms, and show how the improved scoring and weighting approach of MCDA increases the differentiation between the most and least harmful drugs. However, the findings correlate poorly with present UK drug classification, which is not based simply on considerations of harm.

These findings are somewhat better described and more accessible in

Drugs that cause most harm Scoring drugs (Economist Nov 2nd 2010, The Economist online)
enter image description here

The prohibition policy that is associated with the War on Drugs is not in any way based on reality, rationality, common sense or risk/benefit analysis but ideology based on moral panics and a crime against humanity in itself. Still that list is not to be read that the above table is giving any substance a free pass on the basis that if it is deemed less dangerous than alcohol and alcohol is legal∞ so…
These numbers are composite aggregates and as such have a weakness of too much information reduction necessary to convince uneducated voters and politicians to readjust their decision making on perhaps some basis of rationality and a more balanced view of the available evidence.

Getting this into an again more complicated to read table, with numbers and legal status again for the UK:

  1. Heroin –– Class A drug. Originally used as a painkiller and derived from the opium poppy. There were 897 deaths recorded from heroin and morphine use in 2008 in England and Wales, according to the Office of National Statistics (ONS). There were around 13,000 seizures, amounting to 1.6m tonnes of heroin.
  2. Cocaine –– Class A. Stimulant produced from the South American coca leaf. Accounted for 235 deaths – a sharp rise on the previous year's fatalities. Nearly 25,000 seizures were made, amounting to 2.9 tonnes of the drug.
  3. Barbituates –– Class B. Synthetic sedatives used for anaesthetic purposes. Blamed for 13 deaths.
  4. Street methadone –– Class A. A synthetic opioid, commonly used as a substitute for treating heroin patients. Accounted for 378 deaths and there were more than 1,000 seizures of the drug.
  5. Alcohol –– Subject to increasing concern from the medical profession about its damage to health. According to the ONS, there were 8,724 alcohol deaths in the UK in 2007. Other sources claim the true figure is far higher.
  6. Ketamine –– Class C. A hallucinogenic dance drug for clubbers. There were 23 ketamine-related deaths in the UK between 1993 and 2006. Last year there were 1,266 seizures.
  7. Benzodiazepines –– Class C. A hypnotic relaxant used to treat anxiety and insomnia. Includes drugs such as diazepam, temazepam and nitrazepam. Caused 230 deaths and 1.8m doses were confiscated in more than 4,000 seizure operations.
  8. Amphetamine –– Class B. A psychostimulant that combats fatigue and suppresses hunger. Associated with 99 deaths, although this tally includes some ecstasy deaths. Nearly 8,000 seizures, adding up to almost three tonnes.
  9. Tobacco –– A stimulant that is highly addictive due to its nicotine content. More than 100,000 people a year die from smoking and tobacco-related diseases, including cancer, respiratory diseases and heart disease.
  10. Buprenorphine –– An opiate used for pain control, and sometimes as a substitute to wean addicts off heroin. Said to have caused 43 deaths in the UK between 1980 and 2002.
  11. Cannabis –– Class B. A psychoactive drug recently appearing in stronger forms such as "skunk". The subject of intense controversy over its long-term effects and capacity for inducing schizophrenia. Caused 19 deaths and there were 186,000 seizures, netting 65 tonnes of the drug and 640,000 cannabis plants.
  12. Solvents –– Fumes inhaled to produce a sense of intoxication. Usually abused by teenagers. Derived from commonly available products such as glue and aerosol sprays. Causes around 50 deaths a year.
  13. 4-MTA –– Class A. Originally designed for laboratory research. Releases serotonin in the body. Only four deaths reported in the UK between 1997 and 2004.
  14. LSD –– Class A. Hallucinogenic drug originally synthesised by a German chemist in 1938. Very few deaths recorded.
  15. Methylphenidate –– Class B drug. Brand name of Ritalin. A psychostimulant sometimes used in the treatment of attention deficit disorders.
  16. Anabolic steroids –– Class C. Used to develop muscles, notably in competitive sports. Also alleged to induce aggression. Have been blamed for causing deaths among bodybuilders. More than 800 seizures.
  17. GHB –– Class C drug. A clear liquid dance drug said to induce euphoria, also described as a date rape drug. Can trigger comas and suppress breathing. Caused 20 deaths and 47 seizures were recorded.
  18. Ecstasy –– Class A. Psychoactive dance drug. Caused 44 deaths, with around 5,000 seizures made.
  19. Alykl nitrites –– Known as "poppers". Inhaled for their role as a muscle relaxant and supposed sexual stimulant. Reduce blood pressure, which can cause fainting and in some cases death.
  20. Khat –– A psychoactive plant, the leaves of which are chewed in east Africa and Yemen. Also known as qat. Produces mild psychological dependence. Its derivatives, cathinone and cathine, are Class C drugs in the UK.

Again, this is not a guideline for anything but an attempt to rationalise. Solvents are one of the stupidest ways imaginable to get intoxicated, rather than inebriated, causing quite a lot of individual damage in a very short amount of time. But since they cause comparatively few deaths and not much crime, they get a good spot on the list.
Cannabis is listed as causing 19 deaths. Which is again difficult to put into perspective, as the substance may have been "involved" in the deaths recorded in that statistic, but certainly did not directly cause any death in itself from an overdose. Chewing just Khat is also listed above. While the leaves have to be chewed for a long time to produce any effect at all, and no deaths are recorded from the leves, the purified substance can be quite nasty and if this chemical is then again adulterated or mixed the results are anyones guess again.

These findings are found refined visually in Drug harmfulness:

enter image description here enter image description here enter image description here

Bringing all these substances into one comparison has its advantages – but it is very difficult comparison in a very complicated matter. One thing to keep in mind besides the overall harm a substance might cause is the directly deadly effect any one given substance might cause. This is a problem for many drugs, as the quality classic illegal drugs from the 1960s like Cannabis and LSD, simply are just not deadly at all, despite causing the moral panic that deludes the public mind until today. Using organically grown coca-leaves as a tea or chew will not kill anyone, using the isolated active substance cocaine migt very well cause a fatal overdose. This is amplified danger if a first purified substance is then again diluted with an unknowable mixture of substances to sell it illegally "on the street".

The greatest harm and the most deaths from any of these substances can be read as caused primarily by the societal and political attitudes and laws around them, not by any pure substance as such.

Deaths directly caused by certain drugs

If – still – only the concrete death rate related to the most troubling substances, and the statistic reduced to the substances alone, recorded in nation-wide statistics are the primary concern, then for the US, the NIH gives the following figures:

Overdose Death Rates – (Revised September 2017) enter image description here

Again, just concerning deaths, this time defined as drug poisoning deaths:

Drug poisoning deaths in the United States, 1980-2008.

If illegal or psychotropic psychoactive drugs were consequently treated like prescription drugs in the terms describing their effects, then one thing becomes apparent: prescription drugs, like chemically concentrated or purified natural drugs tend to have a very narrow therapeutic window or therapeutic index.

Opium has a wider therapeutic window since it's a mixture of opioids that are both synergistically and antagonistically. Opium is also comparatively weak compared to morphine that has a smaller window since it is the most depressing and analgesic substance isolated from opium, heroin is then an artificial derivate with increased potency and purely synthetic opioids, like fentanyl, show so much receptor affinity and a that effect and overdose have to be again much more precisely calculated. Pharmacokinetics and route of administration differ as well.

How many deaths a drug causes also depends on the base rate of users of this drug. This ratio may be calculated with some confidence for users of tobacco and alcohol, but from illegal drugs this is a very convoluted story. Acute overdose poisoning from alcohol and even death is not uncommon, also even from acute withdrawal of that drug. All these effects are very rare from tobacco.

The numbers you are looking for would have to come from controlled lab experiments with pure substances and then extrapolated. Thanks to the current prohibition and uncontrolled market situation, this is largely an exercise in futility.

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  • Note that opiates are that high because as Cary said they are lethal in so small doses that messing up the concentration has pretty devestating consequences. One or two glasses of wine don’t make that much of a difference, but twice the dose fentanyl (as an example) might kill you. – Narusan Mar 15 '18 at 20:46
  • @Narusan-in-coma Yeah. But I think that's a problem of these aggregates. In an illegal situation and possible depression involved, a purposeful overdose is also common, how to differentiate that? The statistics available usually do not record motivation or special circumstances at this level. There are relatively well adjusted heroin users in Switzerland using tested material and then the chaos of prescription users switching to street material in the US. – Opiates are that high also because of their small window, true, but mainly because they are illegalised instead of controlled for quality? – LаngLаngС Mar 15 '18 at 20:53
  • This would be a great answer if the data weren't so ridiculous. Cannabis is more harmful than benzos, methadone, and ketamine? Seriously? Where the hell did they come up with this nonsense? – Carey Gregory Mar 16 '18 at 1:26
  • @CareyGregory I actually tried to address this: the 19 is "involved", (e.g. they count car accidents by drunks who are also high even if the other car caused it…) DEA then says 0 direct causes. Then cannabis comes in so high in the early in the above lists since it is so widespread and so many are in prison just because of it. – LаngLаngС Mar 16 '18 at 2:27
  • Well, I'd love to upvote this for the effort put forth and the quality of the answer, but the data is just pure crap. – Carey Gregory Mar 16 '18 at 3:44

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