The Australian drug harms ranking study

Yvonne Bonomo¹, Amanda Norman¹, Sam Biondo², Raimondo Bruno³, Mark Daglish⁴, Sharon Dawe⁵, Diana Egerton-Warburton⁶, Jonathan Karro⁷, Charles Kim⁸, Simon Lenton⁹, Dan I Lubman¹⁰, Adam Pastor¹, Jill Rundle¹¹, John Ryan¹², Paul Gordon¹³, Patrick Sharry¹⁴, David Nutt¹⁵, David Castle¹⁶

Affiliations

¹ 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia.
² 2 Victorian Alcohol and Drug Association (VAADA), Melbourne, VIC, Australia.
³ 3 School of Medicine (Psychology), University of Tasmania, Hobart, TAS, Australia.
⁴ 4 Alcohol and Drug Service, Metro North Hospital and Health Service, The University of Queensland, St Lucia, Brisbane, QLD, Australia.
⁵ 5 School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
⁶ 6 Department of Medicine, School of Clinical Sciences at Monash Health, Melbourne, VIC, Australia.
⁷ 7 Emergency Department, St Vincent's Hospital, Melbourne, VIC, Australia.
⁸ 8 Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia.
⁹ 9 National Drug Research Institute, Curtin University, Perth, WA, Australia.
¹⁰ 10 Turning Point, Eastern Health and Monash University, Melbourne, VIC, Australia.
¹¹ 11 Western Australian Network of Alcohol and Drug Agencies, Perth, WA, Australia.
¹² 12 Penington Institute, Melbourne, VIC, Australia.
¹³ 13 Catalyze APAC, Sydney, NSW, Australia.
¹⁴ 14 Australian Graduate School of Management, University of New South Wales, Sydney, NSW, Australia.
¹⁵ 15 Imperial College London, London, UK.
¹⁶ 16 Mental Health, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia.

PMID: 31081439
DOI: 10.1177/0269881119841569

The Australian drug harms ranking study

Yvonne Bonomo et al. J Psychopharmacol. 2019 Jul.

. 2019 Jul;33(7):759-768.

doi: 10.1177/0269881119841569. Epub 2019 May 13.

Authors

Affiliations

¹ 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia.
² 2 Victorian Alcohol and Drug Association (VAADA), Melbourne, VIC, Australia.
³ 3 School of Medicine (Psychology), University of Tasmania, Hobart, TAS, Australia.
⁴ 4 Alcohol and Drug Service, Metro North Hospital and Health Service, The University of Queensland, St Lucia, Brisbane, QLD, Australia.
⁵ 5 School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
⁶ 6 Department of Medicine, School of Clinical Sciences at Monash Health, Melbourne, VIC, Australia.
⁷ 7 Emergency Department, St Vincent's Hospital, Melbourne, VIC, Australia.
⁸ 8 Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia.
⁹ 9 National Drug Research Institute, Curtin University, Perth, WA, Australia.
¹⁰ 10 Turning Point, Eastern Health and Monash University, Melbourne, VIC, Australia.
¹¹ 11 Western Australian Network of Alcohol and Drug Agencies, Perth, WA, Australia.
¹² 12 Penington Institute, Melbourne, VIC, Australia.
¹³ 13 Catalyze APAC, Sydney, NSW, Australia.
¹⁴ 14 Australian Graduate School of Management, University of New South Wales, Sydney, NSW, Australia.
¹⁵ 15 Imperial College London, London, UK.
¹⁶ 16 Mental Health, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia.

PMID: 31081439
DOI: 10.1177/0269881119841569

Erratum in

Corrigendum to The Australian Drug Harms Ranking Study.
[No authors listed] [No authors listed] J Psychopharmacol. 2019 Nov;33(11):1471. doi: 10.1177/0269881119877724. Epub 2019 Oct 1. J Psychopharmacol. 2019. PMID: 31575327 No abstract available.

Abstract

Background/aim: The aim of the current study was to review drug harms as they occur in Australia using the Multi-criteria Decision Analysis (MCDA) methodology adopted in earlier studies in other jurisdictions.

Method: A facilitated workshop with 25 experts from across Australia, was held to score 22 drugs on 16 criteria: 9 related to harms that a drug produces in the individual and 7 to harms to others. Participants were guided by facilitators through the methodology and principles of MCDA. In open discussion, each drug was scored on each criterion. The criteria were then weighted using a process of swing weighting. Scoring was captured in MCDA software tool.

Results: MCDA modelling showed the most harmful substances to users were fentanyls (part score 50), heroin (part score 45) and crystal methamphetamine (part score 42). The most harmful substances to others were alcohol (part score 41), crystal methamphetamine (part score 24) and cigarettes/tobacco (part score 14). Overall, alcohol was the most harmful drug when harm to users and harm to others was combined. A supplementary analysis took into consideration the prevalence of each substance in Australia. Alcohol was again ranked the most harmful substance overall, followed by cigarettes, crystal methamphetamine, cannabis, heroin and pharmaceutical opioids.

Conclusions: The results of this study make an important contribution to the emerging international picture of drug harms. They highlight the persistent and pervasive harms caused by alcohol. Policy implications and recommendations are discussed. Policies to reduce harm from alcohol and methamphetamine should be a priority.

Keywords: Alcohol; drugs; harms; illicit drugs; ranking; tobacco.

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The Australian drug harms ranking study

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The Australian drug harms ranking study

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Erratum in

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