Nutt · Lancet (London, England) 2010 · multicriteria decision analysis expert panel · n=?

Drug harms in the UK: a multicriteria decision analysis.

Cited 1670 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Expert consensus scoring and decision analysis modeling (Level 5)

PubMed 21036393 · doi:10.1016/S0140-6736(10)61462-6 · record verified 2026-08-26

What was done

Members of the Independent Scientific Committee on Drugs, including two invited specialists, held a 1-day interactive workshop to evaluate 20 drugs in the UK using multicriteria decision analysis (MCDA). Drugs were scored out of 100 points across 16 weighted criteria, comprising nine individual harm criteria and seven criteria evaluating harm to others.

What was found

Crack cocaine, heroin, and metamfetamine had the highest scores for harm to the individual (part scores 37, 34, and 32, respectively). Alcohol, heroin, and crack cocaine had the highest scores for harm to others (46, 21, and 17, respectively). In overall harm score, alcohol ranked highest (72), followed by heroin (55) and crack cocaine (54).

Why it matters

The study presents a structured, multidimensional method to quantify substance harms, highlighting a disconnect between expert-assessed harm and UK statutory drug classification.

Limits

The scores and weightings rely on subjective expert consensus from a single workshop rather than primary empirical or epidemiological data collection. The exact number of panel members is not reported in the abstract. The model is specific to the UK context.

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