BlogAlcohol and tobacco just as harmful as heroin
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Alcohol and tobacco just as harmful as heroin


The Dutch National Institute for Public Health and the Environment (RIVM) has performed a risk assessment on the harmful effects of 17 illegal drugs plus that of legal drugs tobacco and alcohol.

The assessment was performed by a panel of 19 experts who based their judgement on their own scientific expertise and information derived from the literature. The assessment focussed on toxicity, potential for dependency and social harm at individual and population levels.

The bars in the image indicate:

Pink: physical damage
Orange: social harm to the user
Green: harm to society

The most important conclusions drawn from the assessment are as follows.

Firstly, alcohol, tobacco, heroin and crack scored relatively high on the scale for Total harm, whereas magic mushrooms, LSD and khat scored relatively low.

Secondly, the scores of the Dutch expert panel correspond well with
previous findings from British experts as well as previous advice from the Dutch Coordination point Assessment Monitoring new drugs (CAM).

Thirdly, classed as legal drugs, alcohol and tobacco have been judged by the experts as more harmful than many of the illegal drugs included in the assessment –with the exception of heroin and crack. This accounts for the Total harm at individual and population levels.

Finally, regarding Total harm at individual level, cannabis and ecstasy have been assessed by the experts as moderately harmful.

The study is remarkable, as Dutch drug policy has been making a U-turn in the last 7 years. Magic mushrooms (Paddo's in Dutch) have been banned last December. This study shows magic mushrooms are at the lower end of the risk spectrum, while legal drugs like tobacco (Tabak in Dutch) are much more harmful.

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