Experienced drug users assess the relative harms and benefits of drugs: a web-based survey

Introduction

Earlier expert-led efforts to rank the harms of drugs have used Delphic or multicriteria approaches and found poor correspondence between expert assessments and existing legal classifications. Those studies typically engaged psychiatrists and other drug experts and produced a harm matrix that weighted physical harm, dependence, and social harm, but they did not directly consult experienced drug users despite users having intimate knowledge of drug effects and harms. Lester and colleagues set out to fill that gap by collecting the opinions of highly experienced drug users about the relative harms and benefits of a range of commonly used illicit substances, together with views on how each substance should be classified under the UK Misuse of Drugs Act and which information sources most influence perceptions of harm. The study therefore aims to compare user-derived rankings with prior expert assessments and to capture qualitative reasons why particular drugs are seen as harmful or beneficial.