Development of a rational scale to assess the harm of drugs of potential misuse
Development of a rational scale to assess the harm of drugs of potential misuse
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DOI：
10.1016/s0140-6736(07)60464-4
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发表时间：
2007-03-24
期刊：
影响因子：
168.9
通讯作者：
Blakemore, Colin
中科院分区：
文献类型：
--
作者：
Nutt, David;King, Leslie A.;Blakemore, Colin
药物误用和滥用是主要的健康问题。有害药物是根据声称与每种药物的危害和风险有关的分类系统进行监管的。然而，分类系统所依据的方法和程序一般既不具体，也不透明，这降低了人们对其准确性的信心，并破坏了卫生教育信息。我们开发并探索了使用九类危害矩阵的可行性，采用专家德尔菲程序，以循证方式评估一系列非法药物的危害。我们还包括五种法律的滥用药物（酒精、阿拉伯茶、溶剂、亚硝酸烷基酯和烟草）和一种已被归类的药物（氯胺酮）以供参考。这个过程被证明是可行的，当两个独立的专家组使用时，产生了大致相似的分数和药物危害排名。我们对危害的评估所产生的药物排名与当前监管系统所使用的药物不同。我们的方法提供了一个系统的框架和程序，可供国家和国际监管机构用于评估当前和未来滥用药物的危害。
Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.