Citation

Lachenmeier DW, Rehm J. Sci. Rep. 2015; 5: 8126.

Affiliation

1] Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie &Psychotherapie, Dresden, Germany [2] Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada [3] Institute of Medical Sciences, University of Toronto (UofT), Toronto, Canada [4] Dalla Lana School of Public Health, UofT, Toronto, Canada [5] Dept. of Psychiatry, Faculty of Medicine, UofT, Toronto, Canada [6] PAHO/WHO Collaborating Centre for Mental Health &Addiction, Toronto, Canada.

Copyright

(Copyright © 2015, Nature Publishing Group)

DOI

10.1038/srep08126

PMID

25634572

Abstract

A comparative risk assessment of drugs including alcohol and tobacco using the margin of exposure (MOE) approach was conducted. The MOE is defined as ratio between toxicological threshold (benchmark dose) and estimated human intake. Median lethal dose values from animal experiments were used to derive the benchmark dose. The human intake was calculated for individual scenarios and population-based scenarios. The MOE was calculated using probabilistic Monte Carlo simulations. The benchmark dose values ranged from 2 mg/kg bodyweight for heroin to 531 mg/kg bodyweight for alcohol (ethanol). For individual exposure the four substances alcohol, nicotine, cocaine and heroin fall into the "high risk" category with MOE < 10, the rest of the compounds except THC fall into the "risk" category with MOE < 100. On a population scale, only alcohol would fall into the "high risk" category, and cigarette smoking would fall into the "risk" category, while all other agents (opiates, cocaine, amphetamine-type stimulants, ecstasy, and benzodiazepines) had MOEs > 100, and cannabis had a MOE > 10,000. The toxicological MOE approach validates epidemiological and social science-based drug ranking approaches especially in regard to the positions of alcohol and tobacco (high risk) and cannabis (low risk).

Language: en