National Institute of Public Health and the Environment (RIVM), Centre for Health Protection, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
Regul Toxicol Pharmacol. 2013 Jun;66(1):83-7. doi: 10.1016/j.yrtph.2013.03.007. Epub 2013 Mar 28.
Chronic use at high dose of illicit drugs, alcohol and tobacco is associated with physical disease. The relative physical harm of these substances has not been described before, but will benefit the guiding of policy measures about licit and illicit substances. The physical harm of 19 addictive substances (including alcohol and tobacco), consisting of toxicity and the risk and severity of somatic disease (not psychiatric disease) was assessed based on literature data and the professional opinion of experts using scores ranging from 0 (no physical harm) to 3 (very serious physical harm). For alcohol, tobacco and some illicit drugs strong associations between long-term use or use in high dose versus the risk of somatic disease have been described, whereas for other substances such data are not available. Magic mushrooms, LSD and methylphenidate obtained relatively low scores (0.45-0.65) for physical harm, whereas relatively high scores were given for heroin (2.09), crack (2.32), alcohol (2.13) and tobacco (2.10). For cannabis, tobacco, and alcohol the estimated societal disease burden was higher than at individual level. The present ranking solely based on their physical harm was very similar to a previous ranking based on a combination of dependence liability, physical harm and social impairments.
长期大剂量使用非法药物、酒精和烟草会导致身体疾病。这些物质的相对身体危害以前没有被描述过，但将有助于指导关于合法和非法物质的政策措施。根据文献数据和专家的专业意见，对 19 种成瘾物质（包括酒精和烟草）的身体危害（不包括精神疾病）进行了评估，这些物质的毒性以及躯体疾病（非精神疾病）的风险和严重程度的评分范围为 0（无身体危害）至 3（非常严重的身体危害）。对于酒精、烟草和一些非法药物，长期使用或大剂量使用与躯体疾病风险之间存在很强的关联，而对于其他物质，则没有相关数据。迷幻蘑菇、LSD 和哌甲酯的身体危害评分相对较低（0.45-0.65），而海洛因（2.09）、快克（2.32）、酒精（2.13）和烟草（2.10）的评分相对较高。对于大麻、烟草和酒精，估计的社会疾病负担高于个人水平。目前的排名仅基于它们的身体危害，与以前基于依赖 Liability、身体危害和社会障碍的综合排名非常相似。
