Toronto, Canada: The use of alcohol and tobacco causes far greater overall harms to both individual consumers and to society than does cannabis, according to a scientific analysis published in the Journal of Psychopharmacology.
An international working group of experts assessed the aggregate harms associated with the use of sixteen psychoactive substances, including alcohol, tobacco, cannabis, opioids, benzodiazepines, and methamphetamine. Substances were scored based upon the likelihood that their use causes specific harms to the user (e.g., mortality risk, physical or mental health damage, dependence, etc.) and/or to others (e.g., environmental damage, economic loss, motor vehicle injuries, etc.).
Experts ranked alcohol as the substance associated with the greatest overall harm, followed by tobacco, non-prescription opioids, cocaine, and methamphetamine.
The finding is consistent with those of other international expert panels, including those conducted in Australia, the European Union, New Zealand, and the United Kingdom, which all rank alcohol as the drug responsible for the greatest amount of overall harm. Similarly, a 2024 US study published in the Journal of Studies on Alcohol and Drugs determined that “secondhand harms from others’ alcohol use were substantially more prevalent than those from others’ use of any other drug.” A more recent evaluation in the United States ranked only fentanyl, methamphetamine, crack, and heroin above alcohol in terms of potential harm.
Full text of the study, “Drug harms in Canada: A multi-criteria decision analysis,” appears in the Journal of Psychopharmacology.