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Drug harms in the UK: a multicriteria decision analysis
Evaluation criteria and their definitions
Drug-specific mortality
Intrinsic lethality of the drug expressed as ratio of lethal dose and standard dose (for adults)
Drug-related mortality
The extent to which life is shortened by the use of the drug (excludes drug-specific mortality)—eg, road traffic accidents, lung cancers, HIV, suicide
Drug-specific damage
Drug-specific damage to physical health—eg, cirrhosis, seizures, strokes, cardiomyopathy, stomach ulcers
Drug-related damage
Drug-related damage to physical health, including consequences of, for example, sexual unwanted activities and self-harm, blood-borne viruses, emphysema, and damage from cutting agents
Dependence
The extent to which a drug creates a propensity or urge to continue to use despite adverse consequences (ICD 10 or DSM IV)
Drug-specific impairment of mental functioning
Drug-specific impairment of mental functioning—eg, amfetamine-induced psychosis, ketamine intoxication
Drug-related impairment of mental functioning
Drug-related impairment of mental functioning—eg, mood disorders secondary to drug-user's lifestyle or drug use
Loss of tangibles
Extent of loss of tangible things (eg, income, housing, job, educational achievements, criminal record, imprisonment)
Loss of relationships
Extent of loss of relationship with family and friends
Injury
Extent to which the use of a drug increases the chance of injuries to others both directly and indirectly—eg, violence (including domestic violence), traffic accident, fetal harm, drug waste, secondary transmission of blood-borne viruses
Crime
Extent to which the use of a drug involves or leads to an increase in volume of acquisitive crime (beyond the use-of-drug act) directly or indirectly (at the population level, not the individual level)
Environmental damage
Extent to which the use and production of a drug causes environmental damage locally—eg, toxic waste from amfetamine factories, discarded needles
Family adversities
Extent to which the use of a drug causes family adversities—eg, family breakdown, economic wellbeing, emotional wellbeing, future prospects of children, child neglect
International damage
Extent to which the use of a drug in the UK contributes to damage internationally—eg, deforestation, destabilisation of countries, international crime, new markets
Economic cost
Extent to which the use of a drug causes direct costs to the country (eg, health care, police, prisons, social services, customs, insurance, crime) and indirect costs (eg, loss of productivity, absenteeism)
Community
Extent to which the use of a drug creates decline in social cohesion and decline in the reputation of the community
CD 10=International Classification of Diseases, tenth revision. DSM IV=Diagnostic and Statistical Manual of Mental Disorders, fourth revision
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