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Classification of illegal and harmful drugs

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38929.578414.80 (Published 03 August 2006) Cite this as: BMJ 2006;333:272

Rapid Response:

Alcohol could be substituted with safer alternatives such as benzodiazepines or marijuana

It is pleasing to see some rationality creeping into the debate on
the escalating alcohol problem [1]. The UK now combines internationally
high rates of alcohol consumption with the binge drinking patterns typical
of high latitude countries [2]. But it seems unlikely that traditional
means of controlling alcohol consumption by abolition, raising price and
restricting access will be viable in modern societies [2].

A radical new approach is required. Alcohol users should be regarded
as rational consumers who are drinking in order to attain specific
psychological effects - and who would substitute alcohol for safer
alternative drugs if these were legal, available and affordable [3, 4].

For example, benzodiazepines are a safer alternative for achieving
the relaxed sociability of slow, low-dose alcohol consumption, while
marijuana is a safer and less violence-inducing intoxicant than binge
drinking [4].

Preliminary economic analysis suggests that consumers will indeed
make these safer substitutions - when the choices are available [5]. All
that is needed is for public policy to swing away from being prohibition-
oriented to being choice-oriented.

1. Gossop M. Classification of illegal and harmful drugs BMJ 2006;
333: 272-273

2. The Economist. Drinking culture: in a pickle – Britons drink
southern European quantities in northern European style. The Economist
March 18 2004.

3. Nutt DJ. Alcohol alternatives - a goal for psychopharmacology? J
Psychopharmacol. 2006; 20: 318-20.

4. Charlton BG. Diazepam with your dinner, Sir? The lifestyle drug-
substitution strategy: a radical alcohol policy. QJM 2005 98: 457-459.

5. Chaloupka FJ, Laixuthai A. Do youths substitute alcohol and
marijuana? Some econometric evidence. Eastern Economic Journal. 1997; 23:
253-276

Competing interests:
None declared

Competing interests: No competing interests

04 August 2006
Bruce G Charlton
Reader in Evolutionary Psychiatry
Newcastle University, NE1 7RU, UK