Nutt et al proposed a scale for evaluating the potential for misuse posed by a drug. This can help determine the actual risk posed by a drug or substance. The authors are from the University of Bristol, the Forensic Science Service (London), the MRC and Oxford University.
Assessment parameters:
(1) acute physical harm
(2) chronic physical harm
(3) intravenous harm
(4) dependence risk based on intensity of pleasure
(5) psychological dependence
(6) physical dependence
(7) social harm from intoxication
(8) social harms not due to intoxication
(9) health-related costs
where:
• Another parameter to measure might be non-health-related costs.
Subgroups:
(1) physical harm - items 1, 2 and 3
(2) dependence - items 4, 5 and 6
(3) social harm - items 7, 8 and 9
|
Risk
|
Points
|
|
none
|
0
|
|
some (minimal to mild)
|
1
|
|
moderate
|
2
|
|
extreme (significant, severe)
|
3
|
overall average score =
= SUM(points for all 9 items) / 9
average subscore for physical harm =
= SUM(points for first 3 items) / 3
average subscore for dependence =
= SUM(points for items 4, 5 and 6) / 3
average subscore for social harm =
= SUM(points for last 3 items) / 3
Interpretation:
• minimum average score: 0
• maximum average score: 3
• The higher the score the greater the risk of the drug or substance.
Additional scores might include:
(1) number of extreme risk items
(2) sum total (without averaging)
(3) sum for each subgroup
Using a nonlinear point assignment (1 for mild risk, 3 for moderate and 7 for high) would reflect the nonlinear impact.
