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Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach

 Report  by Dirk Lachenmeiera, Jürgen Rehm dated 2015/01/30

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Subjects: Cannabis
Example of: Scientific report
Source: US National Library of Medicine (Link)

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A comparative risk assessment of drugs including alcohol and tobacco using the margin of exposure (MOE) approach was conducted. The MOE is defined as ratio between toxicological threshold (benchmark dose) and estimated human intake. Median lethal dose values from animal experiments were used to derive the benchmark dose. The human intake was calculated for individual scenarios and population-based scenarios.

The MOE was calculated using probabilistic Monte Carlo simulations. The benchmark dose values ranged from 2 mg/kg body weight for heroin to 531 mg/kg body weight for alcohol (ethanol). For individual exposure the four substances alcohol, nicotine, cocaine and heroin fall into the ‘‘high risk’’ category with MOE < 100. On a population scale, only alcohol would fall into the ‘‘high risk’’ category, and cigarette smoking would fall into the ‘‘risk’’ category, while all other agents (opiates, cocaine, amphetamine-type stimulants, ecstasy, and benzodiazepines) had MOEs > 10,000. The toxicological MOE approach validates epidemiological and social science-based drug ranking approaches especially in regard to the positions of alcohol and tobacco (high risk) and cannabis (low risk).