The Harm Matrix
Side-by-side comparison across 7 critical harm categories. Scores represent relative harm severity (0-100). The data is drawn from the updated MCDA framework published in the Journal of Psychopharmacology (2026), funded by the Canadian Institutes for Health Research.
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Overdose Potential
stat_minus_1High — Directly lethal via respiratory depression. BAC >0.40% routinely fatal.
Zero — No CB1 receptors in brainstem. Fatal overdose biologically impossible.
Organ & Body Damage
stat_minus_1Severe — WHO Group 1 carcinogen. Causes liver cirrhosis, cardiomyopathy, pancreatitis, and 7 types of cancer.
Low-Moderate — Only combustion smoking irritates lungs. Vaping/edibles bypass this entirely.
Dependence Risk
stat_minus_1High (~15%). Withdrawal (delirium tremens) has 5% mortality — fatal seizures and cardiac arrest.
Moderate (~9%). Withdrawal causes insomnia, irritability — physically safe.
Mental Health Impact
stat_minus_1Severe — Strongly correlated with depression, anxiety, suicide. Causes permanent cognitive decline.
Conditional — Can trigger psychosis only in genetically predisposed individuals. Reversible cognitive effects.
Societal & Violent Impact
stat_minus_1Catastrophic — Only drug with direct pharmacological link to violence. 40%+ of violent crime, majority of domestic abuse.
Minimal — Sedative and muscle relaxant. Inverse correlation with violence. Domestic violence drops after legalization.
Healthcare Burden (UK)
stat_minus_1£4.9B+ annually to NHS. Leading cause of premature mortality for ages 15-49.
Minimal — Most costs are from policing prohibition, not health treatment.
Economic Cost (UK)
stat_minus_1£27B+ annually (healthcare, policing, crime, lost productivity).
~£0 direct. The financial cost is artificially created by prohibition enforcement.
The Verdict Is Unambiguous
Alcohol is unambiguously and significantly more harmful than cannabis across almost every metric measured. If alcohol were discovered today, it would be classified as a highly restricted controlled substance.
Sources: Nutt et al. (2010, The Lancet); Updated Journal of Psychopharmacology (2026, CIHR-funded); Canadian Institutes for Health Research