Substance users and addiction experts agree on harm rankings but disagree on benefits: users rate cannabis benefits higher
Both substance-dependent users and addiction medicine experts ranked heroin, cocaine, and amphetamines as most harmful, but users rated the benefits of cannabis, nicotine, and traditional illicit drugs significantly higher than experts did.
Quick Facts
What This Study Found
Users and experts produced similar overall harm rankings, both placing heroin, cocaine, and amphetamines at the top and cannabis, psychotropic mushrooms, and buprenorphine near the bottom. However, users rated the benefits of cannabis, nicotine, and traditional illicit drugs significantly more positively than experts. Both groups ranked alcohol and benzodiazepine harms higher than those of cannabis or psychotropic mushrooms, despite the latter being more heavily regulated.
Key Numbers
117 users and 101 experts; core substances with >50% user experience: nicotine, cannabis, alcohol, cocaine, heroin, amphetamine, methadone. Users rated cannabis benefits significantly higher than experts.
How They Did This
Structured interviews with 117 substance-dependent German adults seeking detoxification or rehabilitation, using the same questionnaire previously administered to 101 German addiction medicine experts. Harm and benefit ratings for 33 psychoactive substances were compared.
Why This Research Matters
Understanding where user and expert perceptions diverge can improve psychoeducation and inform drug policy debates, particularly for substances like cannabis and alcohol where regulatory status does not align with perceived harm.
The Bigger Picture
The finding that both users and experts consider alcohol and benzodiazepines more harmful than cannabis and psychotropic mushrooms, despite the latter being more strictly regulated, highlights the disconnect between drug scheduling and evidence-based harm assessment.
What This Study Doesn't Tell Us
German sample may not generalize. Users were seeking treatment, not representative of all users. Limited experience with many substances among the user group. Potential "attraction bias" in users and "treatment bias" in experts.
Questions This Raises
- ?Would non-treatment-seeking users rate cannabis differently?
- ?Should drug policy weight expert or user perspectives more heavily?
- ?Can closing the user-expert gap in benefit perception reduce problematic use?
Trust & Context
- Key Stat:
- Both users and experts rate alcohol harm higher than cannabis harm
- Evidence Grade:
- Comparative survey with expert and user perspectives, but treatment-seeking user sample introduces selection bias.
- Study Age:
- Published in 2022.
- Original Title:
- Differences between users' and addiction medicine experts' harm and benefit assessments of licit and illicit psychoactive drugs: Input for psychoeducation and legalization/restriction debates.
- Published In:
- Frontiers in psychiatry, 13, 1041762 (2022)
- Authors:
- Bonnet, Udo(8), Specka, Michael(4), Kanti, Ann-Kristin, Scherbaum, Norbert
- Database ID:
- RTHC-03720
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do substance users and experts agree on which drugs are most harmful?
Largely, yes. Both groups placed heroin, cocaine, and amphetamines at the top of the harm scale, with cannabis, buprenorphine, and psychotropic mushrooms at the lower end. The main disagreement was about perceived benefits.
How did cannabis harm compare to alcohol in these ratings?
Both users and experts ranked alcohol and benzodiazepines as more harmful than cannabis and psychotropic mushrooms, even though cannabis is more heavily regulated in most Western countries.
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Cite This Study
https://rethinkthc.com/research/RTHC-03720APA
Bonnet, Udo; Specka, Michael; Kanti, Ann-Kristin; Scherbaum, Norbert. (2022). Differences between users' and addiction medicine experts' harm and benefit assessments of licit and illicit psychoactive drugs: Input for psychoeducation and legalization/restriction debates.. Frontiers in psychiatry, 13, 1041762. https://doi.org/10.3389/fpsyt.2022.1041762
MLA
Bonnet, Udo, et al. "Differences between users' and addiction medicine experts' harm and benefit assessments of licit and illicit psychoactive drugs: Input for psychoeducation and legalization/restriction debates.." Frontiers in psychiatry, 2022. https://doi.org/10.3389/fpsyt.2022.1041762
RethinkTHC
RethinkTHC Research Database. "Differences between users' and addiction medicine experts' h..." RTHC-03720. Retrieved from https://rethinkthc.com/research/bonnet-2022-differences-between-users-and
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.