[OC] Ein Vergleich der akuten tödlichen Toxizität von 20 Freizeitdrogen anhand des Sicherheitsverhältnisses (Freizeitdosis : tödliche Dosis)

In his 2003 study [„Comparison of acute lethal toxicity of commonly abused psychoactive substances“](https://www.researchgate.net/profile/Robert-Gable/publication/14984972_Toward_a_Comparative_Overview_of_Dependence_Potential_and_Acute_Toxicity_of_Psychoactive_Substances_Used_Nonmedically/links/557613d908aeb6d8c01aea8d/Toward-a-Comparative-Overview-of-Dependence-Potential-and-Acute-Toxicity-of-Psychoactive-Substances-Used-Nonmedically.pdf) Robert S. Gable estimates the relative acute lethal toxicity of 20 common recreational drugs. What Gable calls a „safety ratio“ is very similar to a therapeutic index, which is defined by TI = LD50 / ED50, where LD50 is the lethal dose that would kill 50% of the population, and ED50 is the effective dose where the desired effects become present in 50% of the population. Gable uses the term safety ratio because „the intended application [of recreational drugs] is not therapeutic.“ I am using recreational dose / lethal dose instead of Gable’s lethal dose / recreational dose for safety ratio. This is so that the most toxic drugs have the largest bars which I believe is more intuitive than the alternative. It does not change the ranking.

Information about drug scheduling in the US can be found [on the DEA website](https://www.dea.gov/drug-information/drug-scheduling). The schedules for each drug in the visualization were retrieved from [this DOJ Document](https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf). Though safety ratio is a narrow and limited metric of harm, this visualization repeats the theme that US drug schedules do a poor job reflecting the actual danger of drugs.

The visualization was made using matplotlib and seaborn, and daltonlens was used to ensure the figure remains clear when viewed with color vision deficiency. Also, shoutout to [this visualization](https://64.media.tumblr.com/tumblr_l0h1njIdpX1qbw00mo1_500.jpg) of similar data that I borrowed some design elements of.

An important limitation from the original paper:

>Due to inherent imprecision in toxicity assessments, it would be a flagrant misinterpretation of the numbers … to assume that they could be mathematically manipulated. None the less, the range of safety ratios is so wide that the data appear to have the attributes of an ordinal scale. For example, we can be reasonably sure that the safety ratio of nitrous oxide is larger than the safety ratio of GHB. We need not assert that the safety ratio of nitrous oxide is 20 times greater than GHB in order to make a valid ranking.

Another interesting caveat:

>The estimated human lethal dose of all substances was corroborated by non-human animal studies; however, for six of the substances (DMT, ketamine, LSD, marijuana, mescaline and psilocybin) fewer than three reports of human fatality were located. In this situation, the lethal dose in Table 1 is extrapolated from the animal studies. The extrapolated value, reduced by a factor of 10, is noted in the table, and a question-mark follows the related safety ratio. The clinical validity of animal models is always suspect, but the data probably provide a justifiable estimate in the absence of direct evidence.

I’ve recorded some more interesting limitations [here](https://ethleb.com/posts/lethal-toxicity/), or go to the original paper linked above for the full list.

Recreational roofies is really somethin’

A bit missleading. LSD, Marihuana dont really have a lethal dose. Well they do, but at that point its not a matter of Drug anymore. Its impossible to get such a dosis from smoking or eating or drinking.

Same for Mushrooms kinda. But its physically possible to get a Pololethal dose from mushrooms.

What would this look like if stuff like the user hurting themselves or getting a mental illness is added?

Important to note the toxicity is for rodents, not humans. And these are all based on only that substance being consumed, although many human OD’s from these substances are due to combination effects with other substances (mainly alcohol)

I’m not saying this toxicity ratio is a bad metric, just that you could put *water* right up there around the 1:10 ratio, or even less.

holy shit its that easy to overdose on poppers???

I don’t even know what I’m looking at because the „beautiful“ data doesn’t even have labels. What are these ratios? If it’s what I’m thinking it is, toxicity is not really an accurate word. A drug can have a more easily reached lethal dose while still being less toxic than another drug under regular circumstances.

Since when is Prozac a recreational drug

cocaine? prescribed? no its not?