Alcohol – New Therapeutic Approaches and the Burden of Harm – Prof David Nutt

Posted on: June 13, 2019
Last Updated: December 1, 2023

David Nutt is currently the Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit in the Division of Brain Sciences. In addition to several prestigious appointments in the past, David is currently Chair of DrugScience (formally the Independent Scientific Committee on Drugs (ISCD) and President of the European Brain Council. He has edited the Journal of Psychopharmacology for over two decades and acts as the psychiatry drugs advisor to the British National Formulary. David  broadcasts widely to the general public both on radio and television including BBC science and public affairs programs on therapeutic as well as illicit drugs, their harms and their classification.  He has published over 400 original research papers, a similar number of reviews and book chapters, eight government reports on drugs and 27 books.

Author Quotes:  

The reason alcohol is the most harmful drug (in most places) is because of the social harm.

In the UK, alcohol is now the leading cause of death in men under the age of 50. And I’m pretty sure in a couple of years, it will be the leading cause of death in women under the age of 50 in the UK…it’s a massive public health problem.

We suggested that this should be the approach to all drugs, reducing consumption, and we’ve recommended getting rid of the construct of addiction – which polarises people, and often allows people to say, ‘well, I’m not an addict so I can drink what I like, or take whatever drugs I like, – and we want to replace that with the concept of ‘heavy use over time’, because it’s heavy use of drugs that leads to harm, not whether you are addicted to them or not.


Summary and slides: 

Professor David Nutt introduces the first of a series of video clips on his presentation, ‘Alcohol – New Therapeutic Approaches,’ at the 2nd Biennial Drugs, Alcohol and Mental Health Conference, Melbourne 2019.  

He begins with a piece of research, the first systematic assessment of the harms of 20 different drugs in the UK, which has been cited over 1000 times.  

He addresses the problem of high-end consumption and how reduced use reduces harm. 

He describes how the biggest burden of harms of alcohol is driven by individuals who drink very heavily, or who are dependent. 

Moving on, he discusses how alcohol has the largest treatment gap of any brain disorder.

He continues with a discussion on abstinence as a goal, but how this may not be sustainable, and also not necessarily the solution to everyone’s problem. 

This video excerpt concludes with a look at how some treatments work.

Take-home Points: 

  • To be able to reduce harm, we have to accept that alcohol is a problem. 
  • Treatment must be optimized to reduce consumption and find safer alternatives. 
  • The vast majority of people with alcohol use disorders do not get treated. 


Learn more

  1. Illegal Drugs and the Analysis of Harms By Prof David Nutt
  2. MCDA data analysis to inform drug policy by Prof David Nutt
  3. Post-Multicriteria Decision Analysis (MCDA) analysis of drug-related harms – Prof David Nutt
  4. Psychedelic therapy and synthetic alcohol – future treatments? – Prof David Nutt
  5. Multi-Criteria Decision Analysis (MCDA) to evaluate drug-related outcomes By Prof David Nutt