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A new study in The Lancet rates the harmfulness of 20 psychoactive drugs according to 16 criteria and finds that alcohol comes out on top. Although that conclusion is generating headlines, it is not at all surprising, since alcohol is, by several important measures (including acute toxicity, impairment of driving ability, and the long-term health effects of heavy use), the most dangerous widely used intoxicant, and its abuse is also associated with violence, family breakdown, and social estrangement. A group of British drug experts gathered by the Independent Scientific Committee on Drugs (ISCD) rated alcohol higher than most or all of the other drugs for health damage, mortality, impairment of mental functioning, accidental injury, economic cost, loss of relationships, and negative impact on community. Over all, alcohol rated 72 points on a 100-point scale, compared to 55 for heroin, 54 for crack cocaine, and 33 for methamphetamine. Cannabis got a middling score of 20, while MDMA (Ecstasy), LSD, and psilocybin mushrooms were at the low end, with ratings of 9, 7, and 6, respectively.