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This analysis of drug harms in Canada found that alcohol causes the most harm overall Alcohol was followed by tobacco, nonprescription opioids (like fentanyl), cocaine, methamphetamine, and cannabis. Tobacco ranked first in 4 of the 16 harm categories: drug-related mortality, drug-specific damage to physical health, dependence, and environmental damage, the researchers wrote

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Incorporation of the findings from the qualitative research and review by the four experts (SC, TS, KF, and JR) resulted in an updated conceptualization (see Fig