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Alcohol is more harmful than heroin or crack, according to a study published in medical journal the Lancet.
The report is co-authored by Professor David Nutt, the former UK chief drugs adviser who was sacked by the government in October 2009.
It ranks 20 drugs on 16 measures of harm to users and to wider society.
Tobacco and cocaine are judged to be equally harmful, while ecstasy and LSD are among the least damaging.
Prof Nutt refused to leave the drugs debate when he was sacked from his official post by the former Labour Home Secretary, Alan Johnson.
He went on to form the Independent Scientific Committee on Drugs, a body which aims to investigate the drug issue without any political interference.
One of its other members is Dr Les King, another former government adviser who quit over Prof Nutt's treatment.
Classification system
Members of the group, joined by two other experts, scored each drug for harms including mental and physical damage, addiction, crime and costs to the economy and communities.
The modelling exercise concluded that heroin, crack and methylamphetamine, also known as crystal meth, were the most harmful drugs to individuals, but alcohol, heroin and crack cocaine were the most harmful to others.
When the scores for both types of harm were added together, alcohol emerged as the most harmful drug, followed by heroin and crack.
The findings run contrary to the government's long-established drug classification system, but the paper's authors argue that their system - based on the consensus of experts - provides an accurate assessment of harm for policy makers.
"Our findings lend support to previous work in the UK and the Netherlands, confirming that the present drug classification systems have little relation to the evidence of harm," the paper says.
"They also accord with the conclusions of previous expert reports that aggressively targeting alcohol harms is a valid and necessary public health strategy."
In 2007, Prof Nutt and colleagues undertook a limited attempt to create a harm ranking system, sparking controversy over the criteria and the findings.
Legal high
The new more complex system ranked alcohol three times more harmful than cocaine or tobacco. Ecstasy was ranked as causing one-eighth the harm of alcohol.
It also contradicted the Home Office's decision to make so-called legal high mephedrone a Class B drug, saying that alcohol was five times more harmful. The rankings have been published to coincide with a conference on drugs policy, organised by Prof Nutt's committee.
Prof Nutt said: "What a new classification system might look like would depend on what set of harms to self or others, you are trying to reduce.
"But if you take overall harm, then alcohol, heroin and crack are clearly more harmful than all others."
The Lancet paper written by Prof Nutt, Dr King and Dr Lawrence Phillips, does not examine the harm caused to users by taking more than one drug at a time.
Gavin Partington, spokesman for the Wine and Spirit Trade Association, said millions of people enjoyed alcohol "as part of a regular and enjoyable social drink".
"Clearly alcohol misuse is a problem in the country and our real fear is that, by talking in such extreme terms, Professor Nutt and his colleagues risk switching people off from considering the real issues and the real action that is needed to tackle alcohol misuse," he said.
"We are talking about a minority. We need to focus policy around that minority, which is to do with education, treatment and enforcement."
Source: BBC
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