The More We Talk About the Opioid "Crisis", The More Likely Stupid and Unproductive Legislation Will Be Passed

If you want to convince me of the need for restrictions on any substances, such as narcotics, you have to convince me of three things:

  1. That incarcerating users is somehow better for them than their addiction
  2. That ethically abusers of the substance are more worthy of our attention and intervention than legitimate users who benefit from the substance and whose access will likely be restricted
  3. That the negative social costs of the substance's use are higher than the inevitable social costs of the criminal black market (including the freedom-reducing policing laws implemented in response) that will emerge when its use or purchase is banned

Not only have I not been convinced on any of these dimensions on any of the substances we currently call illegal drugs, I have yet to see anyone seriously even attempt to address these trade-offs or acknowledge they exist.


  1. Dustin Barnard:

    We definitely are seeing a large and growing problem with opiate overdose deaths, but I'm as close to 100% certain as one can be that the government's likely response (a crack down on opiate distribution and an increase penalties) will just make the problem worse. Especially since previous crack downs appear to have just driven people to heroin with predictably bad results.

  2. Bill:

    My wife is a psychologist who works with drug and alcohol abusers, so while I agree with you overall, let me address point number 1. Typical court-referred treatment generally lasts two to three weeks. Barely enough time to get dried out and certainly not enough to effect serious treatment. Success rates are on the order of 20%. People come back again and again. In contrast, incarceration is generally much longer and counselors can force offenders to work on the problem and do serious treatment. Success rates rise to roughly 70%.
    If the issue is incarceration, prison and all that, my only response is that we legally cannot force anyone or confine anyone for an extended period except in a prison environment. I would agree that having some way to force treatment without prison would be better, but that has its own issues (giving the gov't the power to confine people, without trial, who they considered somehow deficient is a path I don't want to go down, however well-intentioned).
    But from a treatment point of view, incarceration (and treatment) is the most effective way we have of treating people, hands down.

  3. Rick Caird:

    The other problem with number one is the deaths. It is not an opium epidemic per see. It is a heroin mixed with fentanyl problem and fentanyl is a man made substance. I was talking with a paramedic tonight and he just ordered 600 doses of narcan at $30 per. He said detectives now carry an inhaler version to try to stabilize the guy until paramedics arrive.

    There are too many funerals for 18-30 year old kids today. It is not just the addict that is affected. The damage ripple out well past even close family members.

  4. Rick Caird:

    What I am concerned about is the difficulty of getting pain pills for people with serious pain. I have a friend whose wife gets uo some mornings and sits in a chair crying because she hurts too much. Doctors are afraid to prescribe pain pills and she is one who is suffering. The brilliant government government closed the pill mills and drove people to heroin which is now about 25% of the cost of the pill. But, with a pill, the addicts at least knew what they were getting. Heroin is like playing Russian roulette with three bullets in the cylinder.

  5. ErikTheRed:

    Exactly. People will do the simple stuff if they can get it. Crack was an alternative to cocaine when the government started to dent supplies and drove the cost up (middle- and upper-class people still have exactly zero problems getting coke). Prohibition creates market demand for more powerful drugs. Inconsistent supply and penalties for consumption creates binging behavior. None of these things are terribly mysterious or controversial. If you don't want people to get high to avoid reality, then stop making their reality something that they feel they need to avoid. The truth that nobody wants to hear is behind every kid on drugs is a parent or two that messed them up. I saw it all the time growing up and through my 20s and 30s. Plenty of us did drugs recreationally and we turned out just fine. The ones who had problems with addiction were abused, molested, and / or had serious social issues that their parents exacerbated by pushing harder and harder. Outside of bad parents, the next cause is probably public schools. Not sure which one of these will get me more hate. But whatever.

  6. GoneWithTheWind:

    Here is a solution to your complaints/talking points:
    1. Incarcerate anyone who sells or provides drugs to someone else. They don't have to be pushers they can be codependent users as soon as they pass the doobie they break a law.
    2. Fine, no attention, but no treatment for the drugs at taxpayers expense either. Send the ambulance/fire department and once they see it is an illegal drug user they leave and the druggy survives or dies on his own.
    3. Make it a misdemeanor to use illegal drugs and a capitol offense to be a drug pusher/smuggler punishable where found by injecting all the drugs found in your possession when caught. But if you are a mere user no one cares and unless you break a law we ignore you until we have to dispose of your body.
    4. I will add a fourth point because you ignored the unintended consequences in allowing drugs to be freely distributed. Allow any parent to shot/stab/club to death anyone selling/giving drugs to their under age child and legally avoid arrest or trail based on a self/child defense situation.

    I see no sense in making believe the problem doesn't exist. That is not a solution. But if that is ever our choice then by all means don't make the taxpayers pay for that decision. let the druggies alone and let them overdose.


  7. herdgadfly:

    We can point to the company manufacturing the Epi-Pen-like self injectors which punched prices up 600% at the first of the year and the ACA Committee which pushes for more doses of anti-opioid drugs - with no limit to the number of overdoses treated per person for partially causing the crisis. What other illegal drug is handled this way?

    Law enforcement officers are carrying a supply of the overdose drugs and injection pens, which is in itself unusual for untrained officers. Pain and death are of no concern to those with an opioid addiction - just as long as the pigs are close at hand.

  8. Matthew Slyfield:

    The more politicians and bureaucrats in Washington DC talk about any topic, the more likely stupid and unproductive legislation will be passed on that topic.

    Have they passed anything in the last 30 years that wasn't stupid and unproductive?

  9. Andrew Garland:

    === ===

    Opioid-related deaths are rare even for patients who take narcotics every day for years. The CDC cites "a recent study of patients aged 15–64 years receiving opioids for chronic noncancer pain" who were followed for up to 13 years. The researchers found that "one in 550 patients died from opioid-related overdose," which is a risk of less than 0.2 percent.
    === ===

    I don't believe that the bad effects of increased enforcement are worth "solving" this problem. A problem which has declined since 2012. Bad effects including denial of medication to pain sufferers, harassment of doctors, a growing black market in opioids, more no-knock raids on drug users and innocents, and more spending on police with a diversion of effort from stopping and punishing violent crime.

    I'll believe the government is serious about preventing toxic drug use when it investigates and jails senators and congressmen for any drug use, and puts Obama in jail for 3 years for using drugs as a young man.

  10. kidmugsy:

    My memory on this may be wrong, but for what it's worth here it is. Decades ago US doctors were loathe to prescribe opioid painkillers to the extent that British doctors (for instance) viewed the Americans as causing cruel and needless suffering to their patients. At some point policy, or the laws, must have changed because now American doctors seem to hand them out pretty freely.

    The excitement sounds to me like the customary American behaviour of swinging between two extremes and shouting hysterically.

  11. bloke in france:

    We won't win the drugs war, but we aren't yet declaring unconditional surrender, I would support your bill in the House.

  12. DaveK:

    You seem to forget that with greater regulation there are many more opportunities for graft.

  13. Griz Hebert:

    For every complex problem...

  14. Griz Hebert:

    Whenever the stupid party and the evil party get together and do something it is both stupid and evil.

  15. rxc:

    What I really don't understand is why we now have invented these new opioid drugs, when there have been very good ones around for a long time, available at a very low price. Except for the fact that heroin and morphine and opium have been banned, bcecause they are addictive. Why have we now invented new drugs that seem to be just as addictive? I really don't understand what is going on. Did the FDA approve these new drugs because the drug companies said that they were non-addictive/less addictive, and now it turns out that those assessments were wrong?

    I really like Coyote's analysis, of the costs and benefits. It is logical and rational. Under his standards, we would go back to opium, morphine, and heroin. Which might not be a bad thing, overall, if you compare the cost of banning these substances to the cost of allowing them. Unfortunately, there are always mothers and politicians involved, and stupid children who have to be saved, so something has to be done to protect the stupid ones from their stupidity. The emotional urge overwhelms any rational analysis.

    Instead of spending money on chasing down and incarcerating drug dealers and abusers, spend it on treatment for those who are addicted, and leave the rest of us with cost-effective pain killers.

  16. JTW:

    A large reason for messed up children and teens is bullying. Quite often the parents can't do anything because it happens in school, the school refuses to do anything because punishing the bullies will "upset group dynamics", meaning the teachers are themselves afraid of the bullies, who tend to be the kids the popular children hang out with.
    And the result is, the victims get no help, become depressed, paranoid, lose sight of reality.
    Some of them turn to drugs, some turn to suicide, a few become school shooters, which really is juvenile suicide by cop.

    How do I know? I could have been one of them had it gone on a bit longer. "Graduating" from primary school to high school pretty much saved me, though I've ever since (and that's 35 years now) been prone to episodes of depression.

  17. Matthew Slyfield:

    We don't have a stupid party and an evil party. We have a stupid evil party and an evil stupid party.

    Anything they both agree on is evil to the power of stupid.

  18. mlhouse:

    I agree. Even if you buy all of the libertarian arguments about drugs, incarceration is still teh one opportunity to get drug treatment.

    The other point about drug and gun laws that I support is taht it is much easier to convict someone of these crimes than the others they have committed. It is not a coincidence that crime rates dropped as incarceration rates increased.

  19. MikeM:

    You would understand why new, more powerful pain drugs are needed if you had ever sat at the bedside of someone dying from cancer. My mother passed away July 31 and high dosage Fentanyl patches were the only thing that relieved her pain at the end.

  20. xtmar:

    That incarcerating users is somehow better for them than their addiction

    I realize you're fairly libertarian, and thus probably don't put much weight on society as an entity relative to its constituent individuals. However, isn't one of the rationalizations for jail not that it's good for the offender, but rather what's good for society? i.e. We don't ask if jail is good for a burglar, but rather if everyone else would be better off if he were in jail. To be sure, with a non-violent possession offense it's harder to make the case that they're doing any harm, but I still think the question isn't framed in accordance with how we usually look at jail.

  21. rxc:

    I am not questioning the need for pain meds. I don't understand why we needed a new category of addictive ones, when we already have a number of very effective, but possibly addictive ones, already, even though they are almost entirely banned. My very Catholic aunt knew enough to ask for enough morphine to relieve her pain, and also end her life, when she had cancer. She was at no risk of getting addicted, and even if she did become addicted, it would not have been worse than living with the pain.

  22. joe:

    I am late following up on this topic.

    FWIW - A high percentage of individuals with chronic pain have underlying mental health issues. (estimates as high as 80% of those with chronic pain).

    One medical doctor indicated that he often prescribes anti - depressants instead of pain medication has much greater success treating the pain with anti depressants than with opiate and/or other pain medication.