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We Can't Go Cold Turkey: Why Suppressing Drug Markets Endangers Society

Published online by Cambridge University Press:  01 January 2021

Extract

This essay argues that policies aimed at suppressing drug use exacerbate the nation's opioid problem. It neither endorses drug use nor advocates legalizing the consumption and sale of all substances in all circumstances. Instead, it contends that trying to suppress drug markets is the wrong goal, and in the midst of an addiction crisis it can be deadly. There is no single, correct drug policy; the right approach depends crucially on the substance at issue, the patterns of use and supply, and the jurisdiction's culture, institutions, and material resources. Decriminalization is no panacea for a nation's drug problems. Nevertheless, either de jure or de facto decriminalization of personal drug possession is a necessary condition for mitigating this crisis.

Type
Symposium Articles
Copyright
Copyright © American Society of Law, Medicine and Ethics 2018

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References

Global Commission on Drug Policy, Advancing Drug Policy Reform: A New Approach to Decriminalization, 2016, available at <https://www.globalcommissionondrugs.org/reports> (last visited April 25, 2018).+(last+visited+April+25,+2018).>Google Scholar
See, e.g., Koob, G. F. and Volkow, N. D., “Neurocircuitry of Addiction,” Neuropsychopharmacology 35, no. 1 (2010): 217238.CrossRefGoogle Scholar
Katz, J. and Goodnough, A., “The Opioid Crisis Is Getting Worse, Particularly for Black Americans,” New York Times, Dec. 22, 2017.Google Scholar
See James, K. and Jordan, A., “The Opioid Crisis in Black Communities,” Journal of Law, Medicine & Ethics 46, no. 2 (2018): 404-421.Google Scholar
See Title II, § 6, Volstead Act, Pub. L. 66-66 at 311 (exception for sacramental wine) & Title II, § 33 Pub. L. 66-66 at 317 (exception for possession and personal consumption of pre-Prohibition liquor in one’s dwelling).Google Scholar
See Id., § 7.Google Scholar
See McGirr, L., War on Alcohol (New York: W. W. Norton & Co., 2015).Google Scholar
Musto, D. F., The American Disease, 3d ed. (Oxford: Oxford U.P., 1999): 122–23.Google Scholar
249 U.S. 96, 99 (1919).Google Scholar
See generally van den Brink, W. and Haasen, C., “Evidence-Based Treatment of Opioid-Dependent Patients” The Canadian Journal of Psychiatry 51, no. 10 (2006): 635-646.CrossRefGoogle Scholar
Sees, K. L. et al., “Methadone Maintenance vs. 180-Day Psychosocially Enriched Detoxification for Treatment of Opioid Dependence: A Randomized Controlled Trial,” JAMA 283 (2000): 13031310; See also D. Polsky et al., “Cost and Cost-Effectiveness of Standard Methadone Maintenance Treatment Compared to Enriched 180-Day Methadone Detoxification,” Addiction 99, no. 6 (2004): 718–726.CrossRefGoogle Scholar
See Paraherakis, A. et al., “An Abstinence-Oriented Program for Substance Use Disorders: Poorer Outcome Associated with Opiate Dependence,” The Canadian Journal of Psychiatry 45, no. 10 (2000): 927-931.Google Scholar
van den Brink and Haasen, supra note 11, at 637.Google Scholar
Ritter, A. J., “Naltrexone in the Treatment of Heroin Dependence: Relationship with Depression and Risk of Overdose,” Australian and New Zealand Journal of Psychiatry 36, no. 2 (2002): 224-228, at 227.CrossRefGoogle Scholar
Dissell, R., “Ohio’s Spending on Opioid Addiction Treatment Drugs Vivitrol and Suboxone Spikes, Spurs Debate on what Treatments Work,” Cleveland Plain Dealer, April 30, 2017.Google Scholar
Mattick, R. P. et al., “Methadone Maintenance Therapy versus No Opioid Replacement Therapy for Opioid Dependence,” Cochrane Database Systematic Reviews 3, no. 3 (2009): 10-11.Google Scholar
van den Brink and Haasen, supra note 14, at 637.Google Scholar
Barnett, P. G., “The Cost-Effectiveness of Methadone Maintenance as a Health Care Intervention,” Addiction 94, no. 4 (1999): 479488.CrossRefGoogle Scholar
Davis, C. S. and Carr, D. H., “The Law and Policy of Opioids for Pain Management, Addiction Treatment, And Overdose Reversal,” Indiana Health Law Review 14 (2017): 139, at 17.CrossRefGoogle Scholar
42 C.F.R. § 8.12.Google Scholar
21 C.F.R. § 1306.7.Google Scholar
42 C.F.R. § 8.12(f)(6).Google Scholar
42 C.F.R. § 8.12(f).Google Scholar
42 C.F.R. § 8.11(f)(1).Google Scholar
21 C.F.R. § 1301.28.Google Scholar
See Keefe, P. R., The Family That Built an Empire of Pain, New Yorker, Oct. 30, 2017.Google Scholar
21 C.F.R. § 1306.04.Google Scholar
See del Real, J. A., “Opioid Addiction Knows No Color, but its Treatment Does,” New York Times, January 12, 2018.Google Scholar
Hansen, H., Siegel, C., et al., “Buprenorphine and Methadone Treatment for Opioid Dependence by Income, Ethnicity and Race of Neighborhoods in New York City,” Drug and Alcohol Dependence 164 (2016): 14-21.CrossRefGoogle Scholar
Sigmon, S. C., “Access to Treatment for Opioid Dependence in Rural America: Challenges and Future Directions,” JAMA Psychiatry 71, no. 4 (2014): 359-360.Google Scholar
Peles, E. et al., “Opiate-Dependent Patients on a Waiting List for Methadone Maintenance Treatment are at High Risk for Mortality until Treatment Entry,” Journal of Addiction Medicine 7, no. 3 (2013): 177182.CrossRefGoogle Scholar
See Robinson v. California, 370 U.S. 660, 666–67 (1962).Google Scholar
Matusow, H. et al., “Medication Assisted Treatment in US Drug Courts: Results from a Nationwide Survey of Availability, Barriers and Attitudes,” Journal of Substance Abuse Treatment 44, no. 5 (2013): 473480.Google Scholar
Warbuton, C., “Economic Results of Prohibition,” (New York: Columbia University Press, 1932): at 260; See also J. A. Miron and J. Zwiebel, “Alcohol Consumption During Prohibition,” American Economic Review 81, no. 2 (1991): 242–247, at 242.CrossRefGoogle Scholar
Miron and Zwiebel, supra note 35, at 242.Google Scholar
Cowan, R., “How the Narcs Created Crack,” National Review, December 5, 1986, at 26, 27.Google Scholar
Duke, S., “Drug Prohibition: An Unnatural Disaster,” Connecticut Law Review 27 (1995): 571612, n. 104 at 598.Google Scholar
Warburton, supra note 35, at 260 (comparing consumption from 1927–1930 with that from 1911–1914).Google Scholar
Beletsky, L. and Davis, C. S., “Today’s Fentanyl Crisis: Prohibition’s Iron Law, Revisited,” International Journal of Drug Policy 46 (2017) 156159, at 157.CrossRefGoogle Scholar
Ziegler, S. L., “The Ocular Menace of Wood Alcohol Poisoning,” British Journal of Ophthalmology 5, no. 8 (1921): 365373, at 368.CrossRefGoogle Scholar
Blum, D., The Poisoner’s Handbook (New York: Penguin Press, 2010), at 154156.Google Scholar
Id. at 161–162.Google Scholar
Ziegler, supra note 43, at 365.Google Scholar
Blum, supra note 44, at 157–8.Google Scholar
McGirr, supra note 7, at 59.Google Scholar
Katz, J., “The First Count of Fentanyl Deaths in 2016: Up 540% in Three Years,” New York Times, September 2, 2017.Google Scholar
Smith, H., “A Comprehensive Review of Rapid-Onset Opioids for Breakthrough Pain,” CNS Drugs 26, no. 6 (2012): 509535, at 515.CrossRefGoogle Scholar
Popper, N., Opioid Dealers Embrace the Dark Web to Send Deadly Drugs by Mail, New York Times, June 10, 2017.Google Scholar
DEA Intelligence Brief, “Counterfeit Prescription Pills Containing Fentanyls: A Global Threat,” DEA-DCT-DIB-021-16, (July, 2016) at 4.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction, “Fentanyl Drug Profile,” available at <http://www.emcdda.europa.eu/publications/drug-profiles/fentanyl> (last visited January 23, 2017).+(last+visited+January+23,+2017).>Google Scholar
See Keck, M. and Correa-Cabrera, G., “US Drug Policy and Supply-Side Strategies: Assessing Effectiveness and Results,” Norteamérica 10, no. 2 (2015): 4767, 50–53 (describing history of U.S. interdiction efforts at the U.S.–Mexico border).CrossRefGoogle Scholar
O’Connor, S., U.S.-China Economic and Security Review Commission, “Fentanyl: China’s Deadly Export to the United States,” February 1, 2017, available at <www.uscc.gov/sites/default/files/Research/USCC%20Staff%20Report_Fentanyl-China’s%20Deadly%20Export%20to%20the%20United%20States020117.pdf> (last visited May 2, 2018)+(last+visited+May+2,+2018)>Google Scholar
See Ahmed, A., “Drug That Killed Prince is Making Mexican Cartels Richer, U.S. Says,” New York Times, June 9, 2016.Google Scholar
See Wainwright, T., “Narconomics,” (New York: Public Affairs, 2017): 1327.Google Scholar
DEA, “United States: Areas of Influence of Major Mexican Transnational Criminal Organizations,” DEA-DCTDIR-065-15, July 2015.Google Scholar
See Pollack, H. A. and Reuter, P., “Does Tougher Enforcement Make Drugs More Expensive?” Addiction 109, no. 12 (2014): 19591966.CrossRefGoogle Scholar
See Becker, G. S. and Murphy, K. M., “A Theory of Rational Addiction,” Journal of Political Economy 96, no. 4 (1988): 675700.CrossRefGoogle Scholar
Id., at 692-693.Google Scholar
See, e.g., Faruk, G, and Pesendorfer, W., “Harmful Addiction,” Review of Economic Studies 74, no. 1 (2007): 147172.Google Scholar
See, e.g., Bernheim, B. D. and Rangel, A., “Addiction and Cue-Triggered Decision Processes,” American Economic Review 94, no. 5 (2004): 15581590.CrossRefGoogle Scholar
See, e.g., O’Donoghue, T. and Rabin, M.. “Self-Awareness and Self-control,” in Lowenstein, G., Read, D., and Baumeister, R. F. eds. Time and Decision: Economic and Psychological Perspectives on Intertemporal Choice, (New York: Russel Sage Foundation, 2003): 217244.Google Scholar
See Binswanger, I. A. et al., “Release from Prison-A High Risk of Death for Former Inmates,” New England Journal of Medicine 356, no. 2 (2007): 157165.CrossRefGoogle Scholar
“Government to Double Alcohol Poison Content and Also Add Benzine,” New York Times, December 29, 1926, at 1.Google Scholar
Blum, supra note 47, 158–159.Google Scholar
Institute of Medicine, Preventing HIV Infection Among Injecting Drug Users in High-Risk Countries. An Assessment of the Evidence (Washington, D.C.: National Academies Press, 2006).Google Scholar
Heimer, R., “Can Syringe Exchange Serve as a Conduit to Substance Abuse Treatment?” Journal of Substance Abuse Treatment 15, no. 3 (1998): 183191.CrossRefGoogle Scholar
Brooks, J. T., CDC Outbreak Investigations Involving OPANA® ER 19, presentation at Joint Meeting of the Drug Safety and Risk Management Advisory Committee and the Anesthetic and Analgesic Drug Products Advisory Committee, March 13, 2017, available at <https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndAnalgesicDrugProductsAdvisoryCommittee/UCM547237.pdf> (last visited Jan. 23, 2018).+(last+visited+Jan.+23,+2018).>Google Scholar
Strathdee, S. A. and Beyrer, C., “Threading the Needle—How to Stop the HIV Outbreak in Rural Indiana,” New England Journal of Medicine 373, no. 5 (2015): 397-399.Google Scholar
Ind. Code § 16-42-19-18 (2017).Google Scholar
Ind. Code § 16-41-7.5-5 (2017).Google Scholar
Burris, S. et al., “Federalism, Policy Learning, and Local Innovation in Public Health: The Case of the Supervised Injection Facility,” St. Louis University Law Journal 53 (2008): 10891154.Google Scholar
U.S. Attorney’s Office for the District of Vermont, Statement of the U.S. Attorney’s Office concerning Proposed Injection Sites, December 13, 2017, available at <https://www.justice.gov/usao-vt/pr/statement-us-attorney-s-office-concerning-proposed-injection-sites> (last visited May 2, 2018).+(last+visited+May+2,+2018).>Google Scholar
Bazazi, A. R., et al., “Preventing Opiate Overdose Deaths: Examining Objections to Take-Home Naloxone,” Journal of Health Care for the Poor and Underserved 21, no. 4 (2010): 11081113.Google Scholar
Lankenau, S. E. et al., “Initiation into Prescription Opioid Misuse Amongst Young Injection Drug Users,” International Journal of Drug Policy 23, no. 1 (2012): 3744.CrossRefGoogle Scholar
See FDA, “General Principles for Evaluating the Abuse Deterrence of Generic Solid Oral Opioid Drug Products Guidance for Industry,” November 2017, available at <https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM492172.pdf> (last visited Mary 2, 2018) (“applicant should evaluate its proposed generic drug to show that it is no less abuse deterrent than the RLD with respect to all of the potential routes of abuse.”)+(last+visited+Mary+2,+2018)+(“applicant+should+evaluate+its+proposed+generic+drug+to+show+that+it+is+no+less+abuse+deterrent+than+the+RLD+with+respect+to+all+of+the+potential+routes+of+abuse.”)>Google Scholar
See Evans, W. N., Lieber, E., and Power, P., “How the Reformulation of OxyContin Ignited the Heroin Epidemic,” Notre Dame Department of Economics Working Papers, June 1, 2017, available at <https://www3.nd.edu/~elieber/research/ELP.pdf> (last visited May 2, 2018).+(last+visited+May+2,+2018).>Google Scholar
See Alpert, A., Powell, D., and Pacula, R. L., “Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids,” National Bureau of Economic Research, working paper No. 23031, (2017).Google Scholar
See e.g., Gottlieb, S., “FDA Takes Important Steps to Stem the Tide of Opioid Misuse and Abuse,” FDA Voice by Commissioner Scott Gottlieb, M.D., September 28, 2017, available at <https://blogs.fda.gov/fdavoice/index.php/2017/09/fda-takes-important-steps-to-stem-the-tide-of-opioid-misuse-and-abuse> (last visited May 2, 2018).+(last+visited+May+2,+2018).>Google Scholar
National Alliance for Model State Drug Laws, Compilation of Prescription Monitoring Program Maps, May 2016, available at <http://www.namsdl.org/library/CAE654BF-BBEA-211E-694C755E16C2DD21/> (last visited May 2, 2018) (hereinafter NAMSDL), at 2.+(last+visited+May+2,+2018)+(hereinafter+NAMSDL),+at+2.>Google Scholar
Id., at 18.Google Scholar
Bao, Y. et al., “Prescription Drug Monitoring Programs are Associated with Sustained Reductions in Opioid Prescribing by Physicians,” Health Affairs 35, no. 6 (2016) 10451051, at 1048.CrossRefGoogle Scholar
See Buchmueller, T. C. and Carey, C., “The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare,” National Bureau of Economic Research working paper, No. w23148, (2017); NAMSDL, supra note 84.CrossRefGoogle Scholar
CDC, Opioid Overdose: State Successes, available at <https://www.cdc.gov/drugoverdose/policy/successes.html> (last visited Jan. 23, 2018).+(last+visited+Jan.+23,+2018).>Google Scholar
Mallatt, J., “The Effect of Prescription Drug Monitoring Programs on Opioid Prescriptions and Heroin Crime Rates,” Purdue University Economics Department Working Paper No 1292, (2017), at 2021.Google Scholar
Li, G. et al., “Prescription Drug Monitoring and Drug Overdose Mortality,” Injury Epidemiology 1, no. 1 (2014) at 3.CrossRefGoogle Scholar
Patrick, S. W. et al., “Implementation of Prescription Drug Monitoring Programs Associated with Reductions in Opioid-Related Death Rates,” Health Affairs 35, no. 7 (2016): 13241332.CrossRefGoogle Scholar
Bachhuber, M. A. et al., “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010, ” JAMA Internal Medicine 174, no. 10 (2014) 16681673, at 1671.CrossRefGoogle Scholar
Livingston, M. D. et al., “Recreational Cannabis Legalization and Opioid-Related Deaths in Colorado, 2000–2015,” American Journal of Public Health 107, no. 11 (2017) 18271829, at 1829.Google Scholar
SAMHSA, Results From The 2016 National Survey On Drug Use And Health: Detailed Tables, September 7, 2017, at Table 5.2A, available at <https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf> (last visited May 3, 2018).+(last+visited+May+3,+2018).>Google Scholar
Collins, S. E. et al., “Seattle’s Law Enforcement Assisted Diversion (LEAD): Program Effects on Recidivism Outcomes,” Evaluation and Program Planning 64 (2017) 49-56, at 53.CrossRefGoogle Scholar
Andraka-Christou, B., “What Is Treatment for Opioid Addiction in Problem-Solving Courts: A Study of 20 Indiana Drug and Veterans Courts,” Stanford Journal of Civil Rights and Civil Liberties 13 (2017) 189254, at 230.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction, Drug Consumption Rooms: An Overview of Provision and Evidence (Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2015).Google Scholar
See Kral, A. H. and Davidson, P. J., “Addressing the Nation’s Opioid Epidemic: Lessons from an Unsanctioned Supervised Injection Site in the US,” American Journal of Preventive Medicine 53, no. 6 (2017): 919922.CrossRefGoogle Scholar
Potier, C. et al., “Supervised Injection Services: What has been Demonstrated? A Systematic Literature Review,” Drug and Alcohol Dependence 145 (2014): 4868, at 63.CrossRefGoogle Scholar
Marshall, B. D. et al., “Reduction in Overdose Mortality after the Opening of North America’s First Medically Supervised Safer Injecting Facility: A Retrospective Population-Based Study,” Lancet 377, no. 9775 (2011) 14291437.CrossRefGoogle Scholar
Salmon, A. M. et al., “The Impact of a Supervised Injecting Facility on Ambulance Call-Outs in Sydney, Australia,” Addiction 105, no. 4 (2010): 676683.CrossRefGoogle Scholar
Potier, supra note 100, at 62.Google Scholar
Canada (Attorney General) v. PHS Community Services Society, [2011] S.C.C. 44 (Can.).Google Scholar
Padgett, D. K. et al., Housing First: Ending Homelessness, Transforming Systems, and Changing Lives (Oxford: Oxford University Press, 2015): at 54.CrossRefGoogle Scholar
Padgett, D. K. et al., “Substance Use Outcomes Among Homeless Clients with Serious Mental Illness: Comparing Housing First with Treatment First Programs,” Community Mental Health Journal 47, no. 2 (2011) 227232, at 230.CrossRefGoogle Scholar
Islam, M. M. et al., “Defining a Service for People who use Drugs as ‘Low-Threshold’: What Should be the Criteria?,” International Journal of Drug Policy 24, no. 3 (2013): 220222.CrossRefGoogle Scholar
International Harm Reduction Development Program, Open Society Institute, “Lowering the Threshold: Models of Accessible Methadone and Buprenorphine Treatment,” (2010) at 11-12, available at <https://www.opensocietyfoundations.org/sites/default/files/lowering-the-threshold-20100311.pdf> (last visited May 3, 2018).+(last+visited+May+3,+2018).>Google Scholar
Emmanuelli, J. and Desenclos, J. C., “Harm Reduction Interventions, Behaviours and Associated Health Outcomes in France, 1996–2003,” Addiction 100, no. 11 (2005): 1690–700, at 1696–1699.CrossRefGoogle Scholar
Hong Kong Legislative Council, “Methadone Treatment Programmes in Hong Kong and Selected Countries,” RP12/95-96, March 1996, at 510, available at <http://www.legco.gov.hk/yr97-98/english/sec/library/956rp12.pdf> (last visited May 3, 2018).+(last+visited+May+3,+2018).>Google Scholar
Hong Kong Department of Health, “Methadone Clinics,” May 16, 2017, available at http://www.dh.gov.hk/english/main/main_mc/main_mc.html, (last visited Jan. 23, 2018).Google Scholar
See Plomp, H. N. et al., “The Amsterdam Methadone Dispensing Circuit: Genesis and Effectiveness of a Public Health Model for Local Drug Policy,” Addiction 91, no. 5 (1996): 711721.CrossRefGoogle Scholar
Waal, H. et al., “Open Drug Scenes: Responses of Five European Cities,” BMC Public Health 14, no. 1 (2014): 853, at 7.CrossRefGoogle Scholar
Fischer, B. et al., “Heroin‐Assisted Treatment as a Response to the Public Health Problem of Opiate Dependence,” European Journal of Public Health 12, no. 3 (2012): 228234, at 229.CrossRefGoogle Scholar
See Blanken, P. et al., “Heroin-Assisted Treatment in the Netherlands: History, Findings, and International Context,” European Neuropsychopharmacology 20, Supplement 2 (2010): S105S158.CrossRefGoogle Scholar
Blanken, P. et al., “Craving and Illicit Heroin use Among Patients in Heroin-Assisted Treatment,” Drug and Alcohol Dependence 120, no. 1 (2012): 74-80, at 77–78.CrossRefGoogle Scholar
Oviedo-Joekes, E. et al., “Diacetylmorphine versus Methadone for the Treatment of Opioid Addiction,” New England Journal of Medicine 361, no. 8 (2009) 777786.CrossRefGoogle Scholar
Demaret, I. and Quertemont, E., “Loss of Treatment Benefit when Heroin-Assisted Treatment is Stopped after 12 Months,” Journal of Substance Abuse Treatment 69 (2016): 7275.CrossRefGoogle Scholar
See Nordt, C. and Stohler, R., “Low-Threshold Methadone Treatment, Heroin Price, Police Activity and Incidence of Heroin Use: The Zurich Experience,” International Journal of Drug Policy 20, no. 6 (2009): 497501.CrossRefGoogle Scholar
Zobel, F. et al., Le Marché des Stupéfiants dans le Canton de Vaud. Partie 1 : Les Opioids (Lausanne: Addiction Suisse, 2017) at 3860, 70-90.Google Scholar
Cicero, T. J. et al., “Increased use of Heroin as an Initiating Opioid of Abuse,” Addictive Behaviors (2017): 6366, at 64–65.Google Scholar
See, e.g., VerBruggen, R., “What the Opioid Crisis Can Teach Us about the War on Drugs,” Law and Liberty, November 1, 2017, available at <http://www.libertylawsite.org/liberty-forum/what-the-opioid-crisis-can-teach-us-about-the-waron-drugs> (last visited May 3, 2018).+(last+visited+May+3,+2018).>Google Scholar
See Whalen, J. and Cooper, L., “Private-Equity Pours Cash into Opioid-Treatment Sector,” Wall Street Journal, September 2, 2017.Google Scholar
See Segal, D., “City of Addict Entrepreneurs,” New York Times, January 3, 2018; A. J. Harris and S. Walter, “They Thought They were Going to Rehab. They Ended up in Chicken Plants,” Reveal News, (October 4, 2017).Google Scholar
See Duncan, R., Pubs and Patriots: The Drink Crisis in Britain during World War One (Liverpool, UK: Liverpool University Press, 2013): 121149.Google Scholar