Drug Deaths Are Finally Declining. Nobody Really Knows Why.

“although lower retail prices are the opposite of what drug warriors are trying to achieve, they mean that people are less likely to oscillate between using drugs when they can afford them and abstaining when they come up short. That pattern increases the risk of an overdose because tolerance declines during periods of abstinence, whether they result from arrest and jail, disruption of the local drug supply, or financial factors like high prices.

That is just one way in which the war on drugs increases the hazards it aims to mitigate. Prohibition makes drug use much more dangerous by creating a black market in which quality and purity are highly variable and unpredictable. Efforts to enforce prohibition magnify those hazards by encouraging injection instead of safer consumption methods, creating incentives for adulteration, and driving traffickers toward more potent drugs, such as fentanyl, that are easier to conceal and smuggle.

The crackdown on pain pills made all of this worse by replacing legally produced, reliably dosed pharmaceuticals with iffy street drugs, which became even iffier thanks to the prohibition-driven proliferation of illicit fentanyl. That crackdown succeeded in reducing opioid prescriptions, which fell by more than half from 2010 to 2022. Meanwhile, the opioid-related death rate more than tripled, while the annual number of opioid-related deaths nearly quadrupled.

 Whatever the reasons, the upward trend in drug-related deaths finally seems to be reversing. As Dasgupta et al. suggest, drug warriors should not get credit for that turnaround, since nothing they have done recently can plausibly explain it. But they do deserve a large share of the blame for creating a situation in which an annual toll of more than 100,000 drug deaths looks like an improvement.”  

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