“When governments try to stop people from consuming politically disfavored intoxicants, they make consumption of those substances more dangerous by creating a black market in which purity and potency are highly variable and unpredictable.”
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“Iran’s ban on alcohol consumption by Muslims forces drinkers to rely on illicit sources that sell iffy and possibly poisonous liquor. In a legal market, people who buy distilled spirits do not have to worry about methanol contamination.”
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“Fentanyl is much more potent than heroin, so it is easier to smuggle, and can be produced much more cheaply and inconspicuously since it does not require opium poppies. Xylazine has similar advantages: It is an inexpensive synthetic drug that can be produced without crops. And unlike fentanyl, it is not classified as a controlled substance, so it is easier to obtain.
The emergence of fentanyl as a heroin booster and substitute made potency even harder to predict. The consequences can be seen in record numbers of drug-related deaths.
The government aggravated that situation by restricting the supply of legally produced, reliably dosed opioids, which drove nonmedical users toward more dangerous substitutes and left bona fide patients to suffer from unrelieved pain.”
“In a 2020 review of relevant studies published since the mid-1980s, the authors called out many of these studies for weak methodology. In particular, many researchers had failed to compare the outcomes they were measuring against any kind of a standard that would account for age and parental educational level. (That is: What if the kids of those who used cannabis during pregnancy were born to parents with lower levels of education, which could account for some differences?)
The review authors concluded that overall, “prenatal cannabis exposure is associated with few effects on the cognitive functioning of offspring.” What’s more, they noted, even when abnormalities were identified, almost all were still within the range of normal.”
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“Despite the imperfect data, Mark suspects the risk of fetal harm with prenatal cannabis use is high enough to support recommending against purely recreational use.
“Drug prohibition sows the seeds of its own defeat by creating a highly lucrative and resilient black market that is always adjusting to enforcement efforts. When police arrest a drug dealer, someone else takes his place. Even dismantling an entire trafficking operation does not have a substantial and lasting impact on retail prices or consumption because it creates opportunities that other organizations are happy to seize.”
“It has been more than two years since New York notionally legalized recreational marijuana, and things are not going quite as planned. “Although Gov. Kathy Hochul suggested last fall that more than 100 dispensaries would be operating by this summer,” The New York Times notes, “just 12 have opened since regulators issued the first licenses in November.”
Part of the problem, as you might expect, is red tape and bureaucratic ineptitude. But another barrier to letting licensed marijuana merchants compete with the unauthorized vendors who have conspicuously proliferated since the spring of 2021 is the state’s affirmative action program for victims of pot prohibition.
New York, like several other states that have legalized marijuana, mandated preferences for license applicants who suffered as a result of the crusade against cannabis. While that idea has a pleasing symmetry, it never made much sense as a way of making up for the harm inflicted by cannabis criminalization. And in practice, executing the plan has drastically limited the legal marijuana supply, making it much harder to achieve the state’s avowed goal of displacing the black market.
To be clear: I don’t think people with marijuana convictions should be excluded from participating in the newly legal market, a policy that would add insult to injury. But that does not mean they should have a legal advantage over cannabis entrepreneurs who were never arrested but might be better qualified.”
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“New York reserved the first batch of up to 175 retail licenses mainly for people with marijuana-related criminal records or their relatives. Those applicants needed to show they had experience running a “profitable” legal business in the state. Nonprofit organizations with “a history of serving current or formerly incarcerated individuals” also were eligible, provided they had “at least five full time employees,” “at least one justice involved board member,” and a track record of operating “a social enterprise that had net assets or profit for at least two years.” Another requirement was demonstrating “a significant presence in New York State,” which led to litigation and a temporary injunction against issuing retail licenses in five areas of the state.
Satisfying the state’s criteria required “a lot of documentation,” Bloomberg CityLab reporter Amelia Pollard noted last fall, which gave New York’s Office of Cannabis Management (OCM) “a mound of paperwork to wade through.” As of November, the OCM had received more than 900 applications from would-be marijuana retailers. On November 20, it announced that it had granted 36 “provisional conditional adult-use retail dispensary licenses” to individuals and organizations.”
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“The approved retailers are far outnumbered by unauthorized vendors, many of whom openly sell marijuana from storefronts, trucks, and tables, unencumbered by the state’s licensing requirements, regulations, and taxes. Yelp’s list of the “best recreational marijuana dispensaries” in New York City includes 90 outlets, only a few of which are blessed by the OCM.”
“Pharmacy benefit managers are companies that, behind the scenes, determine what patients have to pay for medications. They manage insurance benefits for prescription drugs, dictating which drugs are covered by insurers and what costs patients will face when they fill their prescriptions.
To do that, they negotiate discounts, or rebates, with drug manufacturers and afford privileged status to the companies that give them the best deals.
And over the past few decades, as the prescription drug market has evolved and become more lucrative, so have PBMs. They run their own mail-order and specialty pharmacies. More recently, they have begun merging with health insurers, creating behemoth companies with the power to determine where and how billions of dollars are spent within the US health system.
Pharmacy benefit managers have become known as the mysterious middlemen of the pharma trade — and as a useful scapegoat for drug companies seeking to deflect blame from their own pricing practices.
Now the Senate, as part of forthcoming prescription drug legislation, appears poised to impose new rules on them. The committee overseeing health care debated last week a slew of measures requiring PBMs to be more transparent about their business and cracking down on some of their moneymaking practices.”
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“Experts generally agree that these companies play a role in driving up drug costs for some US patients, even as they negotiate discounts with drugmakers that benefit others, and that the amount of secrecy about their financial arrangements warrants scrutiny.
But reforms to the PBM industry aren’t a cure-all for making drugs more affordable: Sanders said the PBM measures being considered in the Senate would not meaningfully lower the cost of medicine for most people, even if they would bring more accountability and transparency to the sector.”
“The EU capitals point out that 40 percent of all pharmaceutical ingredients globally are sourced from China, and that production for many of these products is concentrated in just a handful of manufacturing sites. “As a result, Europe (and the world) depend on a few manufacturers for a large bulk of their medicines supply,” notes the paper.”
“The emergence of the animal tranquilizer xylazine as a fentanyl adulterant, like the emergence of fentanyl as a heroin booster and substitute, has prompted law enforcement officials to agitate for new legal restrictions and criminal penalties. That response is fundamentally misguided, because the threat it aims to address is a familiar consequence of prohibition, which creates a black market in which drug composition is highly variable and unpredictable. Instead of recognizing their complicity in maintaining and magnifying that hazard, drug warriors always think the answer is more of the same.”
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“Why is xylazine showing up in fentanyl? For the same reasons fentanyl started showing up in heroin. As a 2014 literature review in Forensic Science International notes, “illicit drugs, such as cocaine and heroin, are often adulterated with other agents to increase bulk and enhance or mimic the illicit drug’s effects.” Because xylazine and heroin have “some similar pharmacologic effects,” the authors say, “synergistic effects may occur in humans when xylazine is use as an adulterant of heroin.”
Before the DEA was warning us about xylazine in fentanyl, it was warning us about fentanyl in heroin, and both hazards are the result of laws that the DEA is dedicated to enforcing. From the perspective of drug traffickers, fentanyl has several advantages over heroin. It is much more potent, which makes it easier to smuggle, and it can be produced much more cheaply and inconspicuously, since it does not require the cultivation of opium poppies. Xylazine has some of the same advantages: It is an inexpensive synthetic drug that can be produced without crops. And unlike fentanyl, it is not currently classified as a controlled substance, which makes it easier and less legally risky to obtain.”
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“American drug users are not clamoring for xylazine in their fentanyl, any more than they were demanding fentanyl instead of heroin. In both cases, the use of adulterants is driven by the economics of the black market. And as usual with illegal drugs, consumers do not know what they are getting. The Times underlines that point by noting one response to the proliferation of xylazine: “Addiction medicine experts,” it says, “urged that newly introduced xylazine test strips, which people can use to check the drugs they buy, be as widely distributed as fentanyl test strips.”
The fundamental problem, of course, is the dangerous uncertainty created by prohibition. Unlike alcohol, cannabis products sold by state-licensed pot shops, or legally produced, reliably dosed pharmaceuticals, black-market drugs do not come with any assurance of quality or potency. The introduction of new adulterants like xylazine increases that hazard. We have seen this story play out many times before. Whether it is vitamin E acetate in black-market THC vapes, MDMA mixed with synthetic cathinones or butylone, levamisole in cocaine, or fentanyl pressed into ersatz pain pills, prohibition reliably makes drug use more dangerous.”
“Legalization linked to fewer suicides, traffic fatalities, and opioid deaths. A new paper on the public health effects of legalizing marijuana finds “little credible evidence to suggest that [medical marijuana] legalization promotes marijuana use among teenagers” and “convincing evidence that young adults consume less alcohol when medical marijuana is legalized.””
“As Cato Institute Policy Analyst Daniel Raisbeck has written for Reason, Plan Colombia’s aid did initially “help the Colombian military to severely weaken the once-formidable [Revolutionary Armed Forces of Colombia (FARC)]. But Plan Colombia’s anti-narcotics element was an unqualified failure.” Per Raisbeck:
“By 2006, “coca cultivation and cocaine production levels (had) increased by about 15 and 4 percent, respectively.” In 2019, there were more hectares cultivated with coca leaf in Colombia (212,000) than two decades earlier (160,000).
The so-called FARC “dissidents,” thousands of fighters who did not demobilize in 2016, still control large swathes of the cocaine business. They wage constant combat over production areas and export routes against other guerrilla groups and criminal organizations, including several with links to Mexican drug cartels.”
American counternarcotics efforts yielded similarly bad results in Afghanistan. The U.S. spent about $9 billion to tackle Afghanistan’s opium and heroin production, only for the effort to be “perhaps the most feckless” of “all the failures in Afghanistan,” according to The Washington Post’s analysis of confidential government interviews and documents. By 2018, Afghan farmers were growing poppies on four times as much land as they were in 2002. Operation Iron Tempest, meant to cripple Afghanistan’s opium production labs, folded within a year. “Many of the suspected labs turned out to be empty, mud-walled compounds,” noted the Post.
The war on drugs has helped turn Latin America into the most violent region in the world. Criminalization has led to the proliferation of black market activity, a boom in many countries’ prison populations, and increased corruption across Latin America. It’s also contributed to a huge number of homicides: At least half of the violent deaths in Colombia, El Salvador, Honduras, Mexico, and Venezuela are estimated to be drug-related, according to the World Economic Forum.
Despite those failures, many Republicans still want to use war on terror tactics to fight Mexican cartels.”
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“The increase in overdose deaths among Americans is tragic and obviously a problem. It isn’t one that will be solved by fighting the war on drugs just a little bit harder. It certainly isn’t one that will be solved by bombing a neighboring country against its wishes, risking further escalation. It requires being realistic about the policies that have made drug use more dangerous. “That starts with bipartisan support for prohibition,” writes Reason’s Jacob Sullum, “which creates a black market where the quality and potency of drugs are highly variable and unpredictable.”
Simply stopping the supply of drugs into the country is an impossible task, as decades of prohibition show. Republicans would be far better off embracing harm-reduction strategies rather than pushing for another episode of military adventurism that is destined to fail.”