A New Study Finds No Correlation Between Opioid Prescriptions and Drug-Related Deaths

“Using data for 2010 through 2019, Aubry and Carr looked at the relationship between prescription opioid sales, measured by morphine milligram equivalents (MME) per capita, and four outcomes: total drug-related deaths, total opioid-related deaths, deaths tied specifically to prescription opioids, and “opioid use disorder” treatment admissions. “The analyses revealed that the direct correlations (i.e., significant, positive slopes) reported by the CDC based on data from 1999 to 2010 no longer exist,” they write. “The relationships between [the outcome variables] and Annual Prescription Opioid Sales (i.e., MME per Capita) are either non-existent or significantly negative/inverse.”
Those findings held true in “a strong majority of states,” Aubry and Carr report. From 2010 through 2019, “there was a statistically significant negative correlation (95% confidence level) between [opioid deaths] and Annual Prescription Opioid Sales in 38 states, with significant positive correlations occurring in only 2 states. Ten states did not exhibit significant (95% confidence level) relationships between overdose deaths and prescription opioid sales during the 2010–2019 time period.””

“Yet the CDC is still pushing the narrative that more opioid prescribing means more opioid-related deaths.”

“In light of what has happened since 2010, Aubry and Carr say, relying on those outdated numbers is highly misleading. They say the CDC’s advice “should be corrected/updated to state no direct correlation has existed” between prescription opioid sales and drug-related deaths or treatment admissions since 2010, and “individualized patient care and public health policy should be amended accordingly.””

The Time Has Come for a Transpartisan ‘Repeal’ Caucus

“The federal government’s decadeslong war on marijuana, one of the most life-mangling policies ever enacted, could be ended with a single sentence: The Controlled Substances Act shall not apply to marijuana.

Put it in a bill, vote on the bill, pass the bill, sign the bill, done. Much of the federal government’s drug war law enforcement machinery would grind to a halt. No legislative horse-trading, no Christmas tree–style gifts to favored constituencies, no giving old bureaucracies new responsibilities. Just the simple and urgent removal of the legal justification for grievous government harm.

This elegant approach, redolent of the 21st Amendment’s repeal of federal alcohol prohibition, is untenable to big-government lifers like Senate Majority Leader Chuck Schumer (D–N.Y.), as Jacob Sullum has repeatedly detailed in these pages. But it’s the shortest line to a point where a supermajority of Americans want policy to be. And it’s a template that could and should be used, at every level of government, by every flavor of politician.”

Mark Cuban’s Drug Company Could Save Medicare Billions

“Mark Cuban’s online pharmacy was founded to sell prescription drugs at the lowest and most transparent prices possible. As Cuban recently told PBS News Weekend, when it comes to medication, “the reality is the only number that matters is cost. What can we as the retailer or the distributor, buy it for and how low can we sell it? So we decided to take the exact opposite approach that politicians have been taking.”

That approach involves selling generic drugs for a 15 percent markup, plus $3 for pharmacy labor and $5 shipping. The result is that Cuban’s company is able to sell generic drugs at significantly lower rates than typical retail prices. For example, a 30-day supply of Amlodipine, a common high blood pressure medication, costs only $3.60 at Cost Plus Drugs, while the typical retail price is $50.10.

Some drugs have even higher savings.”

“Cuban’s company is restricted to unpatented generic drugs. While Cuban can sell these drugs at a massive discount, it is worth noting that research into new drugs, as well as the costs of clinical trials, is funded by the high profit margins derived from patents. While Cost Plus Drugs is a welcome innovation for drugs that are no longer patented, Cuban’s business model likely can’t fund drug innovation.”

“Cuban himself notes that Cost Plus Drugs isn’t the first company to try this approach, but it is the first to succeed”

“Last week, a new study from the Annals of Internal Medicine estimated that if Medicare Part D plans had purchased generic drugs from Cuban’s company, Medicare could have saved $3.6 billion in 2020.”

“Cuban has been vocal on Twitter about the study, asking President Joe Biden and other political leaders to “have your people call my people and let’s get this done.” However, as exciting as reducing Medicare’s budget sounds, progress on the issue seems unlikely. Legislative solutions to the high price of prescription drugs have often been slow-moving and stalled by partisan bickering.”

The War on Weed Continues in California, Which Supposedly Legalized Marijuana Six Years Ago

“The cannabis industry, of course, remains completely illegitimate in the eyes of the federal government. That means anyone who grows or distributes marijuana in California, even with the state’s approval, is committing federal felonies every day. But even though President Joe Biden wants to keep it that way, he has promised not to interfere with states that reject marijuana prohibition. So why are the feds not only busting marijuana merchants in California but doing so in collaboration with local law enforcement agencies?

The explanation, as you may have surmised, is that these particular marijuana merchants were breaking state law as well as federal law. Their businesses were not just “illegal” but also “unlicensed.” Yet the fact that unlicensed pot dealers continue to thrive in California is testimony to the ways in which the state has botched legalization. Most local governments do not allow recreational sales, and even those that do frequently impose caps that artificially limit the supply. Bureaucratic barriers, costly regulations, and high taxes are daunting deterrents for weed dealers who otherwise might be inclined to go legit.

Those burdens, combined with local bans, explain why unlicensed sales still account for about two-thirds of the marijuana purchased in California. As a recent report from Reason Foundation (which publishes Reason) notes, California has one licensed recreational outlet per 29,282 residents, compared to one per 13,838 in Colorado and one per 6,145 in Oregon. Worse, the report adds, California’s stores are distributed unevenly across the state, leading to “massive cannabis deserts” where “consumers have no access to a legal retailer within a reasonable distance of their home.””

COVID-19 Measures Magnified the Wars on Drugs and Sex Work

“”Though Covid-19 measures may have varied from country to country, governments’ approaches to tackling the pandemic have had a common failing,” said Rajat Khosla, Amnesty International’s senior director of research, advocacy, and policy, in a statement. “An overemphasis on using punitive sanctions against people for non-compliance with regulations, rather than supporting them to better comply, had a grossly disproportionate effect on those who already faced systematic discrimination.”

“Contrary to the often-voiced claim by governments that ‘we were all in this together’, the truth is that their responses to Covid-19 have been experienced unequally,” states Amnesty’s report. “Nowhere is this more evident than in the impact of Covid-19 measures on people who are discriminatorily targeted by criminal sanctions or punitive laws, policies or regulations,” including people who are homeless, engage in sex work, or use drugs, as well as people “targeted because of their sexual orientation or gender identity and expression.”

Amnesty’s report comes from a survey of private groups “working on issues including sex workers’ rights, LGBTI rights, drug policy reform, homelessness, racial justice, Indigenous people’s rights, discrimination based on work and descent, and sexual and reproductive rights.” It includes information from 28 countries, including the U.S., Canada, and Mexico.”

107,000 Overdose Deaths Are the Latest Casualties of the War on Drugs

“Amid the news that the U.S. had reached 1 million deaths from COVID-19, this week saw another grim milestone. The Centers for Disease Control and Prevention (CDC) announced that the U.S. recorded more than 107,000 deaths from drug overdoses last year, a record high. This is a 15 percent increase from 2020, which held the previous record of around 93,000 deaths. While there has been plenty of talk about how many COVID deaths were preventable, it’s also worth considering how many overdose deaths were the result of needlessly draconian government policies.

According to The New York Times, an increasing share of the number of total overdose deaths came from users of synthetic opioids and methamphetamine. The number of deaths from synthetic opioids increased from 58,000 to 71,000; most of these involved fentanyl, which is considerably stronger than morphine or heroin, and its analogs, which are even more potent. It is often mixed with heroin or stamped into counterfeit prescription drugs. Deaths associated with meth also rose from 25,000 to 33,000.

Each increase follows a longer-term trend: A decade ago, meth-related deaths numbered fewer than 2,000, but by 2017, the number had risen to 10,000. Similarly, deaths from fentanyl numbered around 1,600 in 2011 but increased more than tenfold by 2016.

Obviously, there are a number of reasons why people may abuse drugs. But the role of drug prohibition in exacerbating the crisis cannot be overstated.

During the same years that fentanyl use increased, the prescription rates of opioids like OxyContin plummeted. This was no accident: In 2018, then-Attorney General Jeff Sessions bragged about how successful the government’s efforts had been at lowering the rates at which doctors prescribed opioids for pain. And yet, the overdose rate continued to climb, as both addicts and chronic pain patients alike were forced to seek out black-market alternatives.

A few years earlier, in an attempt to combat the spread of meth, Congress restricted the availability of the decongestant Sudafed, while the Drug Enforcement Administration cracked down on homegrown meth labs that used it as an ingredient. As a result, cheap, low-quality meth from Mexico with suspect ingredients filled the gap in supply.

Each case provides a perfect example of what Dr. Jeffrey Singer, a senior fellow at the libertarian Cato Institute, refers to as “like playing a game of ‘Whack-a-Mole,'” in which the government cracks down on a drug, only for its users to seek alternatives, typically in a more dangerous form. Prescription opioids, in particular, certainly do have the potential for abuse, though not to the extent often portrayed in popular media. But for those who genuinely need pain relief and who are suddenly unable to get it, the alternatives are much worse.”

A Record Number of Drug-Related Deaths Shows the Drug War Is Remarkably Effective at Killing People

“Three years ago, President Donald Trump bragged that “we are making progress” in reducing drug-related deaths, citing a 4 percent drop between 2017 and 2018. That progress, a dubious accomplishment even then, proved fleeting. The upward trend in drug-related deaths, which began decades ago, resumed that very year, and 2020 saw both the largest increase and the largest number ever. That record was broken last year, according to preliminary data that the Centers for Disease Control and Prevention (CDC) published this week.

The CDC projects that the total for 2021 will be nearly 108,000 when the numbers are finalized, up 15 percent from 2020, when the number of deaths jumped by 30 percent. Two-thirds of last year’s cases involved “synthetic opioids other than methadone,” the category that includes fentanyl and its analogs. Those drugs showed up in nearly three-quarters of the cases involving opioids.

Illicit fentanyl, which has become increasingly common as a heroin booster or substitute during the last decade, is now showing up in cocaine, methamphetamine, and counterfeit pills passed off as prescription analgesics or anti-anxiety drugs like Xanax. That phenomenon vividly illustrates the hazards of the black market created by the war on drugs that Trump thought the government was finally winning.

Joe Biden, a supposedly reformed drug warrior, is still keen on “going after drug trafficking and illicit drug profits,” a strategy that has failed for a century but, he figures, might just work this time around. At the same time, Biden talks a lot about drug treatment and other forms of “harm reduction,” including “key tools like naloxone and syringe services programs.” He proudly proclaims that his drug control plan is “the first-ever to champion harm reduction to meet people where they are and engage them in care and services.””

“If we focus on substance rather than words, the real breakthrough will come when politicians understand and acknowledge the nature of the harm that needs to be reduced. It is not just the harm caused by drug abuse but also the harm caused by misguided and counterproductive efforts to address that problem. Prohibition itself is the most obvious example.

Consider one of the harm reduction measures that the Times mentions: the distribution of test strips that can alert drug users to the presence of fentanyl in a substance sold as something else. Those test strips don’t tell you how much fentanyl a bag of powder or a pill contains; they just tell you whether there is a detectable amount. But even that much knowledge is an improvement in a black market where people routinely buy drugs of unknown provenance, composition, and potency.

The danger that fentanyl poses to drug users is not inherent in the drug itself, which can be used safely when you know the dose, as demonstrated by its various medical applications. I was recently given fentanyl, along with midazolam, as a sedative during dental surgery, and I was not at all worried that it would kill me. Patients who receive fentanyl injections in the hospital or use fentanyl patches, lozenges, or nasal spray to relieve severe chronic pain likewise are not dropping dead left and right.

In the black market, by contrast, drug users may not even realize they are buying fentanyl; hence the test strips. Even if they do realize that, they still don’t know the concentration. That potentially lethal ignorance is entirely a product of prohibition. While the proliferation of illicit fentanyl has made drug use more dangerous by increasing variability and uncertainty, those problems are not new. They are inevitable when the government tries to prevent the use of psychoactive substances by banning them.”

“Biden thinks that “going after drug trafficking” will help prevent drug-related deaths. But the pressure from enforcement drives drug traffickers toward more-potent products, which facilitate smuggling by allowing them to pack more doses into the same volume. Alcohol prohibition shifted consumption from beer and wine toward distilled spirits. Drug prohibition gave us heroin instead of opium, fentanyl instead of heroin, and sometimes even-more-potent fentanyl analogs instead of fentanyl.

Given the economics of the black market, interdiction has always been a hopeless proposition. That should be clearer than ever today as the government vainly tries to intercept little packages of fentanyl, each of which contains thousands of doses. But while “going after drug traffickers” has never been a cost-effective way to reduce drug consumption, that does not mean it has not accomplished anything. It has been remarkably effective at making drug use deadlier.”

Gov. Newsom Proposes Eliminating One of California’s Many Marijuana Taxes

“When Californians voted to legalize recreational marijuana cultivation and sales back in 2016, the industry ended up saddled with state and local taxes that make it inordinately costly to attempt to sell or buy cannabis legally. As a result, the black market for marijuana still dominates sales in a state where it’s legal to buy it. Industry analysts estimate about $8 billion in black market marijuana sales annually in California—double the amount of marijuana purchased through licensed dispensaries.

The cultivation tax has been consistently eyed by industry analysts as a problem. This particular tax is unique among agricultural products in California, and due to the legislation passed in 2017 to establish tax authorities, it’s regularly adjusted for inflation. As a result, cultivation tax rates actually increased at the start of 2022 despite this big black market problem.

The high cost of attempting to cultivate marijuana has both given cannabis farmers second thoughts and has fostered a whole new drug war as state and local law enforcement officers raid illegal grow operations out in the rural and uninhabited parts of the state. Legislators even passed a new law adding more potential criminal penalties for those arrested for “aiding and abetting” any unlicensed dealers.”

“It’s good news that Newsom is proposing eliminating the cultivation tax. He may be doing it in the hopes that the state will make more money, but California residents will also benefit from cheaper legal options. And if this makes it easier for people to grow cannabis legally, there will hopefully be fewer raids and enforcement operations in the future.”