“Bondi’s most obvious mistake is equating potential overdoses with actual overdoses: She assumes that 258 million opioid-naive people would each have consumed two milligrams of fentanyl in one sitting. But Bondi also erroneously assumes that seizing 3,400 kilograms of fentanyl is the same as reducing U.S. fentanyl consumption by that amount.
That is obviously not true. Prohibition allows drug traffickers to earn a hefty risk premium, which gives them a strong incentive to find ways around any barriers the government manages to erect. Given all the places where drugs can be produced and all the ways they can be smuggled, it is not possible to “cut off the flow,” as politicians have been vainly promising to do for more than a century. The most they can realistically hope to accomplish through interdiction is higher retail prices resulting from increased costs imposed on drug traffickers.
That strategy is complicated by the fact that illegal drugs acquire most of their value close to the consumer. The cost of replacing destroyed crops and seized shipments is therefore relatively small, a tiny fraction of the “street value” trumpeted by law enforcement agencies. As you get closer to the retail level, the replacement cost rises, but the amount that can be seized at one time falls.
These challenges—which are compounded in the case of fentanyl, a highly potent drug that can be transported or shipped in small packages containing many doses—explain why interdiction never seems to have a significant and lasting impact on retail prices. From 1981 to 2012, according to the Office of National Drug Control Policy, the average, inflation-adjusted retail price for a pure gram of heroin fell by 86 percent. During the same period, the average retail price for cocaine and methamphetamine fell by 75 percent and 72 percent, respectively. In 2021, the Drug Enforcement Administration reported that methamphetamine’s “purity and potency remain high while prices remain low,” that “availability of cocaine throughout the United States remains steady,” and that “availability and use of cheap and highly potent fentanyl has increased.””
https://reason.com/2025/05/02/pam-bondis-absurd-claim-about-fentanyl-overdoses-epitomizes-the-illogic-of-the-war-on-drugs/
“The study included 2,653 drug seizures and 1,833 opioid-related deaths from 2020 to 2023. “Within the surrounding 100, 250, and 500 meters,” RTI International researcher Alex H. Kral and his two co-authors reported in JAMA Network Open on Wednesday, “drug seizures were associated with a statistically significant increase in the relative risk for fatal opioid overdoses.””
…
“Prohibition makes drug use more dangerous by creating a black market in which quality and potency are highly variable and unpredictable. Ramped-up enforcement of prohibition magnifies that problem, as dramatically demonstrated by the deadly impact of restricting access to pain medication at the same time that illicit fentanyl was proliferating as a heroin booster and substitute.”
https://reason.com/2025/03/20/a-new-study-adds-to-the-evidence-that-drug-busts-result-in-more-overdose-deaths/
“According to preliminary data from the Centers for Disease Control and Prevention (CDC), the death toll from illegal drugs during the year ending in April 2024 was 10 percent lower than the number during the previous year. This would be the largest such drop ever recorded—a striking contrast to the general trend during the previous two decades, when the number of drug deaths rose nearly every year.”
…
“Does this apparent turnaround show the war on drugs is finally succeeding? Dasgupta et al. deemed it “unlikely” that antidrug operations along the U.S.-Mexico border had helped reduce
overdoses. They noted that recent border seizures had mainly involved marijuana and methamphetamine rather than illicit fentanyl, the primary culprit in overdoses, and that retail drug prices have been
falling in recent years—the opposite of what you would expect if interdiction were effective.
While replacing street drugs with methadone or buprenorphine reduces overdose risk, the researchers said, it did not look like expanded access to such “medication-assisted treatment” could account for the recent drop in deaths. But they thought it was “plausible” that broader distribution of the opioid antagonist naloxone (commonly known as the brand Narcan), which quickly reverses fentanyl and heroin overdoses, had played a role.
In contrast with naloxone programs, which help reduce drug-related harm, prohibition magnifies it by birthing a black market in which quality and purity are highly variable and unpredictable. Efforts to enforce prohibition increase those hazards. The crackdown on pain pills, for example, pushed nonmedical users toward black market substitutes, 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.
Drug warriors, in short, should not get credit for reducing overdoses. But they do deserve a large share of the blame for creating a situation in which an annual toll of more than 100,000 deaths looks like an improvement.”
https://reason.com/2024/12/16/dont-credit-drug-warriors-for-reducing-overdoses/
“The annual U.S. death toll from illegal drugs, which has risen nearly every year since the turn of the century, is expected to fall substantially this year. The timing of that turnaround poses a problem for politicians who aim to prevent substance abuse by disrupting the drug supply.
Those politicians include Republican presidential nominee Donald Trump, who promises to deploy the military against drug traffickers, and his Democratic opponent, Vice President Kamala Harris, whose platform is also heavy on supply-side tactics. Neither candidate seems to have absorbed the lessons of the “opioid epidemic,” which showed that drug law enforcement is not just ineffective but counterproductive, magnifying the harms it is supposed to alleviate.”
…
“While replacing street drugs with methadone or buprenorphine reduces overdose risk, Dasgupta et al. say, it does not look like expanded access to such “medication-assisted treatment” can account for the recent drop in deaths. But they think it is “plausible” that broader distribution of the opioid antagonist naloxone, which quickly reverses fentanyl and heroin overdoses, has played a role.
By contrast, Dasgupta et al. say it is “unlikely” that anti-drug operations along the U.S.-Mexico border have helped reduce overdoses. They note that recent border seizures have mainly involved marijuana and methamphetamine rather than fentanyl, the primary culprit in overdoses, and that retail drug prices have been falling in recent years—the opposite of what you would expect if interdiction were effective.
Supply-side measures, which are doomed by the economics of prohibition, not only have failed to reduce drug-related deaths. They have had the opposite effect.
Prohibition makes drug use much more dangerous by creating a black market in which quality and purity are highly variable and unpredictable, and efforts to enforce prohibition increase those hazards. The crackdown on pain pills, for example, drove nonmedical users toward black-market substitutes, 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.
Trump and Harris seem unfazed by that debacle. Trump imagines “a full naval embargo on the drug cartels,” while Harris aspires to “disrupt the flow of illicit drugs.” They promise to achieve the impossible while glossing over the costs of persisting in a strategy that has failed for more than a century.”
https://reason.com/2024/09/25/recent-overdose-trends-underline-the-folly-of-the-war-on-drugs/
“Life expectancy in the United States dropped last year to its lowest since 1996, extending a downward trend that began in 2020, according to new data from the Centers for Disease Control and Prevention.
The latest figures from the CDC, which leave expected U.S. lifespans well below those in other large, wealthy nations, reflect the federal and local governments’ ongoing struggle to meet the demands of concurrent public health crises.
The Covid-19 pandemic has had “a domino effect,” said Nora Volkow, director of the National Institute on Drug Abuse, by “exacerbating the already very severe problem that we have in overdose deaths.”
The two crises, the Covid-19 pandemic and rising drug addiction and overdoses, are “a wake-up call” for government, added Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It clearly is what’s cutting into the health of our communities, unlike almost anything we’ve seen before.””
…
“The ongoing politicization of the U.S. Covid response has negatively impacted many Americans’ decisions about vaccination and other mitigation measures. Roughly 14 percent of Americans and 36 percent of people 65 and over have received the latest booster, according to the CDC.
At the same time, Volkow believes the pandemic drove social changes that made people more vulnerable to taking drugs as a way of escaping. The pandemic also made it harder to get help. “Resources that were able to support people in the past were no longer available,” she said.”
“”While safe injection sites may sound counterintuitive to some people as an effective means to combat addiction, there’s no arguing with the data. Results from other countries have shown that safe injection sites lead to a reduction in overdose deaths and transmission rates of infectious disease and an increase in the number of individuals seeking addiction recovery.””
…
“Newsom’s presidential ambitions, or simply his desire to appear less soft on crime, might be getting in the way of a safe and effective public health strategy for preventing drug overdoses.”
“Substantially reducing the doses of pain medication prescribed for patients on long-term opioid therapy is associated with a threefold increase in suicide attempts and a 69 percent increase in overdoses, according to a study published this week in The Journal of the American Medical Association (JAMA). The study reinforces concerns that the “tapering” encouraged by federal guidelines as a response to the “opioid crisis” causes needless suffering among patients, leading to undertreatment of pain, withdrawal symptoms, and emotional distress.”
…
“Although the CDC’s advice was not legally binding, and although the guidance said doses should be tapered only when medically appropriate, doctors, lawmakers, insurers, and pharmacies interpreted the agency’s warnings about daily doses exceeding 90 MMEs as a hard limit. “These and other widely disseminated recommendations have led to increased opioid tapering among patients prescribed long-term opioid therapy,” Agnoli et al. note.”
…
“The CDC is mulling revisions to its advice. “A revised CDC Guideline that continues to focus only on opioid prescribing will perpetuate the fallacy that, by restricting access to opioid analgesics, the nation’s overdose and death epidemic will end,” Mukkamala warned in his letter to the CDC. “We saw the consequences of this mindset in the aftermath of the 2016 Guideline. Physicians have reduced opioid prescribing by more than 44 percent since 2012, but the drug overdose epidemic has gotten worse.””
“After years of steadily moving in tandem, two of America’s worst public health trends diverged during the coronavirus pandemic.
Drug overdose deaths jumped 30 percent last year to 92,500, according to newly released federal data, a sudden surge following years of incremental increases once the opioid epidemic took hold. But suicides actually dropped slightly, from 47,500 in 2019 to 44,800 in 2020.
Those two trends have tracked closely over the past decade, so much so that there is an umbrella term in academia that encompasses both of them (among other things): deaths of despair. Much of the recent stagnation in US life expectancy can be explained by these premature deaths, concentrated especially among young men, and scholars have theorized about the economic and social conditions driving those trends.
That was the situation before Covid-19. So what happened during the pandemic?”
“Obamacare’s Medicaid expansion, which gave millions of low-income adults access to health insurance, was linked to a 6 percent reduction in opioid overdose death rates — potentially preventing thousands of deaths — according to a new study in JAMA Network Open.
The study looked at what happened in counties in states that expanded Medicaid under the Affordable Care Act by 2017, compared to counties in states that didn’t expand Medicaid, accounting for variables like demographic and policy differences. The Medicaid expansion was made optional in a 2012 Supreme Court ruling, and only 32 states and Washington, DC, had opted to expand by the study period (with the total rising to 37 in the past few years).
The study helps put to rest claims by some Republican lawmakers, particularly Sen. Ron Johnson (WI), that the Medicaid expansion made the opioid crisis worse by expanding access to painkillers. The new study, echoing others before it, suggests the Medicaid expansion had the opposite effect, and that there wasn’t a link between the expansion and more deaths caused by painkillers, with the possible — and relatively uncommon — exception of methadone used in pain treatment.
The researchers found that Medicaid expansion counties had a 6 percent lower rate in opioid overdose deaths than non-expansion counties. That was mostly due to an 11 percent lower rate of deaths involving heroin and a 10 percent lower rate for deaths linked to synthetic opioids excluding methadone”