“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.”
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“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.”
“Those laws create a black market in which the composition and potency of drugs is uncertain and highly variable. They also push traffickers toward highly potent drugs such as fentanyl, which are easier to conceal and smuggle. As a result, drug users like Gentili typically don’t know exactly what they are consuming, which magnifies the risk of a fatal mistake. The “poisoning” that Peace and Caban decried therefore is a consequence of the policies they were proudly enforcing in this very case.”
“Joe Biden “was a key figure in passing the 1994 Crime Bill, which disproportionately harmed Black communities through harsh sentencing laws and increased incarceration rates,” Donald Trump’s campaign reminded voters last week. If elected, Trump promised in a speech at the Libertarian National Convention two days later, he will free Ross Ulbricht, who is serving a life sentence for running Silk Road, an online marketplace used by illegal drug vendors.
Trump’s criticism of disproportionate drug penalties contradicts his own platform, which threatens defendants like Ulbricht with death. The former and possibly future president wants to have it both ways, slamming Biden for his long history as a zealous drug warrior while portraying himself as even tougher.”
“The main idea behind Measure 110 was that consuming politically disfavored intoxicants should not be treated as a crime. Since drug use itself violates no one’s rights, it is hard to argue with that premise.
Eliminating criminal penalties for drug possession, however, does not require tolerating conduct that offends, incommodes, or alarms people who have an equal right to use sidewalks, parks, and other taxpayer-funded facilities. That problem—which many major cities face, regardless of whether they routinely arrest people for drug possession—is distinct from drug use per se, just as disorderly alcohol-related conduct is distinct from drinking per se.”
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“According to a 2016 systematic review, “evidence does not, on the whole, suggest improved outcomes related to compulsory treatment approaches, with some studies suggesting potential harms.” The authors conclude that “given the potential for human rights abuses within compulsory treatment settings, non-compulsory treatment modalities should be prioritized by policymakers seeking to reduce drug-related harms.”
One danger of jailing noncompliant drug users is that incarceration raises the risk of a fatal overdose because forced abstinence reduces tolerance. According to a 2023 study, that risk is “markedly elevated” among people recently freed from prison, especially during the first two weeks after release.”
“It is important to keep in mind that Oregon’s Measure 110 did nothing to address the supply of illegal drugs, which remain just as iffy and potentially deadly as they were before the initiative was approved. Decriminalization was limited to drug users, and it was based on the premise that people should not be arrested merely for consuming forbidden intoxicants. This distinction between drug users and drug suppliers is similar to the policy enacted during Prohibition, when bootleggers were treated as criminals but drinkers were not.
Measure 110 changed low-level drug possession from a Class A misdemeanor, punishable by up to a year in jail and a maximum fine of $6,250, to a Class E violation, punishable by a $100 fine. Drug users who receive citations can avoid the fine by agreeing to undergo a “health assessment” that is supposed to “prioritize the self-identified needs of the client.” That assessment might result in a treatment referral, but participation is voluntary.
Despite the limited nature of Oregon’s reform, which was not designed to reduce the hazards posed by the highly variable and unpredictable composition of black-market drugs, Stephens thinks the fact that drug-related deaths continued to rise in Oregon shows that decriminalization has failed. “In 2019 there were 280 unintentional opioid overdose deaths in Oregon,” he writes. “In 2021 there were 745.”
Stephens neglects to mention that drug-related deaths rose nationwide during that period, from about 71,000 in 2019 to more than 107,000 in 2021. The number of deaths involving opioids rose from about 50,000 to about 81,000—a 62 percent increase.
To be sure, the increase in Oregon that Stephens notes was much larger. But how does it compare to trends in other jurisdictions that did not decriminalize drug use?
Between 2019 and 2021, Oregon’s age-adjusted opioid overdose death rate rose from 7.6 to 18.1 per 100,000 residents. California saw a similar increase: from 7.9 to 17.8. In Washington, the rate likewise nearly doubled, from 10.5 to 20.5. And even in 2021, Oregon’s rate was lower than the national rate (24.7) and much lower than the rates in states such as Connecticut (38.3), Delaware (48.1), Kentucky (44.8), Maine (42.4), Maryland (38.5), Tennessee (45.5), Vermont (37.4), and West Virginia (77.2). On its face, this does not look like evidence that decriminalization is responsible for Oregon’s continuing rise in opioid-related deaths.*
While Measure 110 does not seem to have caused an increase in drug-related deaths, it manifestly did not prevent that increase.”
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“a heavy drug user who steals to support his habit is not immune from criminal penalties. It also means the government can justifiably regulate what drug users do in public, where their actions might offend, incommode, or alarm people who have an equal right to use sidewalks, parks, and other taxpayer-funded facilities. Although Stephens implies otherwise, eliminating criminal penalties for drug possession does not require tolerating public drug use, defecation, or blowjobs.”
“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.”
“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.”
“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.”