Legalizing Heroin

In my home state of Massachusetts, we are currently going through an opioid “epidemic”. There certainly more people using opioids now than 10 years ago. It’s incredibly hard to detect an true drug epidemic . To make policy decisions even more difficult there is certainly a global pain epidemic. Drug laws do more harm than good and are the product of public outcry. I find that some people get angry at the idea of heroin being legal or even decriminalized.

The next question to ask: “have many drug users’ lives been made better by sending them to prison?”. There is a high probability that the answer is no. This is especially likely if you know someone who has been arrested for possession or distribution of marijuana. Marijuana is currently the drug gaining the most traction towards decriminalization/legalization. This is great news, but a worrying prospect is that the “end the drug war” types will stop with that victory.

There is a sentiment that marijuana is essentially harmless and that all other drugs are bad. Marijuana is certainly less harmful than most substances, but public perception is still highly inaccurate when assessing other drugs.  When asked if someone without any prior offenses was caught with a small amount of heroin, 13% of Americans favor “A fine or no punishment” which is higher than many expect. Yet 10% favored imprisonment for “10 years or more”. This poll is 3 years old, and the “heroin epidemic” has been getting more attention, especially in Massachusetts. Recently governor Charlie Baker emotionally signed a new law that is rather toothless at best, and at worst an annoyance. Patients have to go back to their doctors after a week to get a new painkiller prescription, adding to the cost of having a pain problem whose severity requires opioids.

Aside from all the moral panic going on, teen drug use has remained stable or declined in the past decade. The number of high school students who used heroin or painkillers sometime within a month-long period prior to being surveyed (an important statistic to indicate addiction) has been declining over the past decade as well. Dr. Carl Hart estimates that only 20-25% of all heroin users are actually addicted using the measure of disrupted socioeconomic functioning. Governments measure overdoses using incredibly inaccurate methods, typically if someone dies with opioids in their system, it is counted as an opioid-related death. The public fear of opioids as the result of flawed government reports and anecdotes puts pressure on legislators, regardless of what they actually think, to do something. An overdose death has an immediate emotional impact, while someone who dies from lung cancer after decades of smoking isn’t as visceral. Although people may favor making cigarette-smoking illegal, virtually none would want to impose a 10+ year prison sentence on someone for smoking.

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Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health

 

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(Monitoring Future National Survey Results on Drug Use 1975–2014)

 

People engage in all kinds of unhealthy behaviors. Some people eat a big mac and drink Coke while other people smoke weed or crack. More importantly, we retain more users in the health system when heroin use isn’t a criminal offense, which allows people who truly have a problem to ask for help with relative ease. People could sue heroin producers for making drugs of questionable quality, which is a moderate factor in drug overdoses. They could also tarnish a producer’s reputation by some other means (rating websites, etc), creating a market incentive to produce the “good stuff”. Additionally, moving the drug trade from black market to free market internalizes the cost of the industry. Drug enterprises would have to compete for customers rather than fight with other gangs over turf in zero sum games. A large number of violent deaths could be reduced by legalizing drugs. I’ve never heard of Budweiser having a shootout with Corona over product placement at a bar.

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