• The Perils of Legalization - The New York Times
    https://www.nytimes.com/2022/04/24/briefing/drug-legalization-opioid-crisis-week-ahead.html

    Drug overdose deaths in the U.S. reached their highest point ever recorded last year, with more than 100,000 deaths over 12 months. Deaths are up nearly 50 percent since the start of the Covid pandemic.

    Whenever I write about deadly overdoses, some readers ask: Why not legalize and regulate drugs? They argue that the government causes more harm by outlawing drugs and enforcing those bans through policing and incarceration. They suggest that legalization and regulation could better minimize the risks involved.

    So today I want to explain why that argument goes only so far — and why many experts are skeptical.

    “Drug warriors said we should have a drug-free nation, which was totally bogus,” Jonathan Caulkins, a drug policy expert at Carnegie Mellon University, told me. “But it is totally bogus on the other side to say we can legalize and all the problems will go away.”

    In fact, we are living through a crisis that shows the risks of legalization: the opioid epidemic.

    The problem began with a legal, regulated drug: prescription painkillers. Pharmaceutical companies promised the drugs would help address pain, a major public health issue. But when the pills were made widely available in the 1990s, their use skyrocketed — along with addiction and overdoses. And instead of carefully regulating the drugs, officials consistently gave in to profit-minded pharmaceutical companies, which sold opioids to millions of people.

    As we now know, those opioids were not as safe or as effective as claimed.

    But federal agencies consistently failed to act as painkiller overdose deaths quadrupled, the drug policy historian Kathleen Frydl argued:

    After approving OxyContin with faulty data, the Food and Drug Administration did not explicitly restrict its use until the 2010s.

    The Drug Enforcement Administration sets limits on how many opioids can be produced, but it increased those limits for years, until the mid-2010s. The quota for oxycodone was nearly 13 times higher at its peak in 2013 compared with 1998. Without higher quotas, “we wouldn’t have an opioid crisis,” Frydl told me.

    The Centers for Disease Control and Prevention did not publish guidelines calling for stricter prescription of opioids until 2016, more than two decades after OxyContin was approved.

    The bottom line

    No one drug policy is perfect, and all involve trade-offs. “We’ve got freedom, pleasure, health, crime and public safety,” the Stanford drug policy expert Keith Humphreys has told me. “You can push on one and two of those — maybe even three with different drugs — but you can’t get rid of all of them. You have to pay the piper somewhere.”

    #Opioides #Légalisation #Drogues