Jeff Sessions' Plan to Put Strict Limits on Painkiller Manufacturers Will Only Make the Opioid Crisis Worse: Reason Roundup

Plus: Pompeo's secret trip to North Korea, Justice Sotomayor's skepticism over online sales-tax justifications, and Charleston tour guides' fight for free speech.

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Bartek Szewczyk Westend61/Newscom

Jeff Sessions proposes D.E.A. control country's supply of legal opioids. Once again misdiagnosing the problem entirely, Attorney General Sessions on Tuesday proposed to combat America's opioid-addiction issues by exerting extreme control over the inventories of legal painkiller manufacturers. Under Sessions' proposal, the federal government would force pharmaceutical companies to account for and justify all pills sold to medical providers.

"If D.E.A. believes that a company's opioids are being diverted for misuse, then they will reduce the amount of opioids that company can make," said Sessions.

Sigh. For all the well-deserved attention to opioid-related harm and deaths in this country, few manage to avoid mystifying the crisis or making it into a more complicated issue than it is. Surely it's true that some people are abusing heroin to fill existential voids brought on by economic hardships, just as some people got hooked on prescription opioids due to careless prescribing by pharma-bought doctors—though far fewer of the latter than many people suppose. But what makes "the opioid epidemic" so particularly dramatic and deadly at this current moment is more pharmacological than psychological. The market is flooded with fentanyl (or similarly strong synthetic opioids), and nobody outside a lab knows how to dose it right.

One of the simplest things the government could do to ease the pain of the fentanyl problem is to make it easier for people to test heroin and black-market pills to see what they really contain. At the very least, it could stop pushing people away from heroin alternatives by limiting access to detox-friendly drugs like methadone and making medical professionals afraid to prescribe opioids to people in serious pain. Instead, our authorities see shady drug cartels everywhere, and fantasize about busting up both Mexican ganglords and pharmaceutical companies alike.

For more on why Sessions has the wrong approach here, see Reasoners Jacob Sullum ("Don't Blame Pain Pills for the Opioid Crisis" and "Jeff Sessions' Cruel Prescription for Pain") and Ron Bailey ("Misdiagnosing Causes and Casualties in the Opioid War") and the Cato Institute's Jeffrey A. Singer ("Making the Case, Once Again, That the Opioid Crisis Is a Product of Drug Prohibition, Not Doctors Prescribing to Patients" and "Stop Calling it an Opioid Crisis—It's a Heroin and Fentanyl Crisis").

As Sullum has previously noted, strict limits on the number of pills people can legally sell or prescribe tends to mean more opioids sold through the black market (and a greater likelihood for harm to users). In January 2018, "Arizona became the 15th state since 2016 to impose a statutory limit on the length of initial opioid prescriptions for acute pain," wrote Sullum. "The rationale for such laws is that shorter prescriptions will mean fewer pills in circulation and less potential for abuse and diversion. But recent research suggests the opposite may be true, because patients tend to get refills when the initial prescription is too short."

FREE MINDS

Tour guides await federal court ruling on city-mandated quizzes. After hearing the case from Charleston, South Carolina, tour guides last week, U.S. District Judge David Norton said folks can expect an opinion from him by August. The Institute for Justice (IJ) helped several city tour guides file the federal suit challenging Charleston's requirement that all tour guides register with the city and be licensed by showing off historical knowledge. To obtain the license, tour guides—even those doing specialty tours not dependent on conventional Charleston history—previously had to pass an oral exam and a 200-question written test with a score of 80 percent. After the lawsuit was filed, the city relaxed these rules to nix the oral portion and only require a 70 percent score on the test.

FREE MARKETS

Sotomayor skeptical small businesses can afford new sales-tax regime. The Supreme Court heard oral arguments yesterday in the momentous sales-tax case covered here earlier this week. The case concerns whether states can order online merchants—including the likes of individual sellers on platforms like Amazon and eBay—to charge state sales tax even if the business or seller has no presence in that state. From that discussion:

Justice Sonia Sotomayor: So there's going to be a host of questions. What happens when the tax program breaks down, as it already has for the states who are using it, and merchants can't keep track of who they've sold to? All of these are questions that are wrought with difficulties.

What Sotomayor seems to be contemplating is whether state authorities are (or should be) prepared to start investing massive enforcement efforts into collecting sales tax. She also questioned "what are we going to do with the costs that [this would] put on small businesses?" and didn't seem impressed by South Dakota Attorney General Marty Jackley's insistence that it was "that small business on Main Street" being hurt under the current tax regime.

JUSTICE SOTOMAYOR: Actually, they're put at disadvantage … by the fact that there are massive discount sellers, not just on the Internet, but even in stores now. I -- I'm talking about the added cost of doing business for the small businessman, someone -- one of the briefs said it was a $250,000 cost to implement one of these sales programs, one of these sales tax programs?

MR. JACKLEY: That brief left out that it begins -- it's to scale, and it begins at $12 a month for 30 transactions. When you look at the cost associated with collection, it -­ it really depends -­

JUSTICE SOTOMAYOR: That doesn't include auditing. It doesn't include integrating the program with the existing sales program of the company. It doesn't account for the maintenance of the program. There's lots of costs that are inherent in a process of this type.

You can read the full oral arguments here.

QUICK HITS

Pompeo spent Easter with Kim Jong Un in North Korea. Dress for the job you want, not the job you have? Over Easter weekend, CIA Director—and President Trump's pick for secretary-of-state—Mike Pompeo flew to North Korea at Trump's behest for a secret sit-down with Kim Jong Un. This morning on Twitter, Trump confirmed that Pompeo had met with Kim to pave the way for Trump's talk with Kim in the near future.