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Overdose Deaths Are the Product of Drug Prohibition

Drug legalization will save lives.

During Prohibition, drinkers never knew what they would get when they set out to slake their thirst. Bootleggers often sold products adulterated with industrial alcohol and other toxins. Some 10,000 people were fatally poisoned before America gave up this grand experiment in suppressing vice.

So it was a tragedy but not a total surprise when three deaths were reported in Illinois from synthetic marijuana laced with an ingredient (possibly rat poison) that caused severe bleeding. Nationally, in 2015, says the Drug Policy Alliance, "poison control centers received just under 10,000 calls reporting adverse reactions to synthetic cannabinoids, and emergency rooms received tens of thousands of patients."

People consume synthetic cannabis for the same reason people once consumed bathtub gin: Their drug of choice is illegal. Criminal organizations that cater to forbidden demands don't always make a fetish of quality control. After Prohibition was repealed, though, tipplers could buy from legal, regulated suppliers. They no longer had to worry about ingesting sudden death.

In nine states and the District of Columbia, pot users now enjoy the same protection. Recreational marijuana is allowed and subject to government regulation and the discipline of the market—ensuring purity through accountability. But in most places, Americans who want to get high have to take their chances with unsanctioned dealers who may be sorely lacking in moral scruples.

The bigger toll from modern drug prohibition, however, comes among opioid users. By making criminals of many people who are dependent on prescription painkillers such as oxycodone and hydrocodone, the law exiles them to the black market. There, consumers may find legitimate FDA-approved medicines, but they may also buy counterfeit versions or heroin—which often carry far greater hazards.

The most urgent danger comes from fentanyl, an opioid at least 30 times more powerful than heroin that illicit producers often mix with other opioids. It plays a rapidly growing role in the epidemic of drug overdose deaths.

The number of deaths caused by fentanyl and other synthetic opioids, says the National Center for Health Statistics, increased by 88 percent per year from 2013 through 2016. In 2016, these drugs killed more than 19,000 people.

Why would traffickers cut a dangerous drug (heroin, oxycodone) with an even more dangerous one? Fentanyl's low cost and high potency allow sellers to make more money. The iron law of prohibition stipulates that banning a substance encourages more powerful alternatives because they are more compact and thus easier to hide (boxes of pills versus bales of marijuana). The side effect is to greatly compound the dangers of drug use.

As if its role in opioids weren't bad enough, fentanyl has shown up in cocaine. Law enforcement agencies in Connecticut and Massachusetts report a surge in this particular mixture, which is especially dangerous because cocaine users usually lack a tolerance for opioids.

Fentanyl was just the beginning. The latest additive is carfentanil, a compound 100 times more powerful than fentanyl that is used to tranquilize elephants. It's shown up in a street drug known as "gray death," which sells for much less than pharmaceutical opioids. Its advent is likely to boost the casualty count.

These side effects are an inevitable result of treating a vice, or a medical condition, as something to be punished. The simplest way to curb the epidemic would be to make it possible for those addicted to opioids to obtain and use them legally. Pharmacists don't mix up cocktails with sedatives meant for animals weighing 6 tons.

Short of some form of legalization, useful steps could be taken. Drug testing kits can detect the presence of fentanyl and other contaminants—but in many places, including Illinois, they are classified as illegal drug paraphernalia. The District of Columbia recently decided to grant an exemption letting syringe exchange programs screen drugs for the people they serve.

In some states, syringe exchange programs don't do that because there aren't any. Twenty-two states criminalize the mere possession of hypodermic needles.

It would help to have facilities where opioid users could inject drugs under the supervision of medical professionals who could intervene to reverse overdoses—not to mention offer counseling and treatment referrals.

In 2016 alone, more Americans died of overdoses than were killed in the Vietnam War. Drug prohibition is justified as a vital protection against the ravages of abuse and addiction. But our graveyards are filling up with people it was supposed to save.

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  • BestUsedCarSales||

    . But our graveyards are filling up with people it was supposed to save.

    Even taking them at word, the drug was is to save people from fucked up druggies. Once you're a drug user they don't give a single shit if you live or die.

  • The Laissez-Ferret||

    But once Mendosi got hooked on the smack, he got a bad dose with fentanyl and passed away.

    Don't be like Mendosi.

  • MarioLanza||

    You allude to the main issue. The explosion of opioid deaths are pretty much entirely due to fentanyl. It is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin. IT IS VERY DANGEROUS!!!

    Now I know that many of the supposed libertarians here are libertarian about drugs and are commie/leftists about everything else, but should such a drug be legal to sell at the marijuana dispenseries? Would that increase or decrease deaths?

  • WillPaine||

    And yet "they" love their coffee, alcohol, tobacco, anti-histamines, sleep aids, psych meds. Yes, alcohol is a drug; so is coffee, albeit delightful. if you ever use the term: "drugs and alcohol", know you have just lied. More than 120,000 people die each year from alcohol, and that is the suppressed number. Alcohol; America's drug of choice. More than 200,000 people a year die from psych meds in this country alone. (Look it up. Look to Denmark). Is there some kind of "crisis". You bet. In Vietnam, water buffalo did not eat poppies. Until bombs began to fall, and then, they did. Bruce Alexander looked at the government's standard rat experiment. He saw, and asked, what's wrong with this picture? A rat alone in a nearly sterile cage with nothing to do but drink cocaine water, or morphine water. Put a rat in a "Rat Park", with toys, and other rats, and they stop drinking the drug water. The U.S. government suppressed his experiment. It doesn't fit into a reality "the government" peddles. It is a lie, and an illusion, just like much of the opioid crisis. Welcome to it anyway.

  • WillPaine||

    And remember, "they" are friends, neighbors, and loved ones. "They" are us.

  • MarioLanza||

    Such poor logic. First off, your analogy of "alcohol deaths" is poor. There are deaths due to diseases related to alcohol and the more relevant acute alcohol poisoning deaths. There are about 2,000 EtOH poisoning deaths per year. Most are NOT college students but middle aged men. Probably a fair share are suicides. EtOH poisoning is merely their method of choice. There are 22 times as many deaths per day due to EtOH poisoning versus opioid overdose.

    And if the U.S. government "suppressed" Mr. Alexanders experiment results, they did a poor job of that suppression. You can find discussion of them easily with google. What exactly do you think is the relevance to humans of his experiment of the rat in the cage with great toys don't turn to drugs?

  • DajjaI||

    Hey Reason - do an investigation into overdoses. Interview people who survived and ask them if it was intentional. Results will be surprising - it's not "I just wanted to get high and ooops I took one too many." Usually it's intentional suicide. Meaning, the drug war is killing people to stop them from killing themselves. Also, the people dying are not typical addicts. Many are Trumpkins who despair that they missed their 'last chance'. Again, interview family and friends and see for yourselves.

  • Palin's Buttplug||

    Many are Trumpkins who despair that they missed their 'last chance'.

    Deplorables are lashing out in many ways. Angry, sullen, and turning to bigotry as a defense mechanism.

  • Elias Fakaname||

    I suggest that those who feel a need to 'lash out' do it constructively. Slaughtering Marxists is an excellent way of turning that negative energy into positive energy. Woth each Marxist snuffed out, the world becomes a little better.

    Right comrade?

  • Shakes||

    "usually it's intentional suicide"
    So a majority of overdoses are intentional? I think if you bothered to cite a source, it would read "my butt".

  • ThomasD||

    "So a majority of overdoses are intentional?"

    In the basic sense that, yes they intended to consume the substance, then yes. But, like other intentionally risky acts (e.g. skydiving) there may be no intention to die right now. So maybe no.

    It's the distinction between an immediate suicidal act and a death wish. Repeatedly choosing to put yourself in harms way, with the understanding that 'harm' could or will eventually mean death - and all chronic users seeking a high know that a little never stays little for long - is a slow form of suicide. They know it. they especially know it now because they probably know people who have already died.

    Skydiving, done properly, gets no more dangerous each time you do it. The same cannot be remotely said about consuming opioids, especially anything of questionable provenance, that degree of recklessness clearly crosses the line.

  • ThomasD||

    Getting honest and meaningful answers from a population that skews highly self-destructive is more than a little problematic. But yes, it is a sort of variation on what you say. Closer to "I knew this stuff was going to kill me one day, but I didn't think it would be this time. This time I just wanted to feel better."

  • LEAPGuyAZ||

    The overdoses I saw as an EMT were because the user got 30% heroin one time, and 80% or fentanyl the next. Imagine take your heart medication and not knowing if it was 5% or 100% of the required dose?

    Then there are the pain patients who give up the constant fight for pain relief and end the pain. Some are intentional overdoses who save enough pills to end their life. Others are suspicious deaths, single vehicle accidents with no obvious cause....

    Bottom line is Prohibition Kills.....

  • ||

    The always unmentioned fact in these *opioid death* reports is that a cornucopia of other drugs are present in the dead bodies - with alcohol being the most prevalent. I would wager that not one of these deaths is attributable to heroin alone.

  • Michael Ejercito||

    Wow.

    Just imagine what we could accomplish with gun prohibition.

  • MatthewSlyfield||

    Civil War?

  • WillPaine||

    Mathewslyfield; you funny...:-)

  • Elias Fakaname||

    That would finally create a pretext to dispose of the unpleasantness we call the progressive population.

  • ThomasD||

    " The simplest way to curb the epidemic would be to make it possible for those addicted to opioids to obtain and use them legally."

    Sounds simple, but it's not. The vast majority of opioid treatment programs are not abstinence based, they are maintenance programs (be it with methadone, suboxone, or other agents) with a strong focus on improving and maintaining social functioning (keep your job, keep family, keep your house.) So while access is limited we already have a means by which those addicted to opioids can obtain and use them legally.

    Just maybe not in the exact same way they'd otherwise choose to use them.

    And therein lies the rub. These people are addicts precisely because they have demonstrated a poor ability to control their behavior associated with these drugs. They do not choose well on their own. Success rates in programs vary (as do the metrics) but overall they are not great. So, while I am in no way opposed to your approach, I don't think it can realistically be considered any sort of curb on the epidemic.

  • MatthewSlyfield||

    You completely ignore the fact that the aggregate capacity of the treatment programs you mention is at least one order of magnitude short of the need.

  • Echospinner||

    Heroin maintenance programs are being tried in Europe. Users can go to centers where they are given heroin injections under medical supervision. They have been shown to produce marginal gains over methadone and are only recommended as a last resort when other options have failed.

  • Hank Phillips||

    Switzerland was handing out smack in 1997. Early in 1929, NY prosecutor Tuttle made a big stink about Switzerland exporting tonnes of heroin. It made the newspapers in NY and London and was a source of discomfort.

  • WillPaine||

    All respect Echo, but, and that is not exactly accurate. Benefits from legalization and control have been writ large. Drop cannabis into the drug war solutions, and the benefits from legalization are writ very, very large. Six billion just announced by Trump, for the opioid war alone. As if the well meaning authorities don't have enough American treasure wasting already. Don't be afraid to look at what is real. And, yeah, it requires about the effort of eighth grade reading assignments, a few books, a visit to the net, and answers appear, through the fog of war. We can win the drug war; who doesn't want us to? The cartels, for one; drug lords, a force to be reckoned with. So, reckon, America. Legalize, control and tax the substance business. It's being done all over the world (not much coverage there, eh? free press?)?

  • Echospinner||

    Too late to reply in the discussion but I thought your comment I should reply to.

    Legalization is not what I am trying to address.

    Opiate addiction and what works or does not is where I am looking. It is an open issue.

    Obviously law approach is not the way to focus.

    Results from Netherlands, Switzerland and Portugal and many other approaches are available. There is a lot of active activity in this long neglected area.

    Truth is that we are not talking weed here which I could care less about. It is less toxic than almost anything. It is less toxic than Tylenol.

    Fentanyl. It is a very difficult drug. The safety window is in micrograms. It is useful under the right circumstances if you know what you doing. Those would be anesthesia for surgery, invasive procedures for sedation and immediate post operative pain. Other than that there are few indications that I know of.

  • Shirley Knott||

    "They do not choose well on their own."
    Therefore, we should step in and choose for them?
    I think not.
    It's the legislation that's the problem, not the addicts.

  • WillPaine||

    Shirley; yes.

  • WillPaine||

    TD; look to where it has happened; in Europe, Colombia, Spain; many countries. In Portugal, heroin dealers threw stones at the heroin clinic vans. "Chasing the Scream" reveals the man behind the curtain and his name was Harry Anslinger. He mentored Joe Arpaio. Two old queens really can cause world wide suffering. Top officials in the military, and captains of industry know the plant Papaver somniferum. A serious plant. The problem with opioids is the way they are being controlled. In 1910, you could buy diacetylated morphine over the counter for a dollar an ounce. Heroin; it was called calming powder. Opioid is very serious medicine, and should be approached seriously. Not with the scattereshots of fear, the government does so well. The drug war has nothing to little to do with drugs. "Our drug war policies had nothing to do with drugs. The counter culture, and Blacks scared Nixon. That's why we did what we did." H.R. Haldeman, Nixon's right hand man. Otherwise known as Nixon's son of a bitch. A few old queens.

  • MikeP2||

    Doesn't this go against the conventional wisdom on overdoses?

    It's not that fentanyl is used because it's cheaper per high.

    It's that users develop tolerance, and need increasing levels/activity to achieve the high they are looking for, leading to dangerous and possibly deadly substance levels.

    Making an overdose-prohibition direct link seems like a very unhelpful stretch. There are better arguments.

    but hey, it's Chapman.

  • dchang0||

    Agreed. The title should say "SOME overdose deaths..."

    Does anyone here believe that overdose deaths won't occur if drugs were fully legalized? Some proportion of users will accidentally overdose just by mixing drugs (as some people mix prescription drugs and alcohol, both legal). And some proportion of users will simply make errors and overdose in search of higher highs. And some drugs will simply be too powerful, in that it is very easy to overdose (one cannot argue that such drugs would not exist if all drugs are fully legalized--there are plenty of races-to-the-top in legal products to see who can max out a spec, such as the easily-deadly horsepower race in modern muscle cars).

  • Hank Phillips||

    Steve doesn't notice that Republican and Democrat politicians would poison their own mothers with People's Temple cyanide in exchange for kickbacks on confiscated drug sales, asset-forfeiture looting, votes from the dupes of televangelism and donations from pharma companies, brewers and distillers painfully aware of mixed economy corruption. Prohibitionist financial collapses in 1872, 1907, 1929, 1987, 2007 and the flash crashes of 2010 and 2015 the fake media covers up. The remaining alternative--before we wake up in a blackout, throats slit in revenge by prohibition victims--is to vote libertarian and force prohibition pseudoscientists to throw their coercion under the bus to save their own seats.

  • Elias Fakaname||

    Your arguments, are bizarre, obscure, and unpersuasive.

  • WillPaine||

    Nice opioid article. Something we have lost sight of in the "fog of war" are the many tens, if not hundreds of thousands of Americans who have, and may benefit from opioid pain medicine. Pain you will experience later in your life, began from your first bicycle wreck. The human body has not adapted in 100 years, to sustain and heal the injuries most have in the "modern world". Hope you never have pain so great you would pray for opioid. Chronic, ongoing, anger producing pain. And now, the government wants to control medicine, without medical understanding. You have to have gone through it, and I don't recommend such to anyone. For the countless thousands of people who now face misery, unble to obtain, or to titrate comfortably with pain medicine. Misuse of opioids has led to their being maligned, as the "opioid crisis" is in our face. Opioid should be a last resort. Six billion dollars for the "opioid crisis". Sam Quinones, author "Dreamland" a very down the line analysis of "the opioid crisis" says there may be 16,000 overdose deaths attributable to opioid. Stats almost everywhere include any opioid detected, is called an opioid involved death. 99,000 people die each year from HAI; Hospital Acquired Infection. We can win the drug war. Many countries are. We have mercy on the dying, have mercy upon the living. May you live long enough to know.

  • Eman||

    Why should any drug be categorically anything? The unstated and untrue assumption underlying the drug war is that one drug will have one effect on one hundred percent of users, which is such obvious bullshit to anyone who has ever actually used a drug i have no idea how it was ever even considered, much less been common knowledge for a century.

  • Eman||

    Well duh. If drugs had gotten as much better and cheaper and safer as everything else has over The past few centuries I'd be even higher than I am right now and Prince would still be alive. Talk about, you know, the stupidity of the American voter.

  • dchang0||

    You cannot assume that drugs would have gotten safer if legalized.

    The prescription market is legal, yet there are some very dangerous drugs being made with all sorts of hazardous side effects.

    I'm not arguing in favor of regulation, mind you, but we cannot assume that perfect free market forces are enough to incentivize drug producers to make safer products. After all, the legal junk food industry is happy to keep slowly killing its customers in spite of the fact that obesity-related deaths and disease are prevalent and widely-known.

  • LEAPGuyAZ||

    As pain management physicians lower doses of patients out of fear, patients loose. Prohibition will force patients to the street, to unknown sellers, and unknown substances, and to death simply for trying to relive their pain.

    Someone needs to be held responsible for every death. Not overdoses deaths, but the suicides of patients who simply can't live in constant pain, and give up.

    When someone abuses opioids and overdoses, that's sad.
    When a someone commits suicide for lack of pain control, that's a tragedy......

  • ||

    The DEA is like the *heroic* fireman rushing into a burning building set ablaze by his own match.

  • inoyu||

    I am confident that 90% of all human beings would choose a medically administered heroin centered lifetime after a fair introduction to heroin. There really is nothing better than unimaginable pleasure.

  • Sebastian Cremmington||

    Many countries allow codeine and muscle relaxers OTC...guess with two countries have the most strict opioid regulations??? Germany and America!! The two countries with by far the highest number of opioid deaths!! These people that are making opioids more difficult to get have blood on their hands.

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