Power & Market

China is Right, Washington Should Only Blame Itself for Opioid Crisis

As good as Washington is at making bad things happen, it is just as good at finding other people to blame it on. A great example of this is the push the last year to blame America’s opioid crisis on one of its favorite boogeymen: China. While it’s perhaps not so surprising to see such rhetoric from the Trump Administration, it’s a narrative that has received a bipartisan endorsement in Congress.

The argument is that it is far too easy for Chinese chemical manufactures to send products like fentanyl to the United States, and therefore China deserves blame for its role in overdoses. This argument, however, is absurd for a number of reasons - including that by Congress’s own analysis, it’s the United States Postal Service that is the preferred method of transport (perhaps this explain’s Trump’s new desire to privatize the post office?) In responding to the allegations in a press conference today, the Chinese government rightfully pointed the finger at the only government body that deserves blame: the Federal government.

“It’s common knowledge that most new psychoactive substances (NPS) have been designed in laboratories in the United States and Europe, and their deep-processing and consumption also mostly take place there,” said Liu Yuejin, deputy chief of China’s National Narcotics Control Commission.

“The U.S. should adopt a comprehensive and balanced strategy to reduce and suppress the huge demand in the country for fentanyl and other similar drugs as soon as possible,” said Liu, who comments coincided with the release of China’s annual drug situation report.

“When fewer and fewer Americans use fentanyl, there would be no market for it.”

While the Chinese officials didn’t go so far as to explicitly blame Washington for the problem, they would have been justified in doing so.

Last year Mark Thornton did a great job walking through how the opioid crisis is the direct result of misguided government policies that escalate the very issues politicians claim to want to fix:

The real cause of this epidemic is various government policies and the real solution is the dismantling of those same policies, in perpetuum.

The Four Causes

Let us start with drug prohibition which dates back to the Harrison Narcotic Act of 1914. Drug prohibition results in a black market where illegal products are not commercially produced and where suppliers are not constrained by the rule of law and product liability law. The result is that illegal drugs are more dangerous than legal drugs. Potency varies greatly from batch to batch and products often contain dangerous impurities and substitute ingredients. Opiate overdoses often occur when an addict is unaware that a particular dose is highly potent or contains Fentanyl, a pain medication that is 50 to a 1,000 times more potent than morphine.

The next cause is called the Iron Law of Prohibition, a phrase first used by Richard Cowan to describe the phenomenon that when drug law enforcement becomes more powerful, the potency of illegal drugs increases. One of the effects of enhancing prohibition enforcement is that suppliers will produce a higher potency drug. For example, during alcohol prohibition in the 1920s suppliers switched from producing beer and wine to highly potent spirits, such as gin and whiskey.

A second result of more rigorous prohibition enforcement is that suppliers will switch from lower potency drug types to higher potency drug types. For example, during Ronald Reagan’s “war on drugs” during the 1980s, smugglers switched from bulky marijuana to highly concentrated cocaine and domestic suppliers turned much of this cocaine into crack cocaine, resulting in the crack cocaine epidemic. The Iron Law of Prohibition explains why we see more and more dangerous drugs on the black market and why we see decreases in overdoses in states that have legalized cannabis.

Government intervention in the economy is a largely unrecognized cause of addiction. Intervention has at least two distinct channels of creating addicts. The first is war. War creates addicts through both painful physical injuries and painful emotional and psychological disorders, such as Post Traumatic Stress Disorders. The second cause is the general impact of widespread government intervention in the economy. Much of government interventionism results in the creation of privileges and monopoly power. For example, licensing requirements provide members of a profession, such as medical doctors, with monopoly profits by restricting the number of practicing physicians. This enriches licensed doctors and impoverishes potential doctors who must find work in another profession. These excess potential doctors thereby suppress wages in other labor markets. Given the pervasiveness of government intervention, this creates two classes in labor markets — the advantaged and the disadvantaged and addiction tends to develop in disadvantaged labor markets where people are more likely to be despondent and lack hope and economic resources.

The three above causes have been around for a long time creating the environment for drug overdoses, but at much lower levels than we see today. The final cause has only been around for a couple of decades, but it is now responsible for the majority of deaths. Alluded to above, Big Pharma undertook “aggressive marketing” in order to encourage doctors to write massive numbers of prescriptions for opiate painkillers and to change to pain prescribing guidelines in order to sell more of these heroin-like pills.

As a result, doctors began prescribing drugs such as Oxycontin and Vicodin, which are similar to opiates, such as morphine and heroin, for ordinary injuries and minor surgeries. The problem with this is that if you take these pills for 30 or 60 days, there is a distinct possibility that you will become physically addicted to them. The doctor is not going to write you refills for the prescription once the injury has healed.

This leaves the addict with three bad choices. One, you can enter a drug addiction rehabilitation program, but these programs are expensive and are not necessarily effective. Two, you can go cold turkey. However, detoxification comes with a slew of physical and psychological symptoms and can result in suicide and death. Three, you can go into the black market and buy illegal Oxycontin and Vicodin pills. The problem with this option is that such pills are expensive and have an unstable supply.

What happens if you choose this option, but run low on money or have trouble acquiring the pills? Well, very often the drug dealer who sold you the pills can also sell you heroin or tell you where to buy it. Heroin is often cheaper per dose and has a more stable supply. This is how people who would never even consider entering a room in which heroin was present become heroin addicts. This process is what has caused the major surge in drug overdoses.

So the solution to the opioid crisis is to end the failed policy of prohibition. While public demand has forced the Federal government to make some progress on respecting state sovereignty on marijuana, we are still far away from the Washington significantly re-evaluating its approach to drugs overall. As such, we are far more likely to see even tighter controls placed on legal pain medication – such as what we saw in Florida this year – which will tragically only make the epidemic of heroin and fentanyl deaths worse.

We will see who else Congress can find to scapegoat as a result. 

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