To Reduce Overdose Deaths, Lawmakers Must Look beyond the News Headlines

pa href=https://www.cato.org/people/jeffrey-singer hreflang=undJeffrey A. Singer/a
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pUsing data from the Centers for Disease Control and Prevention, emThe Hill /ema href=https://thehill.com/policy/healthcare/3917058-teen-overdose-deaths-have-doubled-in-three-years-blame-fentanyl/reported/a on March 26 that teen overdose deaths doubled from 2018 to 2021, mainly due to fentanyl. This alarming and disturbing fact was announced with the headline, “strongTeen overdose deaths have doubled in three years. Blame fentanyl/strong.”/p
pBlaming overdose deaths on fentanyl is like blaming gun violence on guns. Readers who glance at headlines but don’t take the time to read the entire article might conclude, as many members of Congress apparently do, that fentanyl is some evil pathogen launched into our country by Mexican drug cartels, aided by the Chinese who supply the cartels with the raw materials to make the drug. Once fentanyl crosses our southern border, it seeks out hosts to infect, addict, and kill, like anbsp;deadly virus./p
pBut, as Inbsp;a href=https://www.cato.org/multimedia/media-highlights-tv/jeffrey-singer-testifies-hearing-subcommittee-crime-federal-0explained/a to the House Judiciary Committee’s Subcommittee on Crime and Federal Government Surveillance earlier this month:/p
blockquotepLeaders and commentators often refer to the fentanyl overdose crisis as an “epidemic” or an “invasion.” But these are inappropriate metaphors. Fentanyl is not anbsp;viral pathogen that jumps from host to host or anbsp;hunter seeking defenseless prey. The influx of fentanyl is anbsp;response to market demand./p
pBut more crucially, fentanyl is just the latest manifestation of what drug policy analysts call “the iron law of prohibition.” Anbsp;variant of what economists call the Alchian‐​Allen Effect, the shorthand version of the iron law states, “the harder the law enforcement, the harder the drug.” Enforcing prohibition incentivizes those who market prohibited substances to develop more potent forms that are easier to smuggle in smaller sizes and can be subdivided into more units to sell./p
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pThose who read emThe Hill/em’s article and not just the headline will surmise that the reporter, Daniel De Visé, must be aware of the iron law of prohibition and how it makes the black market deadly:/p
blockquotepspanThe main reason is fentanyl. Teens consume the powerful opioid unwittingly, packaged in counterfeit pills tailored to resemble less potent prescription medications. Drug traffickers lace pills with fentanyl to boost the black‐​market high. Dangerously addictive, fentanyl can be lethal, especially to children experimenting with drugs./span/p
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pspanMaking the same points that Inbsp;made to the Subcommittee, De Visé continues:/span/p
blockquotepspanFentanyl, anbsp;synthetic opioid, has proliferated on the underground market of counterfeit pills for the past several years. Inexpensive, easily manufactured and powerfully addictive, fentanyl has emerged as the narcotic of choice for drug traffickers and dealers…/span/p
pspanspanAdolescents are well‐​versed on the opioid epidemic and well‐​aware of the danger of opioid addiction, addiction experts say. Most teens don’t want to abuse opioids and have little access to prescription medications such as oxycodone. /spanThe problem with black‐​market fentanyl is that, in many cases, teenage customers don’t know they are buying it. /span/p
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pspanemThe Hill/em article correctly points out that most teens and adolescents prefer to use prescription pain pills recreationally because they are legal and regulated, so they can rely on their purity and dosage. In recent years as a href=https://www.cato.org/white-paper/cops-practicing-medicinelawmakers and law enforcement have pressured doctors/a into reducing opioid prescribing, the number of prescription pain pills diverted into the black market has plummeted. Therefore, teens are turning to social media channels and the internet to purchase what they think are authentic prescription pain pills or other controlled substances, such as Adderall or Xanax. Unfortunately, these are often counterfeit and laced with fentanyl or other deadly ingredients./span/p
pspanspanIn my opening statement to the Subcommittee, Inbsp;stated/spanspan: /span /span/p
blockquotepAs anbsp;parent and grandparent, my heart breaks whenever Inbsp;hear stories of teenagers who thought they were buying anbsp;diverted prescription drug like oxycodone and then died from an overdose because the pill contained fentanyl. Those young people were not seeking and did not know they were buying fentanyl. The black market killed those youngsters./p
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pIf Congress wants to reduce overdose deaths, it should address the root cause: drug prohibition and the deadly black market it fuels. If ending prohibition is not yet politically feasible, Congress should consider a href=https://www.cato.org/white-paper/drug-decriminalization-portugal-lessons-creating-fair-successful-drug-policiesdecriminalizing/a drugs so that people are no longer put in cages for ingesting substances not approved by the government, ruining their futures by branding them with felony records./p
pEven if drug prohibition ends, harm reduction will always be needed. Harm reduction is a href=https://insidesources.com/a-former-governor-sees-things-the-way-doctors-do/not an alien concept for doctors/a. When doctors prescribe blood pressure medicine, cholesterol‐​lowering drugs, or diabetic pills to patients whose lifestyle and dietary choices put them at greater risk for heart attack, stroke, or kidney failure, they are engaging in harm reduction./p
pIn response to questions from members of the Subcommittee, Inbsp;urged lawmakers to remove government obstacles that prevent organizations from trying to reduce the harms of using black‐​market drugs. Inbsp;urged them to repeal 21 U.S.C. Section 856, the so‐​called “crack house statute,” which makes it federally illegal for organizations to operate a href=https://www.cato.org/briefing-paper/overdose-prevention-centers-successful-strategy-preventing-death-diseaseoverdose prevention centers/a. Inbsp;encouraged lawmakers to repeal state and federal a href=https://www.cato.org/policy-analysis/drug-paraphernalia-laws-undermine-harm-reduction-reduce-overdoses-disease-statesdrug paraphernalia laws/a that, among other things, make it illegal to distribute equipment or devices to test black market drugs for fentanyl and other contaminants. Inbsp;also suggested that lawmakers make it easier for health care practitioners to a href=https://www.cato.org/blog/modernizing-opioid-treatment-access-act-good-step-right-direction-it-should-go-further-0prescribe methadone/a to treat people with opioid use disorder./p
pUnfortunately, Mr. De Visé doesn’t discuss alternative approaches to the overdose crisis in his article./p
pI concluded my opening remarks to the Subcommittee with these words:/p
blockquotepI urge the Subcommittee to avoid doubling down on policies that will not only fail to stem the flow of illicit fentanyl but will fuel the development of more deadly replacements./p
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pAlas, it appears many lawmakers are all‐​too‐​ready to double down. Some even propose that Congress pass an a href=https://crenshaw.house.gov/2023/1/reps-crenshaw-and-waltz-introduce-aumf-targeting-mexican-drug-cartelsAuthorization for the Use of Military Force/a (AUMF) to permit President Biden to send special forces or ground troops into Mexico, hoping to root out the cartels./p
pUnless lawmakers look beyond the headlines and search for root causes, the vicious cycle of harder enforcement leading to harder drugs will continue./p