Attorneys and whistleblowers, even though the law that defines the violation, the Food, Drug, and Cosmetic Act, falls well within the purview of the FDA. Aggressive in opioid approvals, the FDA has been lethargic in responding to the consequences. The DEA, meanwhile, has the power to set production quotas for some opioids, like hydrocodone and oxycodone, produced for sales.
It could have used this power, as it did during past drug crises , to limit the supply of these dangerous drugs. But Frydl pointed me to data that showed that the agency has since at least let the quota for opioids rise and rise and rise — effectively relinquishing a tool it could have used to limit the rapid growth of opioid use.
Much of this is the result of aggressive lobbying from pharmaceutical companies. And it often worked: In Maine, for example, drugmakers successfully pushed for a bill that required insurers to cover opioid painkillers that are supposedly harder to abuse. In fact, the DEA admits that pharmaceutical companies played a key role in its decision making in its own statements.
The DA [sic], based on the date [sic] provided, has increased the aggregate production quotas for both oxycodone for sale and hydromorphone and has determined that a hearing is not necessary. Consider cigarettes. Sure, smoking rates have come down by nearly three-fourths in the past five decades, in large part thanks to government efforts like higher taxes on cigarettes and stricter enforcement of smoking age laws.
But despite these efforts, smoking still kills an astonishing , people each year by some estimates and , by others. It would take roughly 30 years of murders, at the rate , to kill this many Americans.
By the latest estimate, excessive drinking is linked to about 88, deaths and millions of hospitalizations each year. If anything, this seems to be getting worse: As opioid overdose deaths have risen, so too have alcohol-related deaths.
And while experts have all sorts of ideas including something as simple as raising alcohol taxes to combat alcohol misuse and death, lawmakers and regulators have failed to do much of anything — in large part because alcohol companies aggressively lobby them not to, blocking anything from higher taxes to nutrition labels.
These drugs are dangerous and kill people, but Americans and policymakers have become largely desensitized to the deaths — seldom speaking to these hundreds or tens of thousands of deaths as a crisis or epidemic. So these issues, particularly with alcohol, blend into the background, letting the industry get away with its excesses as lawmakers get a pass for inaction. This just seems to be how legalization works in America.
I disagree with Kevin Sabet, a co-founder of the anti-legalization Smart Approaches to Marijuana, on many drug policy issues. If we were a country with a history of being able to promote moderation in our consumer use of products, or promote responsible corporate advertising or no advertising, or if we had a history of being able to take taxes gained from a vice and redirect them into some positive areas, I might be less concerned about what I see happening in this country.
But I think we have a horrible history of dealing with these kinds of things. Drugs should not be legalized. There are also many arguments against legalization. Legalization would increase the number of casual users which, in turn, would increase the number of drug abusers. More drug users, abusers, and addicts would mean more health problems and lower economic productivity. The argument based on the analogy between alcohol and tobacco versus psychoactive drugs is weak because its conclusion—psychoactive drugs should be legalized—does not follow from its premises.
It is illogical to say that because alcohol and tobacco take a terrible toll for example, they are responsible for , premature deaths each year , a heavy toll from legalization is therefore acceptable. Indeed, the reverse seems more logical: prohibit the use of alcohol, tobacco, and psychoactive drugs because of the harm they all do.
Additionally, marijuana, heroin, cocaine, crack, and the rest of the psychoactive drugs are not harmless substances—they have serious negative consequences for the health of users and addictive liability.
Pablo Escobar, who ran the Colombian Medellin cartel in the s and s, exemplifies the power and corrosive influence of criminal syndicates in drug-producing countries. Not surprisingly, many opted for the silver. Once the coca leaves are collected, they are processed to produce a white powder — cocaine — which is then smuggled to the destination country. Once there, it will be distributed by organised gangs who are enriched and empowered by the trade.
They resort to violence to defend their market share from other gangs, and sometimes to bribery to defend it from the police. Finally, the cocaine reaches the end user, who pays for it.
The greatest ills associated with the illicit drug trade are a direct product of its illegality, not of the nature of the substances being sold. Americans are not killing each other to sell alcohol, although they did just that in the Prohibition era of the early 20th century. It was only the end of Prohibition that put gangsters like Al Capone out of business.
Ending the misery caused by the drug trade requires full legalisation — making it legal to produce, transport and sell currently illicit drugs — not just decriminalisation.
The major barrier to reform is uncertainty about how a legal market would work. One option would be the unconditional and unregulated legalisation of all currently illegal drugs. This would allow children to pop into a shop for a chocolate bar and a bag of heroin. Obviously, this is a terrible idea. There is a better option: a regulated market, much as we have for alcohol and tobacco, with controls on who can buy what, when, where and how.
It provides the flexibility to treat different drugs differently, thereby minimising the harms of drug consumption and ending those associated with the illicit drug trade. A recent report from Transform, a UK think tank, points out there is already a range of existing regulatory frameworks used to manage legal recreational and medical drugs that currently illicit substances could be slotted in to. One of the arguments for legalisation is that it would eliminate or at least significantly reduce the illegal black market and criminal networks associated with the drug trade.
Other arguments include moving the problem away from police and the criminal justice system and concentrating responses within health. Governments could accrue taxation revenue from illegal drugs as they currently do from gambling, alcohol and tobacco. The strongest argument against legalisation is that it would result in significant increases in drug use. We know that currently legal drugs, such as alcohol and tobacco, are widely consumed and associated with an extensive economic burden to society — including hospital admissions, alcoholism treatment programs and public nuisance.
So why create an environment where this may also come to pass for currently illegal drugs? But suppositions can be made about the extent of cost-savings to society. Indeed, some of our research on a regulated legal cannabis market suggests that there may not be the significant savings under a legalisation regime that some commentators have argued.
But these are hypothetical exercises.
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