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Prohibition Is the Obvious Cause of Opioid Crisis as CDC Releases Preliminary Casualty Numbers for 2017
By Jeffrey A. Singer of Cato.
"Earlier this month the Centers for Disease Control and Prevention released preliminary estimates of
the opioid overdose rate for 2017. The total overdose rate rose to
approximately 72,000, up from a total overdose rate of 63,600 in 2016,
an increase of roughly 10 percent. The total overdose rate includes
deaths from numerous drugs in addition to opioids, such as cocaine,
methamphetamine, and benzodiazepines. The opioid-related overdose rate
increased as well, from a little over 42,000 in 2016 to over 49,000 in
2017. This increase occurred despite a 4 percent drop in heroin
overdoses and a 2 percent drop in overdoses due to prescription opioids.
A 37 percent increase in illicit fentanyl-related overdoses explains the jump in the death rate.
All of this is happening while the prescribing of high-dose opioids continues to decrease dramatically—over 41 percent between 2010 and 2015, with a recent report showing a further decrease of 16 percent during the year 2017.
This is more evidence, if any more was needed, that the opioid
overdose problem is the result of non-medical users accessing drugs in
the black market that results from drug prohibition. Whether these
users’ drug of choice is OxyContin or heroin, the majority have obtained
their drugs through the black market, not from a doctor. A 2007 study by
Carise, et al in the American Journal of Psychiatry looked at over
27,000 OxyContin addicts entering rehab between the years 2001 and 2004
and found that 78 percent never obtained a prescription from a doctor
but got the drugs through a friend, family member, or a dealer. 86
percent said they took the drug to “get high” or get a “buzz.” 78
percent also had a prior history of treatment for substance abuse
disorder. And the National Survey on Drug Use and Health has repeatedly
found roughly three-quarters of non-medical users get their drugs from dealers, family, or friends as opposed to a doctor.
Media and policymakers can’t disabuse themselves of the false
narrative that the opioid problem is the product of doctors hooking
their patients on opioids when they treat their pain, despite the large
number of studies showing–and the Director of the National Institute on
Drug Abuse stating—that
opioids used in the medical setting have a very low addiction rate.
Therefore, most opioid policy has focused on decreasing the number of
pills prescribed. Reducing the number of pills also aims at making less
available for “diversion” into the black market. This is making many
patients suffer from undertreatment of their pain and causes some, in
desperation, to turn to the black market or to suicide.
Since 2010, opioid policy has also promoted the development of
abuse-deterrent formulations of opioids—opioids that cannot be crushed
and snorted or dissolved and injected. As a just-released Cato Research Brief as well as my Policy Analysis from
earlier this year have shown, rendering prescription opioids unsuitable
for abuse has only served to make non-medical users migrate over to
more dangerous heroin, which is increasingly laced with illicit
fentanyl.
This is how things always work with prohibition. Fighting a war on
drugs is like playing a game of “Whac-a-mole.” The war is never-ending
and the deaths keep mounting.
The so-called “opioid crisis” has morphed into a “fentanyl and heroin
crisis.” But it has been an unintended consequence of prohibition from
the get go."
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