If drugs were legalized, wouldn’t that lead to more drug use, more drug abuse, and more deaths by drug overdose?
Question 109 in Faith Seeking Freedom: Updated & Expanded
This question is from Faith Seeking Freedom: Updated & Expanded, available in paperback, PDF, and Kindle.
It is hard to say whether drug legalization would lead to elevated drug use. It might. Legalization might even lead to more drug abuse. But when it comes to overdoses, it seems to be the case that most drug overdoses occur because of a dangerous combination of variable potency of black market drugs and the unwise choices of multi-drug users. Most drug users take drugs to feel good, not to die. According to data reported by the United States National Center for Health Statistics, most of the approximately 100,000 fatal overdoses per year, roughly 85–95 percent, are unintentional (NCHS Data Brief, Number 457. Dec. 2022).
A major cause of these unintentional overdoses is the great variability in the potency of black market drugs. Opioid drugs are the leading drugs found to be responsible for fatal drug overdoses. The original recreational opiate—opium—was introduced to the American market as a drug that could be smoked or eaten, and while addiction was common, fatal overdoses were rare. Smoked opium would usually render the user insensate far before he could consume enough to overdose. Opium-smoking was associated in the popular press with Chinese immigrants, and in 1875 one of the first local laws banning opium dens was passed in San Francisco. Seven years later, the Chinese Exclusion Act of 1882 was passed in the U. S. Congress, driven in large part by a stereotypical association of Chinese immigrants with opium.
With the rise of legal and social stigma, some fatal overdoses began to occur as liquid opiate preparations became more common, including laudanum and various patent medicines. While opium was stigmatized and made harder to legally acquire, opioid users started injecting morphine, thanks to the recent invention of the hypodermic needle. Barely two decades after the first anti-opium laws, the Bayer Company began marketing diacetylmorphine (heroin) as a “non-addictive” alternative to morphine. In the early twentieth century, federal law continued to focus on prohibition of the safer, but more “foreign” smoked version of opium, while only requiring accurate labeling of injectable or oral opioids. The Harrison Narcotics Tax Acts of 1914 then outlawed legal opioids for most addicts and sent them to the black market to feed their addictions.
A succession of synthesized opioids were subsequently developed, and while many users started addictions with legal pharmaceutical drugs, they maintained their addiction through the purchase of illicit pills, including counterfeit drugs, that were available on the street. Progressing from codeine to oxycodone to fentanyl, the therapeutic dose became tinier and so too did the lethal dose. Overdoses are now commonly attributed to pills that are designed to appear like legitimate pharmaceuticals while actually containing fentanyl. Even though fentanyl is more dangerous, drug smugglers are incentivized to traffic in it instead of safer, less potent opioids, because the risk of smuggling is better rewarded when the contraband is more concentrated and represents more individual doses for sale in the prohibited market. Thus, it is prohibitionist policies that have driven the drug overdose problem.