U.S. drug policy has sometimes implicitly — and incorrectly — assumed that all drug-related harm is caused by drug use, so reducing drug use necessarily reduces drug harm proportionately. Instead, drug policy should try to reduce the sum of both harms incident to drug consumption — including harms to users as well as harms to others — and policy-generated harm in the form of illicit markets, enforcement costs, and increased harmfulness of drug-taking due to controls. A strict prohibition can meet these criteria when it succeeds in keeping illicit markets “thin” and consumption very low. However, promulgating wise policies toward “thick” markets with widespread consumption necessarily involves trade-offs among competing objectives. Recent U.S. history illustrates both the futility of trying to control already “thick” markets using very long prison sentences for dealers (as in the cocaine market) and the risks of allowing “thin” markets to “thicken” by neglecting regulatory and enforcement efforts as prevalence starts to rise (as in the market for prescription opioids).
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Until the mid-to-late 1990s, the major drugs would be listed as heroin, cocaine, methamphetamine, and marijuana, but heroin has been joined by fentanyl and various diverted prescription opioids and liberalization of marijuana policy has been accompanied by a proliferation of product forms — including edibles, concentrates, lotions, dabs, and vapes — not all of which are even smoked.
Here and throughout prices should be thought of in terms of purity-adjusted (for cannabis, potency-adjusted) prices. Often the way that effective prices rise in drug markets is via a decline in purity. If the proportion of material in bags of white powder falls from 40% heroin to 20% heroin, then users will have to buy twice as many grams to get the same “high”. If the nominal price per gram remains the same, that doubles the effective cost. Cf., Caulkins 2007.
MacCoun (1993) describes additional mechanisms that operate in parallel with these structural consequences of illegality.
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Caulkins, J.P., Kleiman, M. Lessons to be Drawn from U.S. Drug Control Policies. Eur J Crim Policy Res 24, 125–144 (2018). https://doi.org/10.1007/s10610-018-9376-3
- Drug policy
- Drug use
- Drug enforcement