Understanding Drug Legalization

By Caulkins, Jonathan P.; Kasunic, Anna et al. | International Public Health Journal, July 1, 2014 | Go to article overview

Understanding Drug Legalization


Caulkins, Jonathan P., Kasunic, Anna, Kleiman, Mark, Lee, Michael A. C., International Public Health Journal


Introduction

In a sense, drugs are just consumer goods, like doughnuts and dietary supplements. But caveat emptor is no longer the rule for even routine consumer goods. Doughnut shops must comply with public health inspections, and nutraceutical manufacturers must follow good manufacturing practices, eschew false labeling, and report the adverse effects of their products. Regulation is not the same as prohibition, though. Governments generally do not block the open market from catering to consumer desires.

There are exceptions, often rooted in cultural or religious mores. Both Judaism and Islam proscribe pork, a ban that several Muslim-majority states have incorporated into their national laws. Prohibitions of consumer goods are less common in contemporary secular societies, but still occur. Health, quality of life, ethics, and human rights concerns motivate laws forbidding prostitution, child pornography, and human organ markets. Other bans protect non- humans, such as those against the ivory and tropical hardwood trades. In 2006 Congress effectively banned eating horse meat by withholding federal funds for required slaughterhouse inspections. The prohibition remained in place for five years until the Obama Administration lifted it, even though in many countries eating horse meat is no more controversial than eating beef.

Historically, intoxicants have been a frequent target of prohibitions. England's King James I tried to prohibit tobacco in the 17th century, and alcohol has been subject to numerous bans. Neither tobacco nor alcohol is prohibited in the United States today (a few "dry" counties aside), but the Controlled Substance Act places scores of other psychoactive chemicals into one of five "schedules" depending on their potential for abuse and their potential value in medicine. Schedule I substances include heroin and marijuana (high potential for abuse, no recognized medical value). Cocaine and methamphetamine are in Schedule II, despite high potential for abuse, because they have medical uses (as a topical anesthetic and as a treatment for ADHD and narcolepsy, respectively).

That drug use can harm users is, for some, sufficient justification for market intervention. Consumers are usually left to deal with their own odd choices, but overdoses of pet rocks and low-rider pants are not fatal. Drugs are different, so the argument goes, because they are so seductive and dangerous. Drug-induced behavior can impair decision-making processes through dependence or intoxicated reasoning; the "choice" to continue abusing drugs is something less than completely free. Users may not fully understand the risks before initiating use. After all, the great bulk of initiation is by adolescents and young adults, for whom immediate pleasures cloud judgments involving probabilistic risks of adverse outcomes that are mostly in the future. Precocious use is also a strong risk factor predicting subsequent dependence. Once users become dependent, it can be psychologically and/or physically painful to abstain. Furthermore, the minority of heavy users account for a disproportionate share of all drug consumption, which means that a goodly share of all "decisions" to imbibe are made while judgment is impaired by earlier doses.

While drugs can harm users, so can other unhealthy consumer goods or high-risk activities. Yet few laws forbid eating artery-clogging foods, competing in mixed martial arts, or bungee jumping. Though two states, Michigan and Florida, have introduced temporary bans on bungee jumping, and others highly regulate the activity. What makes drugs-legal and illegal-different from those examples though, is their capacity to harm nonusers, including people completely uninvolved in the market. Nonusers suffer when passersby breathe secondhand smoke, when drug use during pregnancy causes congenital defects in newborns, or when impaired drivers smash their cars into other cars, pedestrians, or property. More diffuse damage arises when drug use reduces worker productivity orcreates healthcare costs others in the same insurance pool must bear. …

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