You cannot solve a problem if you don't understand the problem.
Silicon Graybeard has a long and information rich post about how the war on drugs is simultaneously keeping patients from being able to control chronic pain while making no headway at all in reducing opioid overdose deaths:
The problem, as usual, is that the Government regulators are starting from a bad assumption. They assumed today's junkie shooting contaminated fentanyl is yesterday's patient who started out on prescription drugs and got addicted that way. Only about 8% of people who receive prescription opioids develop addictions. 80% of addicts get started in other, less legal, ways.In my field of computer security there's a saying: sometimes its easier not to do something stupid than it is to do something smart. Issues are complicated, and data are often sparse. Fortunately, there's still a sense here that we don't know as much as we'd like to.
As the Journal of Pain Research points out, the government’s campaign is based on a false premise: “Today’s non-medical opioid users are not yesterday’s patients.” Medical users usually do not become addicts.Wrong assumptions lead to wrong law, and doctors are being threatened with their livelihoods by new regulations.
But not in the realm of public policy:
A study by Harvard’s Jeffrey Miron and others shows the government’s anti-opioid crusade has backfired and actually increased opioid addiction and overdose deaths:Again, issues are complicated and data are sparse. It is, once again, easier not to do something stupid than it is to do something smart. And yet here we are, mired up to our necks in stupid.
Opioid overdose deaths have risen dramatically in the United States over the past two decades.… The opioid epidemic has resulted from too many restrictions on prescribing, not too few. Rather than decreasing opioid overdose deaths, restrictions push users from prescription opioids toward diverted or illicit opioids, which increase the risk of overdose because consumers cannot easily assess drug potency or quality in underground markets. The implication of this “more restrictions, more deaths” explanation is that the United States should scale back restrictions on opioid prescribing, perhaps to the point of legalization.
What SiGraybeard does not venture into is motivations. How is it possible for all of the Organs of the State to have produced a result that is not just worse than doing nothing, but probably worse than any other policy conceivable? After all, overdose deaths are skyrocketing, opioids are for sale on ever street corner in the land, the prisons are packed to overflowing, and patients are forced to live in excruciating pain for years. It's hard to come up with an outcome worse than this, and yet the War on Drugs persists.
I think that the explanation is summed up in Jerry Pournelle's Iron Law of Bureaucracy:
Pournelle's Iron Law of Bureaucracy states that in any bureaucratic organization there will be two kinds of people":
First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.
The Drug Enforcement Administration has a bunch of folks who are trying to keep people from killing themselves with narcotics. They're in the first group. But the Iron Law says that they will not be the ones who end up running the Agency. Those will be from the second group - those who work to increase the power, scope, and budget of the DEA.Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization.
Note that keeping patients out of excruciating pain is not going to increase the power, scope, or budget of the DEA. And so it does not happen.
The idea that really smart policy, implemented by smart and dedicated public servants is one that we scoff at when it is proposed for gun control. It's right that we scoff, because it's no more plausible than Unicorns. It's a tale to comfort small children.
And so with the stupid War On Drugs. We're not going to get smart policy implemented by smart and dedicated public servants. The Iron Law explains everything that you need to know about why. It's long past time to declare victory and bring the troops home.