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May 26, 2006 - Drug War Chronicle (US)

Editorial: Making Sure Drugs Kill

By David Borden, Executive Director

Return to Drug War News: Don't Miss Archive

Often people object to drug legalization, at least for drugs other than marijuana, because, as they say, "drugs kill." It's true that drug abuse or even experimental use of illegal drugs can be deadly. But the phenomenon is often a self-fulfilling prophecy.

A rash of overdose deaths in cities as wide-ranging as Atlanta and New York and Chicago makes the point. Fentanyl, a synthetic opiate that is 80 times as potent as morphine (according to Wikipedia), has hit the streets, either mixed in with heroin or sold as heroin. Not realizing this, users have taken what they thought was the heroin they were used to, instead getting something massively more potent.

More than 20 people have died from fatal overdoses in a fentanyl outbreak in Detroit since this weekend alone -- deaths that might have been prevented, advocates and family of victims have pointed out -- if the word had been spread as would have been done if a single bird flu case had cropped up. Instead, it took this week's dramatic tragedy to finally spur authorities into action.

Such criticisms are legitimate and need to be made if lives are to be saved within the present situation. But even better than improving the public health system's responsiveness to dangerous street drug situations would be to eliminate the prevalence of dangerous street drugs.

The law of supply and demand prevents that from being done through enforcement -- too many people are willing to pay too much money for drugs for that to ever succeed -- so something else needs to happen. The fentanyl situation is clearly a consequence of drug prohibition, something that would virtually never happen under a system of regulation. Not surprisingly, this angle has been essentially absent from the media's discussion of the incidents.

At least they're reporting the overdoses; hopefully some people will be warned away and those with the power to help the situation will stay focused on it. But it's time for the media and for opinion leaders to acknowledge the consequences of prohibition as such. Until they do, the drug debate will continue to languish in its current, highly simplistic state.

Baltimore's former mayor, Kurt Schmoke, recognized this and attempted to educate the public on the nuances of the drug issue. At a May 1996 forum in New York city organized by the Partnership for Responsible Drug Information, Schmoke pointed out that what is commonly viewed as the "drug problem" is really three separate problems: crime, addiction, and AIDS. Crime, he said, arguably calls for a health-based approach, but addiction and AIDS clearly call for public health approaches.

To the extent that we are motivated by the desire to protect people from the ravages of addiction or other drug-related dangers, we need to also recognize the impact our laws have on the lives of the very people affected by those dangers. Thousands of Americans die from drug overdoses every year -- the recent rash of them in some cities is only a particularly gripping case of this. While legalization might not prevent all such overdoses, the fentanyl outbreak shows how prohibition makes overdoses much more likely.

In effect, then, what we are doing is increasing the likelihood of death through overdose -- making sure drugs kill -- in hopes that some other group of people who do not use drugs now but would otherwise do so are thereby rescued from the consequences of those hypothetical choices they are not now making.

But those dying from overdoses now are by definition the people we claim we most want to help -- they died, after all, that's what we're trying to stop. Whereas the people being saved -- from themselves -- are un-indentifiable and may or may not really exist. From the moral standpoint this is highly questionable; from the public health standpoint it is downright incoherent.

Numbers and complex arguments aside, each of these unnecessary deaths is an unnecessary tragedy, for the victims and for their families, friends and communities. The book "Between Two Pages: Children of Substance" tells some of their stories in the words of their survivors. (We reviewed "Between Two Pages" last week -- check it out if you haven't already.) We owe it to those who've lost loved ones to addiction -- or to those who could, which is any of us -- to rationalize our thinking on this issue and start to approach it in a more moral and effective way. Their worlds have been changed in a way that can never be repaired. But we can move on and help fix the world itself.

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