A plausible economic theory states that prohibition of drugs or alcohol will increase the potency of the drugs that people consume illegally. More potent drugs are more economical for both users and dealers because they pack a bigger punch into a smaller volume, making them easier to transport and to conceal. Potent drugs can sometimes also deliver the required dose more quickly, which can help users to evade detection. There is evidence, for example, that alcohol prohibition during the 1920s caused an increase in the consumption of hard liquor relative to beer and wine. After all, there’s no point risking arrest at a speakeasy just to nurse a lite beer; the point is to get smashed.
The other problem with illegal drugs is the lack of quality control. So at the same time that the drugs are more potent, the lack of transparency and quality control makes the level of potency difficult for the user to determine. This uncertainty regarding potency dramatically increases the likelihood of overdose.
The conclusion is that the War on Drugs actually causes users to resort to drugs that are more dangerous than they might otherwise consume. Perhaps not so coincidentally, America’s current heroin epidemic took off right after authorities cracked down on prescription opioids like OxyContin. Abusing prescription opioids is bad; but at least OxyContin is produced by a reputable pharmaceutical company and not cooked up by gangsters in a Mexican hideout.
Now the New York Times reports that potency on the illicit market has ratcheted up to the point where people are using synthetic opioids up to 5,000 times more potent than heroin. The stuff is so dangerous that a tiny speck can kill, and cops are refusing to field test samples for fear of coming in contact with the stuff. The synthetic opioids are largely responsible for a record 200 overdoses in Cincinnati in just a two-week period.
Addiction specialists said the sharp increases in overdoses were a grim symptom of America’s heroin epidemic, and of the growing prevalence of powerful synthetic opiates like fentanyl. The synthetics are often mixed into batches of heroin, or sprinkled into mixtures of caffeine, antihistamines and other fillers.
In Cincinnati, some medical and law enforcement officials said they believed the overdoses were largely caused by a synthetic drug called carfentanil, an animal tranquilizer used on livestock and elephants with no practical uses for humans. Fentanyl can be 50 times stronger than heroin, and carfentanil is as much as 100 times more potent than fentanyl. Experts said an amount smaller than a snowflake could kill a person.
Around Cincinnati, police officers and sheriff’s deputies are so concerned about the potency of carfentanil and other synthetic opioids that they carry overdose-reversing naloxone sprays for themselves, in case they accidentally inhale or touch the tiniest flake.
The problem is growing so fast that overdose deaths in Hamilton County have doubled since 2012, and in the overall Cincinnati area overdose reports have more than doubled in just the past six months.
Meanwhile, the only response to the problem seems to be to send more and more people to jail. That’s the response in particular from the ‘law and order’ types in the rural and suburban counties. The New York Times published another fascinating report about how the Drug War is filling up jails in rural and suburban counties. Dearborn County, Indiana, just a bit west of Cincinnati, now sends more people to prison per capita than nearly any county in America.
By 2014, Dearborn County sentenced more people to prison than San Francisco or Westchester County, N.Y., which each have at least 13 times as many people.
A collection of small, quiet towns near the Ohio River, Dearborn County does not look like a prison capital. Violent crime is rare. There are few empty storefronts. And local officials, flush with money brought in by a popular local casino, have built a convention center and a high school football field fit for a movie set.
But the extraordinarily high incarceration rate here — about one in 10 adults is in prison, jail or probation — is driven less by crime and poverty than by a powerful prosecutor, hard-line judges and a growing heroin epidemic.
Opioid addiction spread early here. Mr. Negangard, the prosecutor, has fought the heroin crisis by aggressively going after drug crimes.
“If you’re not prosecuting, then you’re de facto legalizing it,” Mr. Negangard said.
But maybe legalizing would stop people from overdosing because they wouldn’t have to resort to taking elephant drugs smuggled from Mexico.
If legalization, de facto or otherwise, seems too risky, then we can at least halt the crackdown on prescription pills and focus just on the really dangerous opioids.
Donnie Gaddis picked the wrong county to sell 15 oxycodone pills to an undercover officer.
If Mr. Gaddis had been caught 20 miles to the east, in Cincinnati, he would have received a maximum of six months in prison, court records show. In San Francisco or Brooklyn, he would probably have received drug treatment or probation, lawyers say.
But Mr. Gaddis lived in Dearborn County, Ind., which sends more people to prison per capita than nearly any other county in the United States. After agreeing to a plea deal, he was sentenced to serve 12 years in prison.
“Years? Holy Toledo — I’ve settled murders for a lot less than that,” said Philip Stephens, a public defender in Cincinnati.
If we’re punishing people more for prescription pills than for murder, and the drug problem only gets worse, maybe it’s time to try a different approach.