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I have yet to see a single proponent of drug legalization (with the underlying reasoning being that if drugs were legal and produced to pharmaceutical standards, then no one would ever use them dangerously) write a single piece, in any venue, arguing that this claim is simply not true. One would think that if they really believed in their professed position, they would be screaming from the rooftops that the Sackler family should be absolutely praised for flooding the market with carefully crafted, pharmaceutical quality drugs, because the only logical conclusion is that this action necessarily saved lives by giving consumers a choice to use a well-regulated product rather than possibly tainted cartel dope.
Can anyone link me to even one such argument? It can be from the weirdest economist that you can dig out of the George Mason basement; it can be the weirdest communist stoner with a cushy lefty sinecure; I don't care. I just want even one that actually embraces the premises of the legalization movement and actually applies them to the case of the Sackler family, concluding that everyone else has gotten it wrong, and that we must necessarily view their actions as an unalloyed good for the world.
I am a proponent of drug legalization, but that underlying reasoning is garbage and I cannot think of a single person I know who holds the position I do based on that reasoning.
I mean, obviously, I was being flippant in a parenthetical. But yeah, there are people in this very thread who are saying that pharmaceutical drugs have nothing to do with overdose deaths, at least. I haven't gotten them down to the nitty gritty of other types of dangerous use, but most advocates of drug legalization generally don't want to talk about any type of dangerous use.
In any event, would you praise the Sackler family for at least trying to flood the market with pharmaceutical drugs (whether they succeeded in this endeavor or not, would you praise the endeavor)? Would you say that the only real problem is that they didn't manage to sell billions more pills through millions more doctors looking the other way to millions more straw purchasers? That if only they had flooded the market enough that the street price of pharmaceutical drugs dropped to rock bottom, then it would have positively helped the opioid crisis?
Absolutely not - I come at this from the "smelly hippy" angle rather than the libertarian one, and I think that what they did was actually monstrous. I'm a proponent of drug legalisation, but I think that legalisation should be accompanied with responsible education and policies with regards to addiction and the like. The Sacklers were ultimately responsible for and made substantial profits from a legal and corporate structure that heavily encouraged and even induced addiction in cases where it wasn't necessary. I absolutely think that drugs should be legal, but I think that part of that liberalisation should include responsible management of them. Encouraging addiction because those ruined lives are extremely profitable is the part of what the Sacklers did that I object to, not so much the distribution of the drugs themselves.
How so?
Someone else has already written this up for me, so I'll just quote them.
https://web.archive.org/web/20201004103052/https://www.newyorker.com/news/news-desk/the-sackler-familys-plan-to-keep-its-billions
This is an absolutely magic sentence that tells us nothing about how any of this works. There is no model here. At least, there is no model that can be stated in words, in public. My suspicion for why is because the model that is implicitly being used violates the claims of people who are pro-legalization.
Did you actually click the link? I didn't include the sordid details but they do actually explain what happened and how it worked. A magic sentence like that is totally fine when you include the explanation in another part of the text.
I did click the link. I read the whole thing. They don't explain any sort of model for the intermediate steps. If you need to convince yourself of this, just try. Try on your own to reconstruct a model of how it's supposed to work from the article. Use your own words. See if you can do it.
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That pro-legalization people refuse to endorse your strawman is still not a point against legalization. The Sacklers were not trying to flood the streets with pharmaceutical drugs; they were trying to sell more drugs through already-legal channels. And charge more for them than generic pharmaceutical drug producers were charging, too. Insisting on misrepresenting the Sackler's actions as somehow the ideal of what drug legalizers would want, and then attacking drug legalizers for not endorsing them, proves nothing outside your own mind.
Where is the daylight between these things? If they sell more and more drugs through already-legal channels, especially if they can use doctors who will look the other way and straw patients who will then put them on the streets, then the latter helps accomplish the former.
Nope. I don't think at all that it is the "ideal" of what drug legalizers would want. But it sure as hell helps the world, helps the situation, helps the opioid crisis, under the commonly-stated model of how the world works. It's a completely beneficial work-around, rather than the ideal, but isn't it absolutely a work-around that has positive impact? Shouldn't someone at least remark on this wonderful positive impact, that it's one of the very few ways that people are helping, rather than hurting?
Where's the evidence that the Sacklers were using unethical doctors and straw patients to get their product out to recreational users?
One example. Fundamentally, the claim is that Purdue/FDA believed that, with non-abusive use, extended release was less likely to result in addiction. This is probably true for some value of true (interesting discussion to be had about RCTs, selection effects, ideal/typical use/abuse, with connections to things like obesity/alcoholism/etc.), which then led to physicians being much more nonchalant about prescribing them. Thus, the pipeline was born, and there have been plenty of profiles of 'kingpins' running straw patient networks to siphon as many pills as they could into the streets. (The Sacklers didn't need to personally set up networks of doctors/patients.) This entire chain worked together to accomplish the important final outcome: more pills on the streets.
Given the beliefs about this pipeline, its mechanism of operation, and its final outcome, one can pretty much take the entire proposition to be, "This is a way to get pharma-quality opioids onto the streets." It's a work-around, yes. But any utilitarian consequentialist, who also believes the preliminaries about making pharma-quality opioids, should think that this work-around is an absolute utilitarian Good (TM). They could agree to quibbles on many edges, but they should absolutely endorse the project as a whole.
But really, we can divorce ourselves from any specifics. Let's just assume a hypothetical world, and it's purely questions about the pipeline that are in play. It's like the Underground Railroad, but for pharmaceutical opioids. Sure, it's not the abolitionists' ideal world; it's a kludgy work-around, but it gets more pharmaceutical opioids into the streets (gets more slaves away from slavery). Different abolitionists might quibble with different details, but at least somebody would be willing to stand up and say, "Getting slaves out of slavery is a Good, and if we could get more slaves out of slavery via the Underground Railroad, it would be Better." Similarly, somebody should be willing to say, "Getting pharmaceutical opioids into the streets is Good, and if we could get more pharmaceutical opioids into the streets, it would be Better." Would you agree with that?
Yes, there were people running straw patient networks and unethical doctors to prescribe to them. But the Sacklers weren't doing this; not personally and not through proxies; it was a side-effect. This was not, so far as I can tell, a goal of theirs, and that would be required to satisfy your idea that drug legalizers should somehow lionize the Sacklers.
Your AMA Journal of Ethics column, BTW, is crap. It claims "patients became dependent on the prescription drugs and moved on to cheaper and readily available illicit drugs, including heroin and fentanyl." with a footnote that makes no such claims. May as well cite Porter and Jick.
I would agree that pharmaceutical-quality opiods displacing low-quality opiods on the streets would be a good thing. Pharmaceutical-quality opioids adding to low-quality opiods would be a bad thing. (I think recreational drug use is most often a bad idea, though I do not think it should be illegal). We can see that when pharmaceutical-quality opiod supplies dry up, low-quality opiods substitute for them, but I think strictly speaking there has not been strong evidence for the reverse; I would expect it to happen under true legalization but for it to be caused by the entry of high-quality suppliers into existing black markets seems less certain.
I don't know what you mean by this. I don't think this is a knob we can tune, even in our hypothetical model. In our hypothetical model, we can basically just turn up/down the quantity of pharmaceutical opioids that make it to the street. We can't really determine whether they displace low-quality opioids or add to them. The market would decide this, right? Unless you're saying that the project of pumping more pharmaceutical opioids into the streets is only Good if it's combined with some other form of crackdown on low-quality opioids?
I think the fundamental claim underlying a lot of positions is that if we just turned the knob of increasing pharmaceutical opioids on the street, then the market will totally, definitely, automatically treat them as a substitute, and they will displace low-quality opioids. This is like, the basic claim that allows people to continue on a chain of reasoning that legalization -> pharmaceutical opioids become widely available -> substitution of pharmaceutical opioids for low-quality opioids -> unmitigated win. I think if you're saying that this chain of reasoning just doesn't hold, because we just have no idea whether they'll substitute or add, then I would view that as being a pretty generic argument against the type of drug legalization reasoning that I've been saying all along doesn't go through. Like, it would appear that we actually agree?
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Here you go, courtesy of Jacob Sullum writing for the libertarian Reason Magazine. Amusingly, the one wrongdoing he accuses Purdue Pharma of committing was reformulating the drug to make it harder to abuse, which was correlated with an increase in overdose deaths.
This is close, thanks. He's just missing the real important step. He's mostly focused on showing that perhaps they didn't actually get enough pills into the market to really have been much of a major driver in the increase in usage. What he's lacking is the, "...and it would absolutely be an affirmative good if they had churned out billions more pills and pumped them into the market via even more doctors looking the other way and correspondingly more straw patients." There's gotta be someone out there endorsing this as a project for good, rather than simply saying that they didn't actually manage to sell enough pills to make a difference. There's gotta be someone finishing that sentence at least with, "...they didn't actually manage to sell enough pills to make the clearly and obviously positive difference that they would have made had they sold more pills."
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Coming up with a position you think your opponents should hold and then demanding that if they were sincere they would have come up with it and advocated it really isn't the argument you think it is. The main reason not to defend the Sacklers is it's far, far, far outside the Overton Window; doing so instantly ejects you from the discourse. It's also possible the drug warriors are correct that the Sacklers lied about the addictive qualities of Oxycontin, which would make them villains for both sides.
That's why I explicitly said that you could bring me the weirdest economist that you can dig out of the George Mason basement or the weirdest communist stoner with a cushy lefty sinecure. Give me literally anyone, even if they're outside of the Overton Window. Hell, we have shitloads of people here who make all sorts of arguments that are wildly outside of the Overton Window, and not even one?! Not even one!?
Oh yes. The legalize all drugs folks are going to make sure that legal heroin makers have to publish a scientifically-proven coefficient of addictiality (with p-values!). That'll be the line they definitely hold.
Actually, yes, it will. Entirely aside from the fact that fraud is very well established as something that most libertarians think should be illegal, people who want to consume drugs have significantly more interest than average in those drugs being as advertised.
(TBF, I'm not quite on team "legalise all drugs" (I'm generally opposed to methamphetamine legalisation on the grounds of "murders are an externality", and I'm nervous about the dose ratio of opiates) and I'm personally straight-edge (haven't even had alcohol in a decade).)
The joke is that there is no such thing as a coefficient of addictiality. It's not possible to do such a thing, so if that's the line that they will actually hold, they'll be demanding something impossible.
Purdue was involved in fake science, though, helping to spread the myth that less than 1% of people become addicted to prescription opioids. That fails to meet even the very low bar of "don't actively mislead people".
They give no cite for that claim, so it's hard for me to evaluate what's going on. I can think of a few hypotheses, but can't really check.
In any event, are you saying that flooding the market with a drug, even one that is of pharmaceutical quality, that has some addictive potential (quantity unclear, in part because it's probably impossible and in part because we have no cite to that number) might actually cause some people to be addicted and might actually do things like "make the opioid crisis worse"?
Like, I feel like you're on my side here. It's the legalization folks who think that you can just flood the market with dangerous and addictive drugs, so long as they have the magic stamp of being 'pharmaceutical', and that nothing bad could possibly happen.
Yes, obviously.
Here's the thing. If people of legal age and relatively-sound mind decide that becoming an opiate addict is a great life choice, is it really my place to tell them "no"? It is my place to ensure that they are aware that choosing to consume opiates will likely result in becoming an opiate addict, and it's not my responsibility to save them if it turns out to fuck them up, but ultimately I think people mostly have a right not to be coddled for their own good; I'm a libertarian.
Remember, functional addicts do exist. Technically, I'm one; I'm at least physically addicted to theobromine (psychologically I don't easily get addicted; I've a chronic problem with forgetting to eat, let alone use drugs, and have gone cold turkey several times by accident). It costs me, oh, probably about 15 cents a day? Chocolate is cheap, and keeping a habit is therefore quite possible; I like the taste, I have uses for the high, and the sort I eat (70%) at the quantities I eat (probably about 5-10 g per day) is considered actively healthy. My aunt was a functional alcoholic; she drank a bottle of wine a day for a decade that I know of, and only drunk drove once. That was considerably more expensive, but it was her money (she was childless) and her liver and she wasn't a violent drunk, so I considered that none of my business. There used to be (some) functional opiate addicts; there aren't anymore because the cartels switched over to using cut fentanyl, which gives users a hilariously-short life expectancy (and, as you yourself noted, this is largely contingent on their prohibition).
You want me to ban drugs outright? You need a better reason than "people might get addicted", because some people choose that, some people can actually make it work, and if people who can't want to fuck themselves over that's their problem. Carfentanyl, okay, I can get behind "no having a kilogram of carfentanyl without a good reason"; the stuff's a viable chemical weapon and I'd rather not make the next Aum Shinrikyo's job easy. Methamphetamine, I'm mostly convinced; meth is strongly associated with murders and that's an externality - a harm to someone not agreeing to be harmed. Opiates (in forms/quantities not usable as weapons), I'm torn on, if mostly because of the issue with people committing random thefts and robberies to get the money for more; I'm open to being convinced either way. I'm definitely against people pretending opiates aren't addictive, though, because if someone's tricked in that fashion then she's not choosing to be an opiate addict and is becoming one anyway - non-consensual harm.
I mean, I haven't actually taken a position on what the policy specific should be, nor a rationale underlying them. But let's see if we can think of some rationales for some specifics. Oh hey! Look at this:
It kind of sounds like you're negotiating on price. It kind of sounds like perhaps there are reasons, other than a simplified strawman, to do something other than completely legalize all drugs. Look, I'm not going to say that there are easy answers here, especially with the wide variety of drugs that are possible and the social phenomenon that occur around their manufacture/sale/use. But what I am saying is that people mostly don't actually believe the naive, "If we just had pharmaceutical quality-controlled products abundantly available..." line. And I don't think that this is a strawman; I think it's pretty popular with a lot of folks. They just haven't taken it to its logical conclusion, because it really doesn't give them the things they want to imply that it gives them (without having to get into details).
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Last time you made this claim, someone DID bring up the point that the overdoses vastly accelerated with the crackdown on Oxycontin, more than its introduction.
Sneering isn't much of an argument either. Many of the legalize-all-drugs people would object to a drugmaker claiming an addictive drug is non-addictive.
No, they didn't.
Ok, let's not sneer. Let's be straight. There is no such thing as a coefficient of addictiveness. There is no such line in the parameter space of coefficients of addictiveness with which to draw a distinction between "addictive" and "non-addictive". It's entirely about them being all, "It's less addictive," other people not liking that, and the lawyers/courts doing what you always expect them to do: beat up on somebody that they don't like, based on extremely squishy, subjective shit, like what you always complain about constantly. Moreover, please find the pro-legalization folks who have some sort of plan for how their new world is going to manage this issue. How they're going to draw lines, require certain types of disclosures, and police squishy statements about various products. Oh, and how strict their regulatory regime (that I'm sure you'll love) will be when it comes to exhaustive testing of unfindable coefficients of addictiveness for every minor drug variant that any producer wants to put on the market.
No, that's all bullshit. The reality is that someone outside of the Overton Window, like we have plenty of here, should at least be able to stand up and say, "We can debate how disclosure should work and whether the Sacklers screwed up there, but we absolutely cannot blame them for the opioid crisis, because they're the only people who are doing the very thing that we want to happen in order to help the opioid crisis." The italicized part is important. Somebody, even one, should be up yelling that the fundamental project of the Sackler Family is Good (TM), and that we shouldn't lose sight of that, and that we definitely shouldn't be blaming them for the opioid crisis.
The closest you're going to get is that pharma companies are fundamentally in the business of solving their patients' pain issues (the "doing good" part), that the opiod overdose crisis is unrelated to this, and that overdose deaths aren't correlated with prescription rates. In short, Richard Lawhern is arguing that we have an overdose crisis A. because synthetic opioids that became pervasive in street drugs during the 2010s have a very low margin for user error and B. we have too many people suffering from something akin to shit life syndrome.
Perhaps a good sanity check would be to check on non-opioid problems with addiction. Say what you want about the Sacklers, but they aren't in the food and beverage industry, and thus can't plausibly be blamed for the rise in alcohol deaths or 10% of Americans being morbidly obese.
I don't want to live in a world with more pillheads, think that full libertarian wet dream drug legalization would be a disaster (It would almost certainly lower the death rate among active drug users, but you'd almost certainly get a lot more users, as happened with Marijuana legalization.), and even accept that crucifying the Sacklers may be a societally necessary action, but I'm not convinced that Oxycontin in particular is what broke everything.
I'm also not on the train that Oxy in particular broke everything, FYI. I'm just wanting to find someone who is willing to go the step further, using the axioms of the drug legalization movement, to come out and say that it doesn't actually matter whether the pharma companies parrot the line that they're just trying to solve patients' pain issues. That it's nice, but also unimportant that overdose deaths aren't correlated with prescription rates. What's important is that they get pharmaceutical drugs into the streets, as many as possible. Because that allows users to carefully and scrupulously use drugs in the way that they prefer, knowing exactly what they'll get, and which is definitely not dangerous to their life or their lifestyle (and like, probably won't increase usage or something).
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Sorry about that, I did see that claim, but it was over at Data Secrets Lox, based on (unsurprisingly) a Cato Institute analysis
You're still sneering. Anyway, there are certainly plenty of legalization proponents who would want more regulation than me.
The italicized part is not, in fact, true. The Sacklers did not invent pharmaceutical-grade opiates, and they certainly were never the only producer.
Fair enough. They should be able to stand up and say, "We can debate how disclosure should work and whether the Sacklers screwed up there, but we absolutely cannot blame them for the opioid crisis, because they're some of the extremely few people who are doing the very thing that we want to happen in order to help the opioid crisis."
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