Wednesday, June 19, 2013

If Heroin Were Legal: Part II

If Heroin Were Legal: Part II

(This is a continuation of the previous “If Heroin Were Legal: Part I)

Legalizing heroin is, paradoxically, both the least risky and the most frightening approach to drug law reform.   Part I of this essay, looking at the drug and its users, showed that almost no risk, personal or social, would be incurred by legalizing access to heroin.  Part II, in examining the supply business, regulation and control, and law enforcement, will show that the changes resulting from legalization will be minimal and, on the whole, beneficial.

Heroin Business:  For all practical purposes, the heroin business would disappear under a legal regime.  Doctors would continue to prescribe opiates as they do today, and in approximately the same ratios.  Heroin would have a few specialized uses: it can often be administered to patients allergic to morphine, and British experience indicates it better in palliative uses in some terminal patients.  Although a comparatively small amount would be needed to supply compulsive users, it would be virtually impossible to detect in the larger market for medicinal opiates.  Street and black market sales would disappear, just as they have for alcohol since Repeal.

Legal heroin would be ridiculously cheap.  The opium poppy can grow almost anywhere.  In the U. S., opium was previously grown commercially in Florida, New Hampshire, Louisiana, Arizona, and California; and the Confederate States grew all they needed for both civilian and military use during the Civil War.  The production of heroin from poppies involves rather simple techniques using cheap chemicals.  While heroin was legal, the Bayer Company (which invented both) sold heroin and aspirin for the same price.  The rate of return would be too small for criminal enterprises to support themselves in a heroin market, just as the bootleggers could not compete with legal alcohol sellers when Prohibition ended.  The remaining sellers of illegal marijuana, cocaine, and amphetamines might occasionally supply small amounts of opiates, but their presence in this market would be minimal.

David Musto was the first to demonstrate that, on a percentage basis, the number of opiate addicts in the U. S. remained constant, or even lowered slightly, from before the Harrison Act to the present.  These figures did not vary appreciably even when price, availability, or risk of arrest changed greatly.  His work is supported by Prof. Nickolas Rasmussen’s findings on amphetamine use.  While the number of experimental users might increase slightly, the number of compulsive users should remain about the same.

Regulation and Control:  Opiates will probably remain prescription drugs and remain under something similar to the current scheduling scheme for the near future, and heroin would be subsumed into this broad class of prescription drugs.  The major change would be some provision for drug access by compulsive users without the necessity of frequent, repetitive doctors’ visits.  American views on health care make free distribution of heroin to addicts on the Swiss or British methods unlikely.  However, some kind of periodic certification (perhaps annually) by either a medical specialist or government agency that would allow supply by pharmacists could be instituted economically.  Some opiates would still go to experimental and casual users, but historically this has been a very small amount and can be expected to remain so.  Normal, minimal leakage from prescription opiates should meet this demand as it does for many other drugs.  In fact, legal maintenance of compulsive users should significantly reduce the amount of opiates now diverted from the prescription market.

 Three new programs could result from legalized heroin, two of which should be funded in large part by a small tax on maintenance opiates. 

First, legalization should enable research on the most effective maintenance drug and on the best ways to deliver it.  Methadone has been used as a replacement for heroin for forty years, but its use has been empirical and opportunistic rather than experimentally based.  Fentanyl or oxycodone, among other possibilities, may prove better, and transdermal patches or implants may be more effective means of administration.  Research can sort out these issues.

A small consumption tax on maintenance opiates could fund two other important programs.  The first would be providing rehabilitation facilities for compulsive users desiring to moderate or stop their use.  The other would be to develop and employ scientifically based drug education as part of normal health education in elementary and high schools.  Both of these programs could provide excellent returns on investment.

Law Enforcement:  Legalization of heroin should lead to substantial savings both in law enforcement and lower social costs from criminal activities.  Since opiate use itself has never been shown to lead to criminal activities, most of these savings will be indirect, coming from the reduced criminality of the underground heroin market.

Most drug law enforcement efforts are not directed at heroin offenses.  Marijuana offenses comprise over half of all drug law arrests and seizures.  Cocaine enforcement is the next largest chunk, followed by amphetamines.  Even diverted prescription opiates receive more attention than does heroin.  If all heroin investigations and arrests stopped, the total amount devoted to drug law enforcement would remain at nearly the same level.

The savings would result from the drastic decrease in crimes committed to procure heroin in the grotesquely inflated black market.  Illegal heroin is so expensive and hard to find that being an addict becomes a full-time career.  As a consequence, most addicts are unemployed and support themselves and their habit with non-violent property crimes – usually shoplifting, car burglary, and construction thefts.  Over a hundred dollars a day is needed for this life style, and stolen property can normally be sold for only about a tenth of its value.  If each of 500,000 addicts steals an average of $1,000 a day, then the overall economy loses $500 Million per day, all because of refusal to make available a drug that could be supplied for pennies a dose.

This unbelievable number is supported by several studies that interviewed long-time addicts in several cities over an extended time.  Most of those interviewed each claimed to have committed several thousand crimes per year. 

All of those crimes have to be investigated (even if not solved) by the police.  They could be better employed on murders, rapes, and robberies – or even directing traffic.

Legalizing heroin would be virtually risk-free.  Failure to do so subjects everyone to risk and high costs.  Now is the time for Congress to act sensibly and repeal this expensive failure.


No comments:

Post a Comment