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Back in April, the Deep End featured a story about the upsurge in heroin use in the USA. As a recent article in the Economist explains, the trend is an alarming one:

“Over the past six years the number of annual users has almost doubled, from 370,000 in 2007 to 680,000 in 2013…heroin’s resurgence means that, by some measures, it is more popular than crack cocaine, the bogeyman of the 1980s and 1990s. Its increased popularity in America contrasts strongly with Europe, where the number of users has fallen by a third in the past decade.”

Even more dramatic is the change in the demographic pattern of heroin use:

“Forty or fifty years ago heroin addicts were overwhelmingly male, disproportionately black, and very young…These days…More than half are women, and 90% are white. The drug has crept into the suburbs and the middle classes. And although users are still mainly young, the age of initiation has risen: most first-timers are in their mid-20s…”

As also noted in the earlier article, the explanation for this phenomenon can be found in America’s addiction to prescription pills:

“The 1990s saw a big increase in prescriptions of opioids for chronic pain. In some states the number of opioid prescriptions written each year now exceeds the number of people.”

This has resulted in a number of malign interactions with the illegal trade in drugs. For a start, there’s a massive black market in prescription pills – “people who would never dream of injecting heroin seem to assume that opioids in packets are safe.” Even worse, some users are selling their pills and using the money to buy heroin, which is cheaper.

It’s interesting to see the Economist – a publication which advocates the liberalisation of drug laws –  cover this story.

While some states, such as Colorado, have embarked upon the legalisation of cannabis, there are no such experiments in regard to heroin. However, the super-abundance of legal opioids does provide a parallel – after all, making narcotics available within a non-criminal and regulated environment is key to the promised benefits of liberalisation.

Prescription opioids are not the same thing as heroin, but they are the next best thing (I’m using the word ‘best’ loosely here). Furthermore, like all legal pharmaceuticals in the US, they are subject to extensive regulation.

Supporters of liberalisation might therefore draw some comfort from the regulatory response to the problem of over-prescription:

“‘Pill mills’, clinics that churned out prescriptions with no questions asked, have been shut down. And drug manufacturers have made their medicines harder to abuse: the latest OxyContin pills, when crushed, turn into a gloop that cannot easily be snorted or dissolved for injection.”

“These measures have had some impact: rates of prescription-drug abuse and of overdose have dipped a little in the past two years.”

Still, this is only a small improvement on an epidemic that shames America. There’s also a nasty sting in the tail:

“…as the supply of pain pills has dropped, and their black-market price has risen, many addicts have turned to heroin to satisfy their craving more cheaply.”

The idea that the state can displace the dealers by arranging a ‘safe’ supply of drugs to a discrete population of addicts is simplistic. As the American experience shows, the user-base does not remain discrete and the criminals adapt to new market conditions.

Of course, the state could try to destroy the market altogether by making pure heroin available at an unbeatable price to anyone who might like some – which really would be an experiment.

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