Will synthetic drugs change drug markets?

Synthetic drugs are becoming more common in markets previously composed entirely of drugs that originate from plants (e.g., heroin, cocaine, marijuana). In Estonia, the powerful opioid fentanyl is now more widely used than heroin. In the U.S., synthetic cannabinoids have become more widely used by adolescents, and as everyone knows, we also have an epidemic of addiction to prescription opioids.

It’s an intriguing exercise to speculate what the world of drugs and drug policy would be like if synthetic drugs end up supplanting the old agriculturally-derived standbys. There would be no programs of crop eradiction and international interdiction. Law enforcement efforts might be entirely domestically focused. This might be a more just world of drugs in that the costs of drugs and drug control would fall at home rather than being exported overseas (Although on Twitter, policy maven Alejandro Hope pointed out that synthetic drugs could still be traded internationally, just as meth currently is between Mexico and the United States).

I mull these possibilities over at Washington Post’s Wonkblog. The piece is more speculative than what I usually write, so I could very easily be wrong about the future of synthetic drugs. At the same time very few industries don’t go through dramatic changes now and then, and the shape of current drug markets has been fairly stable for an awfully long time.

Providing Drug Treatment Under Threat of a Felony Charge

untitled Proposition 47, which California voters passed by a large margin last month, converts simple drug possession from a felony to a misdemeanor. Opponents of the law maintain that the threat of a felony and the prison time that goes with it are necessary to pressure drug offenders into addiction treatment. This argument makes four assumptions, all of which I find questionable.

(1) Everyone who gets charged with drug possession needs addiction treatment. Epidemiologic data shows that the number of people who use drugs is substantially larger than the number of people who meet medical criteria for a substance use disorder. This means that the population of people who could be charged with simple drug possession includes many people who don’t have a disorder that an addiction treatment professional like me could treat.

Let me give you a concrete, real-world example: A noise complaint about a party results in a police officer discovering a group of freshman college students crushing and mixing Vicodin tablets into their beers. The tablets were purchased on line without a prescription and at the time of arrest half of dozen people in the room have them in their possession illegally and could therefore be charged. One of these young people has been a heavy drug user for years but of the others, a couple have only experimented with drugs a few times, a couple others are using drugs for the first time, and one has never used drugs at all, not even at the party that night: He is just holding one of the bottles as his friends use.

If you threaten all these people with a felony charge unless they enroll in drug addiction treatment, it could help the one with the established drug problem, but what about the others? They face a choice between a possible prison term or receiving treatment they don’t need. They will likely choose to take the unnecessary treatment, thereby wasting taxpayer dollars and taking a treatment slot away from someone who needs it.

(2) People who have drug problems and refuse treatment deserve prison sentences. Let’s say someone truly is addicted and the court gives them a choice between 30 months in prison or treatment. They might opt for treatment. But what if they say no? Is it fair to punish refusal to seek addiction treatment at the same level of severity that we might punish attempted rape? And is it worth over $100,000 to taxpayers to punish someone for refusing treatment?

Continue Reading…

Alcohol, “rape culture,” taxation, and libertarianism

Robby Soave of Reason’s Hit & Run pokes fun at some feminists so fixated on the gender dynamics underlying physical and sexual violence against women that they want to deny the role of alcohol. Fair comment, I suppose, though it seems to me that Soave’s colleague Elizabeth Nolan Brown offers a more sensible interpretation of the “rape culture” idea.  (The tendency to give other people’s words trivial and vicious interpretations rather than looking for sensible interpretations of them must rank very high on the blogosphere’s list of besetting sins.)

And of course there’s no reason why acquaintance rape, like other phenomena, shouldn’t have more than one cause. In a culture whose ideas about masculinity involved less sexual score-keeping and less tolerance for violence, alcohol use might be associated with less rape; at the same time, in the culture we actually have (which feminists, with little enough help from the Robby Soaves of the world, are trying to change) less use of alcohol (both by those who become perpetrators and by those who become victims) would probably also lead to less rape. There’s no contradiction there, just the acceptance of a multi-causal world. Nor does pointing to the role of alcohol diminish the culpability of the rapist; the rape may well have been done under the influence, but the decision to get drunk (and, frequently, to encourage the intended seducee/victim to become drunk) was made by a sober man, or – often enough – a sober adolescent trying to pretend he’s a man.

That said, I’m grateful to Soave for pointing out the role of alcohol, and to the editors of Hit & Run for publishing the piece. Now that we’ve agreed that alcohol is a key factor in rape, as it is in homicide and motor vehicle fatality, the question is what to do about it. The obvious answer, if one believes in markets, is to raise the price of alcohol by taxation.

But of course the official libertarian line is that taxing alcohol would be unfair to those drinkers who aren’t drunken rapists or drunken brawlers or drunken drivers.  Any unfairness to rape victims from low alcohol taxes is simply the price of a free society. (Oh, and alcohol taxation is also “regressive,” which you must admit is a weighty argument from people who hate progressive taxation.)

Where does that leave us? Why, with vacuous prescriptions about “fostering”  ”a teen culture of responsible alcohol consumption,” for example by “lowering the drinking age.”

But of course that’s all moonshine, with the marketing and political muscle of the booze industries solidly lined up against anything that might foster moderation in alcohol use, even if we knew how to do so. And of course limiting the commercial and political “free speech” of the people who make their money selling products that kill 90,000 people a year and send hundreds of thousands to emergency rooms, rape crisis centers, and prison cells would be unthinkable.

So what’s a libertarian to do? Why, make fun of feminists! That’s always safe.

Hat trick

Over the past couple of weeks, my essays in search of temperate cannabis policies have appeared in Slate, Vice, the New York Times, and now National Review. Other than the expected trolling from pot fans, pot-industry flacks, and fundamentalist libertarians, they haven’t drawn much response. I sometimes think that trying to talk reasonably about cannabis is a little bit like trying to talk reasonably about football on sports-talk radio. It’s a subject so hard to think clearly about, and so easy to get angry about, that saying anything other than “Racist drug war! Legalize it!” or “Brain damage! What about the children?” seems to miss the whole point of the exercise. But I’m grateful to all the editors involved for giving me the space.

 

 

Those who fail to study history …

John Buntin at Governing looks to the development of alcohol policy after Prohibition for cautionary lessons about the future of the legal commercial cannabis industry, and some alternatives to that future. It’s the kind of solid, thoughtful reporting that is Buntin’s hallmark, and well worth a read.

 

Rob MacCoun on growing your own cannabis legalization

Stop right now and read Rob MacCoun’s essay on cannabis legalization. Whether or not you’re actually interested in the issue – more exciting than it is important – Rob’s piece shows how policy analysis is done. In particular, he focuses on what advocates almost always deny: the fact that policy choices involve tradeoffs among competing values.

Let me offer one technical amendment to what Rob says: in my view, high taxes – as long as they allow prices close to current illicit prices – will decrease health risk and also increase revenue.

Annals of commerce: Beerkeley

Mark says alcohol creates more social cost than all other drugs combined.  I work for a university that has a persistent alcohol problem among its students.

It also has a sideline in big-time athletics, but that operation has made some very bad decisions in recent years and is genuinely desperate for money.  Three years ago, we made a three-year deal to let Coors use our name to sell beer.  No, really; there was an enormous billboard on the local interstate, but no-one on campus noticed. Last year such a billboard went up again, and the 15-year-old son of a public health [sic] prof noticed, producing some faculty outrage and this 21/XI/13 assurance from Claire Holmes, our Associate Vice Chancellor for PR:

… I am working on this issue with Vice Chancellor Wilton and have a meeting to discuss this with him Tuesday next week.  As you know,  contracts are binding agreements, so there is a process involved to change any agreements.  What I can assure you though is that there are no more beer ads planned for the foreseeable future.

Oops:

billboard 14a(Photo Terray Sylvester/SF Chronicle)

It appears the “process” didn’t work, or AVC Holmes was misled, or the folks who could sign a three year contract couldn’t foresee a year ahead…or everyone at our higher financial levels missed the MBA class where they explained that any contract can be abrogated for a price (which would be pretty small while Coors had a whole year to figure out how to use the billboard without us).  Or maybe our campus leadership just decided $200,000 was an appropriate price at which to sell our students’ welfare and our principles, and endure public humiliation in the eyes of every driver and Chron reader.   You might think the 200 large at least went to the health center for alcohol emergencies, or the police and fire departments who have to deal with the alcohol poisonings and sexual assaults on Saturday night, or the undergraduate dean’s office for student alcohol education and safety programs, but as far as I can tell, you would be wrong.  The money is Intercollegiate Athletics’ to use as they wish.

This year’s poster has a couple of little logos in the corner saying “Party safe”and “21 means 21″, so it’s fine! Cigarettes are OK with a little health warning on the pack, right? OK, I’m ready to get with the program…but we can do a lot better.  At the least, we need to start selling beer at games again.  Several years ago, I offered what I thought was a surefire scheme, but so far haven’t been able to sell it.  Never mind: how about we partner with these guys, so they can put our logo right on their page as long as they also have a little box that says “Don’t plagiarize!” But the payoff from that deal pales in comparison to what we can get for adjusting research results, from companies who would kill to have a UC study finding their products safe/effective/whatever.  A notice on our web home page, and on the title page of each such lucrative report, to the effect that “UC Berkeley does not support compromising academic standards” would surely sanitize such deals.

I’m already shopping for my new office furniture.

Cannabis legalization in Oregon: Why Measure 91 is close enough for government work

Ballot initiatives are a terrible way to make policy changes when the technical details matter. Despite the simple-minded sloganeering on both sides, the question of creating a legal cannabis market is about as technical as they come, with equally valid public goals in sharp conflict, many unknowns, a variety of tricky design issues, and some big risks.

But sometimes initiatives are the only way to go, because legislators simply won’t do what a majority of voters want.

Cannabis legalization is that sort of issue, too: legislators are scared of cops and prosecutors, and most cops and prosecutors really hate legalization.

In Oregon, advocates went to the legislature and said, “We can and will put legalization on the ballot unless you handle the issue.” The legislature didn’t move. So the advocates acted on their threat, giving us Measure 91.

What they produced is noticeably less crazy than the measure that failed in 2012: for example, the quotation from the Book of Genesis about “herb bearing seed” is missing.  It seems to reflect a good-faith effort to craft a law that will allow adults to get cannabis, wipe out the illicit market, provide some revenue, and prevent a big increase in use by minors.

But Measure 91 does not reflect a sophisticated understanding of the problems of illicit markets or a nuanced view about substance use disorder. Focusing on the goal of eradicating the illicit cannabis market in Oregon, it doesn’t pay enough attention to the risk that Oregon might become a source of illicit supply to neighboring states. Focusing exclusively on preventing use by minors, it neglects the risk of increasing dependency among adults.

The basic fact about a legal cannabis market is that the product will be remarkably cheap to grow; once competition and industrial-style production have taken effect,  a legal joint would cost (before tax) about what a tea-bag costs, rather than the illegal or medical-dispensary price, which is 100 times as high. And the tax provided for in Measure 91 would add only about 50 cents to the price of a joint: not a high price to pay for two hours or more of being stoned.

Lower prices won’t much change the behavior of adult casual users; even at today’s illegal prices getting stoned is a bargain compared to getting drunk.  But lower prices would matter a lot to frequent users, and most of all to frequent underage users, simply because what they spend on pot represents significant element in their personal budgets: at current prices, the cost of a heavy cannabis habit can exceed $5000 per year.

Of course the claim that barring minors from buying in cannabis stores will keep them from having access to diverted supplies doesn’t pass the giggle test: just consider how easy it is for a minor to get alcohol from an older friend or relative or from the poor heavy drinker hanging around the liquor store, willing to buy a case for a teenager as long as he gets to keep a couple of bottles for himself. Cheap cannabis for grown-ups inevitably means cheap cannabis for kids.

Unless the legislature decided to raise it, the $35-per-ounce tax in Measure 91 would lead, within a couple of years, to prices way below current illicit prices and way below legal prices in Washington State. That in turn would mean big increases in use by minors and in the number of Oregonians with diagnosable cannabis problems. It would also mean substantial diversion of cannabis products legally sold under Oregon’s low taxes to Washington, where taxes are much higher. (Currently the flow goes the other way, with the two biggest-selling legal cannabis stores in Washington being the two closest to Portland.)

It wouldn’t be hard to draft a better-balanced measure than the one to be voted on in two weeks. For example, it might be wiser to limit legal production and sale to co-ops or non-profits, keeping the profit motive out of the business altogether.

But the choice Oregon voters face isn’t between what’s on the ballot and some perfectly designed cannabis policy; it’s between what’s on the ballot and continued prohibition at the state level, until and unless a better initiative can be crafted, put before the voters, and passed into law.

Measure 91 would enact an ordinary law, not a constitutional amendment. If it passes, the legislature will be free to amend it the next day by a simple majority vote; such moves are allowed not only by law but by the conventions of Oregon politics.

So the question facing Oregonians who want adults to be able to buy cannabis legally – without the nonsense of finding a “kush doctor” and faking an ailment – is whether to defeat the proposition and hope that the legislature will act on its own (or that a better-drafted bill will appear on the ballot in 2016) or whether instead to pass the current proposition and hope that the legislature will move to fix what’s wrong with it.

Given the balance of political forces, it seems more reasonable to trust the legislature to rein in a too-lax legalization scheme than to expect it to do what no legislature in the nation has been willing to do yet: pass a full cannabis-legalization law.

It’s not hard to identify the key points that need amendment, within the context set by the initiative: cannabis sold by a set of for-profit enterprises under state regulation. (That leaves aside such interesting ideas as just letting consumers grow their own, or requiring that growers and retailers be not-for-profit co-ops or public-benefit corporations, as well as the alternative of state-monopoly retailing, which has some attractive features but can’t be done while the federal Controlled Substances Act is in place, because the state can’t tell its officials to violate federal law.)

* Recognize preventing adult substance use disorder among the goals of the law.
* Assign some of the regulatory authority to the health department rather than giving it all to the revenue department.
* Give the regulators explicit authority to restrict the quantity of cannabis that can legally be grown. (Ideally, growing rights ought to be auctioned off rather than given away, giving the financial windfall to taxpayers instead of to the lucky few who end up with licenses.) * Increase the proposed taxes, and make them adjustable to keep legal prices at about the current illegal level as production costs fall. In the end, to prevent a big price decrease, the tax would have to be a very large fraction of the current illegal or quasi-medical price of about $10/gram.  Ideally, taxes would be based on the intoxicating power of the product – measured in milligrams of THC, the primary active chemical – rather than on the total weight of the plant material. (We tax whisky more heavily than beer or wine; why shouldn’t cannabis taxation work on the same principle?)
* Require that retail clerks have some serious training in pharmacology and substance use disorder, and make it part of their job to discourage excessive and dangerous consumption patterns, rather than letting their bosses just tell them to sell as much product as they can.
* Make sure there’s enough enforcement against illicit growing and dealing to make the legal market competitive.
* Rein in the medical-marijuana business. Once Oregonians with medical need can buy tested and labeled product at commercial outlets, there’s no need to have an entire parallel distribution system. It makes sense to offer tax exemptions for limited quantities to genuine patients, but the current practice of “patients” buying “medical” supplies for illicit resale has to stop.

There are lots of other good ideas around. (See the forthcoming RAND report on legalization options for Vermont.) But those will do for a start.

Would the legislature pass them all? Probably not. But Oregon’s chances of getting to a temperate cannabis policy will be better if the voters force the legislators to get off the dime.

It’s not an easy choice; as a Californian, I’m glad I don’t have to make one like it (yet). But if I had to vote in Oregon, I’d vote “Yes.”

The (Drug Control) Empire Strikes Back

By and large, I’m not a fan of the work of the (self-appointed) Global Commission on Drug Policy. The Commission’s latest report draws strong conclusions:

Ultimately the most effective way to reduce the extensive harms of the global drug prohibition regime and advance the goals of public health and safety is to get drugs under control through responsible legal regulation.

Unfortunately, those strong conclusions aren’t backed with strong evidence or strong argument. Calling your drug laws “regulations” or “taxes” rather than “prohibitions” doesn’t make them any easier to enforce. The claim that it’s possible to “get drugs under control through responsible legal regulation” has, for now, to be filed under “Interesting, If True.” Experiments with legal supply of “cannabis, coca leaf, and certain novel psychoactive substances” are a good idea, but of course most of the action in the “war on drugs” is in cocaine, heroin and methamphetamine; the drugs we would most like to legalize in terms of reducing the costs of prohibition would be among the hardest to legalize successfully in terms of public health. (We always have the bad example of  alcohol – which causes more violence, more health damage, and more addiction than all the illicit drugs combined – staring down at us.)

That said, the frustration with current drug policies that motivates the Global Commission is entirely justified. Changing the goals and means of the current international drug control regime in the direction of less violence and less incarceration is harder and more complex than denouncing the drug war in abstract terms, and less dramatic than legalization, but it’s necessary and important work, and someone who reads the Commission’s reports but doubts the existence of a regulatory utopia might be motivated to engage in that work.

Naturally, the international drug control empire is going to fight back. Yuri Fedotov, one of its Grand Pooh-Bahs as Director of the UN Office on Drugs and Crime (serving, one might note, as the representative of a government with an especially stupid, vicious, and unsuccessful set of drug policies), says of the Commission report that “It’s very hard to reconcile these recommendations with the major provisions of drug-control conventions.” That, of course, is true.

But what Fedotov doesn’t say, and which is also true, is that it’s very hard to reconcile the premises of the drug-control conventions with observable reality. The Single Convention was written in 1961, before anyone knew about neurotransmitters and receptors. Why should we allow the outdated concepts embodied in that treaty and its successors – treating drugs with abuse potential as evil rather than risky, and assuming that the answer to illicit markets is always more and more law enforcement - to continue to dominate our thinking?

It’s too bad that many of the folks who are willing to say that the existing international drug control regime is based on fantasy insist on pushing the equal and opposite fantasy that there’s a magic wand called “regulation” that we could wave at the problem to bring it under control. But the first step in fixing something is noticing that it’s broken and the Global Commission has at least taken that first step. UNODC and its sister agency INCB, and their allies around the world, are still – if you’ll pardon the use of a technical term – in denial.

 

 

 

 

Using up one more of my fifteen minutes

Which item does not belong on this list?

  • Pope Francis
  • Janet Yellen
  • Rand Paul
  • Mark Kleiman

Politico is out with its annual list of 50 “thinkers, doers and dreamers who really matter in this age of gridlock and dysfunction,” and by some oversight I’m on it, with  an insanely flattering profile and a fairly flattering sketch 

Mark Kleiman

Now, if I had my druthers, I druther be one of the Forbes 400 than the Politico 50, but I’ll take what I can get.

For the record, the BOTEC/RAND team that did the Washington State work included about 50 people, with Jon Caulkins, Beau Kilmer and Angela Hawken (among many others) contributing much of the intellectual firepower and Steve Davenport, Bob Jesse, and Lowry Heussler doing most of the organizational work. The “hemperor” may not be entirely naked, but he’s certainly dressed in borrowed clothing.