The Unintended Consequences of Drug Prohibition (with Jeff Miron)

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00:07 Aaron Powell: Welcome to Free Thoughts. I’m Aaron Powell.

00:09 Trevor Burrus: And I’m Trevor Burrus.

00:10 Aaron Powell: Joining us today is Jeff Miron. He’s Director of Economic Studies at the Cato Institute and the Director of Undergraduate and Graduate Studies in the Department of Economics at Harvard University. Welcome to Free Thoughts, Jeff.

00:21 Jeff Miron: Thank you for having me.

00:22 Aaron Powell: Drug use imposes costs, both human costs and economic costs, and those costs are borne both by drug users and people around them, including citizens who have to pay taxes for public health issues and all sorts of other things. So we, as a society, these costs, we don’t wanna bear them, we wanna minimize them, so we make drugs illegal so that people can’t get them. What’s wrong with that?

00:52 Jeff Miron: Let me focus on three things. So first, it’s absolutely true that some drug use sometimes imposes costs on the user or others, but many, many drug users will claim that drugs make them better off, and it’s only when people overuse them or use them in the wrong circumstances or so on that they’re imposing costs on themselves and others. And of course… Second, that’s true for a huge range of products. People sometimes overuse food by becoming obese, people misuse their bicycles by driving erratically in traffic. Almost any good you can think of is frequently used for the benefit of the user and generally not hurting others, but sometimes misused in a way that does impose costs. So drugs are not different than any other good in that dimension.

01:41 Jeff Miron: Then most importantly, even if we’re concerned about these negative effects on others, we have to ask whether the treatment is worse than disease. If we try to reduce those negative effects by outlawing drugs, we create black markets, and in black markets we have violence, we have corruption, we have poor quality control, which means that those people who continue to use these substances are much more likely to be accidentally poisoned or to overdose and so on. We infringe on civil liberties, we’re tempted much more toward racial profiling in criminal justice enforcement. So a ton of terrible things happen that negatively affect both the users and others if we outlaw drugs. So there may be some policies that try to reduce the negative side effects of drug use for the users or others, but these would be modest things which target those things specifically, such as laws against driving under the influence, not outright prohibitions. There, the costs of the policy are way worse than the costs of the drug use.

02:40 Trevor Burrus: Can we really treat drugs like a normal economic good? There’s a term, I believe it’s hyperbolic discounting, that is used where if you think about what a drug user, what some drug users… And for some drugs, it seems like a lot of ‘em, like heroin, will go through to get the drug, it seems that their demand curve is sort of wildly different than their demand for even food, that they’ll get rid of their family relations, lose their job, go into extreme poor health, all these things, so they’re not really a normal economic good in that way.

03:12 Jeff Miron: So the view that somehow the demand for drugs is different, that people are not rational with respect to their choices about drugs, that’s been around for a long, long time. A lot of research has examined that claim, and it’s subject to the standard criticisms of all empirical social science, but it finds that people behave, with respect to drugs, similarly to all sorts of other things. Their demand is not completely inelastic, they respond to changes in the price. Many of them clearly make forward-​looking decisions about whether to use drugs, where they buy drugs, take steps to buy from reliable suppliers so they don’t accidentally get poisoned and so on. But prohibition, driving the market into the black market, makes it much harder for rational people to take advantage, to use their common sense because they just don’t have good options. And, indeed, it would be irrational or myopic people who would be most affected by driving use into the black market. In a legal market, if you go in and buy a substance, you’re pretty confident it is what it is.

04:12 Jeff Miron: Now, you may choose to consume an excessive amount or use it an inappropriate way, and some users do. But in a black market, even if you care about all those things, even if you’re forward-​looking… Sorry, if you’re irrational and you’re in a black market, you’re gonna not tend to recognize that it’s more likely to be adulterated, it’s more likely to poison you when you purchase it in a black market. And so it’s precisely the myopic, naive users who are most negatively affected by driving the market underground.

04:40 Aaron Powell: Does this… We’ve been using… We’ve been saying drugs, but drugs is not a monolithic thing; there’s lots of different kinds of drugs, and they vary wildly in everything from their cost, to their effect on the user, to their addictiveness. And so it’s one thing to talk about, well, marijuana users can use it rationally, but does this same sort of talk apply to things like heroin, or PCP, or cocaine, or these much harder drugs?

05:10 Jeff Miron: I think that the vast majority of the things I’m saying apply equally to any substance that policy tries to ban if there’s a significant demand for that substance and relatively few alternatives, so when you try to outlaw, you drive up the price and create a black market. If we banned broccoli ice cream, we wouldn’t have drive-​by shootings over broccoli ice cream trafficking. If we banned chocolate ice cream sold by Ben and Jerry’s, people would just substitute toward somebody else’s chocolate ice cream. But if you ban any of these substances, and many other substances we haven’t talked about, you’re gonna have all these same effects because they come from the logic of prohibition, the economic logic that says when people want something and it’s hard to get there’s going to be a black market which will supply it.

05:55 Jeff Miron: Now, some details, of course, vary, depending on which substance we’re talking about. So marijuana does not seem to be able to be consumed in a lethal dose, so the risks for marijuana use are indeed lower in a well-​defined sense than the risks of cocaine or especially opioids. But we have all sorts of legal goods which are potentially lethal if consumed excessively that are sold over the counter day after day after day in every pharmacy, every drug store in the country, and yet people almost never do overdose with those things, except for intentional suicides occasionally, because the information is there and the vast majority of people don’t want to die from taking something, and so they will use common sense and only take two Advil, not 30 Advil, or a bottle full of Advil or something like that.

06:42 Trevor Burrus: But there’s a drug… So Xanax… Alprazolam, I think, is the name of the… The chemical name of the drug, which is a legal prescribed, not over-​the-​counter, but prescribed substance, that kills several thousand people a year in overdoses. That seems to be one that’s kind of… It does… People are buying it and then dying from it in a legal fashion. And so not so much Advil or something like that, but they get Xanax and then they take a couple of ‘em and they die, or they take four of ‘em because they feel sad and then they happen to die.

07:12 Jeff Miron: Well, I would say that makes the case against regulation and government intervention, because that is a drug which has been approved by the FDA, it’s on the market and legally sold only because the FDA allows it to be so. If it were sold over the counter, these warnings might be more visible, people would be less tempted to say, “Oh, since it’s approved, I can just take the doses.” But of course, it also shows that many legally approved drugs are quite dangerous, and so we’re having this incredibly disproportionate focus on the dangers from the currently outlawed drugs like heroin or cocaine or whatever relative to tons of medications which are potentially quite dangerous if you don’t use them in the way that’s recommended.

07:58 Trevor Burrus: Should we be talk… When we talk about really addictive drugs, which marijuana is not so much addictive like heroin is, should we be treating the pleasure of satiating your addiction as the kind of pleasure we should care about? That the actual pleasure is just that right now I don’t feel like I have to crawl out of my skin and I’m not dying because I’m addicted to something. It’s a weird form of pleasure; it’s a pleasure that derives from getting something that if you never took in the first place you would never have that pleasure. Should we treat that as a different kind of pleasure?

08:27 Jeff Miron: I don’t see why; I don’t see what useful comes of treating it as different. I don’t know why policy should say that some kinds of pleasure that people obtain are better or worse than any other kind of pleasure. People do lots of things which cause all sorts of harm to their bodies, by exercising excessively, by participating in very violent sports like football or rugby, and we find those acceptable, and those may be much more dangerous to you than being addicted to an opioid even for a very long time. And going back to the point about policy, even if we disliked people obtaining pleasure in this form, if we try to stop it we’re gonna make those people worse off. And so the treatment being worse than disease is a crucial part. It’s not the only part, but it’s a crucial part of why prohibition is such a misguided policy.

09:14 Aaron Powell: How much does drug prohibition cost? So take the federal government, how much does the federal government spend on drug prohibition?

09:24 Jeff Miron: I have some estimates of this. It’s not trivial to be precise, but in round numbers, adding together all drugs, and for the moment adding together all levels of government, my estimate is roughly $100 billion effect on the overall US deficit. About half of that is the expenditure for enforcement: Prisons, police, etcetera, and about half of that is the foregone revenue that would be collected if drugs were sold in a legal market like alcohol or tobacco.

09:52 Trevor Burrus: But the taxing of drugs, we expect that to happen, but it’s not exactly the optimal world, or are you saying the government should tax these drugs? In terms of revenue, that’s what you’re talking about, like alcohol taxes and things like that, right?

10:04 Jeff Miron: Right. The calculation I did took as a given, as a political constraint…

10:09 Trevor Burrus: Yes.

10:09 Jeff Miron: That if we legalize drugs we would, at a minimum, tax them at the same rate that we tax cigarettes or alcohol.

10:15 Trevor Burrus: Toaster ovens, or…

10:17 Jeff Miron: Alcohol, cigarettes, and so on. But for libertarians, I think it’s not at all obvious we should be imposing sin taxes, that is higher than normal taxes on particular goods, because it’s very hard to figure out which goods are actually the ones that are causing the excess burden on others, in the economics lingo, the externalities on others. For sure, sometimes some people’s use of, say, alcohol is costly to others because you drive under the influence and cause accidents. But you could say that late night TV causes accidents because people stay up too late, they’re not well-​rested, and they drive on the highway. You could say the antihistamines generate accidents, people eating causes them to use more of excessive healthcare, of publicly funded healthcare. So figuring out which goods we should treat as sins… Of course, libertarians don’t like that term, but even if you use that for the moment, it’s so complicated, I think we would say just treat everything exactly the same.

11:11 Trevor Burrus: In the public health world, when you talk about alcohol taxes, a lot of the people who are for relaxing the prohibitions on certain drugs, are also for strengthening at least taxes or even prohibitions on alcohol. You see people like David Nutt in the UK who famously lost his job when he said that horseback riding is more dangerous than meth, [chuckle] but he is of the public health ilk where he says, “Well, we weigh the harms to society, and what should really be the case is marijuana should be legal and low taxed, and alcohol should be highly restricted and high taxed.” Is that something you would endorse, too, as a way of approaching the harm these drugs cause?

11:50 Jeff Miron: Breaking it down into a couple pieces, the claim that use of alcohol is more likely to cause some significant negative health effect or cause driving fatalities, I think the evidence tends to be supportive of that view, so that is consistent with his position. The claim that alcohol is generating net cost to society is messy because… Let me take the even more extreme example of cigarettes. People make the same argument: Yes, smokers tend to have higher than average health costs, and to the extent healthcare is publicly funded, that’s a negative effect on everyone else. However, sounds gruesome to talk this way, but smokers tend to die young, so they’re less likely to collect Medicare or Social Security and so on, which means that the right level of taxation is not necessarily so high, and existing estimates suggest we’re sort of about in the right ballpark. All of that sort of leading to the bottom line of it’s really hard to figure out which things overall should have the net higher or lower taxes. So that brings me back to let’s try to be neutral.

12:57 Aaron Powell: Would the taxes actually… So take alcohol taxes. Would they actually have the affect of reducing consumption? Do they have the affect of reducing consumption as opposed to, say, instead just getting people to consume the amount but cheaper stuff? So you’re not buying as many microbrews, but you’re instead buying a whole bunch of Pabst Blue Ribbon?

13:19 Jeff Miron: The studies that are out there… Again, empirical social science is an imprecise art, [chuckle] to say the least. But they suggest that there are both responses in terms of the quantity consumed, the quantity of actual units of alcohol, effective dosage consumed. But for sure some of the response is changing to a cheaper brand because the price of the premium brand has gone up and things like that.

13:43 Trevor Burrus: So on some level it’s safe to say that prohibition does work in the sense that probably low-​level users stop or would stop. You’d have to be pretty motivated to go through black markets and things like this, you may not just know where to go to your local heroin dealer, but if it was at your CVS, you might go and buy some heroin. Did we see that during alcohol prohibition? Do we think that alcohol use went down during prohibition?

14:10 Jeff Miron: I think the best evidence, which is a paper that I wrote… [chuckle]

14:14 Trevor Burrus: I know the paper, yes.

14:14 Jeff Miron: Which looks at cirrhosis death rates as a proxy for alcohol consumption because, of course, when it was officially illegal, no one was collecting data on how much alcohol was consumed. It suggests 15%-20% decline in alcohol consumption per capita during Prohibition, so that’s not zero. And sometimes legalizers sort of slip into saying prohibitions have no effect on use at all. Common sense, standard economics, and the data don’t quite support that. They do suggest the effects are pretty small, and as you just outlined, plausibly… Although, again, hard to have good evidence, most of the effect’s on casual users. If you really don’t care that much whether you have a glass of red wine or marijuana, and one’s illegal, and you don’t wanna have to answer questions on your security clearance, your job application, etcetera, you’re just gonna stick with the red wine. The Douglas Ginsburg example is the famous illustration.

15:04 Trevor Burrus: Yeah, right, exactly. In the marijuana, we’re doing, some people would say, a kind of crazy experiment, people on the prohibition side or some of the public health people, that we’re legalizing marijuana for recreational use throughout the country in probably 20 states within the next 10 years, a total of 20 states, but we don’t really know what the effects of this will be. Are we kinda playing with fire? For example, there’s some data that shows that if you smoke a bunch of marijuana when you’re 15 it might stunt your brain development. And if we have a bunch of 15-​year-​olds smoking marijuana, are we gonna make our societies just stupider and more inebriated for no real benefit?

15:47 Jeff Miron: I think those claims are based on almost no or no evidence whatsoever. First of all, we have lots of experience with people having access to marijuana. We’ve had medical marijuana laws going back to 1996, and we have those now in something like 33 states.

16:03 Trevor Burrus: But that’s all sodas and stuff you see in Colorado, right, like gummies and candies and sodas and powders. I was just there, trust me, it’s crazy.

16:10 Jeff Miron: I agree that in some states the dispensaries are sort of cra… I wouldn’t call it crazy, but they are very open, it’s very easy to get a medical marijuana prescription, and so on and so forth. Other states are somewhat more restrictive. But still we’ve seen that that easy access has not led to any obvious significant negatives. I have work that Cato has published that looks at what happened before and after the state legalizations that have happened so far, looking at crime statistics, at use rates, at uses of other substances, at education outcomes, crime statistics. None of it shows any noticeable change, positive or negative, as a result of these state legalizations. We also, of course, have other substances which have been legal for a long time we can draw to, we have a period before marijuana was outlawed that we can look at, we have other countries that have effectively legalized marijuana such as parts of the Netherlands and Portugal. And so these claims that we don’t have any information are not accurate.

17:12 Jeff Miron: Second, we have information on what happens when you do have prohibition, and all of that’s negative, so… And we have all these other legal goods that are potentially dangerous, but that people do not routinely sort of misuse. So they’re either being ridiculously cautious or disingenuous.

17:31 Trevor Burrus: Wouldn’t you expect… We would have to grant that, say, insofar as marijuana impairs your driving ability, and it does for some people, you would expect accidents to go up. I would expect accidents from alcohol to go up after you legalize alcohol, and I would expect the same thing with marijuana. Should we just sort of grant that fact?

17:51 Jeff Miron: It turns out not, because the studies that have examined this that considered states that had either medicalized marijuana or decriminalized it back in the ’70s, different studies, and other kinds of information suggest that marijuana and alcohol are, to some degree, substitutes. Obviously not for everyone, but many people seem to switch back and forth based on availability or price of those two. And so when marijuana became more readily available there was a non-​trivial substitution from alcohol to marijuana in use patterns. And while marijuana is clearly not good for your driving ability, it’s less bad for your driving ability than alcohol, and so traffic fatalities, in fact, went down not up.

18:33 Trevor Burrus: Total traffic fatalities, yes, yep.

18:34 Jeff Miron: Total traffic fatalities. And so, again, most people have some degree of common sense of not wanting to be in accidents, of not wanting to harm themselves, so when they have the information and the freedom to exercise their judgment, they generally do reasonable things. Of course, not everybody, but overall.

18:52 Aaron Powell: Is this data… As far as taking this and then analogizing to other substances that we might legalize or decriminalized, is this data… The conclusions we can draw from it somewhat weakened by the fact that, yes, we made marijuana more available, but marijuana has been really available for a long time. Of the illegal drugs, it’s by far the easiest one to get, and basically anyone who is interested in it could quickly figure out how to do it. And so not that many more people… You might think, but that’s a question is how many more people are actually using it now that it’s legalized or using it more than were before?

19:33 Trevor Burrus: Well, and to add onto that, being a native Coloradan, and Aaron lived there for 10 years, that it’s not the case… Everyone was already… Who wanted to smoke marijuana in Colorado was pretty much already doing it. It’s not the case that no one was smoking marijuana and then that state legalized marijuana, they’re usually states where people are already smoking a pretty good amount of marijuana, so maybe you won’t be able to see too many changes because there aren’t that many change in users.

19:53 Jeff Miron: That’s a totally fair point. I, in fact, state that in my Cato papers. One reason we might see very minimal effects from the official legalization or medicalization is that de facto many states… Not just the ones that have legalized, but lots of other states as well, are pretty close to tolerating marijuana use and production and sale. As Aaron noted, you can grow it in your attic, or your basement, or in some local public park [chuckle] where you don’t have to worry about the government seizing your land and so on. So that is certainly one reason, and that’s why I mentioned earlier, we shouldn’t assume there’s no change in use if you went from… If you repealed a serious prohibition, such as alcohol prohibition in the 1930s.

20:36 Jeff Miron: If we fully legalized opioids now, then for sure we might see increases in use, we might see significant changes in the patterns of which opioids are consuming, but I would say the evidence shows that most of that will be in a beneficial direction, and many people who will start using opioids will be people like relatives of mine who are in severe pain, they’re prescribed opioids by their doctors, and they refuse to take it because they think they’re gonna turn into some addict lying bleeding out in the street or something like that. So that would be a good thing if people are not experiencing this hysteria over opioids and are willing to take medicine that might be beneficial for them.

21:18 Trevor Burrus: Is hysteria the right… Not to minimize, we have the numbers, at least last year, of 72,000 people dying of drug overdoses. It’s a pretty well-​known story now. That’s more than guns and auto accidents combined. It’s one of the leading causes of deaths for people between age 25 and 60 years, so is that… Maybe we should be a little hysteric about these opiates and how you’re taking them, and maybe you should be scared about whether or not you’ll become addicted if you’re in pain. That’s something you should be aware of, at least.

21:54 Jeff Miron: It’s certainly a serious problem, however, the evidence is very clear as when people receive opioids as part of a prescription, their likelihood of becoming addicted is extremely low. There have now been 25, 35 studies over 35 or so years, they find that the addiction rates year two, five out are something like 1%-5%, and a large fraction of those who are continuing to use post-​prescription or are addicted post-​prescription were addicted or using before they ever got the prescription, so it’s probably not mainly due to the description.

22:33 Jeff Miron: Second, consistent with everything else we’ve said, when policy started restricting access to prescription opioids, which happened in a big way in the US starting about 2010 through various different government policies, the following happened: Use of prescription opioids stopped increasing nearly as quickly and even leveled off or went down a small amount, and deaths associated with prescription opioids went down, but deaths from illicit opioids, heroin and fentanyl, started growing much more quickly. And the total number of overdoses, the rate of increase of that, has not declined, if anything has accelerated because people substituted away from prescription pills where they knew the dosage and had some ability, therefore, to avoid overdose to going to the black market where they deal with super potent substances that are not labeled, that are not tested, that they have no information about.

23:25 Aaron Powell: How much, too, would we expect to see… We see a lot of progress in prescription medications over time; they get better, new ones come out that are more effective, or have fewer side effects, or do less long-​term harm, things like that, and that’s because we can put R&D dollars into this. And these costs of ODs are a cost that consumers don’t want to bear. They like the euphoria of the drug but they’d rather not die from it. And so if it were legalized, if we could then put R&D dollars into it, and if there’s a market, which there are clearly appears to be, could we expect to see that same kind of R&D research, that we would simply replace the existing harmful substances with ones that produce similar effects but weren’t as harmful?

24:17 Jeff Miron: I think there’s a scope for that. We see examples of that, say, in the marijuana case where a product that’s becoming quite popular now is cannabinoid oil, which allows you to get, apparently, some of the medicinal benefits that you would have gotten by smoking marijuana but without any THC, the active ingredient that gives you the high. And so lots of people who don’t wanna get high have been made better off by the research that went into producing that. I wouldn’t wanna pretend that we can eliminate the risks; tons of things are gonna have risks, and probably opioids are always gonna carry some of that. But yes, having research that packages pills with the accurate dosage, that packages them in ways that you can be very sure you’re not accidentally taking too much, and that maybe can separate some of the risk of side effects from the effects people desire, can package them with the antidote, with Narcan, so that if you accidentally take too much, you have the antidote right there. A legal market allows all those things to happen much more readily than a prohibitive market.

25:19 Trevor Burrus: But a legal market would also have fentanyl, let’s say, just over the counter. And as you remarked, that is a particularly dangerous drug, terrifyingly so; a lethal dose is about 2-3 milligrams. And so isn’t that the kind of drug that you would… Many of these drugs we can… Marijuana, PCP, meth, whatever, but fentanyl is more poisonous than arsenic. Why would you sell it to people over the counter?

25:45 Jeff Miron: Because for some people it’s extremely effective at relieving their pain, and some people can live their lives in a better way, not a perfect way, who have horrible back pain or other chronic conditions. You can find all sorts of testimonials from people who say that they are despondent, that they’re depressed. And indeed in, I think, 23 well-​documented cases so far, committed suicide because their doctors cut them off from access to the prescription opioids they were taking. On fentanyl or even more potent versions, sufentanil, carfentanil, all these things, if there were really a demand for that… And there might not be much if it were legalized and people had better access to, say, just morphine in known dosages. But if there were a case for that, then it would be packaged in a way in a legal market that it would be very hard for you to accidentally overdose because there would be a little teeny dot that you had to separate at some nontrivial effort, just like it’s impossible to get NyQuil out of the stupid package they put it in. [chuckle] And that would discourage the vast majority of the accidental overdoses.

26:55 Trevor Burrus: Wouldn’t we expect… I can see the point that corporations and drug companies would want to provide Narcan and the kind of product people would want, but wouldn’t we also expect these corporations, like perhaps we saw during the build up to the opioid crisis, that they actually would want someone to be addicted to their product, and that they would make it that way, and they would try to rope in these consumers and then have them at the end of a leash and make all this money off of ‘em?

27:21 Jeff Miron: I have no doubt that some companies, maybe many companies, want consumers to buy their… Keep buying their product, and if the product is addictive in the physiological sense, then yes, maybe that. But zillions of people stop using addictive goods all the time. That’s true for alcohol, it’s true for cigarettes, it’s true for opioids, and so on. Many people use opioids in ways that do not fit the standard addiction. They use it once a week or once a month, they just chip occasionally when they go out to parties and things like that.

27:52 Jeff Miron: And second, let’s say that people do get addicted, and they feel that they don’t wanna go through withdrawal symptoms of getting over that addiction. First answer is, so what? What’s the cost? Now, there may be some cost. There’s the actual expense of buying the pills, but that’s pretty trivial because opioids are really cheap. There’s any negative side effects that you may get from the opioids. They have some, they’re not life-​threatening, they’re things like constipation and stomach upset, but that’s one reason not so many people will get addicted, they won’t like those side effects, and so they’ll stop using them. You can also withdraw from opioids without going cold turkey; you can gradually reduce your dose, just as lots of people did when they were trying to stop smoking or when they wanted to get off of drinking so much coffee or things like that. And so is that unfortunate for some people, it entails some costs? Yes, but it can’t possibly justify killing tons of people because we drive the market underground.

28:51 Aaron Powell: It also seems that by… If this stuff was decriminalized, if more of it was decriminalized, then access to services to help you through all of that would improve because those services… You wouldn’t be admitting that you engage in illegal activity to seek them out. And so we’d have… If not rehab, the patch or other products that could help you.

29:18 Jeff Miron: Yes. Yeah, excellent point.

29:19 Trevor Burrus: I’m trying to figure out, Mr. Crazy libertarian, [chuckle] what drug you think should be, ’cause… So let’s postulate. Okay, there’s a drug, let’s call it… What is the drug in Brave New World? Soma, is that what it’s called? Anyway, whatever. [chuckle] And it has a 50% chance of turning into a homicidal maniac, and a 50% chance of giving you blinding euphoria, and that’s the two sides of this drug.

29:42 Jeff Miron: Why are those two things mutually exclusive?

[chuckle]

29:45 Trevor Burrus: It’s just, you know… Well, this is… It’s an absurd example in that no drug is that clear, but when you talk about… I am a product of DARE, so I learned some things, important things about my brain on drugs. But PCP was the one that we talked about at DARE, and if you read the history of the drug war you see the same thing with cocaine and marijuana, that turns you into a homicidal maniac, and unkillable, and possibly able to throw cars at cops and things like that. But PCP does have some pretty bad effects on some people, so let’s say it’s like that. But let’s say that is an actual drug. Would that be something that we would prohibit? That seems like a pretty big externality, 50% percent homicidal maniac.

30:22 Jeff Miron: It’s such a hypothetical, I find it hard to really think about it. If someone ever presented evidence that there really was such a thing, I guess I would be willing to consider the possibility that we should restrict access. But I don’t think I would end up endorsing it because I think the demand for such a thing would be infinitesimal, and the set of people who engaged in it would quickly weed themselves out of the population. [chuckle]

30:47 Trevor Burrus: Well, they would already be crazy ’cause they would be crazy to take it.

30:51 Jeff Miron: I think it’s hard to make thoughtful policy based on incredibly implausible hypotheticals, so I try not to go there.

30:57 Trevor Burrus: Okay. Fair enough.

30:58 Aaron Powell: And I think we also have to… The kind of counter example or the thing that needs to be explained in a lot of cases whenever people are talking about prohibiting drugs is alcohol and the legality of alcohol, because alcohol doesn’t have a 50/50, but alcohol does make a lot of people violent, alcohol does make a lot of people impose extraordinary externalities: Drunk driving, domestic abuse, all sorts of stuff. And albeit a lot of people can use alcohol responsibly, but this is a dangerous drug, and yet we are totally cool with it and, in fact, celebrate its use in all sorts of cultural ways.

31:39 Trevor Burrus: But it’s also not just legal. That’s the other question, so it’s… You have to have a license to be a licensed drug dealer, a bartender, you have to have the liquor license. Producing it requires some sort of… Home brewing was illegal and home distilling is still federally illegal. And you have age restrictions and other restrictions on its use. Are those at least sensible things that we should consider… Would do for other drugs if we were to make them legal, but not just, hey, vending machines in parks, [chuckle] public or private, that are selling heroin?

32:14 Jeff Miron: Let’s take age restrictions as an example. If we had an age restriction of five to be able to legally purchase alcohol or marijuana, I think most libertarians would say I don’t really care because it just has so little effect. If you have an age restriction of 18, first of all, you’re keeping a lot of 14, 15, 16, 17-​year-​olds from consuming alcohol in ways that will be beneficial to them, that won’t impose costs, so that should certainly factor into the discussion. Even worse, once it’s 18, somebody’s gonna try to make it 21. And the current practice in the US seems to be incredibly counter-​productive, it just teaches 18-​20-​year-​olds and the people of other ages around them that laws are for suckers, and breeds people to think… Even if they don’t wanna violate that law, well, people are getting away with laws they don’t happen to like, maybe I should go ahead and try to get away with laws I don’t happen to like: Paying my taxes, or not speeding excessively on the highway, or things like that. The notion that the the 21-​year-​old drinking age keeps any college student who wants to drink from drinking is utterly laughable, and so I would prefer… In libertarian land, I would say there’s no minimum legal drinking age, but if instead we kept it at something like many European countries of 15 or 16, maybe that’s an okay acknowledgement of the potential problems.

33:37 Aaron Powell: What does the experience look like in those European countries where teenagers are allowed to buy alcohol? Do we see the kind of horror stories we would imagine here if we lowered it?

33:48 Jeff Miron: Not at all. It’s, again, hard to compare countries that have a lot of things that are different, but I have a short piece that looked at traffic fatalities for people in those relevant age ranges across Europe versus the US, and if anything, they were slightly higher in the US than in most of the European countries that had substantially lower drinking ages, and lower… As low as 13 or 14 in a few countries.

34:08 Trevor Burrus: Thirteen, 14, yeah. Yeah, the social… I’ve spent a lot of time in Germany, and the social… Some good friends of mine are German, and the social element is really strong, where there are these official drinking ages but you can… During Oktoberfest if you’re with your parents and your parents are like, “Oh, he can have a beer, he’s 13 or 14,” a lot of times they will or maybe they won’t on their own. But it’s not really a legal control, it’s a social control. And I guess we could expect some things like that to develop if we did legalize all drugs where people would just… Businesses would say, “I’m sorry, I’m not selling heroin to 10-​year-​olds,” even though there’s not a law against it, and possibly legal liabilities, maybe.

34:47 Jeff Miron: Perhaps.

34:47 Trevor Burrus: Yeah, for companies that did that to their parents or something would perhaps.

34:51 Jeff Miron: Perhaps. That’s a tough question.

34:53 Trevor Burrus: Now, okay, so if there are some people who don’t take these drugs, as we said, on the margins because they’re not legal and they can’t access them, and we legalize everything, and so now you can go get your heroin lollipop or opium lollipop at the CVS, are we really doing a good thing to our country if we’re just saying inebriated citizens walking through life like zombies… We talked before we were recording, you don’t like vacations, you like [chuckle] working really hard, so that’s your preferences. Is this a thing that could make America or any other country great, just increasing the access to inebriation sedatives? [chuckle]

35:33 Jeff Miron: I think it might not go so far as making the country great, but I think that avoiding all of the direct costs, avoiding the infringements on people’s liberty, reducing the crime, the corruption, the racial tension that’s exacerbated by prohibition, I think those are very significant things that would make America or any country that did it a better place to live. A lot of the violence in Latin America arises because the US is trying to enforce… Help get them to enforce our drug prohibition in their countries. There are a lot of negatives that come from prohibition, so…

36:08 Trevor Burrus: Well, we could just decriminalize them, not legalize, just decriminalize.

36:11 Jeff Miron: Decriminalizing is…

36:12 Aaron Powell: So what’s the difference, just…

36:13 Jeff Miron: So the difference is decriminalization in the way most people use it means it’s legal to possess it, and I guess to purchase it, depending exactly what you’re talking, but not to produce it and sell it. So first, that makes an economist’s head exploded [chuckle] because it just doesn’t make any sense. It’s like a pair of scissors that only has one of the two pieces; you can’t cut unless you have both pieces. You have to have supply and demand, so if we’re gonna legalize the demand side, you’re implicitly saying there’s a supply side there, you should legalize that as well, just for logical consistency. But more importantly, if you don’t legalize the supply side, if you really still are enforcing these laws against production and sale, then you’re still gonna have almost all the negatives of prohibition: You’re gonna have an underground market, you’re gonna not be able to collect tax revenues, you’re gonna have quality control issues, crime, corruption, and all those sorts of things.

37:05 Jeff Miron: So decriminalization has probably, in many instances, maybe most instances, been a useful step in the right direction, but in large part because it came along with reduced enforcement on the supply side as well, not just because it eliminated penalties for possession.

37:24 Trevor Burrus: So what do we need to do if we’re going to try and move to a more rational drug policy, which I think a lot of at least the academic world has moved in… We’re not living in the ’60s anymore, most public health people, although they’re terrifying in their own way, but they would say that we should have harm reduction at least. So there’s at least in the scholarly world and things like… Agreement that the war on drugs seems to have failed.

37:49 Jeff Miron: How much of that is just because all those people are boomers?

[laughter]

37:54 Trevor Burrus: I think that has something to do with it. But so what do we need to do to start moving this, what are the big things you think that they need to change to try and get people to start thinking about drugs differently?

38:06 Jeff Miron: So I’m not as good about political prognosticating or forecasting or strategizing, but in the case of opioids, it’s a absolutely a step in the right direction if maintenance therapy is allowed to expand, and if we reduce, eliminate government restrictions of that. By maintenance therapy I mean treating somebody’s addiction to opioids by giving them opioids. Now, of course, many people hear that and they say, “That’s idiotic, it’s like curing someone of their addiction to single-​malt Scotch by giving them rotgut, that’s just sort of stupid.” [chuckle] But the fact seems to be that many people have a very strong demand to continue taking opioids. If they get continued access to a legal known dosage, non-​adulterated dosage of opioids, they can function, they can be lawyers, doctors, professors, whatever. And so that is a totally reasonable way to treat their problem. Their problem is, in large part, getting access to safe opioids, not the fact that they’re taking opioids per se.

39:07 Jeff Miron: So you can maintain people using heroin, or using morphine, using methadone, using buprenorphine. So government policy currently makes that pretty hard. A lot of people currently do get access to legal maintenance treatment, but not nearly as many who would like to take it up. So that is a half-​way house that appeals to the public health community that doesn’t sound nearly as scary to the public, but is a step toward legalization; it’s a partial legalization. So I think that would be the way for people who wanna make actual progress instead of just say crazy things in the ivory tower [chuckle] to get us going in the right direction. And as more and more people were doing that, and it became more known, and you’d have neighbors, friends, co-​workers, who were engaged in that, then maybe people start to realize that the hysteria and the concerns are exaggerated, and that being a long-​term user under the right conditions shouldn’t be scary to anybody.

40:07 Aaron Powell: Sounds like you’re describing the same path kind of acceptance of homosexuality took.

40:14 Trevor Burrus: Like coming out, yeah.

40:14 Aaron Powell: That it was this strange and crazy thing that only weirdos did, but then as it just became more accepted, people were like, “Eh, this is… It’s not something to get worked up over.” And then it became legal, and then gay marriage.

40:28 Jeff Miron: I guess that’s right, I think that people are… There’s this huge debate in economics whether people are rational or not. But even the people who are pushing the non-​rational are not saying people are idiots, that people pay no attention, that they don’t learn, that they don’t… And that’s, I think, what goes on with drugs, with respect to people’s attitudes towards homosexuality, is as they get more information they do move in the direction of the information. Maybe not as fast or as far as we would like them to be, but people are rational enough, sensible enough, that giving that better information will make progress.

[music]

41:09 Aaron Powell: Thanks for listening. Free Thoughts is produced by Tess Terrible. If you enjoy Free Thoughts, please subscribe to us on iTunes, or wherever you get your podcasts. If you’d like to learn more about libertarianism, visit us on the web at www​.lib​er​tar​i​an​ism​.org.