04 February 2005

Markets redux

In comments, reader JD asks a good picky question about the policies I would enact as King of America. How I can say that I want radical drug decriminalization but heavy taxation of sugar?
Why is being strung out on sugar worse than being strung out on meth? If warning labels are good enough for (currently illicit) drugs, why shouldn't the warning labels that are already on fatty, sugary foods be sufficient to keep people informed about the risks they're taking by eating them?
Obviously, being strung out on meth is worse than being strung out on sugar. So why does it seem that I am trying to keep people from using sugar but not meth? The difference lies in what remedy I think is necessary for the two different classes of problems ...

In both cases I want to discourage the bad choice, but not prohibit it, and I want to find the most effective means I can of affecting the fundamental problem. I want to fix the problems I can affect, accept the problems I cannot affect, and permit as much personal liberty as I can in the process.

Medicinal drugs are a question of civil liberties. If I have reliable information about a drug's known effects and risks, then I am equipped to make an adult decision. I should be able to make my own risk assessments, especially if I have a really scary disease. If inadequately-tested drugs have a big red sticker on them saying "RISKY: the FDA does not certify that this drug is either safe or effective," that should work pretty well.

The only public health problem I can think of that is affected here is the development of antibiotic-resistant bacteria from antibiotic abuse, but our current restricted regime is already screwing this one up, so I don't think that freer access will really make things worse.

The major social problems with illicit recreational drugs are

  1. Some people are prone to addiction and screw up their lives
  2. Drug users create medical crisis intervention costs bourne by society
  3. Addicts are willing to do socially destructive things to supply themselves with the drugs they desire
  4. Drug supplier mafiosi engage in violence and generate political corruption
Considering point #1, it's well understood that the best thing we can do for that is an extensive public education campaign, as has been slowly but surely effective in the case of tobacco smoking, together with providing resources to help people clean themselves up. Making a drug illegal appears to do little or nothing to prevent some people from finding them and spinning out of control, but it does complicate efforts to reach those folks with rehabilitation services once they reach that point.

On point #2, again the legality of a drug does little to affect how many people do stupid things that lead to this need. If anything, making a drug illegal leads people to wait to seek aid until their condition is more acute and expensive to treat.

On points #3 and #4, these problems arise largely from the availability constraints that arise out of illegality. Nicotine is more addictive than heroin, but people don't break your car window to steal your car stereo to buy cigarettes, because cigarettes. are cheap and readily available. But people will rob you to buy heroin because they have to deal with heroin dealers, who manipulate price and supply, to placate.

Thus the social ills from recreational drugs are actually better addressed through a set of policies that create more availability, not less.

Sugar, on the other hand, is a problem of too much availability. America is a great big candy store. For the poor and hungry, sugar gives you the most calories for your dollar. For the rich and busy, it's one of the most conveniently available ways to get your calories. The cheapness of sugar creates an incentive for food manufacturers and retailers to sell consumers more of it in more formats, and drives sugarless foods out of the market.

If we make sugar more expensive --- not prohibitively expensive, just enough that it's a bit of a luxury --- we shift the incentives in favor of making more wholesome alternatives available. Candy won't go away, but if it's easier for food makers and sellers to make money on fruits and vegetables, then they will offer a greater variety of these in more venues. I'm still free to eat sugar, but I'll be less likely to just turn to it by default. And if I want to not eat sugar, I'll have more options.


Anonymous said...

When someone says X is more addictive than Y, what exactly does that mean? Does it mean that it's 1) more addictive initially--it's easier/faster to become addicted one drug than another; or does it mean that 2) it's more difficult to pry oneself loose once one is already experiencing the symptoms of addiction? Because if it's the first one, I can immediately accept it, but I have a harder time coming to terms with nicotine being more addictive than heroin if it's the 2nd.

My understanding is that the pain of withdrawal from heroin is infinitely more agonizing than withdrawal from nicotine--not that I would know from experience. In my mind, this would make heroin more addictive than nicotine. Certainly a forced period of withdrawal coupled with lack of funds can send a heroin addict into a frantic state, whereas someone who is say, on an overseas airplane, is going to be cranky because he can’t smoke for several hours, but he’s probably not going to try and break down the cockpit doors because he has to wait for it. He’ll most likely have a cigarette in his had when he deboards the plane, but he isn’t going to roll around drooling on the baggage claim in if he can’t get one.

So I do take your point about an addict’s criminal tendencies when a substance isn’t readily available, but to consider nicotine and heroin specifically--do you think that if nicotine were an illegal substance with a ridiculously inflated price that addicts would be breaking through car windows to steal stereos in order to get it? Okay, actually yes, I think they would because people are crazy. But do you think it would happen at the same rate for nicotine as with heroin? Even if heroin was legal and the addicts didn’t have to go through the dealers, I think it would still be the same people on the street doing it. They still wouldn’t have any money to buy it, and they’d still be breaking windows to get at the juicy innards of your car. Or they’ll be breaking off the glass spark-plug bits of your motorcycle so that they can smoke the crack which they’ve already acquired.

So maybe I just think that heroin is so much worse because of the image of the stereotypical heroin user. Or maybe I’m just getting hung up on the phrase “more addictive” by getting it confused with “worse”. I’m not saying that it ought not to be legalized. And I’ve rambled away from my original question, which is what does it mean to say that one substance is more addictive than another.


Jonathan Korman said...

Of course, the question of addictiveness is complicated, but experts generally agree that giving up cigarettes is, if anything, harder than giving up junk.

TheWayOfTheGun said...

If the FDA were run the way you and I would prefer, then I agree that labels like "RISKY: the FDA does not certify that this drug is either safe or effective," would work pretty well. Sadly, in today's FDA, money and politics often hold sway over science. Did you ever go into a health food store and try to find out which supplements to take for a given condition? Or what MSM / Glucosamine tablets might be good for? Common sense tells me that some supplements don't do much of anything while others can be quite helpful in some circumstances. The FDA works to make it hard for me to learn which are which. And don't get me started on homeopathy. I don't think today's FDA has wide enough credibility.

As for the price of sugar, the real stuff is actually more expensive here than in other countries. Ever wonder why Coke has high-fructose corn syrup instead of sugar? You can thank ADM (supermarket to the world) for that.

Conceptually, I like the idea of sin taxes, but the economics can be slippery. In the case of tobacco it turns out that smoking actually saves money in the health care system. We all know that tobacco kills, but it often kills people right before they are about to become quite expensive to the health care system and does so in a comparatively cheap manner. The good people at Haa-vaahd's Kennedy School say so. One of the big tobacco companies actually got in trouble for touting that "advantage" to third world governments. Oops.