Prohibition Kills | Cato at Liberty Blog

Over the past few years, a number of plaintiffs have accused opioid makers and related companies of misleading patients and doctors that their products were relatively safe, allegedly causing widespread prescriptions, addiction and overdoses. Last month, the Supreme Court ruled against an $8 billion settlement that gave Purdue Pharma’s owners, the Sacklers, protection from future lawsuits. The court said such protection was not authorized by bankruptcy law.

Regardless of their legal basis, these lawsuits are unlikely to reduce the opioid overdose epidemic because they do not address the government policies that caused and perpetuate it.

The risk of overdose from proper medical use of prescription opioids is low. As I wrote in a Cato policy analysis with Laura Nicolae and Greg Sollenberger:

Opioid overdose deaths have risen dramatically in the United States over the past two decades. The standard explanation blames the expanded prescribing and advertising of opioids since the 1990s.

This “more prescriptions, more deaths” explanation has led to increasing legal restrictions on prescribing opioids. Federal and state governments have enacted a series of policies aimed at limiting prescribing and going from doctor to doctor, and the federal government has raided pain management facilities that were deemed to be overprescribing. Proponents believe that these policies reduce the supply of prescription opioids and thus reduce overdose deaths.

We find little support for this view. Instead, we suggest that the opioid epidemic is the result of too many restrictions on prescribing, not too few. Rather than reducing the number of deaths from opioid overdose, restrictions push users away from prescription opioids and toward diverted or illicit opioids, which increases the risk of overdose because consumers cannot easily assess the strength or quality of the drug in underground markets. The implication of this “more restrictions, more deaths” explanation is that the United States should reduce restrictions on opioid prescribing, perhaps to the point of legalization.

The past five years have confirmed our 2019 findings. Prescriptions are declining, as are overdoses attributed to prescription opioids. However, fentanyl overdoses and total opioid overdoses have risen sharply in recent years.

The lesson for decision-makers is clear: prohibition kills.

Lemoni Matsumoto, a student at the University of Chicago, contributed to this article.