The Cost of Meth Prohibition

My husband is suffering from a pretty nasty cold.  Last night he had to duck out before dinner with my family to purchase some Sudafed, because he was miserably congested.  Alas, not being aware of the difference, he decided it wasn't worth waiting in line to buy cold medicine from behind the counter, and instead bought the stuff on the shelf.  He took some, and then suffered through dinner until we could get home to my box of 24-hour Sudafed.  This morning he came down and said, "It's amazing how much better you feel when you take medicine that actually does something."  Then after a pause, he said, "So why do they sell you cold medicine that doesn't do anything?"

If you've been following drug laws at all, you'll know that you can no longer buy cold medicine with pseudoephedrine without getting a clerk to get it for you from behind the counter, and signing for it.  That's because pseudoephedrine is an ingredient in the most popular amateur syntheses of methamphetamine.  By making it hard to get, authorities hoped that they could fatally damage the meth trade.

It's long been an article of faith among libertarians that this was simply going to push manufacture to Mexican gangs, but  now Keith Humphreys tells me that it hasn't even done that.  Instead, armies of "smurfers" are getting around the sudafed purchase limits; a box of pseudoephedrine-laden pills purchased for $7 to $8 can bring $40 to $50 from meth dealers.  So meth use is back up:

Following the federal 2005 Combat Methamphetamine Act and the augmentation of controls of meth precursors in individual U.S. States and in Mexico, the meth trade went into a swoon. Treatment admissions, drug purity and meth lab incidents all dropped substantially. Alas, all signs are that the respite is over.

The National Survey on Drug Use and Health invariably underestimates meth use for a range of reasons, but because this measurement error is fairly systematic, NSDUH is still helpful in judging trends. The latest survey found an eye-popping 59.8% percent increase in the number of Americans reporting past-month meth use. Meth lab incident data also pose some interpretational challenges because of the large variation in size of labs, but the more than 100% increase in the past two years is simply too large to fob off as error of measurement, as the Wall Street Journal recently reported.

And yet, Humphreys doesn't conclude that prohibition is futile; he concludes that it isn't tough enough:

The only policy that has been shown to lastingly curtail meth labs is making pseudoephedrine containing medicines (e.g., Sudafed) prescription only. Many states are now introducing such legislation, but the cold medicine industry is responding with a flood of lobbying money to prevent the change.

Among the counter-arguments I have heard, the feeblest had been offered by some law enforcement officials who say that Methcheck helps police find and bust methlabs. Since when in law enforcement is it better to allow a crime to happen and bust someone than it is to prevent the crime entirely? Another is that reducing access to cold medicine is too much of an inconvenience to the citizenry. It is an inconvenience, but in a state such as Tennesee that spent countless millions of dollars last year dealing with meth lab explosions, every taxpayer is coughing up something worse than phlegm: Hundreds of extra dollars in their tax bill every year (and people -- including a disturbing number of children -- who get burned when the labs go up in flames clearly pay a much worse penalty than that)

Let me start by saying two things:  first, that meth addiction is very bad, and the world would be a better place without it; and second, that home meth synthesis is obviously very dangerous.

But it is not actually so bad that we shouldn't count the costs of suppression.  Which are considerable.

After all, what we're effectively talking about is making it impossible for people to unplug a stuffy nose without going to a doctor.  Which in turn means either that we're going to spend $50 to $100 per cold (obviously, much more expensive than even a bunch of really terrible meth lab fires) or that people are going to go without treatment.  I'm guessing that Keith Humphreys does not suffer from chronic ear or sinus infections, which are considerably worse than coughing up a little phlegm.

Moreover, we don't know that moving to a prescription-only model will actually permanently reduce amateur meth production.  Perhaps right now it makes more sense to get your meth out of state in the few places that have taken this step, but a nationwide placement of pseudoephedrine on the prescription schedule would simply encourage development of work-arounds like smurfing.  Limits might even make meth synthesis accidents more likely--there's anecdotal evidence that the difficulty of obtaining pseudoephedrine has caused meth labs to shift to the "shake and bake" method, which uses less decongestant, but also has a nasty tendency to explode if the pressure in the container gets too high.  And while fires used to happen on the stove, which is mostly fireproof, now they explode in peoples' hands, which aren't.

It's unfortunate that the only effective mass market nasal decongestant also happens to be useful in making meth.  But it's far from proven that it's worth everyone in the country suffering through their colds is worth preventing meth fires--or even that this will prevent meth fires.  And it's really far from clear that it will prevent methamphetamine addiction over the long run.