The Goals and Means of Meth Control

Yesterday, I came across this link to an absolutely heartbreaking photo series about an HIV-positive drug addict who the photographer found in a shelter, and then followed for 18 years.  Like Laura, I shamelessly cried at the images.  Then I noticed that the woman in them was ten months younger than I am.  By 2004 she looked like an old woman.  Her body and her life were ravaged by her infection; she died without reaching her 37th birthday.

It doesn't make it any sadder that she was my age, of course, but it does make it seem more real to me.  This is probably the right frame of mind in which to blog about Mark Kleiman's response to my post on the cost of methamphetamine prohibition, in which he points out the important distinction between the cost of prohibition, and the cost of various policy alternatives for enforcing prohibition:

Having not looked closely at this case, I'm not sure whether Keith's preference for regulation or Megan's aversion to it provides better policy guidance in this case, though the history of supply control efforts is anything but encouraging.

But Megan makes a common conceptual mistake when she heads her post "The Cost of Meth Prohibition." The cost she's concerned with is the cost of a specific enforcement initiative. If we put Sudafed back on the pharmacy shelf, methamphetamine would still be prohibited. Compared to legal commerce, that alone greatly reduces the availability of the drug. So the case for less vigorous regulatory efforts to enforce prohibition isn't the same as the case against prohibition itself.

In the case of meth, it's not just the drug that's noxious; so is the production process. And it's true that prohibition faces us with a choice between tighter restrictions and more lab activity (assuming that the restrictions would be effective nationally in the long run, as they have been at the state level in the shorter run). So there's a possible argument - though not, in my view, a convincing one - that the costs of increased meth abuse due to legalization would be preferable to the costs of either more lab activity due to loosened restrictions or the losses to patients due to tighter restrictions. (Keith's claim that there would be clandestine production even if the drug were legal seems hard to sustain; meth as a legal drug would cost next to nothing to make.)

But we can't have a sensible debate about the tactics of drug control if every tactical issue gets linked to the prohibition/legalization argument. They're simply not the same thing.

It's an important distinction, I understand, but I do view this criminalization of ancillary behaviors as itself a product of prohibition. I blogged about this in 2003, also in response to something Mark wrote:

Money laundering statutes and their ilk illustrate beautifully one of the major potential costs of ineffective legislation. If you outlaw something that a motivated group of people really, really want to do, you will find that many of them still do it. Many of these people will be very dedicated to keeping you from catching them. Because it is hard to catch them (and because prohibition tends to produce nasty blackmarkets, with the associated crime), legislators will find it convenient to pass more laws making ancillary behaviors illegal. If left unchecked, this process will make so many things illegal that prosecutors can always get you for something. The prosecutorial wisdom that "they got Al Capone for tax evasion" is an extremely dangerous thing. Prosecutors know that they are good people, and criminals are not; it is natural that they should want as much power as possible to pursue them. (Which is why Janet Reno and John Ashcroft seem to be about equally hard on civil liberties.) But prosecutors are not perfectly wise, and it is folly to trust them with so much power.
So with meth, we made it illegal, and then it turned out you could make the stuff from cold medicine in a very dangerous and dirty home production process, so we made it hard to get cold medicine, so they switched to an even more dangerous process, so now we're going to make it even harder to get cold medicine . . . 

At every step, we don't consider the whole cost of functionally prohibiting cold medicine; we consider only the marginal cost of the new prohibition.  And we compare that marginal cost to the whole cost of drug addiction, nasty amateur meth labs, etc.  This policy ratchet means we can easily end up in a situation where the sum of our drug laws are worse than the disease of drug addiction, even though no one particular prohibition is.

Are we in that place?  Well, if you're someone who needs a decongestant, particularly someone with chronic allergies or sinus or ear infections, then this is a pretty major cost--as anyone with recurring episodic problems can tell you, it's getting harder and harder to get doctors to write you prophylactic prescriptions, because of dual pressure from healthinsurers and the government.  This is particularly true in the case of things where the DEA has an interest, such as pseudoepinephrine.

And then we have to look, as Mark notes, at the problem of home meth labs, which is simply a direct cost of prohibition--as long as we prohibit the stuff, people will take a whack at making it themselves.  These are super dangerous to both users and neighbors, and can contaminate homes to the point where burning the place down may be the most cost-effective recovery method.  That's a huge cost of meth prohibition, and I very much doubt it's going away.  Leave aside the cold medicine: what if some bright boy discovers an even more noxious synthesis that doesn't need pseudoepinephrine?  Do we start all over with some other substance?  Or say the synthesis and packaging just moves to Mexico.  Is the world really a better place because even poorer people are bearing the risk for us?

Against all this, you have to weigh the fate of people like Julie.  Legal drugs undoubtedly mean more addicts.  Maybe not a lot more--I don't think we know how many people would get hooked on blow or crystal meth if it were legal.  Personally, I haven't tried the stuff not because it's illegal, but because I am fabulously addictive to stimulants, and it seems sensible of me not to try anything that I might like well enough to sacrifice family, friends and career on its altar.  I suspect that most people are like me.  But it's hard to say without running a big, scary natural experiment.

Personally, when I throw in the crime these black markets create, and the personal liberty costs of prohibition, I favor legalizing all of them.  But I recognize the cost is more lives blighted like Julie's.  My only answer is that this would also be a world where fewer black kids lose their parents--or themselves--to the prison system, and fewer babies are badly burned when Daddy's meth lab explodes.  There are no real happy answers here--only damage control.