Despite almost 50 years of the drug war—a policy that creates black markets, enriches drug cartels, and fuels killing zones in scores of cities, even as it causes the United States to cage more human beings than any other democracy in the world—it remains extremely easy for Americans to acquire the most addictive, deadly drugs.

“Overdoses from heroin, prescription drugs, and opioid painkillers have overtaken car accidents to become the leading cause  of injury-related deaths in America,” The Economist reports. “In 2014, they were responsible for 28,647 deaths.  Between 2001 and 2014, deaths from heroin overdoses alone increased six-fold, according to the National Institute on Drug Abuse. On average, 125 people a day die from drug overdoses, 78 of them from heroin or painkillers. These numbers have been compared to deaths from HIV in the late 1980s and 1990s.”

Had the War on Drugs merely failed to prevent this epidemic, even as it destabilized numerous countries and undermined domestic liberties, it would be an abject failure. But federal drug policy has actually been worse than useless in heroin’s rise.

In a saner world, American researchers and patients would’ve spent the last several decades experimenting with marijuana to maximize its potential as a pain reliever. Pot use isn’t without health consequences, but is much less harmful than many prescription drugs. Instead, drug warriors fought to stymie marijuana research, keep pot illegal, and stigmatize medical marijuana as a dangerous fraud, even as doctors prescribed more opioid painkillers—that is, medical heroin.

Many get addicted, and when the pills run out, they seek a street substitute.

“Heroin use, which used to be concentrated among low-income men in urban areas, now cuts across regions and demographic groups,” The Economist continues. “It is rampant in rural and suburban areas, like West Virginia and New Hampshire, and increasing among women and Americans in higher income brackets. Among adults aged between 18 and 25, heroin use has more than doubled in the last ten years. The problem has come increasingly into public view as police find users unconscious or dead in bathrooms, restaurants, parks, and libraries.”

The spread of medical marijuana is promising. As the Washington Post reported earlier this year:

Marijuana is effective at treating pain

A big meta-analysis of 79 studies in the Journal of the American Medical Association found solid evidence that marijuana is effective at treating chronic pain. The researchers noted “30% or greater improvement in pain with cannabinoid compared with placebo.”

Marijuana is safe when used to treat pain

A Canadian study published last year in the journal Pain found no evidence of serious side effects among medical marijuana users after a year of treatment. Users did report some incidence of “non-serious” side effects, such as coughing and dizziness, however.

Medical marijuana users are less likely to drink or take other painkillers

Research published last year in the journal Drug and Alcohol Review found that 80 percent of medical marijuana users reported substituting pot for painkillers, and 52 percent said they drank less when taking medical marijuana.

“The high rate of substitution for prescribed substances, particularly among patients with pain-related conditions, suggests that further research into cannabis/cannabinoids as a potentially safer substitute for or adjunct to opiates is justified,” the researchers concluded.

States with medical marijuana laws have fewer painkiller overdose deaths

In 2014, a study published in JAMA Internal Medicine found that states with medical marijuana laws saw a 24.8 percent reduction in opioid overdose deaths, compared with states without such laws. That worked out to about 1,700 fewer deaths in 2010 alone.

Medical marijuana availability decreases the rate of opioid dependency and death

An NBER working paper published last year found that the presence of marijuana dispensaries was associated with a 15 percent to 35 percent decrease in substance abuse admissions and a similar drop in opiate overdose deaths.

Still, the Drug Enforcement Administration continues to oppose medical marijuana, the NFL still prefers its players to relieve their pain with prescription opioids, and the worse-than-useless War on Drugs rages on, with predictably ruinous consequences.

For example, in St. Louis, one of America’s most dangerous cities, turf wars among drug dealers responding to an influx of cheap heroin from a Mexican cartel fueled a sharp spike in the murder rate, according to a weekend story in The New York Times. “In a trend mimicked in large cities nationally, many of the heroin consumers in St. Louis are young whites in their 20s, who drive into the city from suburbs and distant rural areas,” the newspaper reports. “And while most heroin overdose victims here are white, nearly all of the shooting victims and suspects in St. Louis this year have been African-American men and boys, police data shows.”

This violence would not exist but for prohibition, a policy with costs that fall disproportionately on residents of poor, mostly black and Hispanic neighborhoods.

“What has made it previously difficult to emphasize treatment over criminal justice,” President Obama said last month, “is that the problem was identified as poor, minority, and as a consequence, the thinking was, it's often a character flaw in those individuals who live in those communities, and it's not our problem they're being locked up. One thing that's changed in this opioid debate is that it reaches everybody. Because it's having an impact on so many people, we're seeing a bipartisan interest in addressing this problem … not just thinking in terms of criminalization or incarceration, which unfortunately has been our response to the disease of addiction."

But even today’s reformers are far too timid. The War on Drugs rages daily, and it is still a catastrophe.

The catastrophe is rooted in the black markets that federal policy creates. It is exposed by the urban killing zones that those markets guarantee. It is shown to be futile by the ease of acquiring the most addictive drugs despite prohibition. And it is exacerbated by decades of efforts to prevent milder drugs from serving as substitutes.

End it.