The CDC issued a report in late 2021 declaring accidental fentanyl overdoses as the leading cause of death for Americans ages 18 to 45.
It was widely reported in the news and further crystalized the country’s problem with the powerful synthetic narcotic that’s both shipped into the United States and increasingly cooked up in domestic makeshift labs.
But the fentanyl statistic didn’t surprise economist Audrey Redford, who kicked off the 2022 Scott L. Probasco Distinguished Chair of Free Enterprise lecture series at University of Tennessee at Chattanooga on Wednesday.
For years, Redford has studied and tracked drug overdose deaths and the proliferation of fentanyl and other illicit drugs for her research on the unintended consequences of drug prohibition policies.
“It’s just sad. For the issue to have to reach this critical mass for people to pay attention is also sad,” she told the audience in the Gary W. Rollins College of Business.
“It’s confounding. We’re spending a lot of money and have well-intentioned people working on the problem, so why is it getting worse?” she asked.
An assistant professor of economics at Western Carolina University, Redford grew up discussing drugs at the dinner table with her mother, a substance abuse counselor and addiction program administrator.
She said examining drug policy through the lens of economics removes many of the emotions and moral judgments often attached to discussions about the “war on drugs” and the people involved, from lawmakers and law enforcement to addicts, drug dealers and Big Pharma.
The current uptick in the use of fentanyl and heroin, she said, is connected to prohibition laws aimed at medical-grade oxycontin and oxycodone, the generic equivalent.
“If we only think about the fact that there might be fewer people who are ever introduced to the drug, we can think about that in isolation and say that’s a good thing.” she said. “But that must be weighed against the fact that the people previously using pharmaceutical-grade substances. Since they no longer have access to those drugs, where are they going to turn?”
Users are turning to heroin and fentanyl products because they’re the closest equivalent and are still accessible, according to Redford, who said disrupting an illegal drug supply chain doesn’t typically curb the habits of its users.
Outlawing a drug typically makes it more expensive and leads suppliers to do things such as diluting or concentrating their product. In the case of fentanyl, all forms of which are synthetically produced from chemicals, producers will slightly alter compounds to make the drug technically legal while producing the same high.
But as drugs morph in concert with changing laws, they tend to get worse. Redford has coined the term “malnovation,” or bad innovation, to describe this effect.
For fentanyl, minor alterations can drastically affect potency. One form of fentanyl is twice as powerful as morphine and another is 50 times as powerful. Many die instantly after using them.
“There’s a huge human cost to this,” she said.
In short, “Laws to make things safer have a lot of perverse outcomes,” she said. Disrupting supply chains of illicit drugs isn’t eradicating their use, so “maybe we should try something else.”
“Or perhaps, just to be provocative,” she said. “The world would be a better place if you could buy heroin at Walmart.”