Tag: drugs

The Other Drug War

 

Earlier this month, the Food and Drug Administration rejected the application of Biomarin Pharmaceutical to market its drug Kyndrisa™ (drisapersen) for use in the treatment of Duchenne muscular dystrophy. The FDA, as is often the case when it rejects a drug application, listed all sorts of technical reasons why the data presented was not sufficient to establish by respectable scientific means that the drug in question was safe and effective in its intended use. Without question, much evidence from the clinical trials revealed serious complications from the drug’s use, including blood-platelet shortages that were potentially fatal, kidney damage, and severe injection-site reactions. But the no-treatment alternative could prove far worse.

Duchenne is a rare but fatal genetic disorder that attacks only young boys, roughly 1 in 3,500 to 5,000. Typically, it first manifests itself between two and five years of age. With time, it relentlessly weakens the skeletal muscles that control movement in the arms, legs, and trunk. Most of its victims are wheelchair-bound between the ages of seven and 13. By 20, many have died.

Making Drugs Affordable

 

shutterstock_197494286Remember Martin Shkreli, the pharmaceutical executive who jacked up the prices of an off-patent drug used by some AIDS patients last year and who was recently perp-walked for securities fraud? The Left treated his arrest as a victory for the common man, but it hasn’t made pyrimethamine, the active ingredient in Daraprim, any more available to those who need it.

Mark Baum, however, has done just that: Since last year’s media fiasco, the compounding pharmacy he runs has been selling drugs with the same chemical properties (with an added, relevant vitamin) for about a $1 a pill. That’s among the reasons why Shkreli’s antics didn’t lead to a pile of dead bodies.

The reason Baum’s company has been able to do this so quickly and inexpensively is because compounding pharmaceuticals are not subject to the same regulatory scrutiny as generic manufacturers and are often able to charge prices closer to the costs of manufacture.

Pain and Suffering in New England

 

imageHere in New England, it’s hard to get through a news cycle without at least one mention of the region’s opioid epidemic. Every media outlet covers it; governors are creating task forces faster than you can count; and the presidential candidates expect daily questions on the matter, often from parents who lost a child to an overdose. (Notably, Jeb Bush’s daughter has struggled with addiction for years, and Carly Fiorina’s stepdaughter died of an overdose.)

Is the problem worthy of the hype? More so than I had thought. In Massachusetts last year, there were nearly 1,100 confirmed deaths from opioid poisoning, and that number is likely to crawl higher as some investigations are completed. That’s up from 711 deaths in 2012, which constituted very nearly 30 percent of all accidental deaths in the state. Most depressingly, confirmed overdose deaths have increased every year since 2010, when the number was just 555. New Hampshire has only a fifth as many people as Massachusetts, but almost a third as many fatal cases. These rates are significantly higher than national averages.

Now, statistics like this are only a reflection of reality and often a distorted one: It’s wholly possible that the increase in the number of recorded incidents reflects, at least in part, a growing awareness of such causes of death (when you start looking for things, you tend to find them). Still, that’s a staggering number of deaths, both in absolute numbers and as a proportion of preventable deaths. I’m hesitant to use the word “epidemic” to describe things short of the Spanish Flu, but there’s a undoubtedly a very serious problem here.

Anatomy of a Market Failure

 

ShkreliDespite all the pushback Pope Francis has been getting from free-marketeers, two important stipulations are in order: markets are not equally good at solving all problems, and many of their best features can be undermined by the greedy or immoral. They can work miracles like nothing else, but they’re also somewhat dependent on flawed human beings

As David Sussman notes on the Member Feed, the Interwebs are currently awash with news of alleged price gouging by Turing Pharmaceuticals. The drug in question, Daraprim, was developed decades ago and is used to treat toxoplasmosis, a parasitic infection that’s a minor problem (at worst) for the healthy, but a serious one for the immunodeficient or babies whose mothers were infected while pregnant. The drug was developed decades ago and has a tiny market — currently, under 9,000 prescriptions per year. It had been available for as little as $50 per prescription as recently as five years ago. After being sold to another company, the price of the drug rose to $500 per prescription in 2011, then to $1,100 last year. Assuming everything remains constant, the same prescription under the newly-announced price would cost just shy of $63,000. I’m not sure about babies, but the Mayo Clinic reports that the immunodeficient may need treatment for life.

As Megan McArdle wrote a few weeks ago, drugs that are in fierce demand by a small number of people are an inherently difficult problem for markets — or, really, any system — to solve. When you also factor in the regulatory costs, the fact that most drugs are actually purchased by third parties, and the fact that drug manufacturing is relatively inexpensive, you’ve got what looks like a perfect storm of grossly unfair and exploitative price gouging. Even if it’s genuinely the best a market can do under difficult circumstances, it sure looks bad.

Vape Your High

 

shutterstock_274257785This may instantly mark me as a hopelessly out-of-it person, but it’s something I didn’t know. From YaleNews: (yeah, yeah, I know, I know)

E-cigarettes not only vaporize nicotine, but they work with marijuana as well, American teenagers are discovering.

Yale University researchers surveyed 3,847 Connecticut high school students and found nearly one in five e-cigarette users also have used the device to vaporize cannabis or byproducts like hash oil, according to a study published Sept. 7 in the journal Pediatrics.

Christie, Pot, and the Rule of Law

 

shutterstock_133014050As Ricochet member ShellGamer wrote late last year, Colorado and Washington’s (and now Alaska’s) legalization of marijuana has both created and exposed a constitutional mess. In brief, neighboring states are suing the Obama Administration for its policy of turning a blind eye to federal drug laws. Meanwhile, Congress shrugs its shoulders and acts uninterested in either forcing the president to enforce the law, or in repealing or amending it. If elected president Governor Chris Christie says he’ll have none of it:

“If you’re getting high in Colorado today, enjoy it,” Christie, a Republican campaigning for the 2016 presidential nomination, said Tuesday during a town-hall meeting at the Salt Hill Pub in Newport, New Hampshire. “As of January 2017, I will enforce the federal laws.” […] “That’s lawlessness,” he said. “If you want to change the marijuana laws, go ahead and change the national marijuana laws.”

Christie certainly has an argument, especially on that last point: when confronted with genuinely bad laws, the proper response should always be to repeal or reform. Keeping laws you don’t plan to enforce on the books encourages lawbreaking in general, and invites caprice on the part of enforcement. If one thing unites the entire spectrum of the right, from anarcho-capitalists to NeoCons, it’s the belief that the rule of law matters.

General Principles for Controlling Substances

 

shutterstock_162691106Yesterday, Fred Cole challenged members who support the prohibition of at least some drugs to describe the first principles they use to come to their conclusions. That thread got pretty contentious, so I thought I’d start a second one answering his question.

Below you will find what I believe to be an excellent starting point for a general guiding principle related to making some drugs illegal. Before you read that, some guidelines and definitions.

By “drug”, I mean any of those substances commonly used recreationally. This includes, but is not limited to, alcohol and tobacco, as well as those substances more generally considered “drugs,” such as meth, heroine, cocaine, etc. That’s generally what we are all discussing, so there’s no need to ask question like “Oh yeah, well what about caffeine?”

What’s Your General Rule on Drug Prohibition?

 

shutterstock_158845502Let me be very upfront here: I’m one of those radicals who thinks we should legalize all drugs. I’m not just in favor of marijuana legalization, but also the “hard stuff”: heroin, cocaine, LSD, and just about anything else you can think of. If you’re one of those weirdos who wants to put mescaline in your eggnog, I don’t think there should be a law against it.

We’ve had several awesome discussions recently here on drug prohibition. However, one thing that seems to be lacking, among prohibition advocates is a general principle. So to any of you prohibitionists, I’m issuing a challenge. I’m willing to listen to any prohibition standard you’re willing to propose. What I’d like to hear is a general rule on what the government should and shouldn’t prohibit, but I’m going to add a sticking point: you must apply it across the board to drugs, prescription medications, tobacco, and alcohol.

There it is. Prohibitionists are able to come up with all kinds of arguments, but I’ve yet to hear one that couldn’t also reasonably be applied to alcohol. But, I could be wrong (it happens… occasionally), so let’s hear it: What’s your general rule?

Member Post

 

David Deeble directed me to this story at the Washington Post, which in turn cites Ben Swann’s website. Basically, an 11-year-old student remarked on his mother’s use of cannabis oil during an anti-marijuana presentation at school, after which the boy was seized by CPS and the mother’s home was forcibly searched for illegal drugs. There […]

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A Backstage Perspective on Legalized Drugs

 

After reading about Chris CricochetPot1hristie’s aggressive stance against the legalization of marijuana in Thursday’s edition of The Daily Shot, I thought I’d share my experience with both illegal and legal drugs from the “backstage at the rock concert” perspective, based on two recent experiences. Mind you, I don’t take drugs, so my experience as an observer will have to do.

In February and March of this year, The Vandals were on a big tour in Australia with some of the biggest bands in the business. I’m not going to mention any names because I plan on incriminating some. Some, of course, are sober after abusing their privileges to various degrees, but some are definitely not. It was sad but interesting for me to watch them (i.e., artists and/or the crew) hit the bars after their set, then eventually begin “fiending” for illegal drugs. The drug portion of their evening doesn’t really get underway until the illicit retailer shows up at the hotel room after the bars close at 2 AM. That leaves them up all night with very risky people up to very risky business — and unable to do a good job the next day.

The Poverty Trifecta: Despair, Dependency, Drugs

 

I’ll admit that our justice system is discriminatory: it favors those who can afford a viable defense and it disfavors the defiant. I’m no sociologist, but I guarantee that defendants represented by private counsel are more apt to receive leniency than those represented by public defenders. Defendants invested in private counsel are more likely to take the advice of counsel seriously and conduct themselves with humility and contrition throughout the judicial process. This garners leniency. These observations are intuitive and cannot likely be proven or reasonably measured; nonetheless, I’m confident they are true and profound.

Consider the state of the poor communities in urban America. Crime rates in these urban areas are legion, but this is not just an African-American problem. The problems of gangs and drugs go hand-in-hand with welfare dependency and persistent single parenthood, and it’s not hard to find pockets of white or Hispanic citizens where these problems persist. In fact, this is not even an urban problem. These problems are epidemic in many small rural towns (especially in California), on the reservation, and in rural Appalachia. That they are most acute in urban black communities does not mean the issue is fundamentally about race.

The Costs of Prohibition

 

shutterstock_177594347Continuing on today’s theme of prohibition, a common and very reasonable argument made by prohibitionists is to point to all the dangers, criminality, and immorality associated with proscribed activities and ask whether society should invite more of them. The implication is that these problems are intrinsic to the activity itself and should further tip the scales toward prohibition.

Examples abound. Consider Bill Bennett & Robert White’s point in Going to Pot that modern marijuana is more potent than ever before; dangerously so, they say. Regarding a different kind of vice, prostitution opponents have, of late, focused their attention on the dangers and exploitation women and girls face, to the point that the trade is sometimes presented as being nearly synonymous with human trafficking.

While we can stipulate that intoxicants and the selling of sex are more likely to be fraught than other industries, prohibition — or regulations equivalent to it — can have the simultaneous effect of reducing consumption (at least a little) while making what consumption remains even more dangerous than before. As Milton Friedman argued nearly 40 years ago, increasing a drug’s potency increases its portability, something highly desired in contraband. Analogously, consider both how much easier it is to smuggle whisky into a party than a full case of beer and how much more potentially dangerous the former is.

Let’s Just Criminalize Prohibition

 

imageAs marijuana legalization and decriminalization gains traction nationwide — DC this morning, as well as Alaska, the first red state to decriminalize — I can’t help but feel that it is inevitable that my own home state of New Jersey will follow suit sooner rather than later. Although New Jersey can, at times, feel like living in a liberty hinterland, the state’s blueish nature should, at least theoretically, lead to gains on the civil liberties front. Nonetheless, we still find that our politicians rely upon old saws in constructing their political positions on the intoxicant.

For instance, take the claim that marijuana is a gateway drug that will lead to a general decline of society. Assemblywoman Mary Pat Angelini (R-Monmouth) is putting together an anti-legalization activist group. Its platform will include arguments relating to “health and incarceration statistics about marijuana users, and questions about additional costs that might be incurred as a result of legalization.”

I’m certain the assemblywoman means well, but, frankly, the tide of facts and history moves against her efforts. Without having the benefit of really being able to parse her incipient group’s position, it seems hard to believe that legalized marijuana will do anything but dry up a significant portion of the criminal trafficking in our state and nation. Thus, at the outset, a major social cost related to enforcing prohibition disappears — if not overnight, then very quickly.

What is the Problem with Illegal Drugs?

 

shutterstock_154594889My father was a cocaine addict who died of an overdose. He began using when I was about eight, and died when I was 24. He tried to quit a couple of times — twice he went into treatment centers — but he was not successful.

I’ve spent a lot of time thinking about the problem of illegal and addictive drugs but have avoided drug-related threads because they’ve just been too painful to read. When I was younger and still considered myself a libertarian, I was very sympathetic to legalizing drugs. The “War on Drugs” is extremely expensive and its success is debatable. At this point, I’m just not sure which way is best. (For whatever it’s worth, according to this ngram, the phrase “war on drugs” didn’t become widely used until after 1980. Thanks to Mike H for that interesting link.)

Though — as I said — I haven’t followed all the arguments as closely as I should have, I think there’s a “supply and demand” aspect to illegal drug use that gets overlooked, mostly because both sides focus so much on the “supply-side” arguments, aruging either in favor of continuing or removing restrictions on the amount of drugs.

What is the Problem with Heroin?

 

OLYMPUS DIGITAL CAMERAIn his post “Bringing Conservatives and Libertarians Together” about marijuana legalization, Fred Cole wrote:

I think it’s the situation with marijuana that it’s already so widely accepted and widely available, that most people who want to smoke already do. Whatever society costs it imposes are already there.

So marijuana prohibition means we get all of the downsides of legalization and all of the downsides of prohibition, but none of the upsides that come with legalization. It’s the worst of both worlds.

Member Post

 

First let me say that I am a staunch Conservative. My first vote cast was for Barry Goldwater and I have voted for conservative candidates ever since. My comments here may be construed as taking the liberal line but considering the options I think not. On our southern border we have total chaos and I […]

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The Sky Hasn’t Fallen On Colorado’s Roads

 

25 SouthWhen Washington State and Colorado voters legalized marijuana in 2012, many worried that the decision would lead to mayhem on the Evergreen and Centennial states’ roadways.

The good thing about experimentation, however, is that you get results. As the adviser to Washington’s state-appointed board overseeing the implementation put it, the repeals offer a chance for the nation to learn about the effects of legalization:

If Washington does this right, we’ll learn something. If they do it in some sensible way and it crashes and burns—the system doesn’t work at all, we get a massive increase in use by minors, carnage on our highways—then we’ve also learned something about the cannabis-legalization experiment that the next person might learn from.

Evil and the Conservative Mind

 

shutterstock_59006443I lost an argument the other day. It wasn’t one of those arguments that you lose because you didn’t care or because you didn’t try. It wasn’t an argument that you lose for a lack of articulation or for an inability to make others see what you see. It was the sort of argument that you lose simply because the law wasn’t on your side. That’s a difficult loss to take, and trying to sleep that night, exhausted and alert, as if shouting as loud as I could in an attempt to locate silence, I knew it was a problem for which I would find a solution only years after the opportunity had passed. Immediately after the argument, I stepped out and took a little walk with my client, a 14 year old girl, just to get her away from all the commotion of the courtroom. We talked about a lot of things, and anticipating conflict ahead, I told her of the principle of charity, to interpret every word spoken in the best possible light, to grant what good she could find, and to always argue tactics over intentions; she smiled and thanked me for helping her to get away from everyone.

Some time ago, a woman stared at me from a plastic chair across a table. We sat in a concrete room, her in an orange jumpsuit, and me in the usual suit and tie; the 4×4 table took up roughly 80% of our allotted space, with the rest adequate only for ingress and egress maneuvers. I tried what every other adult in her life has attempted, but was wholly unable to cut through the actual mental illness, the influence of her peers, whatever residual effects of drug use, and the ignorance of youth, to convince her that those people around her – the people she tells me she hates because they just want to control her and pretend like they know what’s best when she knows perfectly well what’s best – really do want to help her, and they really can help her, but only if she accepts that help. She got out of juvi and ran back to the gang whose insignia is tattooed across her back, where she trades sex for money and drugs, or is used herself as currency; but they also recognize mental illness, and where risperidone is replaced with beatings, eventually, the only solution is a permanent one.

Another solution would be forced medication with non-amphetamines, involuntary commitment, placement in a locked facility of the sort that got a bad name during a time when people seemed to acknowledge the existence of evil, and the occasional necessity for its ranking in order to settle upon the lesser of two. Today, I’m not sure what exactly we’re thinking. There are a few old mainstays when it comes to thoughts about insane asylums; the guy who thinks he’s Abraham Lincoln, the guy who thinks he’s Jesus, the guy who thinks he’s Caesar. They lived within padded walls for the very demonstrable reality that they were not, in fact, who they claimed to be. Today, we take a man who believes he’s a woman, and we give him hormones, silicone implants; we mutilate his body so that he will look like a bad caricature of the woman that he is not, has never been, and will never be. We don’t yet sew on beards, paste artificial moles, supply tophats, and house our country’s many Mr. Lincolns at the white house… but it isn’t entirely clear to me why we should change the word “delusion” to “personal reality” only in some cases and not others. And if we require that men’s bathrooms accept the short-haired, flannel-clad, woman with a chemically induced soul-patch and a silicone replica penis, why don’t we require Graceland to admit that guy down on 40th who sincerely believes himself to be Elvis? He’d certainly be more comfortable there.

Member Post

 

I have some specific questions about relabeling (old, off-patent) drugs and filling the distribution channels for a relabeled drug that is being used for an off-label use. It is quite lucrative, but while my partners in this are experienced in medicine, we don’t have the specific knowhow in this area. Ricocheteers who may be able […]

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