Kermit, a small town in West Virginia’s Mingo County, has seen nine million hydrocodone pills flooding into its rural territory in the past two years thanks to one small pharmacy. Another town in Wyoming County, the nation’s leader in overdose deaths, is dealing with a similar exorbitant flood of OxyContin pills, most of which are making their way into the county through a mom-and-pop pharmacy in Oceana.
Within just six years, drug companies have sold over 780 million units of both hydrocodone and oxycodone to patients, and 1,728 West Virginians fatally overdosed on those same painkillers.
According to a Sunday Gazette-Mail investigation, the high amount of pills flooding the rural WV area would be enough to provide every man, woman, and child in the entire state with 433 pills each.
Undoubtedly, this is a grim situation for everyone involved.
Locals don’t understand why addiction has swept the state. Authorities focus on pharmaceutical companies and the small pharmacies taking in these prescriptions. Their willingness to flood the state with so many highly addictive and potentially fatal drugs, authorities say, is irresponsible and criminal. The public understandably blames Big Pharma alone for putting profit over lives while forgetting that individuals themselves decided to consume a deadly dosage of drugs. Somewhere in this mess, however, lies yet another culprit, one cloaked in mystery and protected by people’s trust in government: the Feds’ involvement in regulating drug production and use.
Like Prohibition, Strict Regulation Creates Perverse Incentives For Drug Makers
As economist Mark Thorton explains, Big Pharma’s involvement in the opioid crisis is another case of “legal bribery and corruption in the market for legal opiates,” but it’s not just that. Over time, regulation has similar effects as prohibition, leading drug providers to act as drug dealers by taking the market out of the equation and forcing consumers to go to monopolies for their wants and needs.
As enforcement becomes more effective, drugs in the black and legal market also become more potent.
“[Another cause of the opioid epidemic] is called the Iron Law of Prohibition, a phrase first used by Richard Cowan to describe the phenomenon that when drug law enforcement becomes more powerful, the potency of illegal drugs increases. One of the effects of enhancing prohibition enforcement is that suppliers will produce a higher potency drug. For example, during alcohol prohibition in the 1920s suppliers switched from producing beer and wine to highly potent spirits, such as gin and whiskey.”
In other words, when laws either prohibit a substance from entering the market or lift enough barriers to allow only a select few to provide these substances to consumers, one of the first things we notice is that the drug in circulation becomes more potent. This is also a result of the lack of market input, as consumers are not given an opportunity to choose. Instead, they are forced to go for whatever is available, whether because the government granted a particular company monopoly rights or because that happened due to total prohibition.
The heavy regulation we now have, which started with the Harrison Narcotics Act of 1914, has done nothing but turn an entire industry on its head by shielding Big Pharma from competitors and eliminating their need to compete in an open market of drug makers that take into consideration what consumers need and require from their products. In other words, they no longer must respond to consumer demand.
As pharmaceutical companies get used to having government secure their gains over time by granting them the privilege of being the sole providers of certain drugs, these same firms find themselves in the position of bribing Congress and regulators so further rules are enacted, keeping competitors trying to meet consumer demand from entering the market.
The result? Companies produce expensive drugs that meet federally-mandated standards only but fail to do what they are supposed to: meet the market’s demands. A good example of this vicious cycle is what happened with Mylan, the maker of the EpiPen. Their influence within Congress guaranteed that they would be the only ones making EpiPens, allowing them to skyrocket the price of the device as there were no competitors to come up with an alternative.
Much like the drug war, which ends up giving dealers in the black market an incentive to offer stronger, less safe drugs to users, strict regulation gives a handful of companies total control over the supply of a particular drug. It also gives these companies the government’s seal of approval, meaning that no matter how strong, addictive, unsafe, and deadly these drugs are, their use isn’t questioned because government literally tells us not to worry.
As these companies flood the market with unsafe yet approved drugs, investing heavily in advertising, doctors who are unable to look elsewhere for more effective treatments are left with no alternatives. And as high demand for legal and powerful drugs becomes a reality, even among patients who do not have access to a prescription, dealers move from selling only heroin to bribing doctors for prescriptions so they, too, can deal these pills in the black market.
It’s clear that the opioid crisis didn’t arise out of the blue, and it definitely didn’t originate a few years ago.
The process that has been ongoing — and that has created the perfect environment for the current epidemic of opioid abuse — is why we have a problem to begin with. Unfortunately, no government entity or bureaucracy will admit as much. And while we sit and watch these drugs getting stronger and more people becoming addicts, officials continue to sue a company here and imprison a doctor there so they can tell the public they are doing something about it.