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Drugs and moral panics

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I hate this kind of abuse of statistics:

Obviously opioid addiction in general and fentanyl abuse in particular is a huge problem right now, resulting in the vast majority of the 100,000-plus “poisoning” — the public health term for fatal overdoses — deaths the US will see this year.

But the “enough fentanyl to kill everyone in the United States” line is a garbage statistic, straight out of the moral panic handbook.

Let’s look at how many potentially fatal doses of another drug got sold, perfectly legally, in the US this year.

This drug generated $262 billion in legal sales, which works out to pretty much exactly $1000 for every adult in the country. But, conservatively speaking, half of the population essentially never buys or uses this drug, so the average spending on it in 2022 by Americans who do use it was at least $2000, among the the 130 million or so buyers in this market.

Very optimistically speaking, $50 worth of this drug is certainly enough to cause a fatal overdose in almost anyone who ingests it, so lets see here — two carry the four divided by 130 — so the average American who bought this drug this year bought around 40 fatal doses of it, give or take. Enough of this drug got sold legally to cause 40 fatal overdoses in every user, or if you prefer 20 fatal doses in every American adult, or if you want to think of the children, 15 fatal doses in everyone from sea to shining sea.

You’ve probably guessed by now that the drug in question is ethanol, which you are free to purchase in very much more than fatal quantities, in an almost endless variety of forms.

The point is that what makes opioids, alcohol etc. dangerous is not the raw quantities of the drugs that are available to the market for them, but rather the way those drugs are consumed. Fentanyl is delivered to the market in forms that make it exceedingly more dangerous than it would be if it were heavily regulated, as alcohol is. Alcohol is nevertheless a dangerous drug — no regulatory regime can change that, just as no regulatory regime can make opioids benign — but we’ve come to accept that alcohol abuse is a fundamentally medical problem. The fact that the sellers of the drug sell enough of it every year to kill every user of it dozens of times over doesn’t change that.

Quoting garbage stats about how little fentanyl it takes to can kill you just makes it harder to engage in genuine harm reduction strategies when it comes to the demonic substance of the moment, which if I’m remembering my moral panics correctly have looked something like this over the past century-plus:

Liquor: First two decades of the 20th century

Cannabis: 1930s

Heroin: 1960s-1970s

Cocaine: 1980s

Crack cocaine: 1990s

Methamphetamine: 2000s

Opioids/fentanyl: 2010s-present

I no doubt missed some stuff in there.

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