Sin Tax

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Advantage 1 is Health
America is in a drug crisis, leading the world in overdose deaths.
German Lopez Vox, 6-28-2017, |German wrote for Vox since it launched in 2014, with a focus on
politics and policy, and became cohost of The Weeds in 2021. Previously, he worked at CityBeat, a local
newspaper in Cincinnati, covering politics and policy at the local and state level. "America leads the
world in drug overdose deaths — by a lot,"| Vox,
https://www.vox.com/policy-and-politics/2017/6/28/15881246/drug-overdose-deaths-world //Skrishna
America leads the world in drug overdose deaths — by a lot Another grim statistic in the
opioid epidemic. By German Lopez@germanrlopezgerman.lopez@vox.com Jun 28, 2017, 8:10am EDT Share this story Share this on Facebook
(opens in new window) Share this on Twitter (opens in new window) SHAREAll sharing options America has about 4 percent of the world’s
population — but
about 27 percent of the world’s drug overdose deaths. That’s one of the startling conclusions from a
recent report by the United Nations Office on Drugs and Crime. Statista charted the results: Statista
The US has always been
ahead of much of the world in drug overdose deaths — for a variety of reasons. For one, Americans are relatively wealthy,
so they can afford to buy drugs. But there also appear to be cultural and socioeconomic factors at play, driving a broader increase in “deaths of
despair” — such as suicides, alcohol, and drug overdose deaths — in recent years. (If you ask experts what these factors could be, you
can expect them to name, well, basically everything — a weak social safety net in the US compared with other developed countries, poor access
to health care in general, subpar mental health care and addiction services, manufacturing jobs moving out of the country, cuts to local
government services like parks and recreation, individuals losing a sense of spiritual or existential meaning, and so on.) But recently, America
has gotten much worse due to its massive opioid epidemic, which has contributed to a huge spike in drug overdose deaths over the past couple
of decades. In 1999, fewer than 17,000 people died from drug overdoses. In 2015, that grew to more than 52,000. This is, for
now, largely an American problem. After pharmaceutical companies heavily marketed their opioids in the US , and
doctors followed through with massive numbers of prescriptions, America became the world’s leader in consuming
opioids — with UN data putting the US at the top of opioid consumption. (Notably, other developed countries have tighter restrictions on
pharmaceutical marketing than the US does.) These two charts, then, are closely tied: As America consumed more opioids, its
drug overdose deaths climbed. So it began to dominate the world on a very grim statistic. The opioid epidemic, explained In 2015,
more Americans died of drug overdoses than in any other year on record — more than 52,000 deaths in just one year. That’s higher than the
more than 38,000 who died in car crashes, the more than 36,000 who died from gun violence, and the more than 43,000 who died due to
HIV/AIDS during that epidemic’s peak in 1995. This latest drug epidemic, however, is not solely about illegal drugs. It began, in fact,
with a legal drug. Back in the 1990s, doctors were persuaded to treat pain as a serious medical issue. There’s a good reason for that:
About 100 million US adults suffer from chronic pain, according to a 2011 report from the Institute of
Medicine. Pharmaceutical companies took advantage of this concern. Through a big marketing campaign, they got doctors to prescribe
products like OxyContin and Percocet in droves — even though the evidence for opioids treating long-term, chronic pain is very weak (despite
their effectiveness for short-term, acute pain), while the evidence that opioids cause harm in the long term is very strong. Painkillers
proliferated, landing
in the hands of not just patients but also teens rummaging through their parents’
medicine cabinets, other family members and friends of patients, and the black market. As a result, opioid overdose deaths trended
upward — sometimes involving opioids alone, other times involving drugs like alcohol and benzodiazepines (typically prescribed to relieve
anxiety). By 2015, opioid overdose deaths totaled more than 33,000 — close to two-thirds of all drug overdose deaths. Seeing
the rise in opioid misuse and deaths, officials have cracked down on prescriptions painkillers. Law enforcement, for instance, threatened
doctors with incarceration and the loss of their medical licenses if they prescribed the drugs unscrupulously. Ideally, doctors should still be able
to get painkillers to patients who truly need them — after, for example, evaluating
whether the patient has a history of drug
addiction. But doctors, who weren’t conducting even such basic checks, are now being told to give more thought to their prescriptions. Yet
many people who lost access to painkillers are still addicted. So some who could no longer obtain prescribed painkillers turned to cheaper,
more potent opioids: heroin and fentanyl, a synthetic opioid that’s often manufactured illegally for nonmedical uses. Not all painkiller users
went this way, and not all opioid users started with painkillers. But statistics suggest many did: A 2014 study in JAMA Psychiatry found 75
percent of heroin users in treatment started with painkillers, and a 2015 analysis by the Centers for Disease Control and Prevention found that
people who are addicted to painkillers are 40 times more likely to be addicted to heroin. So other types of opioid overdoses, excluding
painkillers, also rose. That doesn’t mean cracking down on painkillers was a mistake. It appeared to slow the rise in painkiller deaths, and it may
have prevented doctors from prescribing the drugs to new generations of people with drug use disorders. But the likely solution is to get opioid
users into treatment. According to a 2016 report by the surgeon general, just10 percent of Americans with a drug use
disorder obtain specialty treatment. The report found that the low rate was largely explained by a shortage of treatment options.
So federal and state officials have pushed for more treatment funding, including medication-assisted treatment like
methadone and buprenorphine. Some states, such as Louisiana and Indiana, have taken a “tough on crime” approach that focuses
on incarcerating drug traffickers. But the incarceration approach has been around for decades — and it hasn’t stopped massive drug epidemics
like the current crisis.
The drug crisis
Advantage 2 is Behavior
Next, Solvency

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The drug crisis

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