Drug use, by the numbers:
The costs of legal and illicit drug use in the United States exceed $700 billion annually, according to the National Institute of Drug Abuse1. These costs include crime, lost work productivity, and health care.
The United States spends an estimated $309.5 billion on prescription medicines annually2. Per capita and spending as a share of GDP in the United States far outpaces other developed nations10:
Meanwhile, more than $51 billion is spent annually in the United States on the “war” on drugs, adding up to more than $1 trillion over the last forty years3. The rate of addiction in the United States remains unchanged by this spending, while the use of illicit drugs has actually increased.
An estimated 2.1 million people in the United States suffer from opioid addiction related to prescription opioid pain relievers. Of those, an estimated 467,000 are addicted to heroin4.
Fundamentals of Healthcare
Drug use and addiction in the United States is a direct result of over-prescription and heavy reliance on opioid-based pain relievers. While the United States accounts for 5% of the world population, it’s citizens consume 80% of the global opioid supply.
Why have doctors become so reliant on synthetic opiates or opiate-based drugs? Pharmaceutical companies’ deep pockets, and their access to doctors, might be one reason. A study has shown that doctors who receive gifts, ranging from consulting fees to food and drink, are “more likely to prescribe or recommend their products”6.
It should come as no surprise that pharmaceutical companies spent a staggering $240 million on government lobbying in 20157. More surprising is the $24 billion, with a b, spent on “advertising” to physicians8.
Meanwhile, opioid-based drug users accounted for 33,091 of 52,404, or 63% of drug overdoses in 20159.
Affordable Drugs: Access Denied
The United States allows pharmaceuticals special privileges as a result of the billions of dollars spent on lobbying and efforts to convince doctors to use their drugs. While other developed nations have limited the ability for big pharma to patent drugs and price gouge consumers, the United States has done little to ensure it’s citizens have access to affordable drugs.
The United States does not allow the importation of pharmaceuticals on the grounds that it cannot guarantee the safety or integrity of those products. However, drugs sold by American pharmaceutical companies in Canada can be purchased at fractions of the costs paid in the United States. Those who live near the border can benefit by crossing over regularly to pick up their prescriptions so long as it does not exceed a three month supply. Foreign pharmacy websites also exist, however their integrity is sometimes questionable.
The protectionist policies in the United States are not meant to ensure access to quality pharmaceuticals. They are meant to ensure the profitability of big pharma corporations.
Changing Healthcare
Pharmaceutical companies should have limited lobbying capabilities, which should not directly influence legislation regarding importation of prescription drugs. These companies should be allowed excessive profits only until research and development costs have been recouped. After that number is met, profit margins should not exceed 25%.
Additionally, pharmaceutical companies should not be allowed to incentivize the use of their drugs by providing doctors or healthcare organizations with gifts, paid speaking events, or other ways of transferring wealth directly from the company to individuals and their companies. Curtailing the sales efforts of big pharma should put the focus back on the actual effects, good and bad, of the drugs that are being prescribed and consumed.
The process of prescribing drugs in the United States requires a great deal of reform. Antibiotics, pain relief, anti-depressants and anti-psychotics, and numerous other types of drugs are far too often prescribed carelessly and without adequate evidence of need. Access to counseling and other mental health services could greatly reduce the reliance on some of these drugs.
Finally, the stigma surrounding cannabis needs to end. Initial research has provided a great deal of evidence that marijuana could be a much less addictive option to opioids, while also having less severe side effects.
Big pharma should be forced to compete, rather than have their profits protected. Doctors and healthcare organizations cannot be allowed to financially benefit from relationships with big pharma. Consumers will benefit from lower prices and a more objective understanding of the effects of the drugs they are being prescribed.
Conclusion
Reducing drug prices by increasing competition will cut healthcare costs. Increasing access to less addictive pain management drugs, like cannabis, will reduce the reliance on opium extracts produced abroad and create massive new farming and refinement industries in the United States.
Distancing the influence of big pharma on legislative and healthcare decision-making will refocus politicians and doctors on the health of the patient, rather than the health of an industry that benefits on the sicknesses of people.
At least half of the $51 billion used to fight the illogical “war on drugs” should be reallocated to treatment facilities. These facilities create real economic and sociological value.
Finally, addiction is not a character flaw – it’s a sickness. Encouraging the use of addictive drugs to sick people, especially children, is like throwing gas on a flame. The millions of addicts in the United States should not be alienated and punished by the system, for it was the system that failed them in the first place.
References
1 NIDA. Trends & Statistics. Retrieved March 7, 2017.
2 Chicago Tribune. 2016. Report: Americans spent 8.5 percent more on prescription drugs in 2015.
3 Drug Policy Alliance. 2017. Wasted Tax Dollars.
4 NIDA. 2014. America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.
5 Gusovsky. 2016. Americans consume vast majority of the world’s opioids.
6 Leonard. 2016. Doctor Prescribing Linked to Industry Gifts.
7 Chon. 2016. Rising Drug Prices Put Big Pharma’s Lobbying to the Test.
8 The Pew Charitable Trusts. 2013. Persuading the Prescribers: Pharmaceutical Industry Marketing and its Influence on Physicians and Patients.
9 American Society of Addiction Medicine. Opioid Addiction 2016 Facts & Figures.
10 Brodwin. 2014. 11 Charts That Show Exactly What’s Wrong With The US Healthcare System.
The Rational Moderate 