The content of Kirby Wilson’s article on changing patterns of heroin use in Durham beautifully (but unintentionally) illustrates the power of relative prices. It also serves as warning against listening to physicians and other “health professionals” who give us advice about how to tackle the problem of drug use. First of all, not all drug use is a problem. Some drug users are rational consumers, rather than addicts frothing at the mouth, and—according to Harvard economist Jeffrey Miron—most drug users are not drug addicts. This claim is likely to make some people angry, but anger doesn’t make it false.
Second, while the author of the article is simply reporting on changing patterns of use, economics can help us explain why more people are turning to heroin than prescription opioids. Specifically, as more stringent regulations and penalties for prescribing legal opiates like oxycodone and morphine make it more difficult to get drugs to patients, supply decreases, which drives up the price of prescription opiates sold on the black market. Even if the price of heroin remained the same, the relative price of heroin is lower than it would be without increased penalties and policing of prescription pain killers, which are almost perfect biochemical substitutes for heroin. Thus, Cynthia Kuhn, a professor of pharmacology who was interviewed for the article, is wrong when she says “One of the most useful things [the federal government] is doing is to try to shut down ‘pill mills’.” Unless we think it is better if people use heroin rather than oxycodone or morphine, it is hard to see why Professor Kuhn thinks more government intrusion in the legal market for prescription opiates is a good idea. Since it lowers the relative price of heroin, it is likely to have exactly the opposite of its desired effect.
Assistant visiting professor, Duke-UNC Philosophy, Politics and Economics Program