A recent report from the Los Angeles Times underscored what amounts to an epidemic of deaths in the US caused at least in part by overdoses of legally prescribed drugs. The root problem, though, is one of cultural technology rather than chemistry or regulation.
We can begin to sketch the limits of the problem by noting that “keeping out” dangerous drugs is impossible, as there’s no medically useful substance that isn’t, when used improperly, dangerous or even lethal. A second observation is that legal regulation, while necessary, is hardly sufficient, because the personal and financial incentives involved are huge (both arguments, by the way, are equally applicable to the War on Non-FDA-Approved Drugs).
This is hardly a new feature in human history, which can, up to a point, be characterized by our search of psychoactive substances and activities. Drugs like alcohol, opium, or tobacco have at times caused significant societal damages, which led to different degrees of legal regulation, but in all cases, the key factor in their long-term management has been the culture-wide development of a shared knowledge base on how to best use the substance in a way the culture feels balances its benefits and drawbacks. The divergent stories of alcohol and tobacco regulation in the United States show how complex can be the interplay between cultural mores, the law, and medical knowledge, and how, ultimately, societal learning is what makes laws effective in this regard if they are to be all effective.
This isn’t an smooth or even irreversible path. Witness Russia’s high rate of alcohol-related deaths after the fall of the Soviet Union, despite their long cultural experience with the substance. To be fair, that kind of geopolitical shock will affect you no matter what, and alcohol probably just happened to be their poison of choice.
There are things, however, that can slow down this process of learning, extending the problems associated with any substance. Making drugs (whether with or without known medical uses) downright illegal or assuming that regulation alone will work, which puts the use and knowledge of these substance in the hands of a very small set of people, do little or nothing to prevent deaths in the short term, and, by severely restricting familiarity with their use, contribute to an unnecessary number of deaths over the long term. A parallel can be drawn with condom usage: it was by widespread knowledge sharing about safe sex practices, and not by preventing sex, than both STDs and unwanted pregnancies have diminished across most of the world – and not coincidentally, in a pattern very well correlated with education and access to information.
There are few things more dangerous than ignorance, particularly when it comes to our bodies and the things we do with and to them. There’s no substitute to informed knowledge when it comes to your own sex life; perhaps it’s time to take a similar level of ownership of our medicine cabinets.