Prescription crackdowns like Iowa’s are making the drug overdose crisis worse

Deadly drug use is on the rise in Iowa. If past experience is any indication, it’s unlikely our government officials will prescribe the right remedy.

Iowa saw a 20 percent increase in drug overdose deaths between 2019 and 2020, according to the Centers for Disease Control and Prevention figures released last week. Nationally, there was a 29 percent increase in overdose deaths, to a record high of 93,000.

Republicans say the uptick proves the COVID-19 lockdowns were bad while Democrats say it underscores the need for even bigger government investments in health care. Both sides think it justifies their support for ever-growing law enforcement budgets.

Drug use is complicated and there is no policy solution for eliminating its harmful effects. Smarter pandemic restrictions and better health resource allocation could have a beneficial impact, but throwing more money at police agencies almost certainly will not.

That’s what’s often missing in the discussion on drug overdoses — that the government and its enforcement regime is exacerbating the crisis. Prohibition makes drugs more dangerous and we’re suffering the deadly effects of our drug-busting status quo.

Opioids are the drugs most often involved in overdose deaths in Iowa and the nation. They have been a top target of police and policymakers for years. However, opioid use is not a single phenomenon — it’s a whole class of drugs that people use several different ways for many reasons.

A favorite response by politicians and bureaucrats is to crack down on prescription opioids such as the painkillers hydrocodone and oxycodone.

We made it harder for people to access relatively safe drugs in a medical setting, and some of them predictably turned to street drugs of unknown origin and quality.

The Iowa Legislature in 2018 unanimously passed a bill to expand the state’s prescription drug monitoring program, requiring health care providers to report opioid prescriptions to a government database. The goal is to prevent patients from “doctor shopping” by getting drugs from more than one provider.

That and similar prescription restrictions appear to be correlated with prescription overdoses flattening out, but that gave rise to something much worse.

In the past decade, a certain subset of synthetic opioids have overtaken heroin and commonly prescribed opioids as the largest share of opioid-related deaths. Annually, there are now far more synthetic opioid deaths than have ever been attributed to heroin or common prescription opioids in a single year.

Most common is fentanyl, which is cheaper and more potent than heroin, giving manufacturers and sellers an incentive to mix it in with or pass it off as another substance, a totally foreseeable consequence of restricting the drug supply.

So far this year in Iowa, fentanyl and similar substances have been involved in 87 percent of opioid overdose deaths, Iowa Department of Public Health officials told the Des Moines Register.

In short, we made it harder for people to access relatively safe drugs in a medical setting, and some of them predictably turned to street drugs of unknown origin and quality. Here’s a radical idea: Just let people buy drugs at the store instead.

People have been taking mind-altering substances for thousands of years and it’s foolish to think the government can stop them. Instead, we should give people the tools for safer drug use. One of those tools is the drugs themselves.

adam.sullivan@thegazette.com; (319) 339-3156

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