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Legal drugs kill (a lot) more people than illegal drugs

 (U.S. Drug Enforcement Administration via AP)

(U.S. Drug Enforcement Administration via AP)

Ninety-five percent of all drug-related deaths in America result from legal substances.

For as much as the war on drugs is sold as necessary to keep Americans safe, illegal drugs kill shockingly few people, according to Vox.

In 2014, almost 440,000 Americans died from tobacco, 31,000 died from alcohol, and 19,000 from opioid painkillers. Heroin, in contrast, only killed 11,000 people, benzodiazepines killed 8,000 people, and cocaine 5,000 people. Marijuana caused no deaths, according to the data from the Centers for Disease Control and Prevention.

The statistics are illuminating, but not everything.

“Some drugs, such as alcohol and cocaine, may induce dangerous behavior that makes someone more predisposed to violence or crime. Other drugs, like psychedelics, may trigger underlying mental health problems or psychotic episodes. When evaluating the overall harm caused by drugs, all of these factors should be taken into account,” German Lopez wrote.

Comparing the overall harm of drugs to users and to others, the worst culprits change. Alcohol, heroin, crack cocaine, and methamphetamine cause the most harm, mostly to the user. Drug deaths are only one aspect of a drug’s danger, of course. The war on drugs focuses on the worst culprits in terms of harm (excluding alcohol), but not necessarily the most deadly ones.

A shift in the war on drugs from prohibition to rehabilitation could change the public debate. While the most harmful drugs remain banned, the legal and lethal ones have a higher social cost. Tobacco, alcohol, and painkillers fall under “legitimate” drug use. Thus, many more people use them and the social harm has been greater.

The Obama administration has proposed an approach of “emphasizing prevention over incarceration” and “expanding access to treatment,” a public-health approach instead of a public-safety approach. The rhetoric has been stronger than substantive policy changes, however.

Were the war on drugs to become a public health issue, it could fuel the rise of paternalism. The government would have to protect users from themselves, effectively, and that could limit access to legal substances. Higher taxes on cigarettes, or restrictions on alcohol consumption.

Much of the danger associated with illicit drugs – high crime, gang violence, dangerous substances – could be mitigated if public policy wasn’t so focused on keeping drugs illegal.

“We believe that drug prohibition is the true cause of much of the social and personal damage that has historically been attributed to drug use,” Law Enforcement Against Prohibition noted.

Shift to harm reduction instead of prohibition, the idea goes, and police can focus on violent crime and gang violence. Preliminary results from marijuana legalization in Colorado suggest that paring down the war on drugs lets the police focus on greater threats to public safety, but researchers won’t have a clear picture for a few more years.

The deadly effects of legal drugs have never been much of a secret. Tobacco, after all, has been under a decades-long siege from health advocates. Alcohol prohibition has been tried already and failed miserably. The public has embraced marijuana legalization, but it’s a long way before projects like “addict recovery rooms” lose their controversial nature.

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