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Bottom Line

Misdiagnosis of a Problem: Why Can’t We Solve the Problem of Addiction Jon Caulkins RAND Drug Policy Research Center Carnegie Mellon University Heinz School of Public Policy & Management. Bottom Line. Drug problems do not fit any pigeon hole Vary by substance Vary by perspective/objective

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Bottom Line

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  1. Misdiagnosis of a Problem:Why Can’t We Solve the Problem of AddictionJon CaulkinsRAND Drug Policy Research CenterCarnegie Mellon University Heinz School of Public Policy & Management

  2. Bottom Line Drug problems do not fit any pigeon hole Vary by substance Vary by perspective/objective Not just a criminal justice problem Not just a medical problem either They are hard problems; no silver bullets

  3. What Drugs Are Dangerous?

  4. Scaling the Problems *Acute, single-cause only ** Multiple-drug, delayed, or indirect result of drug use (accidents, illness, etc.)

  5. Illegal Markets • Tobacco and Alcohol • Sale to minors usually done at cost or as a favor • Marijuana • High-prevalence but low cost so “only” ~$10B per year • Retail distribution within social networks; little violence • “Expensive drugs” (Cocaine, heroin, meth) • Low-prevalence but remarkably expensive so ~$50B per year • High levels of crime and violence • Half is “systemic” (transaction-related conflicts) • One-third is “economic-compulsive” (committed to finance purchases) • One-sixth is “psychopharmacological” (induced by intoxication/withdrawal)

  6. Summary of Sources of Harm • Tobacco • Not a big problem except that chronic effects kill 400,000 or 500,000 people per year • Externalities are primarily through health insurance and second-hand smoke, some from productivity losses • Alcohol • Harms from intoxication, addiction, & chronic use • Expensive illicit drugs • Harms from black markets, control efforts, & addiction • Marijuana • Harms are modest; productivity effects may dominate

  7. Nature of Drug Problem Varies by Perspective • Health insurers: smoking and alcohol • Typical employer: alcohol (& others) • Parents’ short-term fears: marijuana & alcohol • Parents’ long-term fears: (should be) smoking • Childrens’ fears: parents’ addiction (to anything) • Govt budget balancers: alcohol & drug enforcement • Violent death: alcohol & expensive drugs’ markets • Infectious disease: injecting drugs

  8. Controlling the Problems

  9. Bottom Line Drug problems do not fit any pigeon hole Vary by substance Vary by perspective/objective Not just a criminal justice problem Not just a medical problem either They are hard problems; no silver bullets

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