by Elliott Morss, Morss Global Finance
American jails are full of citizens for possessing small amounts of drugs. At the same time, smoking, an activity that kills almost 500,000 American annually, is allowed. Guns kill more than 30,000 Americans per year. They are also allowed.
In a civilized society, government limits on citizens’ actions should only apply where harm to either the individual being restricted or the society at large is significant. In the US, this is sadly not the case. Below, US government restrictions on human activities causing considerable harm are compared to with restrictions on activities causing little harm.
What Causes Harm?
If one measures harm by the number of deaths, smoking leads the list by a wide margin: in the US, more than 480,000 die annually from smoking. And tobacco contains nicotine, one of the most addictive drugs there is. 40,000 Americans commit suicide yearly. And every year, 34,000 Americans die in motor vehicle accidents and more than 2 million are injured annually. Guns are also a killer: more than 32,000 are killed annually by guns (that averages 88 daily) with more than 80,000 injured by guns.
But number of deaths is not an accurate indicator of total harm. While only half as many people die from drinking than smoking every year, a good argument can be made that alcoholism is more harmful. Why? Because drunks lose jobs, kill people while driving, and destroy family/friend relationships.
As I have written in an earlier piece, the World Health Organization (WHO) has developed a “harm statistic” – the Disability-Adjusted Life Years (DALYs). It measures years lost both because of a premature mortality and years lost due to time lived in less than full health. The DALYs for global self-inflicted harm are presented in Table 1.
Table 1. – Dangerous Addictions’ Share of Total DALYs, 2004
Alcohol has the largest DALYs’ share even though DALYs do not include harm done to family/friend relationships. There are two other items worth noting in Table 1:
- The inclusion of overeating as causing harm;
- The small DALY share for illicit drugs.
Overeating Causes Harm: Where Are the Regs?
The DALYs included in Table 1 for overeating come from the “Overweight and Obese” WHO category for all countries. WHO reports that even in developing countries, the number of obese children now exceeds the number malnourished.
The DALYs share for the US has not been calculated but is much larger than the global total: 74% of Americans are overweight and 36% are obese – much higher numbers than for the world or other developed nations. And the DALY number could be much higher. Why? Because of problems in assigning causes to health problems. Table 2 shows what share of cancers, cerebrovascular diseases, diabetes mellitus, heart disease, and osteoarthritis the WHO attributed to being overweight or obese (5%). But look at the other primary headings in Table 2: high blood pressure, high cholesterol, high blood glucose, low fruit and vegetable intake, and physical inactivity. Ask any doctor, and s/he will affirm that all of these are all directly linked to being overweight/obese. So is the 5% accurate? Or should more of the other causes mentioned constituting 22% of total DALYs be included as part of the overweight/obesity DALY Share?
Table 2. – Other DALYs Associated with Being Overweight/Obese
* Indicates illness associated with overweight/obesity
In a recent study, the McKinsey Global Institute concluded that the global cost of obesity has risen to $2 trillion annually — nearly as much as smoking or the combined impact of armed violence, war and terrorism. McKinsey concluded that almost all the identified interventions to reduce obesity are cost-effective for society—savings on health-care costs and higher productivity could outweigh the direct investment required to deliver the intervention when assessed over the full lifetime of target population.
One “saving grace” of smoking is that smokers weigh less and people who quit gain on average 5-10 lbs.
Efforts in the US to curb obesity are just starting – Federal efforts to improve school meals and labeling. Some efforts are misguided such as urging obese people to exercise when their top priority should be to lose weight by eating less. For an excellent new book on the dangers of exercise, see Dr. Steven Barrier, “Exercise Will Hurt You”).
The important point here is that any list on activities that cause harm should include overeating, and it should be high up on the list.
What Does Not Cause Harm?
Prostitution is one of the largest “entertainment” industries in the world. I recently estimated that its revenues exceed $400 billion. With the exception of a few cities in Nevada, prostitution is illegal in the US. This means a criminal element is providing the service. The harm resulting from prostitution is the direct result of it being a criminal and therefore unregulated industry:
- Children are forced into the business by that criminal element and
- Some HIV/AIDS infections occur.
b. Illegal Drugs
Entertainment drugs are like alcohol and food: they are bought because buyers believe they will add value to their lives. And like alcohol and food, most people use illicit drugs in moderation for enjoyment: to relieve stress and relax. Only a small portion of users become addicted. For example, the UN reports that only 2% of the people using Marijuana or Opioids, including Heroin, end up having treatment.
But these drugs are banned in the US. There is considerable evidence suggesting that US efforts to curtail illicit drug use are not working. The 2011 US National Survey on Drug Use concluded:
“The overall rate of current illicit drug use among persons aged 12 or older in 2011 (8.7 percent)…was higher than the rates in most years from 2003 through 2008.”
The UN Office on Drugs and Crime found:
- “[In the US]…the number of prescription overdose deaths exceeds the number of cocaine, heroin, and methamphetamine deaths combined.” Apparently doctors have become a bit “generous” in prescribing “pain killers”.
- “The UN has found that seizures are not an indicator of interdiction success but rather an indication of increased production and consumption.”
In sum, the banned drugs harm few and add value to the lives of most users. And far more people are killed in drug gang wars and US interdiction efforts than from drug use.
It is against US law to take one’s own life. Nevertheless, 40,000 people commit suicide each year, with guns used in about half the cases. Do suicides cause harm? Of course, friends and relatives are troubled. But if a person of sound mind chooses to end their life, it is hard to understand why it should be illegal. Fortunately, some US states are starting to adopt death with dignity laws.
Table 3 summarizes the activities discussed above along with US government programs on them.
Table 3. – Human Actions Causing Harm and Government Programs Related Thereto
Tobacco is a real killer and nicotine is one of the most addictive drugs there is. Despite this, smoking is not illegal. Instead, there are age restrictions along with heavy taxes, treatment and education programs on its dangers. Banning smoking would make things much worse: criminals would start providing the product. The same thing holds for alcohol – we learned this during the Prohibition era.
Given the harm caused by overeating, efforts to curb it are amazingly inadequate: special taxes are not levied on unhealthy food (like sugar). In fact, it is just the opposite: the growers of sugar and other bulk carbohydrates receive subsidies from the US government!
Evidence on the numbers of people shot annually suggest guns are too dangerous for citizens to possess. But a small, selfish group of “law-abiding” gun owners are holding the rest of the country hostage so they can enjoy their gun shooting hunting hobby. Remember Vice President Cheney shooting another hunter by mistake? Through its lobbying arm, the National Rifle Association, Congress has not even passed a bill requiring background checks on gun purchasers. In addition to meaningful background checks, it would make sense to do with guns what we do with motor vehicles: require licenses and insurance for gun owners. The insurance would be costly and would deter at least some gun purchases.
When it comes to illicit drugs, it is important to keep in mind that as with alcohol, a very small percent of consumers get in trouble and need treatment. And as has been said above, when there is a significant market for a product in the US all a ban does is mean it will be provided by a criminal element. We should do with illegal drugs what we do with cigarettes – legalize them and tax them heavily. Some of the revenues can pay for education and the increased treatment costs that would result from legalization. Considerable resistance to any relaxation is drug laws is already coming from the unions of prison workers.
Bans on prostitution and suicide need to be rethought. Like earlier bans on alcohol, they appear to be a residual from an earlier time when the church or state made most decisions for individuals.