Markets and Prescription Drug Addiction.

• Author: Murray, Phil R.

White Market Drugs: Big Pharma and the Hidden History of Addiction in America

By David Herzberg 365 pp.; University of Chicago Press, 2020

Praising and defending markets are among the useful tasks performed by an economist. David Herzberg, a historian, tells the story of a market that is challenging to defend. His White Market Drugs is a history of addiction crises in America. Pharmaceutical drugs, it turns out, are a good example of creative destruction.

Getting the right policies on drugs is a challenging task.

Medicine-drug divide / Herzberg understands markets. Here is what he means by "white markets": "legal and medically approved social institutions within which the vast majority of American experiences with psychoactive drugs and addiction have taken place." White market drugs are "sedatives, stimulants, and opioids." The "white" in the moniker means legal markets, as opposed to illegal black markets. Also, there is a racial connotation: White market consumers are "the doctor-visiting classes: people who were white, native born, Protestant, middle-aged, and middle class." Racial minorities and immigrants shop in what the author calls "informal markets."

The existence of different markets owes to "the medicine-drug divide." This divide pervades and biases our thinking. People think "medicines" are legitimate and "drugs" are illegitimate. People buy and sell medicines in white markets; they buy and sell drugs in informal markets. Doctors prescribe medicine to patients who need medical care; dealers sell drugs to recreational users. The author proclaims, "Both law and custom are designed to promote access to medicines while prohibiting use of drugs." The medicine-drug divide is counterproductive. Too many white market consumers become addicts; too many informal market consumers become prison inmates.

Herzberg blames addiction crises on the profit motive. He claims, "Profit-driven drug markets follow a predictable damaging cycle." He continues:

Companies hype new medicines as safe and beneficial and sell with insufficient regard to consumer safety; a health crisis ensues as consumers are left ill equipped to make informed decisions; authorities respond with consumer protections and destructive drug wars; the pharmaceutical industry devises strategies to circumvent the new restrictions and start the cycle over again. First wave / There have been three addiction crises in the United States. The first involved opioids beginning around the turn of the 20th century. The second involved sedatives and stimulants spanning the middle of the 20th century. The third, familiar to contemporary Americans, involved all three white-market drugs and...