Can Combined Agents Limit Drugs?

Using pre-covid stats, a new J. Law & Econ paper tries to account for all U.S. crime costs, i.e., costs due to not everyone fully obeying all laws. These costs include prevention efforts, opportunity costs, and risks to life and health. The annual social loss is estimated at $2.9T, comparable to the $2.7T we spend on food and shelter, the $3.8T on medicine, and a significant fraction of our $21T GDP. One of the biggest contributions is $1.1T from 104K lives lost in 2018 at $10.6M each, including $0.7T from 67K drug overdoses deaths.

But such drug deaths have been roughly doubling every decade since 1980, and in the year up to April 2021, there were 100K US drug overdose deaths, making that loss by itself $1T, at least if you accepted a $10M per life estimate, which I do think is too high. Even so, drug overdose deaths are clearly a huge problem, worth thinking about. What can we do?

Reading up on the topic, I see a lot of conflicting theories on what would work best. But a big part of the problem seems to me to be that it isn’t clear who exactly owns this problem. We might see it as a family problem, an employer problem, a medical problem, or a legal problem. Yet each of those groups resists taking responsibility, and we don’t fully empower any of them to deal well with the problem.

Now I’m no expert on drug overdosing, bit I do fancy myself a bit of an expert on getting organizations to own problems. So let me try my hand at that.

I’ve previously suggested that people choose health agents, who pay for and choose medicine but who lose lots of money if their clients become disabled, in pain, or die. I’ve also suggested that people choose crime vouchers, who must pay for cash fines when their clients are found guilty of crimes, but who have client-voucher contracts able to set client co-liability and to choose punishments and freedoms of association, movement, and privacy. I’ve also suggested having agents who insure you against hard times, career agents who get some fraction of your future income, and that parents get such a fraction to compensate for raising you.

So as a man with all these hammers staring at this tough nail of drug overdoses, I’m tempted to merge them into one big hammer and take a swing. That is, how would a merged agent who had all these incentives try to deal with a potential drug problem?

Imagine a for-profit experienced expert org approved by the client’s parents when they are a kid, or by the client when they are adult. In a world with with few legal constraints on the contracts that this agent can agree to with clients. An org who probably also represents many of this client’s friends and family. An org who gains from client income, but who must pay when a client is found guilty of a crime, or suffers hard times, pain, disability, or death. An org able to limit client freedoms of privacy, movement, and association, And able to set client punishments for verified events, and to make associated clients co-liable, so that they are all punished together re events involving any one of them.

Such an agent might make sure to get addicts a reliable drug supply, or to have overdose drugs readily available. Or they might forbid clients from mixing with drug types. Or they might test clients regularly, or encourage althetics that conflict with drug use. Or any of a thousand other possible approaches. The whole point is that I don’t have to figure that out; it would be their job to figure out what works.

Now if an org with incentives and powers like that can’t find a way to get clients to avoid becoming drug addicts, or to not overdose if they do, then that would probably either be due to some larger social context that they couldn’t change, or because many individuals just like drugs so much that they are willing to take substantial chances of overdosing.

What if a larger social policy related to drugs or users was a key problem? For example, maybe drug laws are too strict, or too lax. If so, I’d expect these orgs to figure out which and lobby for changes. And given their expertise and incentives, I’d be tempted to listen to them. If you didn’t trust them so much, well then you might consider using futarchy to choose. But honestly I expect such combined agents could handle the problem regardless of larger policies.

In sum, I suggest that the key underlying problem with drug overdoses is that no expert org owns the problem, by being approved by clients yet given clear abilities and incentives to solve the problem. Yes this is a big ask, and this is my generic solution to many problems. Doesn’t mean it won’t work.