FDA Considers Banning Acetaminophen-Based Pain Killers 631
Greg George writes "The FDA has determined that Tylenol enhancing pain killers are dangerous enough to potentially be pulled from the market. Drugs including Vicodin, Hydrocodone, Lortab, Maxidone, Norco, Zydone, Tylenol with codeine, Percocet, Endocet, and Darvocet may be permanently banned from the US market, even if the patient has a prescription from a doctor. The problem is the key ingredient — acetaminophen — can easily damage or destroy a patient's liver if more than 2000 mg are used per day. In many cases that means if you take a pain killer and then take two extra strength Tylenol, you may have gone over the maximum dosage per day."
more pointless prohibition (Score:1, Insightful)
As someone who was prescribed Percocet after reconstructive surgery (my arm is full of plates and pins) the effect they might have on my liver was the furthest thing from my mind. Even had I known of this risk, I'd have not been at all hesitant about the drug.
Its also pretty hard to read that list and not assume the FDA is banning some of the more commonly abused pharmacuticals. Because, ya know, prohibition is totally what people want from their government.
Why? (Score:5, Insightful)
Would it not make more sense to educate the people taking the pills, instead of banning an effective pain reliever? Anyone taking a vicodin and then two Tylenol is either in serious pain that the hydrocodone is not treating, or is unaware of what is in vicodin. A little talk by the pharmacist or doctor can fix both. Lowering the dose of APAP in prescription pills makes sense too, I mean 650mg in Darvocets? Take that 4 times a day and you are already over the daily dose. All of that just to prevent some junkies from getting high?
Not that I will argue too much, since I can't take Aspirin or ibuprofen, it will be much easier to get a script for pure codeine.
Only because of stupid people. (Score:4, Insightful)
The problem is with the idiots that take 1000mg and then cant wait for it to work so they take another 2-4 in an hour or so.
The people that are stupid and dont read the bottle that says" DO NOT TAKE MORE THAN XXX in a 24 hour period." It's clear as day on the fricking bottle.
So we ban something because the average person is too stupid to read the bottle?
Can we ban water as well? if you drink 6 gallons in an hour it will kill you!
Re:not really a ban (Score:2, Insightful)
Yes, let's protect people from their own stupidity. Next, we can make it illegal to sell desks without permanently attached foam on the corners to protect you in case you trip!
Anyone taking medicine should know they have to check for drug interactions and overdoses. The medical industry has been harping about it for years. If the product they offer is safe when following the directions, then it's not their problem if people do stupid things with it.
So wait... (Score:4, Insightful)
The FDA made the drug companies put acetaminophen into the narcotic painkillers to keep people from recreationally overdosing on them (same as they "denature" ethyl alcohol that you can buy at the hardware store by poisoning it with methyl alcohol), and then when druggies take large doses anyway and cause liver damage and death, the FDA is *surprised*?
Well (Score:3, Insightful)
If this is an issue with miss use, then pulling it from the shelf seems ok; however not letting a doctor prescribe it is just stupid.
Re:more pointless prohibition (Score:3, Insightful)
Logic fail (Score:2, Insightful)
Hydrocodone has 0 requirements to be "cut" with acetaminophen. Neither does oxycodone. It's just done as a way of limiting a patient's intake of the various painkillers that are mixed with acetaminophen. Look at the dosing for Vicodin for instance (I had neck surgery a while ago for a herniated neck disc & did a bit of research);
- 5mg hydrocodone for 500mg acetaminophen
- 7.5 for 750
etc
Similar ratios with oxycodone.
So you really end up being limited by the amount of (unecessary) acetaminophen which has _nothing_ to do with the RX painkillers in question. The fact that liver damage etc is so prevalent with acetaminophen simply means they need to remove that component of it, and people consume that as as seperate pill.
Such silliness. Don't force people to take acetaminophen if they don't need it - damage from that is a very real problem with these painkillers. It makes no sense - "let's prevent people from overdosing on the painkiller by adding in something that will cause liver failure if they take too much of it!" "omgz grate idea I just happen to have a great deal worked out with this acetaminophen provider. We'll all get rich!"
Some more harmful things they should ban: (Score:1, Insightful)
-Pointy sticks
-Firearms
-Automobiles
-Anything harder than nerf
'Cos you know, you could kill yourself if you used those things improperly.
Alcohol (Score:5, Insightful)
So when will the FDA ban alcohol for destroying people's livers?
Why BAN and not WARN? (Score:5, Insightful)
As it currently is, with the current ads and warnings, more people think that something like Tylenol with Codeine is pretty safe to take. I mean, its Tylenol, safe for your stomach (too bad just not necessarily safe for your liver).
Re:more pointless prohibition (Score:4, Insightful)
But if you take drugs as correctly prescribed, you can, and should, have both. In spite of the hysteria, people have taken vicodin for pain and not died from liver failure.
Re:Only because of stupid people. (Score:3, Insightful)
"So we ban something because the average person is too stupid to read the bottle?"
Perhaps if ti's the average person, then there is an issue.
Anyways, this is just a ban from putting two specific medication together in the same pill. There reason are good and are not "because the average person is stupid".
Of course, one if the most stupidest things someone can do is post about an article they clearly didn't read. Of course, the most stupiest thing, bar none, is having a land war in Asia.
Therapeutic Index (Score:4, Insightful)
One problem with the substance is that the doses in which it's effective are so close to the doses in which it's toxic, as mentioned.
The other problem is that you can take a fatal overdose, and you'll be fine for three days. Then you die very horribly indeed.
A lot of the time a suicide attempt is the proverbial "cry for help". Someone overdosing on acetaminophen might take their overdose and fall asleep in a tearful puddle, feel emotionally purged and a lot better in the morning. And then discover a few days later that they are the walking dead.
Most other drugs have the virtue of making you feel ill enough to seek (or attract) medical attention. Some of them you can just literally "sleep off", with enough support.
That said, it's an excellent drug. Safe, when taken as prescribed, very few side effects, and effective, as evidenced by the enormous number of combination preparations containing it - it reduces the overall dose of opiates that need to be taken and that's a good thing.
The downside of this profligate mixing with other drugs of course, is that if you're not 100% clued up on which preparations you are taking, you might take an overdose.
I'm an ex-doctor. I had no idea that Vicodin contained it until I read TFS. I've never prescribed the stuff though. If I was living in blissful ignorance every time Greg House popped a little blue pill, imagine what the general level of knowledge is amongst Joe Public.
The tinfoil-hatted part of me thinks that they only mix acetaminophen with opiates to stop junkies abusing them anyway. Who'd be stupid enough to take a fatal overdose of something that doesn't even get you high ... oh , wait, the general public, after we spent so much time and effort dumbing them down...
Re:If You Drink Alcohol Avoid Acetaminophen (Score:5, Insightful)
Maybe your sister should have told you not to drink that much alcohol in first place. Makes a lot of more sense that way.
cigarettes (Score:2, Insightful)
how about Glypizide? (Score:4, Insightful)
Re:not really a ban (Score:5, Insightful)
Of course, instead of the intended effect of less drug abuse, we now have more liver failures, at a higher societal cost. This is the same thinking that has people opposed to clean needles programs - does less clean needles mean people will inject less? No, actually they will still inject, and they will have a higher chance of contracting Hepatitis or HIV.
Re:Alcohol (Score:3, Insightful)
The US government tried banning alcohol. It didn't take.
Easy to OD on acetaminophen. Need better labels. (Score:5, Insightful)
This actually happened to me. A few years back I had open heart surgery. After spending a week in hospital, I was released with a big fat percocet prescription (having your sternum in 2 halves is remarkably painful). I was told to "try" to get by on Tylenol, but to take the percocet if the pain was too much. Funny thing about narcotics...it's pretty easy to forget how many and exactly WHEN you last took the medication. In 3 days, I managed to completely shut down my liver by taking two percocets every 4-6 hours. Back into hospital I went and it took about a week for my liver to "wake up." It could have just as easily failed permanently and resulted in my eventual death.
The doctors and nurses who were responsible for prescribing the medication did a lot of finger pointing about WHO should have let me know about the risk of hepatic failure, but the end result was "you should have known better." I'm a programmer, not a doctor...for fook sake.
Also, as someone else mentioned, it is remarkably easy to destroy your liver when you consume alcohol along with acetaminophen. That should be a big bold warning on the label, not fine print.
Best,
Re:not really a ban (Score:5, Insightful)
Adding an agent that can, and does, cause liver failure and unpleasant death, just to discourage recreational narcotics use, reflects a pretty disturbing set of priorities. Given that recreational narcotics use isn't wildly healthy to start with, it should be able to discourage rational actors without added acetaminophen(and, if it isn't actually that dangerous, why restrict it?). Adding it basically amounts to displaying a willingness to kill drug users, along with people too sick or old to read a bunch of warning labels and cross-check for potential drug interactions. Srsly. WTF?
Re:As someone with a lortab prescription... (Score:1, Insightful)
I think you'll find that it's the hydrocodone that causes nausea. It's a pretty common side-effect of all opiod analgesics. The paracetamol (acetaminophen) has very few side-effects associated with it, besides the liver damage in excessive doses.
Re:Why? (Score:3, Insightful)
Would it not make more sense to educate the people taking the pills, instead of banning an effective pain reliever?
No, because there are too many over the counter medications with acetamenophine in them. If you're takinig vicodin for your injury and cough syrup for your cough and then a shot of Nyquil before bed, you may not know that the cough syrup and Nyquil have tylenol in them.
Better to take the tylenol out of the Vicodin and Nyquil and cough syrup. If theat were the case and you overdosed, then it would be your own fault.
Darvocets are far less effective than the older Darvons for injuries, because acetameniphine won't reduce swelling while aspirin will. Of course, aspirin is so cheap and easy to make that it isn't the cash cow for the pharm companies, which is why they push the less effective, more dangerous Tylenol.
Re:not really a ban (Score:5, Insightful)
Most people have no idea what the maximum safe dosage of acetaminophen is. And even if they do, the point is that it's easy to take your vicodin prescription and then take some Nyquil without realizing that Nyquil has acetaminophen as well. The average person is not a pharmacist, and really shouldn't be expected to be one.
When I had surgery on my hand my doctor's instructions for frequency of use on the vicoden would have put me over the 4000mg limit. The pharmacist told me I needed to make sure I only took 5 a day instead of 6 (or something like that, can't quite remember what the frequency was anymore).
Now imagine my doctor had written the prescription correctly for 5 doses a day. There's no reason for most people to know the maximum daily dose value. It would have been quite easy to take the maximum dosage just on pain pills, then take a few doses per day of some OTC med (maybe something for allergies) that lists acetaminophen in the small print and exceed the max dose by quite a bit. Nyquil Sinus for example has 650mg per dose and allows up to 6 per day. Accidentally exceeding 4000mg would be easy.
Jaundiced junkies in the ER, (Score:5, Insightful)
my wife sees it all the time - dead livers. The concern isn't for people taking this on prescription. They can get a different preparation if necessary. Good riddance. Better yet, get rid of the whole prescription regime. Many doctors are sick of being the narcotic gate keeper. On one side is the DEA looking to pull your license and prosecute, on the other a patient who may or may no be in pain. It's the doctors responsibility to correctly identify drug seekers. Chronic pain rarely kills. What would you do if your livelihood could be taken away for prescribing narcotics to a patient who you believed to be in pain, but was a very clever junkie? I have a feeling there are a lot of chronic pain sufferers that aren't having their pain managed correctly because their physician fears being accused of over prescribing narcotics. More senseless shit brought to you by the War on Drugs. As the late but not so great Bill Hicks said - it's not a war on drugs, it's a war on personal freedom.
Re:not really a ban (Score:5, Insightful)
In this case, assuming suitable labeling, "stupidity" implies possession of fairly low cognitive capacity(for label cross checking) and/or memory(for tracking pills taken over time). Sounds an awful lot like, for instance, the sicker, more arthritic old people who, as a population, probably suck down painkillers and anti-inflammatory drugs like nobody's business.
Obviously, product safety is a matter of degree, with the obviously absurd on one end, and the self-evidently necessary on the other. Navigating the middle, though, is far from obvious. Do you have a particular reason for assigning this case to the "obviously absurd" end of the pool, or is it just a gut reaction?
Re:If You Drink Alcohol Avoid Acetaminophen (Score:3, Insightful)
By the logic in this thread I would suggest that is is alcohol we should take off the market. After all, it damages your liver and all kinds of alcohol can be purchased WITHOUT the advice and guidance of a professional. Furthermore, it is understood that you need to take care when taking medicine; otherwise why would you need a prescription to take much of it. However, it is not the same for alcohol.
I wouldn't go that far, and I find a small problem with your reasoning. While it's true that the warnings against taking too much acetaminophen are printed clearly on the drug facts label while the alcohol containers have only the vague "may cause health problems" warning, the effects of taking too much alcohol can be readily seen. One becomes aware of intoxication, people feel physically sick, and, ultimately, the person is fully aware that they're hurting themselves. All of this can occur in a single night during which little liver damage takes place, and the person can use their sickness as a warning against further abuse or ignore it; it's their choice.
Taking too much Tylenol, on the other hand, does not manifest itself right away. As long as the headache goes away a lot of people will say "screw the warning, I want to feel better so I'll take six...it's never hurt me before". And so without recognizing the problem and despite being warned, people take too much and can't feel their consequences until it's too late.
Personally I'm not in favor of banning either drug, and I really wish the government would just keep providing the warnings as they always have and leave it to the people to ignore them.
Re:not really a ban (Score:3, Insightful)
What's so wrong with a good, 'ol firearm discharged to the temple?
Re:not really a ban (Score:3, Insightful)
Regardless that it would be more effective and less dangerous than most NSAIDs
No. It's not. That's the point.
Aspirin is safer than acetaminophen. Ibuprofen is safer than acetaminophen. For that matter, narcotics are safer than acetaminophen -- you are, no shit, better off with a lifelong narc dependency than you are poisoning yourself with this crap. And it's been pushed on us for years, in various ways, by a well-funded lobby which has all the compassion of the Mafia and all the ethics of your typical sewer rat.
Citation Needed (Score:3, Insightful)
I think I'll need a citation for this one. I find the logic suspect that a typical recreational drug user would avoid abusing Oxys out of concern for acetaminophen overdose.
The article claims that acetaminophen and oxycodone, et al, are packaged together because they act on different pain receptors. I find this explanation to be far more believable than yours, sorry.
Re:What will kill pain then? (Score:1, Insightful)
Yes, some restrictions of freedoms are okay. I am perfectly willing to accept the following restrictions as draconian as they may be:
No killing another person intentionally. ...
No taking of another persons possessions without their knowledge and consent.
No obtaining said knowledge and consent through deceitful means.
Drive on the right hand side of the road.
Obey posted speed limits when driving.
So, yes, I am prepared to take some restrictions in stride, because I know that they are in place to protect people (from killers, theives, fraudsters, oncoming traffic and speeders respectively), including myself.
This is what we call a social contract:
http://en.wikipedia.org/wiki/Social_contract
Re:I for one (Score:3, Insightful)
Do not welcome our nannystate overlords.
Seriously why do we have to keep legislating everything.
When did the FDA become a legislative body? Did I miss that?
The FDA can schedule drugs, so they can decide whether or not I'll get locked in a cage for putting a particular substance in my body. I don't think the term "legislating" is too far off.
Soon after Government run healthcare they are going to tell you want you can and can't eat.
And yet in countries with publicly funded health care the government doesn't do that. It's almost as if your comment is just plain bullshit.
And yet in the US one of the main reasons for taxing tobacco and alcohol is to reimburse Medicare, so a logical conclusion is to tax "bad" food once the State is responsible for everyone's health care. Hell, trans fat is banned in some local jurisdictions so I could see banning other food substances in the future.
michael jackson,heath ledger,anna nicole smith... (Score:3, Insightful)
the issue is not education, as everyone getting a medical degree in anesthetics is impractical, nor is it competency and monitoring, as these celebrities are people who certainly could afford that, and still wound up dead. the issue is the fact you are dealing with addictive substances and intolerant thresholds to real damage and death
banning is superior to warning, as simple human nature is incompatible with responsible use of these substances. warning simply doesn't work
Re:not really a ban (Score:4, Insightful)
As the GP stated, the acetaminophen is put in the pills to reduce the "abuse potential" Since these are considered "less dangerous" (since they'll kill you before they get you very high.) the gov't lets them be given out more easily. So right now my dentist can prescribe Vicodin/etc. after a particularly nasty root canal, but if they take it off the market, he can't just write a script for the controlled substance part of the compound on its own.
Re:not really a ban (Score:3, Insightful)
Tylenol is nasty dangerous stuff. It's very easy to misuse it to a lethal degree.
Really? How so? By not reading the damn labels? I mean seriously, anything is easy to misuse at that point. How hard is it to read a label of Tylenol that says "Adults: No more than 2 tablets every 4-6 hours with no more than 8 tablets in a 24 hour period" And if you do the math, guess what? 2 tablets every 4-6 hours is 8 tablets in a 24 hour period (assuming you wait the full 6 hours).
Tylenol is no deadlier than any other drug on the market. Too damn many people just don't read their labels. If you've already taken a painkiller, it's probably safe to not take any more tylenol. If you have a question, call your freaking doctor. Again, too damn many people try to be their own doctors that it's no wonder people get hurt. You can in fact take Ibuprofen and Tylenol in combination if you take them 3 hours apart (Ibuprofen, 3 hours later Tylenol, 3 hours later Ibuprofen, wash, rinse, repeat).
And every bottle of anything I've ever seen that has acetameniphen in it says "Do not take in combination with alcohol". Just because other people are stupid and don't read the label on their meds doesn't mean I should be penalized. Changing the label on children's tylenol had no effect on those of us with a clue, but an outright ban is going to hurt, especially when the kids are miserable with pain and low grade fevers.
The problem is Acetaminophen (Score:4, Insightful)
The problem is, the lethal dose is very close to the effective dose. In addition, the effect of an overdose is not getting sick, its death. It is not a drug that should be sold over the counter. It is simply not safe.
To compound that, it is being misused. It is being mixed with opiates to prevent people overdosing for kicks on the opiates, by mixing the opiates with a substance which is lethal if too much is taken. This is a misuse of Acetaminophen, it is not being compounded with the opiates for the therapeutic effect, but for social purposes to do with our attitudes to opiate abuse.
Something similar happened in the UK with cough mixture. Everyone, pharmacists and doctors, knows that the only effective cough suppressant is codeine. However, in the mania about stopping abuse of codeine based cough syrups, it is sold either mixed with other positively harmful ingredients or not at all. In Gee's Linctus, for example, an optium extract is sold mixed with Quill, which is a truly noxious substance and one of the worst things to give to an invalid.
We need to do a few things. One is to focus more on getting the opiates to people who are sick, stop worrying about people who are sick and need them abusing them. They will not. This implies that if people need opiates, prescribe the things to them, not mixed with crap they do not need. The second thing is we do have to have a rational drug policy which prevents the crime and disease associated with opiate abuse - but what we do not need is to screw up sick people's access to drugs they need in the name of doing this. Not that it does it, anyway.
The third is we need to take Acetaminophen off the over the counter list altogether.
If a doctor wishes to prescribe a mixture of opiates and Acetaminophen, that's a professional decision. There is no reason why Acetaminophen despite its dangers should not be available on a prescription basis, it may have unique applications. But there is every reason why a drug with those characteristics, and to which there are perfectly good over the counter alternatives, should not be sold over the counter, let alone mixed in half the over the counter pain relief and cold remedies.
We should not be telling people to read the ingredients and not take two over the counter pain or cold remedies at the same time under danger of dying. That is just a totally ridiculous, even criminal policy. We should be making sure that any painkiller ingredient where taking two medicines with it in at once will kill you, is not freely available over the counter.
I left hospital recently with a huge stock of this crap - opiate pain relief mixed with Acetaminophen, with the recommended daily dose right at the limit of how much Acetaminophen you can safely take. I got myself off the stuff as fast as possible at the price of feeling some pain. It was a choice I should not have had to make.
Re:House, MD (Score:5, Insightful)
How about we leave it as it is, and let people read the warning labels.
I'm tired of not being able to get a decent decongestent because of some stupid war on drugs, and now the ONLY thing that works on my headaches might be banned? Fucking enough already.. if you're too dumb to know you can even pop over the counter pills without thinking, maybe you should die of liver failure.
Oh for crying out loud. (Score:3, Insightful)
Doesn't anyone RTFA? Not even the submitter?
They are talking about removing the acetaminophen from the prescription meds. They are not talking about removing it from the market entirely.
This is to prevent inadvertent overdosing. Take a vicodin and a tylenol and you are double dosing on the acetaminophen. Most people don't know this.
IMHO this makes huge sense. Any time you combine prescription and over-the-counter meds in the same pill, you risk ODing on the o.t.c.
Re:not really a ban (Score:5, Insightful)
While what you say is true, aspirin has the same synergistic effects with oral opiates as acetaminophen, and is equivalent in terms of antipyretic and anti-inflammatory action as well. However it has a much wider margin between therapeutic level and destructive overdose level, and since overdosing usually causes tinnitus (ringing in the ears) long before any permanent damage is done, it comes complete with an audible overdose warning system.
So there is not, and has never been, a valid reason for creating acetaminophen based competitors to the aspirin based compounds that were prevalent before 1980. Such as Emperin #3 (replaced by Tylenol #3), APC, APC with Codeine, and so on.
The problem with aspirin in this regard is that about three decades ago several marketing campaigns were pushing Tylenol products by putting undue emphasis on aspirin sometimes causing stomach distress in some people. This was before it was known that stomach ulcers were caused by a bacterial infection, and it was easy to suggest that too much aspirin could be causing some ulcers.
The modern American health care industry is riddled with these kinds of bullshit pharmaceutical fads. "We'll do anything for a buck" seems to be the motto.
Aspirin isn't without its own problems. High doses for an extended period of time can lead to long clotting times, for instance. But on the whole, it is a whole lot safer than acetaminophen. It just isn't as profitable.
Re:House, MD (Score:3, Insightful)
The problem is that obviously, a large segment of people are ODing on acetaminophen and their getting liver damage. This being America where nothing is anybody's fault, obviously the fault lies with the product.
I'm all for education. Hell make the label really explicit to say something like "DO NOT EXCEED 2000MG PER DAY OR YOUR LIVER WILL EXPLODE!!!!"
If the FDA does ban acetaminophen based pain killers, a HUGE (bigger than it already is) black market is going to spring up, which is only going to get more people maimed/killed/livers exploded
* I make this claim on the idea that some people will actually sell real acetaminophen based pain killers, the rest will just sell counterfeit crap.
Re:not really a ban (Score:3, Insightful)
Don't knock your rudimentary instincts, they got our species to where it is today. While there are plenty of people who think that our species is in a sad shape, myself being one of them, I'm still quite happy with my current state of evolution. I'd love to be more 'enlightened', but I'll take what I've got.
Re:You know what? Fuck you guys (Score:1, Insightful)
It is not joking about Lupus. It is making fun of unimaginative and repetitive script writing. It is like calling a Godwin.
Re:not really a ban (Score:3, Insightful)
To the conservatives, saying "don't do drugs, but if you do here's a free needle" would be the same as saying "drug use isn't encouraged, but isn't really bad either".
Why would it be that, and why only to conservatives? Surely if we live in an objectively real world, whether or not two things are the same as each other is independent of political bias!
My argument is not in the least intellectually dishonest: I am stating clearly and without equivocation what I believe to be true of the anti-drug side, based on my experience with them and other puritans over many years. I believe that their explicit arguments are incoherent, like the one you've presented here, and therefore infer that there is another reason they are against these things, and that they are either two cowardly to say it out loud or too unreflective to be aware of (it in fairness, I think the latter is depressingly common.)
The claim "making a dangerous activity less dangerous encourages it" fails the test of empiricism on many counts--so many that it is very, very difficult to credit anyone who makes that claim with any intellectual honesty whatsoever.
It is well-known and well-documented that the United States, one of the least free jurisdictions in the developed world, has a much higher rate of drug use than other, more-free jurisdictions: http://www.sciencedaily.com/releases/2008/06/080630201007.htm [sciencedaily.com]
This despite the conservatives doing everything they can to make drug use as dangerous as possible to users, including limiting access to needle exchanges and treatment, violent interdiction of drug supplies, and incarceration of everyone involved in the drug trade from high level dealers down to individual users.
So it is not clear why conservatives would think that liberal drug laws and programs like needle exchange and other public health measures, which have a record of getting addicts into treatment in other, more free, jurisdictions than the United States, constitute "condoning" drug use. It seems to me on the contrary that such programs do nothing but recognize the fact that drug use is bad... so bad that considerable public health resources need to be directed at the problem of treating addicts, to make things better.
It is ONLY if you take a purely punitive attitude toward drug use on the basis that it is "pure evil", in the sense that "whatever the consequences, it is still bad," that such an approach makes sense, at least to me. I really and honestly don't see any other way to read conservative policies, given the objective facts of the matter: freedom-oriented, health-oriented policies reduce drug use.
Conservative, punitive policies increase drug use by making it harder for addicts to get help and destroying the legal employment prospects of people found guilty of drug crimes. Conservative policies, at the same time, make drug use more dangerous.
Can you give me any non-punitive, non-desert-based account of why conservatives think this is the right thing to do? And failing that, can you give me any rational justification for the claim that drug users "deserve" to be harmed by their activity? I just don't see it.