>> WHILE THE U. S. BATTLES A FENTANYL CRISIS AT HOME, THE TRUMP ADMINISTRATION IS TAKING ITS FIGHT AGAINST DRUGS TO THE CARIBBEAN.

DOZENS HAVE BEEN KILLED SINCE PRESIDENT TRUMP ANNOUNCED MILITARY OPERATIONS AGAINST WHAT THE ADMINISTRATION SAYS ARE DRUG BOATS BY VENEZUELAN TRAFFICKERS.

THERE ARE A LOT OF CRITICISMS.

DRUG HISTORIAN ARGUES THIS STRATEGY IS FALLING SHORT.

>> DAVID, THANKS FOR JOINING US.

YOU WROTE AN OP-ED IN THE "NEW YORK TIMES" TITLED "I'M A DRUG HISTORIAN, TRUMP IS WRONG ABOUT FENTANYL ALMOST EVERY WAY. "

WHAT IS THE BIGGEST WAY THE ADMINISTRATION IS WRONG ABOUT THE NEW WAR OF DRUGS WE SEEM TO BE PROSECUTING?

>> FIRST, THANKS FOR HAVING ME ON TO TALK ABOUT THIS.

THE BIGGEST WAY IS THE IDEA THERE'S A DRUG-FREE AMERICA IN THE PAST WE CAN RETURN TO IF WE JUST STOP THIS FOREIGN SUPPLY OF FENTANYL.

THAT'S THE STORY, THE IDEA THAT OPEN BORDERS HAVE UNDERMINED AMERICA'S TRADITIONAL COMMUNITIES AND IF WE COULD JUST GET BACK TO THAT BEFORE STATE, EVERYTHING COULD BEGIN TO RECOVER AND WE COULD HAVE THAT TRADITIONAL AMERICA AGAIN.

AS A DRUG HISTORIAN, I CAN TELL YOU THERE HAVE ALWAYS BEEN DRUGS IN AMERICA, EVEN IN SUBURBS AND RURAL AREAS AND SMALL TOWNS.

BEEN QUITE A LOT OF DRUGS IN FACT.

IT'S NOT ALWAYS BEEN A CRISIS, BUT THERE ISN'T A DRUG-FREE PLACE TO RETURN TO IF WE STOP THIS.

>> ACCORDING TO THE CDC, THERE WERE 53,000 DRUG OVERDOSE DEATHS IN 2024, DOWN FROM 2023, AND ILLEGALLY MADE FENTANYL WERE IN 65% OF THOSE DEATHS.

EVEN WITH THE NUMBERS DOWN, MORE THAN 50,000 DEATHS A YEAR IS A STAGGERING NUMBER, SOUNDS LIKE A CRISIS.

DOESN'T THE PRESIDENT HAVE A POINT THIS IS A CRISIS?

>> WE SHOULD ABSOLUTELY BE TAKING SIGNIFICANT ACTIONS TO STEM THE DRUG BUT WE WANT THEM TO WORK.

WE WANT THE GOAL TO BE LESS DEATH AND HARM.

AND THE --IF WE AIM OUR POLICIES AT A GOAL THAT'S A MIRAGE OR FANTASY, THEY CAN'T SUCCEED.

WE WANT POLICIES THAT CAN ACTUALLY ACHIEVE SOMETHING TO IMPROVE PEOPLE'S LIVES.

AND FENTANYL IS NOT A GOOD --IT'S NOT A GOOD PRODUCT FOR CONSUMER USE, IT'S POTENT, HARD TO PACKAGE FOR SAFE USE.

SO WE SAW A SHIFT IN ILLEGAL MARKETS FROM HEROIN TO FENTANYL IN THE 2010s, AND THIS WAS A SHIFT THAT DIDN'T OCCUR BECAUSE CONSUMERS WERE ASKING FOR IT, WE WANT A MORE POWERFUL OPIOID.

IT HAPPENED BECAUSE OF POLICY CHANGES THAT CHANGED THE INCENTIVES IN SUPPLY CHAINS AWAY FROM PROVIDING HEROIN, WHICH HAD ITS OWN PROBLEMS OF COURSE, IT'S NOT A PERFECT PRODUCT EITHER.

BUT THEY SHIFTED TO FENTANYL.

WE CAN DO THAT IN REVERSE, SHIFT AWAY FROM DRUGS KILLING SO MANY PEOPLE AND REDUCE THAT HARM.

>> HELP US PUT THIS IN PERSPECTIVE FOR US.

MOST ARE FAMILIAR WITH THE OPIOID CRISIS THAT AMERICA HAS STARTED TO DEAL WITH AND STILL DOES, ESPECIALLY IN RURAL PARTS OF THE COUNTRY.

HOW DID WE GET FROM PILL MILLS, OVERPRESCRIBING, PEOPLE GETTING ADDICTED TO PAINKILLERS, THROUGH HEROIN TO FENTANYL?

>> THE PROBLEM WITH FENTANYL BEGAN IN WHAT I CALL WHITE MARKETS, LEGAL MARKETS THAT SELL PSYCHOACTIVE DRUGS, THE ONES PRESCRIBED BY DOCTORS AND SOLD BY PHARMACISTS.

WHEN THOSE MARKETED SPIRALLED OUT OF CONTROL IN THE OPIOID CRISIS, WHICH AUTHORITIES RESPONDED TO TRY TO FIX THE PROBLEM, THEIR ACTIONS WERE IN KEEPING WITH THE PHARMACEUTICAL ARGUMENT THAT THE PROBLEM IS NOT THE PRODUCT BUT THE USERS, DIVERTING THEM AND MISUSING THEM.

THE STEPS THEY TOOK WERE TO EXCLUDE THOSE BUYERS, PEOPLE WITH ADDICTION, FROM BUYING IN WHITE MARKETS.

THOSE ARE PEOPLE STRONGLY COMMITTED TO BUYING AND USING OPIOIDS AND THEY WANTED TO CONTINUE.

THERE WAS A MISMATCH BETWEEN SUPPLY AND DEMAND BECAUSE THEY DID NOT LIVE IN PLACES WHERE HEROIN WAS SOLD.

HEROIN MARKETS WERE A 20th CENTURY THING, THEY INVOLVED FARMS, WENT TO CENTRAL MARKETS IN MAJOR CITIES.

AND THE OPIOID CRISIS BEGAN IN THE SUBURBAN, RURAL AREAS.

THERE WERE PEOPLE WHO WANTED TO BUY OPIOIDS, NOT ENOUGH PEOPLE SELLING TO THEM.

MEANT SOMEBODY COULD MAKE A LOT OF MONEY.

NEW SUPPLIERS STEPPED IN AS MODERNIZERS.

DON'T NEED FARMERS AND GOP FROM THE SAP OF FLOWERS, THIS IS SO COMPLICATED.

HAVE A SYNTHETIC PRODUCT, MORE POWERFUL, AND INSTEAD OF SENDING TO A FEW MAJOR MARKETS IN NEW YORK, CHICAGO AND LOS ANGELES, SEND TO WHERE THE CONSUMERS ARE.

JUST LIKE EVERY OTHER PRODUCT IN THE 21st CENTURY.

WE HAVE PLENTY OF EVIDENCE THAT CONSUMERS AT THE TIME DIDN'T LIKE FENTANYL, THEY PREFERRED OTHER DRUGS, OXYCONTIN OR HEROIN, BUT IT WAS HARDER TO GET THOSE, SO IT SHIFTED.

>> IF THIS IS A HARD DRUG TO HANDLE, WHY IS IT SO PREVALENT?

YOU HEAR ABOUT FENTANYL IN OTHER DRUGS OR OTHER DRUGS LACED WITH FENTANYL?

>> THE TROUBLE IS FENTANYL IS A BAD PRODUCT FOR CONSUMERS, OBJECTIVELY SPEAKING, IT'S HARD TO MAKE SAFE AND DOESN'T LAST LONG, ET CETERA.

BUT IT'S GREAT FOR SMUGGLING.

I CALL THEM PROHIBITION MARKETS.

WE THINK OF THEM AS TO ELIMINATE THE SUPPLY, BUT THEY DON'T.

FENTANYL IS STILL THERE, THERE'S JUST A DIFFERENT SET OF MARKET INCENTIVES CALLED PROHIBITION.

AND THEY FAVOR A POTENT PRODUCT BECAUSE YOU NEED LESS OF IT TO MAKE THE SAME AMOUNT OF DOSES.

THAT'S VERY --THAT CAN INCREASE THE CHANCES FOR PROFIT.

BECAUSE FENTANYL IS SUCH A GOOD PRODUCT FOR SMUGGLING, IT STARTS TO OUTCOMPETE OTHER PRODUCTS.

BUT ALSO PROHIBITION MARKETS DON'T INCENTIVIZE SAFE PRODUCTION PRACTICES.

WHITE MARKETS, PHARMACEUTICAL COMPANIES HAVE TO DO A LOT OF EXPENSIVE STUFF TO MAKE SURE WHEN YOU BUY THE PRODUCT, IT IS WHAT IT SAYS ON THE LABEL.

BUT IT'S JUST AS LEGAL TO SELL ACCURATELY LABELED FENTANYL, OR POORLY MIXED.

OR SELL SOMETHING YOU CLAIMED AS COCAINE BUT IT'S LACED WITH FENTANYL BECAUSE PEOPLE DIDN'T CLEAN THE MACHINES.

WHAT HAVE YOU.

THERE'S NO INCENTIVE TO DO THE PROCESS, THE INCENTIVE IS AVOID THE COPS.

FENTANYL SPREADS OUT BECAUSE IT'S GOOD FOR PEOPLE WHOSE JOB IT IS TO MAKE MONEY SELLING DRUGS.

>> THERE'S ALSO BEEN QUESTIONING OF WHETHER OR NOT THE BOATS WE HAVE TARGETED AND ATTACKED, ARE THEY COMING FROM VENEZUELA CARRYING FENTANYL ONTO THE SHORE OF THE UNITED STATES?

>> NOTHING I'VE SEEN GGESTS THEY HAVE FENTANYL ON BOARD.

THE SUPPLY CHAIN DOESN'T INVOLVE VENEZUELA, AS FAR AS I'M AWARE, THEY'RE NOT A SIGNIFICANT SOURCE OF ANY DRUGS TO THE UNITED STATES.

I WENT TO THE UNITED NATIONS DRUG AND CRIME REPORT.

SEARCHED FOR COUNTRY NAME.

CHINA COMES UP, MEXICO, A LOT OF TIMES.

VENEZUELA COMES UP LITERALLY WITH ZERO.

THERE'S NO EVIDENCE I HAVE THAT SUGGESTS THEY'RE CARRYING THOSE DRUGS.

THAT'S PART OF THE PROBLEM WITH SHOOTING FIRST AND ASKING QUESTIONS LATER.

THESE ARE IMPOSING THE DEATH PENALTY ON PEOPLE WHO AS FAR AS I CAN TELL HAVE NEVER EVEN BEEN ACCUSED OF A CRIME, MUCH LESS CONVICTED OF ONE.

>> WHAT'S INTERESTING ABOUT THE OP-ED AND YOUR BOOKS, YOU HAVE A LONGER ARC LOOKING AT HOW THE CULTURE AND COUNTRY OF AMERICA HAS HAD PREVIOUS EXPERIENCE WITH DRUGS WE COULDN'T CONTAIN, BECAME SOCIALLY ACCEPTABLE.

PRESIDENT NIXON WANTED TO START THE WAR ON DRUGS AND WE'VE HAD A DIFFICULT RELATIONSHIP TRYING TO FIGURE THIS PROBLEM OUT.

>> WHILE THERE LONG HAS BEEN WIDESPREAD DRUG USE IN AMERICA.

STARTING IN THE YEARS AFTER THE REVOLUTION, HISTORIANS CALLED IT THE ALCOHOLIC REPUBLIC.

DRINKING RATES SHOT UP TO LEVEL NEVER MATCHED SINCE, EVENTUALLY CREATING A CENTURY LONG CRUSADE AGAINST ALCOHOL THAT CAME TO A CONSTITUTIONAL AMENDMENT TO CRIMINALIZE THE SALE AND TRANSPORT OF ALCOHOL.

THE PROBLEM HAS BEEN THERE.

AND THERE'S TIMES THAT WIDESPREAD DRUG USE HAS LED TO PUBLIC HEALTH CRISES AND TIMES OF WIDESPREAD DRUG USE AND NO HEALTH CRISIS.

WHAT'S THE DIFFERENCE BETWEEN THE TWO?

I'VE DEVELOPED A RULE OF THUMB.

PUBLIC HEALTH CRISES USUALLY COME WHEN CERTAIN COMMUNITIES OR LOTS OF COMMUNITIES ARE FLOODED WITH A DANGEROUS DRUG, MEANING IT'S REALLY, REALLY EASY TO ACCESS.

AND THINK ABOUT THIS IN MY OWN LIFE, IN 1980s I WAS IN HIGH SCHOOL AND KIDS KNEW HOW TO GET BEER AND CANNABIS.

OUT OF ALL THE ILLEGAL DRUGS THAT EXISTED, THOSE ARE THE ONES KIDS USED IN MY HIGH SCHOOL BECAUSE THEY WERE EASIEST TO GET.

THERE WAS INFORMAL HARM REDUCTION GOING ON.

IN THEORY, SUPPOSED TO USE NO DRUGS, BUT IN REALITY THE ONES THEY HAD ACCESS TO WERE RELATIVELY SAFER THAN IF I'D BEEN IN HIGH SCHOOL IN THE 2000 s AND EVERY PARTY HAD A TON OF OPIOID PILLS.

THAT FLOODING IS BASIS OF A LOT OF THE CRISIS.

>> DO YOU SEE PARALLELS, NIXON STARTS A WAR ON DRUGS AND PRESIDENT AFTER PRESIDENT IN DIFFERENT WAYS QUOTE THAT OR COME UP WITH THEIR OWN SLOGAN.

JUST SAY NO WITH NANCY REAGAN.

EVEN NOW, ARE YOU SEEING THE RHETORIC POLITICALLY THAT COMES OUT TO STOP FENTANYL, ARE THERE PARALLELS BACK IN HISTORY?

>> A LOT.

EVEN BEFORE NIXON.

FIRST FEDERAL ANTIDRUG LAWS WITH MANDATORY MINIMUM SENTENCES WERE 1950s.

IT'S EASY TO UNDERSTAND THE REACTION.

ADDICTION IS FRIGHTENING, I'M A PARENT OF THREE CHILDREN AND IT'S TERRIFYING TO IMAGINE THESE HARMS BEFALLING YOUR CHILDREN.

THE IDEA OF SOMEONE SAYING I'M GOING TO TAKE A TOUGH APPROACH AND REALLY PUNISH AND SCARE THE PEOPLE WHO WANT TO THREATEN YOUR CHILDREN --IT'S EMOTIONALLY SATISFYING.

AS A PARENT I FULLY UNDERSTAND IT.

UNFORTUNATELY, HISTORY SHOWS IT SIMPLY DOESN'T REDUCE THE RISK, SIMPLY IS INEFFECTIVE.

DON'T HAVE TO DEBATE IF IT'S BETTER OR MORAL, BUT IF YOU WANT KIDS LESS HARMED BY DRUGS, THAT'S NOT THE APPROACH YOU TAKE.

PROHIBITION MARKETS SELECT FOR MORE DANGEROUS DRUGS, MORE DANGER TO YOUNG PEOPLE THAN LESS.

IF WE ARE SWITCHING NOW, SHIFTING BACK TOWARDS THAT RHETORIC, HARSH ANTIDRUG RHETORIC, TRYING TO DEAL WITH DRUG PROBLEMS THROUGH -LIKE ACTIONS LIKE BLOWING UP BOATS IN THE CARIBBEAN, THAT SUGGESTS ANOTHER PERIOD OF LENGTHENED CRISIS BECAUSE THOSE APPROACHES DON'T WORK.

THE WAY THAT APPROACHES HAVE BEEN WORKING TO REDUCE THE NUMBER OF OVERDOSE DEATHS, YOU CITED 50,000.

THERE WERE OVER 100,000 RECENTLY AND NOBODY WAS BLOWING UP BOATS WHEN IT HAPPENED.

IT WAS BECAUSE OF A SET OF PRACTICAL POLICIES WITH THEIR GOAL OF PREVENTING OVERDOSE DEATHS.

TALKING ABOUT FENTANYL TEST STRIPS SO PEOPLE CAN TELL WHAT'S IN THE DRUG THEY'RE ABOUT TO USE.

AND SAFE INJECTION SITES WHICH KIND OF BRING INTO PROHIBITION MARKETS A LITTLE BIT OF THAT WHITE MARKET SAFETY WITH A MEDICAL PROFESSIONAL THERE.

THOSE THINGS HELP REDUCE DEATH.

EVERYONE SHOULD AGREE THAT PEOPLE SHOULD STAY ALIVE AND THAT SHOULD BE THE CENTRAL GOAL OF DRUG POLICY.

>> WHEN YOU THINK OF THE LONGER ARC OF HOW A COUNTRY CAN TACKLE A PROBLEM LIKE THIS, IS THERE A COUNTRY THAT'S DONE IT WELL?

>> I THINK THERE ARE --THERE ARE PRECEDENTS IN THE UNITED STATES.

MOMENTS WHERE THE POLICIES WORKED REASONABLY WELL.

AND I WANT TO BE CLEAR, THERE IS NOWHERE THAT HAS NO DRUG PROBLEMS OR HARMS.

BUT WHAT HAD BEEN HAPPENING IN THE 1950s AND '60s WERE TWIN CATASTROPHES.

WHITE MARKETS SELLING SELLING BARBITUATES AND THERE'S TONS OF HARM, OUT OF CONTROL.

WAVES OF HEROIN ADDICTION WERE WASHING THROUGH AMERICAN MAJOR CITIES.

ALL ELEMENTS OF AMERICAN DRUG POLICY WERE FAILING DRAMATICALLY AND CATASTROPHICALLY BY THE LATE 1960s.

AND INITIALLY THE WAR ON DRUGS LOOKED DIFFERENT THAN WHAT IT BECAME.

INITIALLY INVOLVED TIGHTENING THE SCREWS ON THE PHARMACEUTICAL INDUSTRY, REGULATING THE SELLERS WHO ARE MOTIVATED BY PROFIT AND RESPOND TO INCENTIVES.

AND THEY REDUCED MANY PENALTIES FOR DRUG CONSUMERS, AND TRAINED THEIR SIGHTS ON THE BIG SELLERS.

AT THE TIME THEY INVESTED MASSIVELY IN SERVICES AND SUPPORTS THAT PEOPLE WHO DEVELOPED ADDICTION MIGHT NEED.

THIS IS WHEN METHADON BECAME WIDESPREAD.

WHEN YOU THINK ABOUT THE COMBINATION OF REGULATING SUPPLIERS, AND IN A SMART WAY.

MORE DANGEROUS DRUGS LIKE AMPHETAMINE WERE RESTRICTED STRONGLY.

LESS DANGEROUS, CODEINE OR IN THE SEDATIVE CLASS, VALIUM, THEY WERE LESS INTENSELY REGULATED SO THE MARKET WAS STEERED TOWARD SAFER PRODUCTS.

IN THE MEANTIME THERE WAS SPECIAL RECOGNITION THAT PEOPLE WITH ADDICTION NEED DIFFERENT KIND OF RESPONSE THAN EVERYONE ELSE.

>> WE'VE HAD VERSATIONS WITH PEOPLE RUNNING NEEDLE PROGRAMS AND WE KNOW THE STATISTICS BACK UP THESE WORK.

IF WE KNOW THAT FOR SURE, WHY ARE THERE NOT LARGER SCALE POLICIES TO KEEP PEOPLE ALIVE TO GET OFF THESE DRUGS?

>> A LOT OF IT HAS TO DO WITH CULTURAL FEARS ABOUT DRUG USE AND REDUCING THE MORAL STIGMA OF DRUG USE WHICH PEOPLE BELIEVE PREVENTS PEOPLE FROM USING DRUGS.

BUT IT'S ALSO THAT THERE'S A DEGREE OF LEGITIMACY TO THE FEARS THAT COMES FROM A DIFFERENT ANGLE.

I'VE BEEN MOSTLY TALKING ABOUT HOW PROHIBITION MARKETS SELECT FOR DANGEROUS DRUGS.

BUT IT'S ALSO TRUE THAT FREE MARKETS, LEGALIZATION AND JUST OPEN MARKETS THOSE ALSO LEAD TO SELECTING TO DANGEROUS PRODUCTS.

CIGARETTE INDUSTRY ADDING HUNDREDS OF CHEMICALS TO INCREASE ADDICTIVENESS EVEN THOUGH IT HARMED LUNGS.

IT'S NOT IRRATIONAL TO THINK IF YOU OPEN UP AN INCH --WE LIVE IN A PROFIT DRIVEN SOCIETY, DRUGS ARE PROFITABLE.

CAN BE A REASONABLE FEAR IF YOU OPEN UP AN INCH, CORPORATIONS WILL TAKE A MILE, AND WILL BE DAMAGE.

SO YOU WANT TO KEEP THE DOOR SHUT.

THIS LEADS TO FAILURE OF POLICY CREATIVITY.

YOU HAVE PROHIBITION AND FREE MARKETS.

IF YOU DON'T EXPLORE ANYTHING IN THE MIDDLE, YOU HAVE THE TWO WORST OPTIONS.

IT'S A TERRIBLE TRAGEDY WE'RE NOT WILLING TO TRY TO APPLY THE INCREDIBLE EXPERTISE WE'VE DEVELOPED OVER CENTURIES MANAGING THESE MARKETS, I THINK WE NEED TO PURCHASE LEGITIMACY BY SHOWING WILLINGNESS TO REGULATE THOSE MARKETS ROBUSTLY.

THE GOAL IS NOT FOR EVERYBODY TO USE DRUGS BUT PEOPLE THAT USE DRUGS TO USE SAFER ONES IN SAFER WAYS AND REDUCE HARM.

>> PROFESSOR, THANK YOU.

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