The solution to the Opioid Epidemic is the termination of prohibition. Not just prohibition of opioids, but of all otherwise illegal recreational drugs. The regulation and sale of opiates - as well as methamphetamine, LSD, ketamine, cocaine, etc. - in a manner akin to that of alcohol, tobacco, or marijuana (in some states, these days) shall greatly reduce the societal cost of drug use.

First of all, I want to address the concept of the word 'drug'. Everything that we consume is a drug. As Paracelsus observed, sola dosis facit venenum: The Dose Makes the Poison. Water, in moderation, is required for life; given in excess, one can die from its over-consumption. Grapefruit is a drug: a combination of many different chemical components including the infamous bergamottin which is responsible for acting synergistically with prescriptions thanks to its CYP450-inhibiting activities. Morphine is a drug which is derived from the plant Papaver somniferum; those seeds on that bagel you ate for breakfast contain morphine, codeine, thebaine, and a wide variety of other alkaloids.

So why are some drugs illegal whereas others are widely consumed and thought of as benign foodstuffs? Culture, for the most part. Opium and laudanum were widely used throughout the 19th century, so much so that they were often sold not only by chemists but also by haberdashers and booksellers; heroin was available, as was cocaine (though later, having been isolated only in 1860, half a century after morphine). It was the Harrison Act of 1914 which saw the criminalization of heroin and cocaine, after which time their prices skyrocketed and a new world of criminality was founded.

If you go out and buy heroin off the street or a friend, the odds are you are getting much more than just heroin, if even that. Adulterants are common and range from the mundane - baby powder, etc. - to the devastating, such as glass or fentanyl. In addition, thanks to the necessary formulation of many recreational drugs outside of accredited and quality-controlled pharmaceutical factories, microbial contamination is also a common occurrence. A case of anthrax in heroin in Lanarkshire made the news a few years ago.

There is relatively little risk to injecting pharmaceutical morphine with a sterile needle, especially if done under the supervision of a nurse. It happens in every hospital in the nation on a daily basis with minimal adverse consequences. However, injecting heroin obtained illicitly can be deadly thanks to a long list of potential negative outcomes ranging from cellulitis, abscesses and amputation to pneumonia. Legalization and regulation would lead to a vast improvement in the quality and safety of the drugs of abuse.

But rather than focusing on how legalization would make recreational usage safer for the user, let's look at the societal benefits.

Why do people begin using drugs? Surely there are nearly as many reasons as there are drug users, but I believe they can generally be reduced to a few primary headings.

1) Pain, either physical or emotional. This can be something obvious, such as pain from a car accident, grief at the loss of a loved one, or something which few might consider as pain per se, such as boredom.

2) Culture. Drug use, drug dealing, etc., make up a large portion of many juvenile sub-cultures throughout North America.

Let's imagine an individual who is addicted to heroin. We shall call him Fred. Fred has various means of acquiring his drug, or the money to do so, ranging from prostitution, theft, odd jobs, drug dealing, etc. One method of drug dealing is to entice drug-naive individuals to use for the first time, which leads to an increase in the number of users over time. Thanks to his IV use of heroin and a lack of education in his area on the dangers of dirty needles, Fred has acquired HIV, though his positive status is unknown to him at this time. Over the last six months, Fred has shared needles with at least a dozen of his friends, and he has also had unprotected sex on numerous occasions. He has done everything imaginable to finance his addiction and is personally responsible for having got numerous other individuals hooked as well.

Fred has gotten himself mixed up with gangs, and has even served as a mule to bring a few condoms full of heroin and cocaine over the border. The amount of money he spends in an average year is astronomical, yet he cannot even afford permanent housing. Most of the money he gets goes straight into his veins; his health has suffered severely not only from his addiction itself but also from the addiction's expense. He has endured abscesses and a variety of infections; he is very skinny and clearly malnourished; half of his teeth have fallen out.

Now let us imagine what Fred's life would be like had he been born in a parallel universe in which recreational drugs are regulated like alcohol.

Fred has been on heroin since for close to a decade. Each morning he goes to the local OCB - Opiate Control Board - store to purchase his daily supply. Thanks to his high tolerance he has a special note from his doctor allowing him to purchase twice the daily legal limit, and his name is in The System so that he cannot 'shop around'. While he injects on a daily basis, he has always done so safely thanks to the proper education on drug use offered in his city: abstinence is encouraged, though the reality of human nature is not denied and thus optimal safety guidelines are simply part of the culture. Clean needles are provided at the store, along with all other necessary equipment.

Fred is able to maintain a good job, something which his Real-World Analog has found impossible thanks to his criminal record. The cost of his daily dose is only about $10, something he can easily afford without having to resort to crime; this is because there is a large supply controlled by the free market, not the black market. Thanks to the culture of harm reduction as opposed to abstinence, he has never shared a needle, nor has his heroin ever been anything other than pharmaceutical-grade. He knows with certainty that the molecules going into his veins are all those of heroin, and nothing else other than the few medical-grade fillers used in production. He has never had to resort to prostitution. He has a wife and kids, a home, and a dog. He is a respected member of society, not cursed for trying to deal with the mental anguish which encouraged his first use. He has never been to jail, nor has he ever even knowingly broken a law.

Ending prohibition will end the dangers of drug use to the individual drug users. Ending prohibition will end the otherwise self-perpetuating culture of criminality which keeps so many users trapped; this will also lead to a vast decrease in criminality: muggings, drug smuggling and dealing, prostitution, etc. Ending prohibition will benefit everybody other than the criminals and the prisons. By ending the phenomenon of drug dealing, criminals will no longer profit by encouraging illegal behaviors in others; the vast sums of money acquired by criminals and criminal organizations will disappear, along with the guns and gangs (and thus violence) through which these criminals maintain their existence. Ending prohibition will allow the focus to shift from law enforcement to education, which will make drug use safer for everybody.

Drugs will never disappear from the human experience. What can disappear, however, is the dangers with which they are associated.