Pregnancy and Vice
- posted by Jim Leitzel @ 11:37 PM

The direct costs and benefits of traditional vices, almost by definition, fall almost entirely upon the vice practitioner him or her self. (This is one of the most important features that distinguish, say, a drug addict from a thief.) A drinker enjoys the intoxication and suffers the hangover, a gambler risks her own money and reaps the (usually negative) reward. But there are exceptions, two of the most common being the harms that second-hand tobacco smoke can cause to proximate non-smokers and the harms that some drugs can bring to the fetuses of pregnant women. (Less-than-direct effects, such as those that arise from drunk driving, also fall upon folks other than the vice consumers or producers.) These direct harms to others from vice involvement, not surprisingly, can lead to both government regulations and social disapproval.

Zoe Williams, a now-pregnant columnist for the Guardian, looks at some of the advice that both the British government and others provide to expectant moms about various hazardous behaviors -- including alcohol and caffeine consumption. The government last week altered its alcohol advice to pregnant women, from a regime of very moderate consumption to one of total abstinence. This change occurred in the absence of any new scientific information concerning the effects of alcohol on fetuses. But as Williams notes, limited, non-binge consumption of alcohol does not really seem to pose any risks, and of course, moderate alcohol consumption during pregnancy was common both in the previous generation and throughout human history. Modest caffeine consumption also appears to be safe for babies, but some people (including medical professionals) urge pregnant women to give up caffeinated coffee and even chocolate bars, which contain fairly low doses of caffeine. Williams distrusts much of this advice:

Despite having got yourself into a spot of bother, pregnant women, you are still in the possession of adult judgment, and you are still allowed to use it. If the official advice sounds stringent to the point of insanity, examine it more closely - you aren't just a selfish person, looking for loopholes for your own sorry enjoyment.

Labels: alcohol, Britain, caffeine, chocolate, coffee, externalities

 
A quibble with the host
- posted by Michael @ 6:20 PM

In an earlier post, the Vice Squad host Jim Leitzel argues that cost-benefit analysis has a rather limited role in evaluating policies that involve jailing people. I agree, although I think that this role, while limited, is still quite significant. However, more relevant to the theme of Vice Squad, I do not agree with Jim’s apparent implication that drug possession is obviously a victimless crime that deserves no jail punishment. Presumably, the proponents of drug prohibition think that drug users impose costs on the rest of us (i.e., create negative externalities). One may or may not agree with that view, but it is clearly out there. True, a big part of the argument in Dr. Miron’s paper that I discussed here was that many of the costs that are added up in the COI studies are not external costs, but private costs of drug users. Still, some of those costs such as the cost of health treatment paid for from public funds impose costs on everybody. Moreover, the proponents of prohibition would argue that drug use is associated with increased crime. Again, one may not agree with that argument. I, for one, think that prohibition does a poor job at limiting drug use and it creates more crime than would most forms of legalization. But the prohibition proponents’ arguments cannot be simply dismissed.

One could perhaps say that drug possession by itself certainly doesn’t hurt anybody. But this is not a good argument. Our legal system in general routinely punishes people, often deservedly, for activities that have not hurt anybody yet but increase the probability of doing so in the future. Drunk driving is one of such activities, not to mention attempted murder. And there are good reasons for such punishments (see, for example, David Friedman’s Law’s Order, pp. 74-82) .

I stress that all this is not to defend prohibition, but to take the arguments of its proponents seriously. The major point of cost-benefit analysis of drug prohibition is that the potential benefits of prohibition are highly uncertain and may not even exist at all, while many of the costs are clear and substantial.

Labels: driving, drugs, externalities, Prohibition

 
Alcohol Harm Reduction?
- posted by Jim Leitzel @ 6:15 PM

Ever-vigilant Vice Squad friend Dima Masterov brings us this word on a pill (officially, a dietary supplement) that seems to serve as a hangover preventative. Marketed under the name RU-21 (get it?), the pill is taken (perhaps multiple times) during an evening's drinking, and is claimed by some to remove the usual next-day ill effects. There's a legend tying the invention of the pill to the old Soviet KGB.

The author of the linked article attempts a controlled self-experiment, and proclaims that the pill worked as advertised for him. But his final take is far from an unqualified endorsement: "Over the course of my highly unscientific experiment, RU-21 had indeed made an impressive showing. I marvelled at the possibility of a world without hangovers, a world in which pleasure need not be counterbalanced by pain. After some consideration, however, the idea struck me as hollow. I hate hangovers as much as the next man, but as crazy as this may sound, they may be a necessary evil, the thing that keeps consumption reasonable and, by extension, fun. Maybe the smart thing would be to learn to regard throbbing heads and churning stomachs, once our mortal enemies, as our friends..."

Economists like to distinguish between "internal" and "external" costs of drug use. Internal costs are those that accrue to those who are deciding about drug consumption; external costs are those costs that one's drug use imposes upon others. In the case of alcohol, the major external costs are injuries and deaths to others from drunk driving, and violence. If RU-21 works as advertised, it presumably lowers the internal costs of getting drunk (and hence, as the author speculates, should raise consumption), without reducing most forms of the external costs. So the author's concerns about the pill leading to more immoderate (and hence, as he writes, less fun) drinking might even be magnified when the external effects are considered.

How does this rather negative assessment jibe with Vice Squad's often enthusiastic endorsement of harm reduction measures? In the case of heroin addiction, the main harm reduction strategies are needle exchange and methadone (or heroin) maintenance. Much of the rationale behind these measures is to reduce the incidence of communicable diseases, chiefly AIDS and hepatitis C. But reducing the probability that a drug user will become infected with such a disease has not only a large "internal" benefit, but an external benefit, as having fewer "infecteds" helps to slow the spread of the diseases to others. Further, maintenance can help reduce the petty crimes that addicts frequently engage in to hustle their way to their next hit. So in general, I believe the case for these types of harm reduction is stronger than for RU-21. Nonetheless, I don't favor a ban on this supplement, or anything of the sort. But we might have to direct more resources into severing (or reducing) the link between drinking and violence and drinking and driving if RU-21 works as advertised. (Incidentally, this post should not be taken as an endorsement of RU-21 -- indeed I would be wary of any relatively untested substance that has profound physical effects. Who knows what the long-term consequences of RU-21 use are? More generally, Vice Squad concerns public policy, and is not intended (nor should be used) to alter the private vice policy of the loyal Vice Squad reader.)

Labels: alcohol, externalities, harm reduction