By the time I began as a drug policy reporter in 2010, I was all in on legalizing every drug, from marijuana to heroin and cocaine.
It all seemed so obvious to me. Prohibition had failed. Over the past decade, millions of Americans had been arrested and, in many of these cases, locked up for drugs. The government spent tens of billions of dollars a year on anti-drug policies — not just on policing and arresting people and potentially ruining their lives, but also on foreign operations in which armed forces raided and destroyed people's farms, ruining their livelihoods. Over four decades, the price tag for waging the drug war added up to more than $1 trillion.
Yet for all the effort and cost, the war on drugs had little to show: Drug use had actually trended up over the past several years, and America was in the middle of the deadliest drug crisis ever in the opioid epidemic.
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I wasn't totally naïve. I believed legalization would increase drug use. But I also thought the government could sensibly regulate drugs to make sure the worst cases of misuse were kept under control — by cracking down on misleading marketing, keeping prices sufficiently high and therefore inaccessible to too much use, and, at the very least, making sure kids couldn't get these substances.
Then I began reporting on the opioid epidemic. I saw friends of family members die to drug overdoses. I spoke to drug users who couldn't shake off years of addiction, which often began with legal prescription medications. I talked to doctors, prosecutors, and experts about how the crisis really began when big pharmaceutical companies pushed for doctors and the government to embrace their drugs.
Meanwhile, the government responded very slowly. The opioid epidemic began in the late 1990s, particularly with the birth of Purdue Pharma's OxyContin in 1996. But it wasn't until 2014 that the Drug Enforcement Administration rescheduled some opioid painkillers to put harsher restrictions on them. And it took until 2016 for Congress to pass a law that attempted to seriously address the epidemic.
In fact, the federal government pushed doctors to prescribe opioids through the "Pain as the Fifth Vital Sign" campaign in the 1990s and 2000s, as drug companies misleadingly marketed opioids to treat chronic pain. And in some cases, different levels of government loosened access to opioids after lobbying from drug companies — by passing laws that, for example, required insurers to cover the drugs.
And while Purdue Pharma was eventually fined for its horribly misleading marketing for OxyContin, the hundreds of millions it paid added up to peanuts compared to the tens of billions it's reaped from the drug.
As a result, a lot of people have died: In terms of overdoses, the opioid epidemic is deadlier than any other drug crisis in US history — more than crack, meth, and any other heroin epidemic. In total, more than 560,000 people in the US died to drug overdoses between 1999 and 2015 (the latest year of full data available) — a death toll larger than the entire population of Atlanta. And while many of these deaths are now linked to illicit drugs like heroin and fentanyl, the source of the epidemic — what got people started on a chain to harder drugs — was opioid painkillers, and legal painkillers were still linked to most opioid overdose deaths as of 2015 (although there are signs that changed in 2016).
This was exactly what anti-legalization activists have warned about: Companies got a hold of a dangerous, addictive product, marketed it irresponsibly, and lobbied for lax rules. The government's regulatory response floundered. The government even worked with the drug companies in some cases — under the influence of lobbying, campaign donations, and drugmaker-funded advocacy groups. And people got addicted and died.
Looking at this crisis, it slowly but surely dawned on me: Maybe full legalization isn't the right answer to the war on drugs. Maybe the US just can't handle regulating these potentially deadly substances in a legal environment. Maybe some form of prohibition — albeit a less stringent kind than what we have today — is the way to go.