Harm Reduction, Rational Addiction, And The Optimal Prescribing Of Illegal Drugs

Harm reduction (HR) policy is designed to reduce the social, medical and economic cost of illegal drug use to users and to society at large. It is the most important recent development in international drug policy. However, in the United States and elsewhere, some fear that HR facilities such as needle exchanges and methadone maintenance programs may increase drug consumption and the risk of addiction. This is most likely if users are rational, forward‐looking utility maximizers as in the Becker‐Murphy model (1988). The tendency for HR policy to increase drug consumption may be strong or weak, depending on the type of drug and the elasticity of demand with respect to the full cost of drug use. The model predicts that the effects will differ between social groups and that there is an optimal prescribing policy for addicts who legally receive drugs in treatment programs. Evidence suggests that clinicians tend to prescribe sub‐optimally.