Paul Jacob

Every now and then we see a flurry of news stories about the dangers of prescription drug abuse. We are told that more people misuse doctor-prescribed drugs than abuse illegal “narcotics.” Then the stories disappear for a while . . . only to return again.

The problem exists, it’s large, yet it’s never solved.

We just live with it. Some of us are harmed. The rest of us move on.

This could preface any number of stories:

  1. The tragedy of the War on Drugs.
  2. The sheer insanity of the drug prescription system.
  3. The bizarre inanity of journalistic messianism, with its absurd cycles of jacked-up crises and tarted-up solutions.

Instead, take a step back: The idea of being addicted to the wrong cure — to misusing an otherwise “good” drug — is something we all understand, at least some of the time.

Misusing a cure is no mystery.

A basic truth of pharmacology, too rarely acknowledged in popular discourse, goes something like this: there is no “good medicine” or “bad medicine,” just substances that, given the right diagnosis, work at the right dose. Take too little? Not enough good effect. Take too much? The effects become at first less useful, then, with more additions, positively damaging.

This principle is called hormesis. Think of it as the diminishing returns for drugs. And it applies to all sorts of things.

Medical insurance, for example.

There are reasons why third-party (“insurance”) payments are something we tend to prefer. Super-convenient. But the convenience comes at a cost, as mounting evidence makes quite clear: insurance (and other third-party payers) that remunerate doctors and hospitals directly is what’s driving much of the price inflation in this sector.

Automobile insurance overwhelmingly pays the insurer, and we have no crisis at all in this insured sector.


Paul Jacob

Paul Jacob is President of Citizens in Charge Foundation and Citizens in Charge. His daily Common Sense commentary appears on the Web and via e-mail.