There’s a fly on the wall. Can you swat it?
It’s oddly satisfying, isn’t it? It’s a little bit addicting, even.
“Yeah, a little bit. It’s not that fun,” you say. “I wouldn’t pay money to play this game.”
And you’d be reasonable to say that.
But what if playing this game made time to slip by a little too fast and caused you to be a few minutes late to a meeting?
This kind of harm is pretty low-level. It’s not something we, here, running this site, are likely to hear about. Even if we did hear about the harm this little addictive game caused in your day, we’re unlikely to bear any cost for those harms. We can say, “It’s not our fault you can’t manage your schedule!”
We can also claim this is just an ordinary, run-of-the-mill video game.
Still, things that are addictive can cause far-reaching harm. Our fly game isn’t likely to be a bestseller. We’re not trying to make it compete with Candy Crush. But we all know people with a Candy Crush addiction. Or those who play Pokémon Go obsessively. Or people with very long Duolingo streaks.
That’s because products with addiction potential are not ordinary commodities. There are many externalities and circumstances that drive addiction. These externalities explain a little about how America finds itself in the throes of an addiction epidemic.
The start of the painkiller addiction epidemic
Purdue Pharma, formerly a private company owned by the wealthy Sackler family, has become the leading villain of today’s modern opioid epidemic. Their OxyContin pills arrived in 1996, and the company quickly flooded America with a sophisticated marketing campaign full of promises, advertising to consumers, outreach to physicians, medical presentations, paid testimonials, and funded conferences.
By 2001, state and federal lawmakers, as well as medical professionals, began to realize that a true epidemic was underfoot. Purdue Pharma executives testified before Congress that their marketing was “conservative.” They blamed overzealous doctors who over-prescribed medications and drug abusers themselves. Tellingly, when states began writing laws to curb the abuse of OxyContin, Purdue Pharma sent lobbyists to state houses to nix or water down the bills.
Purdue Pharma is now a shell of its former self, having declared bankruptcy. The Sacklers are still billionaires but have paid $225 million in civil penalties.
Still, Purdue Pharma didn’t create the addictive opioid epidemic on its own. Their marketing and outreach to physicians was not new. Many companies have sponsored conferences, sent doctors samples, and created TV ads.
Purdue Pharma played a larger role in a system that has been in place for generations. Drug epidemics have usually featured a novel new substance, like coffee, tobacco, marijuana, or, more recently, opioids. And these substances usually receive a significant amount of promotion that helps spread their use.
Addictive and psychoactive substances are inelastic
Like our fly game above, we created it to hold on to specific human desires:
- It’s nice to have a little distraction.
- We all know almost instinctively how to use a fly swatter.
- We all get a little annoyed with the common housefly.
- It was free to play and seemed low-risk.
You could imagine how we might develop this game further, release it in mobile app stores, buy marketing campaigns, take out ads, enhance the graphics, and promote it to game reviewers. We could start charging for it, or add micro-payments that encourage people to buy cheat codes or more levels. Some number of people are likely to become a little addicted to it.
Psychoactive substances have a feature economists term “inelastic,” meaning the laws of supply and demand don’t seem to apply.
We see price elasticity at work when hamburger prices rise and people buy more chicken. Still, some people buy the expensive hamburger.
If we charged $100 to play our fly game, you’d probably have gone on to do something else. “This game isn’t worth $100,” you say.
But not all games are the same. The new Mario Kart for Switch 2 is $90 before tax. A lot of people are playing a $100+ Mario Kart game today! That shows some inelastic demand alongside other factors, like brand affinity for Nintendo, the desire for entertainment, and better quality graphics than our fly game. For a lot of kids and teens, Nintendo games are expensive, but they “make it work” to get access.
This economic inelasticity applies to addictive drugs, too. If the price of heroin increases, people figure out ways to make it work.
This is not to say Mario Kart is harmful or addictive like heroin. But people can and do develop unhealthy relationships with some products over others. And video games are not generally psychoactive.
Further, OxyContin and other addictive drugs covered by insurance may not even show price signals to users at all. Heavy users of a substance have a surprising effect on markets, even if they’re not directly bearing those costs.
It falls to governments and regulators to act against these kinds of harms. If a video game became so addictive that schools nationwide attributed chronic absenteeism to it, we might expect some government response. (We see this today with cell phone and social media bans).
Things designed to short-circuit economies and human minds pose obvious dangers, ones that most people agree the government is charged with investigating and addressing.
It’s generally not enough to assume or hope that patients, users, multi-billion dollar pharmaceutical companies, or billionaire pharmaceutical company owners will just walk away from the profits.
This is not new. Even as far back as 1880, Parke, Davis, and Co. promoted cocaine to cure “exhaustion” and “overwork.” German pharmaceutical company Merck, around the same time, thought cocaine could be used to treat morphine and alcohol addiction. It seemed like a wonder drug. Doctors agreed and prescribed cocaine to patients all over the world. Cocaine, as we know, is not a wonder drug!
Local governments are often left to sort through the pieces after a problem has swept through a community. Your local county council is unlikely to outlaw our modest fly swatter game. Your local court system is equally unlikely to have to hear cases where people need court-ordered rehabilitation from our game. But this is precisely the kind of work local governments have had to navigate from opioids, many of which were brought or manufactured legally.
You can watch more about how local judges, sheriffs, and other community leaders are picking up the pieces and working to make communities whole again in The Addict’s Wake.
The award-winning documentary film is available for licensing to groups, including special classroom editions and a version tailored for law enforcement training groups.
A public, hour-long version is also available on PBS.
