It is both a tribute to the genius of the free enterprise system, and it’s a little sick, that a gazillion dollar cottage industry has sprouted up in response to the nation’s prescription drug abuse crisis. Genius: In the private and public sectors, there innovative moves and bold approaches designed to curb drug diversion, overdose, addiction, and improper access. Sick: Industry and the government stand to make a lot of money from all this American suffering, and as with most other iterations of the War on Drugs, in the end the only folks making more money than the government will be the bad guys.

Private sector innovations: First, new drugs are being developed to lower the effective therapeutic dose of opioid pain relievers and hopefully reduce dangerous dependency while providing meaningful treatment for chronic pain. Second, a slew of new rehab programs and drug rehabilitation curricula are opening or being implemented nationwide. Great ideas and Godspeed to both these developments. No objection to their being profitable, either, but isn’t it ironic that in response to Big Pharma’s largest profit maker outside of Viagra, the best remedies will also mean megabucks for the lucky few?

Public sector approaches: First, asset seizures and forfeiture actions against medical providers – I have clients who are going through this now. I strongly condemn most government actions of this nature. Second, the government is imposing huge civil/administrative fines against companies for drug diversion. A good idea but undeniably there’s a financial incentive for the government to hit companies hard. Witness this past week’s $80 million fine levied against Walgreens for diversion in its controlled substance distribution chain. $80 million is a lot of money. It’s not Foreign Corrupt Practices Act money – which the US Government annually takes in by the billions to punish companies that try to bribe overseas officials – but $80 million will keep the lights on. Side effect of profitable law enforcement: Produces a dependency-like craving on the part of government agencies to outdo themselves by asking for a bigger penalty the next time.

Finally, even as the government is making tens of millions, the only folks who stand to make more are the bad guys. It has become clear during the prescription drug abuse crisis that when government cracks down on medical providers, legitimate and ethical doctors get gun-shy and reduce or stop pain scrips. Enforcement chills legitimate prescribing; that is a sad fact of government overreach. And when patients who are morphine-dependent don’t have access to medication, what do many of them turn to? Street heroin. Who makes money from that? The Mexican cartels who produce and import massive quantities of the drug, and the notorious street gangs who either on behalf of or separately from the cartels move “mad volume” of junk at prices lower than prescription pills. The DEA and local law enforcement reap some proceeds when they make a major bust and forfeit assets, but organized crime and street terrorists still make much, much more.

Innovation and bold approaches, as expression of a commitment to curb deadly or dangerous prescription drug abuse and crack down on the small number of truly corrupt medical providers out there, are commendable and worthwhile. But that doesn’t mean they smell good. Some of them absolutely stink.

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