Legalise It: Prohibition’s Repeal and Its Unintended Impact on Public Health

Yves here. This is the sort of piece I enjoy, since it challenges several widely held but inaccurate beliefs about the Prohibition. It also suggests that a better approach to illicit or newly legalized substances that just legalizing them is to legalize them and tax them. In New York City, high cigarette taxes have lowered usage levels.

By David Jacks, J.Y. Pillay Professor of Social Sciences/Yale-NUS (Research Fellow/CEPR; Research Associate/NBER), Krishna Pendakur, Professor of Economics, Simon Fraser University and Hitoshi Shigeoka, Associate Professor, Department of Economics, Simon Fraser University, and Faculty Research Fellow, National Bureau of Economic Research. Originally published at VoxEU

The year 2020 marked the centenary of Prohibition, under which the production and sale of alcohol in the US was banned for nearly 14 years. Though it required an unprecedented intervention into the nation’s economic and social fabric, there has been little quantitative analysis of Prohibition’s impact on public health. This column presents new research suggesting that a substantial increase in infant mortality followed the repeal of Prohibition in the 1930s – an unanticipated, negative health outcome worth considering as debates resume over the legalisation of cannabis and other drugs.

The year 2020 marked the centenary of the federal prohibition on the production, sale, and transportation of alcohol in the US (Neklason 2020). In the years since, there has been broad interest in understanding why the Prohibition movement spread in the years before 1920, how federal Prohibition was enforced in the years after 1920, and why it was so quickly repealed, in 1933 (Rorabaugh 2018).

However, social scientists should be interested in this peculiar episode for more than mere antiquarianism. Federal Prohibition was an immense and unprecedented intervention into the economic and social fabric of the US (Kyvig 2000, Okrent 2010), but there is surprisingly little research in quantitatively assessing its outcomes. Given its scope, such an assessment could also inform policy making in the present, particularly as it relates to the currently evolving legalisation of cannabis and the potential de jure decriminalisation – but de facto legalisation — of even ‘harder’ drugs (Selsky 2021).

Prohibition in the Collective Imagination Versus Reality

A brief review of the popular history of Prohibition in the US suggests that it failed to subdue, and perhaps even encouraged, the long-standing alcoholic proclivities of many Americans. This was the age of cocktails, jazz, and speakeasies, after all. However, in reality Prohibition had its most significant effects on the price — but not necessarily the availability — of alcohol (Cook 2007).

As with anything that effectively functions as a large tax on a product, there was a sizeable impact on consumption due to Prohibition. Contrary to public opinion, total alcohol consumption per person fell by 63% from 1910 (the high-water mark of pre-Prohibition drinking activity) to 1934 (the first full year of repeal). And while illegal sources of alcohol were indeed available prior to and even after 1934, it took until 1973 for apparent per-capita alcohol consumption to recover from the shock of Prohibition (as seen in Figure 1).

Figure 1 Apparent per-capita alcohol consumption, 1910–2010

Note: The figure depicts apparent per-capita alcohol consumption, derived from alcoholic-beverage sales data and measured in gallons of pure ethanol.
Source: LaVallee and Yi (2011).

Another important aspect of Prohibition was how it was ended. Specifically, the process of repeal was not uniform, with national restrictions on alcohol ‘turning on’ precisely in 1920 and ‘turning off’ precisely in 1933. The chief compromise for achieving its ratification was allowing local communities to determine liquor laws appropriate to local conditions. This not only explains why approximately 10% of all US counties still prohibit the sale of alcohol, but also provides useful variation for conducting statistical analysis on the effects of Prohibition’s repeal (as seen in Figure 2).

Figure 2 US counties by Prohibition status, 1930–1942

Note: The figure uses all US counties (n = 3,043). ‘Bone dry’ are dry counties surrounded by other dry counties. ‘Dryish’ counties are dry counties with at least one wet neighbour. ‘Wet’ counties are counties that allow alcohol sales within their borders. The figure treats every county as bone dry prior to 1934. 

In our work, we rely on the sharpest possible distinction in Prohibition status: dry versus wet. That is, we seek to compare outcomes for those cities/counties for which no sales of alcohol are permitted (dry) to those for which at least some sales are permitted (wet). We also make the critical distinction between those cities/counties which are dry and have no wet neighbours (bone dry) versus those cities/counties which are dry and have at least one wet neighbour (dryish). We thereby decompose all dry cities/counties into either bone dry or dryish cities/counties.

Infant Mortality and the Repeal of Federal Prohibition

In Jacks et al. (2021), we explore the link between infant mortality and repeal, from 1933 to 1939. Infant mortality is not only a key determinant of life expectancy, but also a rough indicator of population health, making it an obvious starting point for research focused on the public-health effects of repeal.

In particular, we ask what effect a county’s choice regarding their Prohibition status after repeal had on infant mortality within its borders, and whether that choice had an impact on infant mortality across its borders and into neighbouring counties.

We find that repeal was associated with equivalent and significant increases in infant mortality in both counties that chose to allow for the sale of alcohol (wet counties) and in neighbouring counties that chose not to (dryish counties), suggesting a large role for cross-border policy spillovers. In other words, some people in dry counties found the temptation of alcohol just across the border too tempting to resist.

Cumulatively, we estimate that 4,493 annual excess infant deaths could be attributed to the repeal of federal Prohibition. We have some evidence that this was due to an increase in maternal alcohol consumption by problem drinkers during pregnancy, but other mechanisms are possible.

Urban Mortality and the Repeal of Federal Prohibition

A frequent retort to the results above on infant mortality relates to popular impressions of the Prohibition period, namely that it saw a massive rise in organized crime and an attendant increase in gangland violence directly attributable to Prohibition. In Jacks et al. (2020), we address this issue head-on by assessing the effects of federal Prohibition’s repeal on multiple causes of urban mortality.

We find evidence that legalisation of alcohol sales at the city level is associated with a 14.7% decrease in homicide rates and a 10.1% decrease in mortality rates associated with other accidents (importantly, this category includes accidental poisonings). In understanding these results, there are various hypotheses that run counter to the idea that the repeal of Prohibition would be associated with reductions in both homicides and other accidents.

For instance, one reasonable hypothesis is that repeal would be associated with an increase in other accidents due to drunken misadventure. But another equally reasonable hypothesis is that repeal would also be associated with a decrease in accidental poisonings due to renewed access to legal supplies of unadulterated alcohol. Thus, it is a fundamentally empirical question as to which direction such countervailing forces work themselves out.

When we combine our estimates with the timing of these transitions by cumulating homicides and other accidents by wet status, a back-of-the-envelope calculation suggests an annual reduction of 3,418 urban deaths (565 fewer homicides plus 2,853 fewer other accidents) that could be attributed to the repeal of federal Prohibition.

Prohibition’s Repeal in the Balance

For whatever benefits the repeal of federal Prohibition conferred in terms of consumer welfare, diminished expenditure on law enforcement, and freedom of choice, it also came at the cost of increasing infant mortality in both dryish and wet counties. And this increase in infant mortality was not fully offset by equivalent declines in non-infant urban mortality. Furthermore, from the perspective of assigning the value of a statistical life, any consideration of balancing the respective rates of mortality should put more weight on averting infant — as opposed to adult — deaths.

Naturally, there were other associated components of repeal that remain unexplored and should be added to any reckoning with Prohibition’s legacy. However, the cumulative results suggest that, on net, repeal had negative effects on public health and mortality in the US. This is one history lesson well worth considering as debates over the legalisation of illicit substances remerge.

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  1. Baldanders

    I had read that Prohibition was fairly effective before, but the length of the improvements is surprising.

    I’m not sure how comparable lifting alcohol Prohibition is to lifting bans on other euphoriants. Cannibis acheived widespread use without being legal, and all of our current legal states have imposed taxes so high that the black market is bigger in every one than the legal market. We are certainly going with the “very high taxation model.”

    I’m not sure hard drug use would expand in anything like the way alcohol use did post-prohibition. Social mores have a big impact on that.

    1. WobblyTelomeres

      “all of our current legal states have imposed taxes so high that the black market is bigger in every one than the legal market.”

      Back in the day (60s), the local bootleggers were always in the front pews on Sunday morning. Common cause, I suppose.

      1. Anonapet

        Prohibition is actually contrary to the Bible, eg: Proverbs 31:6-9.

        But so are government privileges for usurers, unequal land ownership and large scale wage-slavery.

        But sadly, an attender of a “Christian” church would likely have to read it him/herself to know those things.

        1. Basil Pesto

          which begs the question, so what? It takes a rather active imagination to believe that the bible is the source of morality and ethics for all time rather than a reflection of them at a certain moment in human history amongst a certain community.

          1. witters

            I thought Anonapet simply quoted from a surely reasonable cultural source. In fact (I checked) that’s what they did.

            And then there was that act of great moral beauty: Water into Wine.

      2. drumlin woodchuckles

        I was too young to know at the time, but I have long since read that when referrenda or similar were held on whether to change counties like Knox Country from Dry to Wet, the preachers and the bootleggers all wore the same bumper sticker on their cars: ” Vote Dry for the sake of my children”.

        1. Bob

          This sort of marriage of convenience exists today in some counties where liquor by the drink is on the ballot.
          As recently as 1995 or there abouts this was the case in Rutherford county NC. Notably a big player was the local cult/ church which would move congregants from one voting district to another in order to swing the vote

    2. Kurt Sperry

      “our current legal states have imposed taxes so high that the black market is bigger in every one than the legal market”

      Is there a citation for that assertion? When legal cannabis sale was introduced here in WA State, pretty much overnight everyone I know who uses cannabis went from obtaining their herb from the black market to the legal one. I think whatever remains of the black market here exists pretty much solely to supply external black market demand that only artificially exists because of the failure of other jurisdictions to reform their own laws. If I were to assign blame, it would be to the states that have deliberately chosen the black market model over the legal, taxed one. Are wet counties blamed for the illicit cross-border supply of alcohol to dry counties? Of course not! The problem of the black market is caused by the dry counties, and not the wet ones.

      Taxation levels have to be calibrated so that the legal market is more attractive than the black market but I suspect most people would, all else being equal, rather walk into a well-stocked store with hundreds of choices than dealing with a black market seller with a “take it or leave it” complete lack of choice.

      1. lyman alpha blob

        From what I’ve heard WA and CO did the taxes right and the price isn’t too bad – if anything it reduced the price from what the street price was previously.

        In Maine, medical cannabis has been available for a couple decades and it was priced somewhat above street price. ME recently legalized it for recreational purposes too while keeping the medical market separate for some unknown reason. So now you can register with the state and purchase medical for somewhat above street price in one store, or purchase recreational for double the street price in another store.

        Not a whole lot of incentive to buy from the store if you have other options, but I am quite likely in the minority with that viewpoint – the stores seem to be doing quite well.

        Eventually I imagine the distinction between medical and recreational sales will disappear, which hopefully will bring the overall price down. That may take a while with our current state legislature – it took them four years after the legalization vote before the first recreational stores were allowed to open.

        1. bassmule

          What I like about buying from legal shops in Massachusetts are the little labels that say “potency analysis.” Percentages of TCHA, TAC, THCVA, CBG, etc. Everything gets tested. If the lab results find lower potency than advertised, they tell you and give you a discount. And you don’t have to worry that some maniac has laced it with something horrible.

          When the town’s shop opened, it was the first one east of the Mississippi. The mayor was the first customer, and got his picture in the local rag. For a while there was a ton of out of state traffic. Lot of people were grousing about that, but eventually it tailed off. Nobody was grousing about the tax take (about a million bucks the first year).

      2. Baldanders

        Unfortunately, my Google-fu is not up to finding the article I read a while back which stated that the black market is bigger than legal market in all states.

        Plenty of articles like this one though:

        States 71% of Canadian sales black market, estimates 75% of Massachusetts sales black market–in 2019. Perhaps things have gotten better?

        I remember when quality sinse (showing my age) beat the market price for gold per gram for “retail consumers…….”

      3. Baldanders

        Just curious–what socioeconomic class are your friends?

        I have a feeling folks lower on the ladder are far more price sensitive than folks higher up.

        Also, daily consumers are probably much more price conscious than occasional/weekend consumers.

  2. Kurt Sperry

    It seems a bit odd to consider relitigation of alcohol prohibition, even as a thought experiment. It’s one of those issues where a rational-seeming case can be built for prohibition that assumes only harms and no benefits from the sale and use of alcohol because the harms can easily be quantified and the benefits cannot. So, any “rational” argument bolstered by “facts and figures” will always favor prohibition over the freedom of choice.

    Meanwhile our state supreme court here in Washington State has ruled all laws prohibiting simple possession of any drug or controlled substance for personal use unconstitutional. Quite correctly too, in my opinion. But the person arguing for prohibition will have a massively easier time making their argument because so-called rational argument inherently favors the facile and quantifiable over the less obvious, unquantifiable, and subtle benefits of freedoms.

    Freedoms vs. harms arguments are generally going to unfairly and significantly favor the “harms” side of any argument for similar reasons.

    1. QuicksilverMessenger

      Excellent comment. It’s very difficult to argue for ‘freedom’ (and a huge discussion could be had on just what this means) versus an onslaught of statistics and tales of risks and harms. And further, the current zeitgeist doesn’t allow for a lot of wiggle room- risk aversion (for some things anyway!) is a first order item. I was watching a movie the other day and at the beginning, they had the usual ‘warnings”: violence, sexual situations and then the last one was ‘movie contains images of people smoking’! OMG really?
      It’s hard to dial back something like these prohibitions once in place which is why it’s sort of amazing that Prohibition was repealed. I guess people really like to drink. I was telling my daughter the other day that when I was young, my dad used to drive us and my friends around in the back of his old Ford pick up. We used to have total blast doing this. She couldn’t believe it though- she’s been buckled in to 5 point harnesses, booster seats, etc all of her life. Can you imagine someone trying to turn the clock back to the old days on this and just let ‘er rip?
      What about smoking bans in bars? Could you imagine a return to that? (though I know some places still allow it)
      And just a quick add-on to the current zeitgeist- two brothers, 8 and 10, asked their mom if they could play down the street. A neighborhood Karxn saw the kids, called 911, and reported “unsupervised” children at play. The children were escorted home by the Fire Department. Again, OMG. My whole entire childhood life was playing unsupervised.

      1. Lambert Strether

        I vaguely recall German theories of toilet training being put forward as an explanation for the Nazis (back in the day when psychohistory was a thing, I suppose). I read stories like this, and I think maybe they were onto something.

        Another piece of that same zeitgeist: Parents jogging while pushing a baby carriage (although sometimes the child is quite old). The child stares interestedly around, motionless with respect to the carriage bearing him or her along. What a preparation for later life….

        1. QuicksilverMethod

          I definitely see this in my somewhat ‘hip’ and upscale Seattle ‘hood. When my daughter was old enough, never did this. Always had her walk (even if it took forever!)
          I also now have a weird tongue-in-cheek-theory- I wonder if the younger cohort now growing up as ‘woke’ (for lack of better word) and out in the world judging and ‘canceling’ is a big payback for being subjected, as babies, to the Ferber Method! Wouldn’t that be something?

        2. Arizona Slim

          Jogging while pushing a baby carriage? My father was a mile-a-day runner for, well, just about as long as I knew him.

          When he went out for a run, that was his private thinking time. Mom and I always respected that.

          And me? As soon as I knew how to get myself around, I was expected to walk. Yes, I was a good bit slower than my folks, and I loved to stop and check out things that were interesting, but I think I learned a lot more about the world than those poor kids strapped into carriages.

        3. hunkerdown

          Did they contact an ethics panel before repeating the Held and Hein experiment on humans, one wonders.

    2. Blatanville

      Also, the period of “increased harms” was trailing on from The Great Depression, surely a period where many were not getting proper nutrition, and were forced to work above and beyond, physically, for survival.

  3. Comboman

    This conclusion totally ignores some other pretty significant impacts on prenatal health during the period 1933-39, like the Great Depression, reduced access/increased cost of health care and medicine (and even food & shelter), increased participation in the labor force by women (at a time when safety was poorly regulated).

    1. Mr Grumpy

      My immediate thoughts as well. Would have liked to see a link to the paper. As is, this summary will spread while the paper and all the gory details are hiding behind a paywall at an academic journal. How much of a true pre-post cross sectional time series analysis was this? What were the controls? Were any spatial controls used? How reliable are 1920s-1930s county level statistics? Did they even consult available historical sociological research (economists almost never engage with or incorporate insights from research from other fields)?

    2. Samuel Conner

      That was my initial reaction too, but I don’t think that’s right. The methodology is to compare counties by “dryness” status after repeal so that provides a control for the state of the economy. It is conceivable that there are confounding correlations between the speed of recovery after 1933 and local decisions about how “dry” to be. I haven’t read the underlying article and so cannot comment further as to whether such correlations were estimated and controlled for.

      1. Greg

        It’s the confounding correlations that immediately occurred to me. With socially conservative policy today, there is generally a skew one way or the other in line with median incomes in the area considered. I can’t think of, but maybe the paper includes, a reason that the same wouldn’t be true in the 1930’s.
        And obviously infant mortality is going to strongly correlate with incomes, because it has for all of recorded history.

    3. rob

      I agree that the point made about infant mortality after the repeal of prohibition, seems seriously “under-thunk”,and questionable.
      And like the others here; I said, “what about the depression” doesn’t effect infant mortality as well. And with the next point saying there wasn’t really a big differemce between wet and dry counties; and all had rises in infant mortality… only to have that possible fact brushed off with a huge assumption that people were getting alcohol across their borders. Which seems a lot like an “attempt” , to sway the narrative back to what they WANTED to say.
      That is what it seemed like… to me. Don’t know why they would have a dog in the fight… but you never know.

  4. John Emerson

    An angle I never see explored (except by me): one of today’s heaviest drinking states is Minnesota, which also is one of the states with the highest life expectancy and one of the states with the vast quality of life.

    The states that drink least , on the other hand,are miserable, short-lived states like West Virginia and Mississippi.

    The conclusion is obvious.

  5. rick shapiro

    You briefly mention policing costs of Prohibition, but fail to note that the enormous militarized war on drugs, and the concomitant mass incarceration, dwarf the analagous efforts during Prohibition. In addition to being ineffective (note the secular reduction in drug prices over the decades), their costs are orders of magnitude greater than the cost of public provision of on-demand drug rehabilitation.
    Be aware that no illegal drugs are significantly more addictive than alcohol, which we manage, and would manage better with universal health care. Furthermore, the additional social costs of complete legalization (which might increase use analagously to the minor increase seen with marijuana decriminalization) are small compared to the criminalization of culture in communities where a large fraction of men have been jailed, and where criminals (drug dealers) provide role models for children.
    Handing the cash flow of a major industry to criminals has subsidized other forms of crime, has corrupted police all over the world (including here) and has brought entire countries (such as Mexico) to the brink of becoming failed states.

    1. John

      Yes, the US satrap in Honduras seems to been deeply involved in his family narco trade. Way better than any stinking democratically elected leftist.(sarc)

      1. drumlin woodchuckles

        Well . . . Hillary Clinton thought so. And probably still does think so. (no sarc)

  6. chuck roast

    Here is a clip from The Thin Man from 1934. It was post-prohibition and pre-code. The amount of drinking in this movie is astonishing. Booze is everywhere, and the dialogue is all…”Can I get you a drink?”…”Where’s my drink?”…”Get me a drink.”…”What are you drinking?”…add yours here. People are staggering all over the place. Watching it is like peeking behind a curtain.

    1. Big River Bandido

      By “pre-code”, do you mean the Hays Code that censored “indecency” out of Hollywood movies? Because that code actually went into effect around 1924.

      As an aside, by coincidence I tried to watch “The Thin Man” a few weeks ago, but I had to stop after about 15 minutes. I couldn’t take the dialogue, or maybe it was the acting. Something about it prevented me from “checking my disbelief at the cinema door”.

    2. MK

      Love the Thin Man series! Absolutely wonderful. Highly suggest anyone watch them all (I think there were 4?) Comedy like that is no longer made, unfortunately.

    3. KFritz

      Dashiell Hammett, the author of the book “The Thin Man,” was a notorious, self-destructive alcoholic (who quit drinking cold-turkey in his early fifties after he promised someone he would. He’d never promised to stop before that). Nick Charles is clearly based on Hammett. Nora is somewhat more loosely based on Lillian Hellman, who herself drank rivers of alcohol when young, but avoided a Hammett-like self-destruction. The repartee and drinking somewhat resemble their life together. Ms Hellman noted that Nick and Nora were a compatible couple who spent lots of time together, a rarity in modern (or perhaps any other period) literature. The information about Hellman and Hammett comes from her introduction to “The Big Knockover” compendium of Hammett’s “Continental Op” short stories.

      1. rick shapiro

        But don’t forget that Mary McCarthy said of Hellman’s memoirs that “every word she writes is a lie, including ‘and’ and ‘the’.”

  7. Susan the other

    I’m sure this indicates that pregnancy and alcohol don’t mix. Nobody would argue. But, as a member of an evolution tree of dedicated alcohol aficionados, I’m wondering if this research doesn’t borrow a tragedy that really belongs to social inequity. Poor countries have higher infant mortality rates. Poor regions of this country have always had higher infant mortality rates. Poor people might not be able to afford safe alcohol – that would be a very small variable after the repeal however. But it’s possible that poorer people sacrifice good nutrition for their favorite vice. How accurate were infant mortality statistics during prohibition? I’d guess much, much higher than today, across the board. What about other countries today? My first instinct is to blame social inequity. Poverty. Ignorance. Disease. Depression. So projecting the pitfalls of legalizing hard drugs, there are concerns. The first one is that some drugs are so dangerous they should never be legalized, aka fentanyl. Most drugs, imo, can be standardized and controlled by price. And taxes. We clearly have a chaotic system today. Nothing seems to be analyzed at all. Let alone researched. It would be nice to see more research on the effects of recreational drugs on human health. It’s most interesting to ask Why hasn’t this been done? I’d venture a biased guess that it is because some very rich people are getting even richer on illegal drug sales than they ever would if drugs were legalized.

  8. Frank Dean

    Note that the peak in per capita drinking in 1980, local trough in 1995, and a subsequent peak in roughly 2009 is likely driven by baby boom, bust, and echo demographics. Only the young can sustain truly prodigious consumption of alcohol. Long term heavy drinkers tend to exit the pool of the living early, or quit drinking entirely.

    1. Arizona Slim

      Yours Truly was a college student in the late 1970s. I plead guilty to helping to push that line way up to the top of the mountain.

    2. Charger01

      I simply never understood binge drinking,.or drinking to get sick. I know that cheap, wheat/rye whiskey in the 1800s destroyed the east coast tradition of a pint of cider with meals, as was the custom.

  9. HotFlash

    Excuse me, but are they saying that infant mortality is a reliable proxy for the efficacy of prohibition? Without mentioning that the previously prohibited substance was, ahem, toxic and/or addictive in itself? Are we (they) seriously trying to compare that to the lifting of a prohibition on marijuana (not very addictive, apparently, and no known direct deaths, apparently)? Are we talking indisputably toxic and/or addictive substances, both regulated and unregulated, such as such as heroin, fentanyl, nutmeg, alcohol, money, coffee, and aspirin? Perhaps we should include chocolate as well. I cannot get a clear picture of MJ addiction, the ‘official sources’ such as Govt of Canada describe symptoms of dependency, but they don’t seem that much different than my relationship with coffee — which is not prohibited, regulated, or even taxed. Or my neighbour’s fondness for skydiving.

    What gives?

    1. Basil Pesto

      While I share some of the reservations discussed in the comments above about this research, it seems to me that the point of the article is more general than any specific point about alcohol, cannabis, etc. The point is: Decriminalisation of substances and making them licit have the potential for corollary consequences, and it’s incumbent upon those who undertake decriminalisation to try their best to anticipate corollary consequences and factor them into the way in which decriminilisation is undertaken. Hence Yves’ suggestion in the intro to implement a Pigovian tax complementary to the act of decriminilisation, rather than decriminilisation being a sort of on-off switch of licitness.

  10. The Rev Kev

    I can see why the authors quoted annual excess infant deaths in their facts. If they had tried to go into adult deaths, then those statistics get polluted by the fact that the federal government deliberately poisoned alcohol which led to the deaths of at least 10,000 people during this time period, skewering any figures. It was actually the Treasury Department which kept insisting that more and more poisons be added to alcohol and probably they were enraged at the income that they could not tax people on-

  11. Baby Gerald

    Why look to 1930s prohibition and repeal of alcohol for guidance on drug legalization when we have the examples of countries like The Netherlands, Portugal and Switzerland that have legalized or at least decriminalized actual narcotics within the last decade or two? These countries can be studied in real time. We don’t need to look a century in the past, where outcomes like infant mortality were based on very different hygienic standards from today, to name one measure offered here. Seems like this article was written for squares that are easily frightened away from alterations to the status quo when confronted with statistics.

    1. Yves Smith Post author

      This is straw manning the post, which is a violation of site Policies. It’s almost entirely about the misperceptions of the Prohibition and only makes a couple of passing references to current policy, and does NOT make any recommendations.

  12. Baby Gerald

    Applying this study of prohibition repeal to current trends in drug legalization isn’t just comparing apples to oranges, it’s comparing them across a century’s worth of improvements in medical science and basic personal hygiene. Instead of looking almost a century into our past and making qualifier-filled conclusions like the following:

    ‘Cumulatively, we estimate that 4,493 annual excess infant deaths could be attributed to the repeal of federal Prohibition. We have some evidence that this was due to an increase in maternal alcohol consumption by problem drinkers during pregnancy, but other mechanisms are possible.’

    how about we look to examples of decriminalization/legalization of actual narcotics in modern times?

    We have at least two countries that have done this and can be studied in real time- Portugal and Switzerland. Here’s a NY Times story from last year on Portugal:

    Pointers From Portugal on Addiction and the Drug War

    and an article about Switzerland from the American Psychiatric Association from 2018:

    Switzerland Halts War on Drugs, Cuts Deaths

    Maybe an honest assessment of the effects of legalization in these countries– changes in crime rates, infant mortality, overdose deaths, etc– would be a better indicator of the sorts of challenges a modern nation will have to confront if it wants to make these changes.

  13. R M L H STOLL

    >should put more weight on averting infant — as opposed to adult — deaths.

    1. Samuel Conner

      I suspect that the concept of “quality-adjusted life years” underlies this aspect of the argument.

  14. Jack Parsons

    The supply side of hard liquor also had a major shift at the same time. Until banks acquired universal deposit insurance in the 1930s, storing barreled booze in the basement was the farmer’s major reliable investment opportunity. Assuming they can keep from drinking their assets.

    In 1920, half of the population was rural, and this had been steadily shrinking. Between these two factors, and I’m sure more, the supply & demand both shifted.

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