The use of mind-altering drugs—including alcohol, nicotine, opioids, cannabis, methamphetamine, and so on—tends to be “self-regarding,” that is, free of those troubling negative externalities. Drug use might be quite risky for the users themselves, but one person’s drug use generally does not “directly, and in the first instance,” impose harms upon others (Mill, 1859, p. 11). For this reason, Mill would not countenance coercive policies intended to prevent or hinder adult drug use, and modern social scientists cannot casually rely upon negative externalities to justify oppressive government interventions into drug markets.

Some argue that another factor, similar to externalities, can also undermine the link between individual choice and social desirability. Drug users, for instance, may be subject to internalities, where they do not fully consider the damage they do to their future selves through their drug consumption (Herrnstein et al., 1993). An internality resembles an externality in that the full personal cost is not adequately weighed by the decision maker when making his choice, though he ultimately will bear the cost of that choice. Internalities present a case for societal intervention, albeit typically not intervention as coercive as those used for serious externalities. For instance, people might be directed toward better behavior but not thrown in jail for insufficiently serving their own interests as ardently as the fully rational version of themselves would have. Public policy aimed at drug-related internalities should recognize the potential for high variance in the extent of regard accorded to self-harms. Not everyone will insufficiently account for drug harms, and some people might place excess emphasis on the dangers from drugs, where the excess is judged from their own long-term, well-informed point of view (Sunstein, 2021).

For a century or so, drugs such as opioids, cocaine, and cannabis have been subject to highly coercive policies on a global scale. Plenty of rationales for drug prohibition have been offered, but the fact that users (especially heavy or addicted users) of psychoactive drugs themselves often suffer from their drug consumption is a main argument deployed in the service of drug prohibition: harms to self, not harms to others. Punishments imposed by the criminal law, even those imposed on drug users (as opposed to sellers), are sometimes claimed to be motivated by a desire to help those drug users, to protect them from their own questionable drug-related decisions, or to get them to enter addiction treatment (Kristof, 2025).

Prohibition backed by criminal penalties is one method of reducing drug use, but it is not the only method. Economists are likely to point out that taxes might achieve similar levels of decline in drug consumption as do bans, and in a less costly manner (Kenkel 1993; Becker et al., 2006). Further, in the past few decades, non-coercive “nudges” have been demonstrated to offer significant behavioral changes without altering the standard “prices” of available options (Thaler and Sunstein, 2021). Nudges seem particularly suitable to dealing with self-regarding decisions, those that might involve harms to self but not harms to others (Benartzi et al., 2017, p. 1051; Thaler, 2017). Drug use, therefore, on the surface seems to be an area of human decision-making ripe for nudge-style regulations. Nudges, such as establishing defaults or making information more salient, are already commonly employed in alcohol and tobacco regulation, and in improving patient compliance with medically recommended drug regimens (Nurchis et al., 2023; Horne et al., 2022).

This article provides some background on drug prohibition and looks at harms that are associated with the demand as well as the supply side of the drug trade. This leads to the conclusion that a reasonable relegalization regime with appropriate nudges toward better decision making is likely to offer much better social outcomes than prohibition. Attention then turns to what sort of policies, including nudges, would be most appropriate within a relegalized drug policy regime. As with alcohol and tobacco, excise taxes can play an important role in this drug control regime. For harder drugs, nudges to encourage abstinence—or, in the absence of abstinence, moderate consumption—are appropriate. Heavy users will be nudged toward entering treatment.

Drug Prohibitions

Drugs like heroin and cocaine currently are prohibited for non-medical use more-or-less worldwide. But prohibitions can come in many different varieties: What precisely is prohibited? Candidates include manufacture, sale, transport, purchase, and possession, and bans can extend to financial gains from trafficking, production precursors, and complements in consumption like syringes and bongs. The longstanding War on Drugs tends to involve the criminalization of a wide array of aspects of the drug market, on both the supply and demand side. This comprehensive criminalization contrasts with what US national alcohol Prohibition (1920–1933) entailed, where most supply activity was banned, but purchase and possession were not similarly suppressed. Some jurisdictions that have embraced drug decriminalization or depenalization are reproducing the Prohibition regulatory apparatus, with stringent enforcement arrayed against supply but relative leniency applied to consumers’ drug-related behaviors.

Supply-Side Harms

Many of the major costs associated with illicit drug use directly implicate the supply side (manufacture, distribution, and sale) as opposed to the demand side (drug purchase and use by consumers). Most obviously, the supply chains of illicit drugs often are highly violent arenas with cartels, for instance, fighting it out (quite literally) for market control. The standard business channels of judicial contract enforcement and police protection are not available to illegal drug suppliers; self-protection is the remaining alternative, and this option often entails arms and a willingness to use them. Some source and distribution countries become almost ungovernable in the face of large, wealthy, and violent cartels. Colombia and Mexico are two nations that have witnessed disastrous consequences emanating from their roles in the drug trade.

Most illicit drugs have legal versions that are either identical to the illegal product or nearly so. Cocaine, methamphetamine, and fentanyl are legal drugs in the United States for medical purposes; their “recreational” use is banned. (Heroin is a legal medicine in some countries, too, though not in the United States.) The existence of a legal supply chain helps to answer the question of what proportion of supply-side drug harms is due to the chemistry/​nature of the drugs themselves and what proportion is due to their illegality. The immediate answer is that almost all the production and distribution harms are effectively prohibition-related, not drug-related. The legal channels of supply of cocaine, methamphetamine, and opium are not drenched in blood, nor is there a large problem with diversion into the shadow economy (though some legal pharmaceutical painkillers have traded on black markets). Prohibition of alcohol in the United States in the 1920s made alcohol distribution a highly violent enterprise. Today’s legal beer, wine, and liquor manufacturers and distributors, alternatively, seem undistinguished from other legal businesses on the violence front. The havoc of the 1920s was Prohibition-related, not alcohol-related, and today’s drug-distribution carnage is of a similar nature.

Violence is not the only supply-side drug-connected harm, of course. Environmental damage and the recruitment of the underage into the drug workforce are among the other problems. But once again, these troubles tend to be exacerbated by prohibition. Certainly, underage workers do not seem to be much of a factor in the legal pharmaceutical trade, while teenagers serve as lookouts and in other roles in the illegal drug trade. Legality doesn’t preclude environmental damage from pharmaceutical manufacturing (Larsson, 2014). But underground production is even more likely to be environmentally destructive, in part because prohibition pushes cultivation into ecologically sensitive areas like national parks (Csete et al., 2016). Legal, regulated production would avoid these harms. Illicit methamphetamine production has been associated with explosions, dangerous for an entire neighborhood, whereas the legal manufacturers are both safer and not located in residential areas.

Quality control is not a strength of illicit production and distribution. Drugs sold on the street are of unknown purity and frequently contaminated. Many (probably a large majority) of the people who have died in the past 15 years from fentanyl-laced drugs had no intention of consuming fentanyl (Babu, 2022). These deaths presumably would have been averted had accessible channels of licit supply (for the drugs that users intended to take) been available to the consumers. Note that users of legal psychoactive drugs generally have access to information concerning side effects and interactions with other drugs, and some legal opioids are administered under medical supervision. These features render the legal versions much safer than their illicit counterparts: Even though prohibition per se doesn’t require poor information or unsafe modes of consumption, it does pressure movements in these destructive directions in ways that are hard to overcome.

Supply-side enforcement aimed at the manufacture, distribution, and sale of illicit drugs results in thousands of arrests and prison sentences annually in the United States alone. These drug war harms fall vastly disproportionately on people of color (Alexander, 2012).

Supply-side harms produce a strong case for assuring that drugs are made available in a legal, regulated market. Prohibition generates violence and corruption, increases overdoses and poisonings, fills prisons, and creates an incentive for distributors to arm themselves.

A relegalization of drugs, depending on the details of the new regulatory regime, could bring an increase in overall drug production. More resources might be attracted to supplying the drug market, but the external harms nevertheless should fall. When there is a fairly steep rise in the manufacture of legal pharmaceuticals, or in the farming of agricultural (and psychoactive) goods like coffee or tea, the social costs generally tend to be quite modest, and the general public is unaware of the shift. The regulations that are applied to these activities keep external costs in check, even in the face of rising output.

One danger of drug relegalization is that legal private producers will find it in their interest to stoke demand for their products using any and all of the wiles that Madison Avenue can concoct. In the United States, the advertisement of legal drugs (but not illegal drugs) might be protected by the First Amendment (Leitzel, 2008, pp. 172–177). To the extent that this advertising is effective and cannot be adequately opposed via other measures (including direct counter-advertising) to protect consumers, relegalization could bring with it a surge of problematic drug use. State ownership or control of the production side, however, as with state lotteries, could be a method to combine drug relegalization with controls on advertising.

Recreational drugs such as cocaine and methamphetamine would remain prohibited for children, and for good reasons. But as with alcohol, drugs would continue to be sought by some teenagers below the minimum legal age. That is, even with legal drug markets, there would exist a parallel, illicit market, drawing participants who for age (or other disqualifying) reasons are not eligible to transact in the formal market. Nonetheless, relegalization makes it likely that the items purchased and consumed in that market (as with the underage alcohol market today) would be produced in legal, regulated farms and factories, so the potency and composition of the drugs would not be highly uncertain. Secondly, the large numbers of drug enforcement officers who currently exist could be removed from the newly legal adult market and repositioned to concentrate only on the relatively small underage market. So, enforcement against the prohibited underage trade could be greatly increased, without calling upon additional resources, to limit the potential for leakage from the legal adult market.

Demand-Side Harms

Many drugs, both legal and illegal, present a risk of a deadly overdose or other types of acute harms and fatalities. This problem, as noted, is exacerbated by prohibition and the resulting unknown and highly variable composition of black-market drugs. These risks also depend on the specific drug and the method of administration. Again, prohibition tends to push both of these dimensions of drug use into riskier territories: increased potencies and less safe methods of ingestion. Alcohol Prohibition demonstrated the problem all too clearly: The consumption of alcohol switched massively away from beer and toward the more potent spirits and wine during Prohibition, only to reverse in the years after repeal (Levine and Reinarman, 1991).

Many people enjoy using drugs, even those that currently are prohibited. This enjoyment is the cause of a chief danger from drug use, namely the potential for addiction or a short-term loss of self-control. Criminalization of drug users’ behavior tends to make it harder to provide effective protections against the dangers of loss of control. The private settings in which illegal drugs typically are consumed do not promote safe use and access to help should problems arise. People are likely to hide their drug consumption (or its extent) from friends and family, as well as from medical professionals and treatment providers. Sellers of illegal drugs have little incentive to counsel moderation for their customers or to verify that they are 21 or older.

Prohibition raises the effective price of acquiring drugs (relative to a “free” market) and thereby reduces drug prevalence. But prohibition increases the average harm suffered by users on a per-use basis, makes little distinction between socially benign (or outright beneficial) drug use and problematic drug use, and has trouble targeting counseling and treatment resources to those settings and users where they are most needed. Some of the shortcomings associated with drug prohibition can be countered by appropriate policies within an overarching prohibition regime; the most notable of these policies fall under the rubric of harm reduction.

Harm Reduction and Decriminalization

Many jurisdictions, dissatisfied with the War on Drugs, have looked to so-called harm reduction measures to lower the costs associated with drug use. The notion behind harm reduction is to concentrate less on reducing the amount of drugs consumed while trying to render the drug use that does occur safer for the users.

Some harm reduction measures are aimed primarily at heavy drug consumers and addicts. The provision of clean needles or exchange of clean needles for used needles is a mainstay of harm reduction aimed at injecting drug users. Needle exchange programs help to reduce the spread of diseases such as HIV and hepatitis C, improving user access to counseling or treatment services if they so desire. Safe-injection sites, often with medical personnel on hand, are another harm reduction measure targeting injecting drug users. The drug users at such sites inject their own drugs, however acquired, but do so with clean needles and under watchful eyes.

Opioid maintenance (with methadone or buprenorphine) is another method intended to bring some stability to the lives of opioid addicts, allowing them to avoid the pains of withdrawal without injecting and without necessitating a recurrent scouting of the illicit market for their next fix. (Some jurisdictions outside the United States maintain heroin addicts on the drug, providing pharmaceutical heroin to heavy users.) Safe injection sites are equipped with the opioid antagonist naloxone, which is also distributed to addicts as well as their friends and families. The administration of naloxone (via nasal spray or injection) is an effective method for (temporarily) overcoming an opioid overdose, so having trained naloxone administrators on hand can help save lives. The branded version Narcan even requires little to no training (NIDA, 2017).

Another harm-reduction strategy is drug purity testing. In settings where drug use is suspected to be widespread—raves or musical festivals for instance—people can have a small piece of their drug supply tested to see if there are any risky additives or impurities. The frequent fentanyl-related fatalities of recent years have spawned the growth of fentanyl testing, using a strip that can be inserted into a bit of dissolved drug that reliably indicates the presence of fentanyl. Nonetheless, such testing (at least currently) holds large benefits only for a subset of the drug-using population: people who will not use the substance until they test it and are assured that no fentanyl is present (Humphreys, 2023, p. 81).

Given the high health risks associated with heavy drug use, the harm reduction measures outlined above appear to be cost effective (Wilson et al., 2015; Csete et al., 2016). The main concern with such measures is that they might (unintentionally) promote heavy drug use (given the harm-reduction-based decline in the effective “price” of using) or, in the case of maintenance measures, serve as a substitute for becoming drug abstinent. In the case of needle exchange and opioid maintenance, I know of no evidence that they spur the number of addicts (other than, perhaps, keeping users alive). And of course, perhaps prevalence of drug use is not an appropriate measure of social welfare (Ellis et al., 2024; McDonald et al., 2025). While we have good reason to try to curb particularly risky drug use, to go further and view any decline in use as a good thing seems to adopt a view that there are no benefits to drug use—and hence a reduction in harm is equivalent to an increase in welfare. But drugs do have benefits: reduced pain, increased pleasure, etc. One of the problems with our broad drug prohibitions is that they do not sufficiently distinguish between low-risk and high-risk recreational uses of drugs.

In a fully legal, regulated market—as opposed to a regime of prohibition—attempts to reduce drug-related harms often would still be sensible. But many harm reduction measures also would be provided without policy. Purity testing would be unnecessary with licit, regulated production, while injectable drugs might be sold packaged with clean needles or even as pre-loaded syringes. Treatment services and anti-overdose actions would still be important explicit components of the overall drug policy regime, however.

For many illegal drugs, one of the chief risks for users arises from the criminal justice system. For this reason, decriminalization (or depenalization)—the removal of criminal penalties for small-scale drug purchase or possession—can itself constitute an important harm reduction measure because those penalties can be so onerous.

Decriminalization is especially helpful when a large component of the social costs of drug regulation arises from the arrests of drug users. (This is the situation, I think, for cannabis in those US states that have not relegalized it for recreational use.) Decriminalization can lead to a sharp fall in arrests. There is a case to be made that any sensible drug-policy regime should not include the arrest of users (Husak, 2002; Leitzel, 2008, pp. 72–92). But decriminalization presents a risky gamble: For many drugs (including cocaine and heroin), it is supply-side violence and quality uncertainty that constitute a large element of the overall social cost of drug production, distribution, and consumption. Decriminalization reduces the risks to consumers, so it is likely that the size of the market will grow—perhaps quite significantly. This market expansion includes a growth in quantity supplied, and that growth can lead to heightened supply-side violence and adulterated doses. (Imagine taking the current illicit markets and doubling or tripling them in size.) The state-level decriminalization undertaken in Oregon between late 2020 and 2024 thus was quite risky (Good et al., 2025). Further, its risks were increased by its uniqueness: Oregon was an island of decriminalization in a surrounding sea of criminalization. Such a relatively liberal drug policy will draw some committed drug users from other states, who would like to take drugs without inviting arrest. And it might draw more violent drug sellers, too.

As with the review of supply-side harms, this brief accounting of demand-side issues leads to a similar conclusion: Relegalization of both the demand and supply of currently illicit drugs offers better outcomes than does drug prohibition. Piecemeal harm-reduction strategies or decriminalizations, while helpful along some dimensions, cannot resolve the structural harms of prohibition. A relegalized drug regime offers broader scope for effective regulation.

Drug Control Without Prohibition

Alcohol, tobacco, and prescription drugs are among the psychoactive commodities that already demonstrate workable supply-side controls without prohibition. (In recent years, cannabis has been added to this list in some jurisdictions, despite an ongoing federal prohibition.) Manufacturers and sellers are licensed, the usual quality controls are in place, and federal and state excise taxes are prevalent. There seems to be no reason why markets for cocaine, heroin, and methamphetamine could not be similarly governed, especially since the existing regulated markets for the legal versions of these goods are viable and unproblematic.

The main supply-side issues that lack close legal drug market analogs today concern the prevalence of sellers and the extent and manner of their advertising and marketing. Should licensed retail outlets be limited in number to make it harder for consumers to acquire their desired drugs? Given the many ways (discussed below) that we can nudge consumers away from drug use and (especially) excessive use, the marginal gains from limiting legal sellers might not be worth the cost in terms of making it hard for low-risk buyers to access their drugs.

Licensing and regulating sellers can also be used to enforce demand-side regulations. Alcohol and tobacco age requirements preclude sales to the underage, and overservice regulations require barkeepers to refrain from selling alcohol to inebriated customers. Regulated markets and underground markets are starkly different in this respect: Sellers in black markets have little interest in policing their customers.

On the demand side, what steps can be taken to promote safe and moderate drug use while dissuading problematic consumption? For cocaine, Leitzel (2021) suggests a “double default” system designed to incentivize abstention and, for the non-abstinent, moderate drug use. The first “default” is that, once the prospective purchaser reaches the minimum age to qualify as a legal cocaine purchaser, he must acquire a buyer’s license. In essence, he would formally have to “opt in” to being a buyer in the marketplace. Obtaining such a license would require that the buyer demonstrate basic knowledge of the risks of drug use and how best to respond in drug-related emergencies. The buyer’s license would be revoked for users who commit crimes under the influence of drugs.

A softer alternative (and perhaps one more appropriate for “softer” drugs) would be to replicate a common gambling control policy: Potential purchasers, worried about developing addiction or other types of drug problems, could voluntarily place themselves on the excluded list, making them ineligible (for a time—perhaps six months or a year or longer) for legal purchases. The self-limitation option could even permit some buyer-chosen legal purchases, perhaps allowing a limited quantity of drugs (per week or month, say) or calendar limits such as no purchases on weekdays or during Lent.

Buyer licensing and self-exclusion/limitation would help deal with a central problem of drug use—indeed, for users, perhaps the central problem, once illegality is off the table—namely, the potential for a loss of self-control. (The rules for acquiring a license also help with another problem: a lack of accurate information about drug harms.) A mandate that buyers acquire a license could provide a boost to self-control for all potential consumers, whether they are cognizant of their self-control shortcomings (if they have them) or not. The voluntary self-exclusion and self-limitation programs, alternatively, could work well for people who understand that their willpower to avoid excessive drug use might be lacking—“sophisticates,” in the usual behavioral economics language—but would hold no appeal to “naifs”—those who, though not possessing perfect self-control, are not fully aware of this aspect of their decision making (O’Donoghue and Rabin, 2015).

Leitzel’s second default (or rather, set of defaults) to further boost self-control concerns the terms of access that are available for licensed drug purchasers. Impulsive purchase can be countered to some extent through a mandate for advance ordering—say, a three-day waiting period. Daily, weekly, and monthly purchases could be subject to default maximum thresholds to dissuade high levels of consumption, though non-problematic users might, at some cost, be given an avenue to override (to some extent) the default maxima.

Excise taxes/​ The policies for relegalized drugs described above generally meet the “nudge” criteria: They do not preclude options (as does prohibition), and they do not impose significantly upon people who are not interested in bolstering their self-control or becoming better informed (see Thaler and Sunstein, 2021, p. 8). One “supply-side” policy is quite clearly not a nudge, however: the imposition of excise taxes on relegalized drugs.

While not a nudge, significant excise taxes on drugs can be part of an “optimal” policy design in a world where many people fail to fully internalize the future health costs associated with their drug use (O’Donoghue and Rabin, 2003). In the absence of an excise tax, such people would overconsume goods such as drugs—and the overconsumption is judged from their own point of view, with respect to their own long-term preferences (Sunstein, 2021). By helping to counter first-order errors in the choices of less than fully rational people, high excise taxes can overcome, in terms of aggregate welfare, the second-order costs of altering the consumption bundles of the well-informed, fully rational folks among us (O’Donoghue and Rabin, 2003). Excise taxes can be used not only to decrease the overall quantity consumed, but by making the taxes progressive with respect to potency, they can also push consumption in the direction of softer versions of drugs (Xing and Shi, 2025).

As a large portion of the social costs associated with drug prohibition arises through supply-side violence, relegalization should be done on such terms that would-be consumers prefer the legal option to continuing black market transactions (Goldstein and Sumner, 2022). Street-level prices of illicit drugs tend to be orders of magnitude higher than the marginal costs of production within a legal market, so considerable excise taxes can be applied to relegalized drugs while still undercutting nominal street prices. Even at a similar nominal price, the quality control advantages of the licit supply and the lowered risk from not dealing in a criminalized environment would be attractive to most buyers. (Within a few years of the repeal of national alcohol Prohibition, nearly all the alcohol consumed in states and localities that did not have their own bans in place was produced and distributed in the formal market, despite significant taxation.) Nonetheless, the desirability of outcompeting the black market does put limits on the size of taxes and the amount of effort required to jump through regulatory hoops such as acquiring a buyer’s license. Heavy users, in particular, should find acquisition of a buyer’s license to be an attractive proposition because their presence in the illicit market renders it much more robust than it would be in their absence.

Currently, legal drugs like tobacco and alcohol are subject to considerable excise taxes as well as various nudges (Alemanno, 2015; Lowenstein and Chater, 2017). The nudges include mandatory warnings and, in the case of tobacco, sometimes graphic labels displaying bad health outcomes along with stark warnings such as “Smoking Kills.” Private sellers do engage in their own nudging—advertising aimed at promoting consumption—but governments also commonly restrict some forms of advertising of legal drugs while subsidizing counter-advertising. Currently illegal drugs, following relegalization, could be regulated under a similar system combining excise taxes with various advertising controls and nudges.

A legal drug market featuring nudges toward abstinence and, for the non-abstinent, nudges toward moderate use can (and should) be complemented by policies that nudge heavy or problematic users (or even moderate users who fear that their drug consumption is in danger of becoming problematic) into treatment. Within the regulated sector, heavy users self-identify, and such users are also among those most likely to benefit from drug counseling and treatment. Improved targeting of treatment resources, then, offers another advantage to enticing heavy users into the formal, legal system.

Nudges toward treatment, whether of the harm-reduction or abstinence variety, can start with material directed toward those consumers who purchase drugs in the greatest volume. People who choose high purchase limits could be required to hold regular meetings with drug counselors, with the aim of ensuring that their drug use is not undermining their well-being and keeping treatment options salient. Monetary incentives toward cutting back or ending drug use could also be employed (though large changes in monetary incentives would not satisfy the usual “nudge” criteria). Heavy users who are trying to become abstinent, for instance, could be eligible for weekly lotteries in which prizes are only awarded to those who test negative. (Heavy users will have paid considerable taxes over time from their drug purchases, so some of those revenues could be earmarked for such prizes.) Drug users could choose to enter commitment contracts that would necessitate that they make a large donation to their least-favorite political candidate should they test positive. They could also be offered the opportunity to commit to relinquishing their buyer’s license in the future (or committing to lower future purchase limits) and even receive some monetary inducement for doing so. Such a program would take advantage of the common propensity of people to be more willing to make healthy choices, or choices indicating greater self-control, when deciding for the future rather than for the here and now (see, e.g., Thaler and Sunstein, 2021, p. 189, and Loewenstein, 1996, pp. 277–278).

Contingency management is very helpful for many drug users seeking to quit their drug habit (Pfund et al., 2024; Lima et al., 2024). The essence of the contingency management approach is to provide positive reinforcement for the desired behavior, such as drug abstinence, often in the form of relatively small gift cards (Petry, 2000). The desired behavior is monitored closely, with drug tests, for instance, conducted on a regular—perhaps daily or multiple times per week—basis. Negative tests are immediately rewarded with a gift card, while a failed or missed drug test results in no reward. As with the lottery system described above, some drug tax revenues could be earmarked for providing funding to contingency management interventions for people seeking to control their drug use.

Concluding Thoughts

The so-called nudge agenda is not without its detractors (e.g., Viscusi and Gayer, 2015; Sugden, 2017). One of their concerns is that once state intervention into individual choices can be justified by claims of less than rational choices, then no human activity will be safe from the gaze and guidance of Big Brother. Small nudge-like interventions could morph over time into large shove-like ones (Rizzo and Whitman, 2009). These are not unreasonable concerns.

However, the current drug control regime is both onerous and of questionable social benefit. A new regime of nudges, and even nudges combined with considerable taxes, would represent a significant decrease in coercive governmental intrusion into adult consumption decisions. The main goal of drug prohibition—to reduce problematic drug consumption—can be achieved without prohibition, and without the vast unintended, negative consequences that drug bans bring. Drug control through nudge-based relegalization offers a rare opportunity to reduce coercion and harm simultaneously.

Readings

• Alemanno, Alberto, 2015, “Nudging Healthier Lifestyles: Informing the Non-Communicable Diseases Agenda with Behavioural Insights,” in Regulating Lifestyle Risks: The EU, Alcohol, Tobacco and Unhealthy Diets, A. Alemanno and A. Garde, eds., Cambridge University Press.
• Alexander, Michelle, 2012, The New Jim Crow: Mass Incarceration in the Age of Colorblindness, revised edition, New Press.
• Babu, Kavita, 2022, “What Is Fentanyl and Why Is It Behind the Deadly Surge in US Drug Overdoses?” The Conversation, UMass Chan Medical School, May 10.
• Becker, Gary S., et al., 2006, “The Market for Illegal Goods: The Case of Drugs,” Journal of Political Economy 114(1): 38–60.
• Benartzi, Shlomo, et al., 2017, “Should Governments Invest More in Nudging?” Psychological Science 28(8): 1041–1055.
• Csete, Joanne, et al., 2016, “Public Health and International Drug Policy,” Lancet 387: 1427–1480.
• Ellis, Jennifer D., et al., 2024, “Harm Reduction for Opioid Use Disorder: Strategies and Outcome Metrics,” American Journal of Psychiatry 181(5): 372–380.
• Goldstein, Robin, and Daniel Sumner, Can Legal Weed Win? University of California Press, 2022.
• Good, Danielle, et al., 2025, “Policing During a Period of Drug Decriminalization: Experiences of People Who Use Drugs in Oregon, USA,” International Journal of Drug Policy 138: 104745.
• Herrnstein, R.J., et al., 1993, “Utility Maximization and Melioration: Internalities in Individual Choice,” Journal of Behavioral Decision Making 6(3): 149–185.
• Horne, Benjamin D., et al., 2022, “Behavioral Nudges as Patient Decision Support for Medication Adherence: The ENCOURAGE Randomized Controlled Trial,” American Heart Journal 244: 125–134.
• Humphreys, Keith, 2023, Addiction: A Very Short Introduction, Oxford University Press.
• Husak, Douglas, 2002, Legalize This! The Case for Decriminalizing Drugs, Verso.
• Kenkel, Donald S., 1993, “Prohibition versus Taxation: Reconsidering the Legal Drinking Age,” Contemporary Policy Issues 11: 48–57.
• Kristof, Nicholas, 2025, “We Thought We Were Compassionate, but We Were Too Permissive,” New York Times, February 8.
• Larsson, D.G. Joakim, 2014, “Pollution from Drug Manufacturing: Review and Perspectives,” Philosophical Transactions of the Royal Society B: Biological Sciences 369(1656): 20130571.
• Leitzel, Jim, 2008, Regulating Vice: Misguided Prohibitions and Realistic Controls, Cambridge University Press.
• Leitzel, Jim, 2021, “Double Defaults: Behavioral Regulation of Cocaine,” Journal of Behavioral Economics for Policy 5(1): 7–12.
• Levine, Harry G., and Craig Reinarman, 1991, “From Prohibition to Regulation: Lessons from Alcohol Policy for Drug Policy,” Milbank Quarterly 69(3): 461–494.
• Lima, Marcelo G., et al., 2024, “Contingency Management for Cannabis Use Disorder Treatment,” European Addiction Research 30(4): 321–337.
• Loewenstein, George, 1996, “Out of Control: Visceral Influences on Behavior,” Organizational Behavior and Human Decision Processes 65(3): 272–292.
• Loewenstein, George, and Nick Chater, 2017, “Putting Nudges in Perspective,” Behavioural Public Policy 1(1): 26–53.
• McDonald, André J., et al., 2025, “Cannabis Use and Misuse Following Recreational Cannabis Legalization,” JAMA Network Open 8(4): e2536035.
• Mill, John Stuart, 1859 [1978], On Liberty, edited by Elizabeth Rapaport, Hackett Publishing.
• NIDA (National Institute on Drug Abuse), 2017, “Naloxone for Opioid Overdose: Life-Saving Science,” March 30.
• Nurchis, Mario Cesare, et al., 2023, “Nudging Interventions on Alcohol and Tobacco Consumption in Adults: A Scoping Review of the Literature,” International Journal of Environmental Research and Public Health 20(3): 1675.
• O’Donoghue Ted, and Matthew Rabin, 2003, “Studying Optimal Paternalism, Illustrated by a Model of Sin Taxes,” American Economic Review 93(2): 186–191.
• O’Donoghue, Ted, and Matthew Rabin, 2015, “Present Bias: Lessons Learned and To Be Learned,” American Economic Review 105(5): 273–279.
• Petry, Nancy M., 2000, “A Comprehensive Guide to the Application of Contingency Management Procedures in Clinical Settings,” Drug and Alcohol Dependence 58: 9–25.
• Pfund, Rory A., et al., 2024, “Contingency Management for Drug Use Disorders: Meta-Analysis and Application of Tolin’s Criteria,” Clinical Psychology: Science and Practice 31(2): 136–150.
• Rizzo, Mario J., and Douglas Glen Whitman, 2009, “Little Brother Is Watching You: New Paternalism on the Slippery Slopes,” Arizona Law Review 51(3): 685–739.
• Sugden, Robert, 2017, “Do People Really Want to be Nudged Towards Healthy Lifestyles?” International Review of Economics 64(2): 113–123.
• Sunstein, Cass R., 2021, “ ‘Better Off, As Judged by Themselves’: Bounded Rationality and Nudging,” in Routledge Handbook of Bounded Rationality, R. Viale, ed., Routledge/​Taylor & Francis.
• Thaler, Richard H., 2017, “Much Ado About Nudging,” Behavioral Public Policy Blog, June 2.
• Thaler, Richard H., and Cass R. Sunstein, 2021, Nudge: The Final Edition, Penguin Books.
• Viscusi, W. Kip, and Ted Gayer, 2015, “Behavioral Public Choice: The Behavioral Paradox of Government Policy,” Harvard Journal of Law and Public Policy 38(3): 973‑1007.
• Wilson, David P., et al., 2015, “The Cost-Effectiveness of Harm Reduction,” International Journal of Drug Policy 26(S1): S5–11.
• Xing, Jin, and Yuyan Shi, 2025, “Estimating and Comparing the Effects of Price- and Potency-Based Taxes on Cannabis Purchase Patterns in an Experimental Cannabis Marketplace,” Addiction 120(9): 1770–1779.