The problems derive from the prohibition, which takes several forms. The forms add up for big profits and bad incentives, for which the consumer pays.<p>FDA approval is the first layer of prohibition. Very expensive, this keeps a lot of competitors out. Lots of market (read: pricing) power is conferred to the winners. Great incentive is provided for regulatory capture.<p>The second layer is patent protection. Again, competition becomes illegal, with outcomes similar to above.<p>Third is scheduling it as a prescription drug. The incentives of the drug company are now to influence doctors, in ways that may be more or less overt. Docs get a cut of the outsize profits, de facto.<p>The fourth layer is opiates being illegal in general. Competitors out.<p>Of course there are legitimate reasons for prohibition, even if I don’t agree with them. One can make an argument for protecting people from harming themselves.<p>But these arguments are naive and static. By “dynamically scoring” the cost of prohibition – following the incentives and the outcomes – we might choose differently.