Why so much drug use in the United States?
That is a question from a loyal reader, and he does not mean pharmaceuticals rather illegal drugs. I can see a few hypotheses:
1. Americans consume more of almost everything. Including health care. We are simply a nation of consumption, for longstanding cultural reasons and supported by our higher wealth and our ability to save through human capital and rising asset prices, thus enabling more spending. So we are going to spend more on illegal drugs too. In fact illegal behavior with the prescription drugs themselves is one of the fastest-growing drug problems in the United States.
1b. Americans also take way more legal prescription drugs than their counterparts in other countries. Under one estimate, Americans consume 80 percent of the world’s painkillers.
2. Corporate interests, including Big Pharma, are in America relatively strong, including politically strong, and relatively prominent in advertising. Some of those companies have worked hard to accustom you to the idea that you ought to “take something.”
3. America has borders with Mexico and the Caribbean, which makes it harder to keep out illegal drugs.
4. Price! (Duh) Somewhere recently I saw price estimates for cocaine in various countries (might anyone recall the link?). It was cheaper in the United States than elsewhere. We are a large market, have economies of scale, and are great at retail and marketing. Many other things are cheaper here to, which in turn brings us back to #1.
5. Compared to say Germany or Denmark, there are fewer people “looking out for you.” Americans are more likely to move away from family and friends, and more likely to live “in the middle of nowhere.” We are lonelier, maybe not at the median but on the left hand side of the distribution. Our demand for therapists is pretty high too.
6. Student life can be more competitive in the United States than in Canada or Europe, and that may induce many Americans teens to use amphetamines, which are more popular in America.
7. America is in general a high-variance country, due to large market size, ethnic diversity, relatively open and competitive markets, and the looseness of many of its social norms. A higher-variance country will have many more people clustered in the unsatisfactory behavior patterns.
7b. Along related lines, American teens are more frequent users of illegal drugs than are European teens. But American teens also have amongst the lowest rates of smoking and drinking. So some of us are very disciplined, others much less so, again reflecting the high variance of both inputs and outcomes.
8. Americans are keener to try new products, relative to most of the rest of the world. Along these lines, we have relatively big problems with the newer opioids and synthetic drugs. Heroin historically has often been a bigger problem in Europe, and that is hardly a new drug. In era of new drugs, as we currently are living in, this will nudge the balance toward Americans doing drugs more.
9. American teens have more disposal income to spend, compared say to European teens. This may come from either jobs or from parental allowances. Furthermore, the European youth, especially in Italy, are more likely to live at home for many more years. That probably limits illegal drug use. Americans are more likely to go away for college to “a campus,” and “a dorm,” a horrible institution if you think about it for too long.