14 February 2011

How problems in WTUs are like drug interaction deaths

Medical issues in the military seem to be getting a lot of press attention these days, so I feel it's important to take a look at the genesis of these problems, specifically the polypharmacy issue and the troubles with Warrior Transition Units (WTUs). The policies leading to these problems have been well intentioned, yet there seems to be little thought or care for how and why they've gone so far astray, although there is plenty that they have gone astray.

Before delving into the issues I mentioned above, let's use a more well known example of these "second order effects." During the toughening of drug sentences in the late 1980s the Anti-Drug Abuse Act made prison sentences proportional to the quantity of illicit substance that a dealer was holding when arrested. The thinking behind such laws is straightforward: stiffer sentences for bigger time drug dealers. At first blush this sounds like a solid enforcement strategy; however, both in theory and in practice these laws had the unintended consequence of incentivizing dealers to hold smaller quantities while still being able to meet demand. Dealers responded to this by placing a new premium on purity. If they could sell their customers half the weight for the same price, they faced a lighter sentence if/when they were arrested. In this way drug laws that were designed to curtail large scale drug dealing had the perverse effect of increasing drug purity, which itself has many second order consequences (higher overdose rates, increased addiction potential, etc).