But recreational use of those drugs isn't legalized and the highest death toll from opiate use comes from people who move from the pharmaceutical-grade drugs to unregulated street drugs.

You can call for both legalization and high regulation… that’s literally what prescription drugs are.

Legalization & certification of quality is a good endpoint, if you can buy cheap heroin of good purity and stable dosage, no need for underground sources laced with fentanyl of variable purity.

I’m here for the FDA regulating what is on the label matching what is in the pill. But there is so an argument for optional certification; it might end up that the steady state cost for FDA compliance leaves room at the bottom end of the market for Mexican underground labs, and I’d rather have US above-ground labs filling that niche (because there are other recourses for egregious behavior like lacing oxy pills with Fentanyl if your supplier is in the US, which are not available against cartel labs in Mexico). It’s an empirical hypothesis though, you might not see prices high enough to matter with FDA compliant labs.

Another temptation to resist is taxing the drugs to pay for social services, “sin tax” in this case would again leave the door open for illegal labs. Again you can tune the parameters when you have evidence from the market.

My point is that we effectively did this for a couple decades with oxycodone and hydrocodone… the result has been disastrous.

We can probably keep more existing addicts alive by full legalization, but we pretty much invite a huge wave of new folks who will spend the rest of their lives with an opiate dependency.

As a sibling noted, I think the takeaway from oxy is a lot more complex. I don’t think many people are dying from prescription meds, I think most are dying when they go to the black market to service their addiction when they cannot get prescriptions, or cannot afford them.

For example if you want oxy, it’s very expensive on the black market, and so many end up taking fentanyl instead, which is more dangerous even if you have known purity medical grade, and is extremely dangerous when purchased on the black market with variable and unknown purity.

So in summary, I really strongly disagree that “we effectively did this”. The decriminalization program has not been seriously tried for opiates anywhere outside Portugal (where it didn’t cause an increase in usage, and did result in decreased harm).

I agree with you but there are pathways for decriminalization and legalization ala cannabis in states that have fully legalized it. There is still a difference between the "medicinal" products which require something resembling a prescription and recreational ones which are sold to anyone of age. Those recreational products still undergo testing and regulation.