The economics of pleasure: How a new approach to drug use could save millions

The conversation around drugs has long been framed by cost. Policymakers calculate the billions lost every year to productivity gaps, hospitalizations, law enforcement and incarceration. The U.S. alone spends an estimated $193 billion annually dealing with the fallout of illicit drug use, according to the National Institute on Drug Abuse.

Yet there is a blind spot. People do not only use drugs because of the usual suspects: trauma, poverty or pathology. They also use them because they feel good. Pleasure. Connection. Belonging. A stronger sense of self.

There is an old joke that goes: “Do you know what’s the problem with drugs? That they feel too good.” And it is spot on. Ignoring this basic human driver has a cost of its own.

Researchers and frontline harm-reduction workers are now introducing a radical, almost counterintuitive idea: what if drug policy and education started not from fear, but from pleasure? What if acknowledging the real reasons people use could reduce overdoses, improve mental health and save governments millions?

As Valentine and Fraser noted in their 2008 study of methadone patients: “Although pleasurable and problematic drug use are often thought to be mutually exclusive, pleasure is reported from both the effects of drugs such as heroin and methadone and from the social worlds of methadone maintenance treatment.”

This is the frontier of “pleasure management” or “pleasure maximization,” a new way of thinking about consumption that blends economics, public health and lived experience. Daniel Bear and colleagues argue that harm reduction too often “foregrounds risks at the expense of benefits.” Their framework of Mindful Consumption and Benefit Maximization (MCBM) begins by asking users why they consume, what benefits they seek and how to reduce risks while preserving those benefits.