Abstract
Overdose deaths, overprescribing of opioids, illicit production of fentanyl, a resurgence of methamphetamine and cocaine, and an epidemic of vaping‐related illnesses and substance use disorders cover the nation's headlines today, as they have for years. These problems are manifestations of commercial recreational pharmacology, the personally controlled use of psychoactive drugs that super‐stimulate brain reward for pleasure. While substance use and addiction have been known throughout history, the recent increasingly greater acceptance of commercial recreational pharmacology in the United States is exacting a toll on the public health of the nation. The most dramatic example is a decline in U.S. life expectancy, which fell three years in a row from 2016–2018 as a result of overdose deaths.
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