This week we’ve seen a striking example of government innumeracy that has a good chance of badly affecting government policy.

The Food and Drug Administration wants manufacturers to package their medications in smaller quantities, such as eight tablets per package. Currently, some generic versions are sold in boxes of up to 200 tablets. The FDA said it also plans to ask online retailers to make it harder to order bulk amounts of the drugs.

The key ingredient in anti-diarrhea medications like Imodium is part of the opioid family, an addictive drug class that includes morphine and oxycodone. At low doses, the medicine, known generically as loperamide, helps control diarrhea. But recent statistics show a rise in abuse of the drug, including massive doses that can cause heart problems and death.

This is from Matthew Perrone, “The FDA Is Cracking Down on Imodium and Other Anti-Diarrhea Medicine Because of the Opioid Epidemic,” Time, January 31, 2018.

drug scales.jpg

And how dangerous are these medications?

Fifteen deaths were tied to the drug between 2010 and 2016, researchers reported in a study last year.

In short, 2.5 deaths a year and, to respond to that, the feds want it to make it more costly in time and money for everyone to get Imodium and similar drugs.

To put that one death a year in perspective, it is 5% of the number of Americans killed in a typical year by lightning.

This one death a year also appears to be an overestimate, according to Josh Bloom. In “Runs On Imodium Before The FDA Clamps Down,” American Council on Science and Health, January 30, 2018, Bloom reports some facts and does his own numeracy analysis:

So, this stuff must be a bubonic plague-like killer, right? Not so much:

“In the 39 years from when loperamide was first approved in 1976 through 2015, FDA received reports of 48 cases of serious heart problems associated with use of loperamide…Thirty-one of these cases resulted in hospitalizations, and 10 patients died.”

Source: FDA

THIS is what all the hysteria is about? This comes to 1.23 cases per year of serious heart problems and 0.25 deaths associated with the use of loperamide. This means there is 1 death annually per 1.1 billion people in the US. One death every 4 years. Here are some comparable death risks.

Death from being hit by a falling coconut (1 in 250 million)
Death from a shark attack (1 in 300 million)
Death from a roller coaster accident (1 in 300 million)
Since every non-problem has a non-solution it should not be surprising that some want the drug behind the counter – an increasingly crowded place.

For more on various small risks, see Aaron Wildavsky and Adam Wildavsky, “Risk and Safety,” in The Concise Encyclopedia of Economics.

HT2 Jeffrey A. Singer