The Monopoly Option: Obsolescent or a “Best Buy” in Alcohol and Other Drug Control?

Given the attractive but problematic nature of psychoactive substances, legal markets in them are commonly subject to government controls, both as a source of revenue and to control levels of use and harm. One control option is government monopolization of all or part of the market. The diverse modern histories of monopolization for tobacco, opium, and alcohol are described, along with evidence on monopolies’ substantial effectiveness in raising revenue and in minimizing harms. Interests and arguments opposing monopolies are described. Monopolization has decreased in the neoliberal era, but the monopoly option has benefits for public health and the public interest.