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包括特朗普总统在内的上上下下，几乎每个人都觉得能在CVS或Walgreens买到的那些药贵得像在敲美国人竹杠。

其他“药”也很贵。这是彭博全球恶习指数（Bloomberg Global Vice Index）的最新发现，该指数每年都会对疑似非法毒品的价格进行追踪。

美国人需要花846美元才能买“一篮子恶习商品”，其中包括阿片类药物、可卡因、大麻和安非他明类兴奋剂等四大类别毒品。这个价格在全世界位居第三，仅低于新西兰和澳大利亚，比去年增长了40％以上。

恶习商品指标仅仅是经济指标，并非对其是否道德或合法进行判断。在不同辖区，允许将大麻、可卡因和海洛因用于不同形式的娱乐或医疗用途，而在美国境内，关于毒品的讨论出现了一些变化。有些州已经放宽了对大麻的限制，而各个层级对合法处方阿片类药物的反对声都在增强，因为此类药物已经导致数万美国人死亡。

该指标还计算维持每周剂量所需费用占平均收入的比例（收入数据出自国际货币基金组织）。美国的比例是70％，几乎是邻国加拿大的两倍，加拿大一篮子的价格是300美元出头，与半个地球之隔的香港基本持平。

卢森堡再次成为最嗑得起药的国家，荷兰跻身第二。前者是因为卢森堡人很富裕，年收入超过10万美元，后者是因为毒品很便宜。在荷兰，一篮子只需93美元，远低于大多数发达国家的市场价格。

荷兰同时也是重要出口国。欧洲毒品和毒瘾监测中心的2018年报告中指出：“暗网上非法贩毒的数量不断增加，据信相当多的供应商都来自于荷兰。”

相较于往年，2019年的彭博指数进行了精简，原来还包括香烟和酒精。该指数还回顾了同一商品的往年数据，进行对比。而保留下来的项目——非法药品很多都是暗地交易，增加了数据收集的难度，而且调查往往会受到时间滞差的影响。还有一些地区非法药品的价格变化更多是因为货币波动，而非其场外行情。

有一个地方的价格高得毫无争议，那就是澳新。澳大利亚的价格居全球之首，为1263美元，相当于每周工资的116％，高于一年前的91％，该变化主要反映了阿片类药物价格上涨。新西兰人每周维持习惯剂量所需费用也高于收入。

据央行估计，截至2017年8月，澳大利亚人当年在非法毒品上花了135亿澳元（97亿美元），冰毒和大麻占购买量的70％以上。这个数字来源于一项该国纸币流通情况的研究：据估计，其中近2％用于非法毒品交易。

价格刻度尺的另一端是老挝、多米尼加共和国和哥斯达黎加等国，这些国家靠近主要生产中心或走私路线。《哥斯达黎加星报》（the Costa Rica Star）12月报道，1公斤可卡因售价约为8000美元，相比之下，美国为35000美元，欧洲的部分地区为60000美元。

彭博篮子包含四种成分，包括剔除盐及其它常见混合糊剂后的1克可卡因；1克安非他明类兴奋剂，如冰毒或摇头丸；1克大麻制品，如大麻草药或大麻树脂；1克阿片类药物，如海洛因或鸦片。

指数中略多于一半国家的篮子价格相较去年有所上涨。美国涨幅最大，大部分原因是可卡因和阿片类药物价格的上涨，2018年全美嗑药致死超7万人，这两类毒品占比将近70%。

奥施康定等止痛药在毒品滥用中的角色得到了密切关注。主营成瘾治疗中心的佛罗里达公司德尔福行为健康集团（Delphi Behavioral Health Group）赞助的一份报告表明，每片奥施康定的场外价格约为处方药价的10倍。扑热息痛的涨幅大约是2比1。

礼来公司董事长、国际制药厂协会联盟（总部位于日内瓦）主席戴维·瑞克斯在2018年摩根大通医疗保健会议上表示：“在这场令人难以置信的危机中，阿片类药物的滥用是重要原因。”

该问题是全球性的。联合国《2018年世界毒品报告》（2018 World Drug Report）中称，“越来越多的处方药被用于非医疗用途（从合法渠道转移或非法制造）”，该报告是彭博的主要数据来源之一。（财富中文网）

译者：Agatha

Almost everyone, from President Donald Trump on down, agrees that Americans are getting gouged when they buy the kinds of drugs you can find at CVS or Walgreens.

They pay a high price for other drugs too. That’s one finding of the latest Bloomberg Global Vice Index, an annual tracker of the cost of drugs that may be illegal.

Americans would need to shell out $846 for a “basket of vice’’ made up of four generic groups of drugs: opioids, cocaine, cannabis and amphetamine-type stimulants. It’s the third-highest price in the world, behind only New Zealand and Australia – and up more than 40 percent from a year earlier.

The vice gauge is purely an economic indicator, not a judgment about morality or legality. Marijuana, cocaine and heroin are permitted for recreational or medical use in various formats and jurisdictions, while inside the U.S. the debate on drugs is shifting. Several states have been easing curbs on cannabis, while there’s a mobilization at all levels against the abuse of legal prescription opioids, which have killed tens of thousands of Americans.

The gauge also measures the share of average incomes (based on International Monetary Fund data) that’s needed to maintain a weekly habit. In the U.S., for example, the figure is 70 percent, almost double the level of neighboring Canada, where the basket costs a bit more than $300, about the same as halfway around the world in Hong Kong.

Luxembourg repeated as the most affordable nation to get high, while the Netherlands jumped a few places to rank No. 2. In the former case, that’s because Luxembourgers are rich – with annual earnings above $100,000 — and in the latter, because drugs are cheap. The Dutch basket costs just $93, well below the going rate in most developed economies.

The Netherlands is a key exporter too. “With the amount of illicit drug trafficking on the dark net increasing, a considerable number of vendors reportedly operate from the Netherlands,’’ the European Monitoring Center for Drugs and Drug Addiction said in its 2018 report.

Bloomberg’s 2019 Index has been streamlined from previous editions, which included cigarettes and alcohol. A look-back measure for the same products was made for comparison. Because so much of the trade in the remaining items happens in the dark, data collection is difficult and surveys tend to suffer from a time lag. Some price changes also have more to do with fluctuations in currencies than in the street price of illicit drugs.

One place where that price is indisputably high is in the Antipodes. Australia’s world-beating price tag was $1,263, or 116 percent of the weekly pay, up from 91 percent a year ago, mostly reflecting a hike in opioids. In New Zealand, the cost of a habit also exceeds a week’s income.

Australians spent $13.5 billion ($9.7 billion) on illicit drugs in the year through August 2017, the central bank estimates, with methamphetamine and cannabis accounting for more than 70 percent of purchases. The figure comes from a study of how the country’s banknotes circulate: it estimated that almost 2 percent of them are used in illegal drug deals.

At the other end of the price scale are countries like Laos, the Dominican Republic and Costa Rica, that are close to key production centers or smuggling routes. The Costa Rica Star newspaper reported in December that a kilogram of cocaine sells for about $8,000, compared with $35,000 in the U.S. and $60,000 in parts of Europe.

A gram of cocaine, stripped of the salts or paste it’s often mixed with, is one of the four components of Bloomberg’s basket. The others are a gram of amphetamine-type stimulants, such as methamphetamine or ecstasy; a gram of cannabis products such as marijuana herb or hashish resin; and a gram of opioids such as heroin or opium.

The basket’s price rose year-on-year in slightly more than half of the countries in the index. The U.S. recorded one of the biggest jumps, with the bulk of the increase coming from cocaine and opioids — classes of drugs that accounted for almost 70 percent of the more than 70,000 fatal overdoses recorded in the country in 2017.

The role of painkillers such as OxyContin in the epidemic has come under close scrutiny. Its street price per pill is about 10 times the prescription price, according to a report sponsored by the Delphi Behavioral Health Group, a Florida-based company that manages addiction treatment centers. The markup on Percocet is about two-to-one.

“It’s too much use of opioids which is driving this incredible crisis,” David Ricks, chairman of Eli Lilly & Co. and president of the Geneva-based International Federation of Pharmaceutical Manufacturers & Associations, told the J.P. Morgan Health Care Conference in 2018.

The problem is a global one. “There has been an increase in the non-medical use of prescription drugs (either diverted from licit channels or illicitly manufactured),’’ the United Nations said in its 2018 World Drug Report, one of Bloomberg’s main data sources for the index.