The inequalities and maladies of our economic systems often manifest in public health crises. At both the systemic and specific levels, these are often exacerbated by the interactions of our privatized health and pharmaceutical systems and the tendency to refer all problems to the criminal legal system. As with all systems, our public health crises break down extremely unevenly on lines of race, gender, class, and other indices of marginalization and exclusion. From the opioid epidemic to spiraling medical debt and prisons that are toxic in every sense, private actors and the legal system interact to the detriment of public health.