Opioids, a class of drugs chemically similar to the painkiller morphine, have been sweeping across North America since the late 1990s into the first two decades of the 2000s. These powerful sedative drugs, which include prescription painkillers like oxycodone and powerful street drugs such as heroin, are extremely deadly because their depressant effects can stop a user from breathing. Because of their widespread and ever-increasing use, drug overdose deaths “are the leading cause of injury death in the United States,” according to the U.S. Department of Health & Human Services (HHS).
According to HHS statistics from 2015, 12.5 million people in the U.S. abused prescription opioid drugs – including 2.1 million first time users, and another 828,000 used heroin – including 135,000 first time users. Together, 33,091 people died from opioid drug overdoses and the economy took a $78.5 billion hit as a result of lost productivity. However, the blight of drug addiction, which is commonly thought to be an equal opportunity life-destroyer, is actually discriminatory in who it targets. Drug addiction hits those who are economically disenfranchised harder than those who are secure in employment and have well-paying jobs.
As Maia Szalavitz, an author on drug addiction, wrote in The Guardian:
“In many black communities, before crack took off, unemployment rates had been high and rising, driven by the decline in manufacturing jobs and biased hiring and firing practices… and [now] white America looks economically a lot more like black America in the 1990s: stable, well-paying jobs are disappearing, replaced by lower-wage positions with far more uncertainty.”
As good high-paying jobs, particularly manufacturing jobs that were once common in the “Rust Belt,” disappeared, drug addiction spiked beginning in the late 1990s in the white working class. Statistics show that drug use rates are higher amongst the unemployed, and far higher for those who are chronically unemployed or underemployed.
Furthermore, heroin addiction, in particular, is more than 3 times more common in those making less than $20,000 annually as opposed to those making over $50,000. Drug addicts usually start their path to addiction in their formative years, and most kick their habit before the age of 30 – if they are able to secure a stable job.
In short, drug addiction is much easier to fall into and stay in if you are poor.
While record wealth inequality is becoming a major (and well deserved) topic of political discussion, the millennial generation is set to be the most “unequal generation in recent memory,” indicating that socioeconomic factors favor the continuation of the opioid epidemic. Sadly, young adults, particularly non-Hispanic whites – 18- to 25-year-olds living in large metropolitan areas – are the most affected by heroin abuse.
Another problem facing a solution to the opioid epidemic is the fact that it is extremely profitable for the pharmaceutical industry. Through intense lobbying from the pharmaceutical industry, coupled with the fact that nearly 100 million people in the United States deal with chronic pain, doctors began over-prescribing painkillers to patients despite extraordinarily well-documented potential for addiction.
Companies have downplayed the cause for concern by lying about the potential for addiction. For example, one company, Purdue Pharma, was forced to pay a $634.5 million fine for claiming that their drug, OxyContin, was less addicting than other painkillers.
“In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills,” according to the CDC.
A lack of regulation on drug sales can be owed to the influence of the pharmaceutical industry in U.S. politics. The pharmaceutical industry has reportedly spent $2.5 billion in the past decade lobbying politicians, the most of any industry. Only 3 U.S. Senators have not taken donations from “Big Pharma” and only 1 out of 10 members of the House; the industry also employs 2 lobbyists for every member of Congress to ensure they are protected from regulations. The Pain Care Forum, an industry-funded interest group, spent $740m over a decade lobbying state and federal lawmakers against enacting limits on painkiller prescriptions.
“From 1999 to 2008, overdose death rates, sales and substance use disorder treatment admissions related to prescription pain relievers increased in parallel. The overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 were four times those in 1999,” the CDC notes.
The federal government has shown slight signs of mobilization on the issue. President Donald Trump announced a rejuvenated effort to combat the deadly epidemic. In one speech, Trump said that "more people are dying from drug overdoses today than from gun homicides and motor vehicles combined,” continuing that, "These overdoses are driven by a massive increase in addiction to prescription painkillers, heroin and other opioids." At the end of his speech, the president signed a memorandum that declared the opioid epidemic a national health emergency, which, in turn, would give federal agencies a wider discretion to combat the epidemic.
However, instead of tapping into federal disaster relief funds, Trump invoked the Public Health Emergency Fund, which reportedly only contains $57,000. On top of this, Trump and his Republican cohorts plan to roll back Medicaid enrollment by making the enrollment procedures more tedious. For example, by requiring regular drug tests for those on the program, which would strip any rehabilitation opportunity for drug users who rely on Medicaid. The Republican’s main sought-after prize – the repeal of the Affordable Care Act, commonly called “Obamacare,” would dramatically reduce Medicaid enrollment and cut minimum required guarantees for private health insurance, which would likely include drug rehabilitation.
“This crisis was produced for profit, and to the detriment of working-class communities all over the country. I find the attempts the administration makes to draw attention to the crisis to be counteractive unless they address the causes of the problem in the first place," said Benjamin Sanning, a student activist and organizer in Northern Kentucky – a community that has been hit hard by the opioid epidemic.
Trump himself once said that Big Pharma “was getting away with murder.” However, his policy proposals show a clear lack of understanding of drug addiction and its main culprit – the neoliberal economic system that has befallen the U.S. that, through corporate deregulation, creates the conditions necessary for widespread social epidemics such as opioid abuse. Not only this, but Trump nominated Tom Marino for 'Drug Czar', a notorious Big Pharma representative that was forced to give up his consideration when it was revealed that he helped devise legislation that would protect irresponsible drug companies from penalties.
Vermont Senator Bernie Sanders tweeted in response to Trump’s proposal, "Trump is right that the opioid crisis is a national emergency. Unfortunately, his announcement today was nothing more than an empty promise."
In a successive tweet, Sanders said, “Millions depends on Medicaid for opioid treatment. Trump's solution is to cut Medicaid by $1 trillion. That is a disgrace."