Welcome Back, Drug War

So what if Jeff Sessions doesn’t realize Reefer Madness wasn’t a documentary, but a propaganda film, best watched high to achieve maximum enjoyment. The opposing viewpoints, far from the quiet of Main Justice, are locking arms behind him. If they have their way, Sessions may end up a hero, prescient in reviving “just say no” as the cell door slams.

It’s the opioid epidemic. Not problem, but epidemic. The thing about using words like epidemic is that they scare people. They make people leap to the conclusion that this problem is so extreme that it must be fixed. Immediately. By any means possible. And this is the word of choice on the left and the right. When consensus appears, hold on to your hats.

German Lopez at Vox says it completely changed his view of legalization of drugs. Apparently, this 2012 graduate of the University of Cincinnati* knows a lot of addicts.

By the time I began as a drug policy reporter in 2010, I was all in on legalizing every drug, from marijuana to heroin and cocaine.

It all seemed so obvious to me. Prohibition had failed. Over the past decade, millions of Americans had been arrested and, in many of these cases, locked up for drugs. The government spent tens of billions of dollars a year on anti-drug policies — not just on policing and arresting people and potentially ruining their lives, but also on foreign operations in which armed forces raided and destroyed people’s farms, ruining their livings. Over four decades, the price tag for waging the drug war added up to more than $1 trillion.

Oscar Wilde called a cynic someone who knew the price of everything and the value of nothing. Like most kids, German could quote statistics, and thought that was good enough to understand the world. He learned otherwise.

Yet for all the effort and cost, the war on drugs had little to show: Drug use had actually trended up over the past several years, and America was in the middle of the deadliest drug crisis ever in the opioid epidemic.

And then he fell prey to the stories of pain.

I saw friends of family members die to drug overdoses. I spoke to drug users who couldn’t shake off years of addiction, which often began with legal prescription medications. I talked to doctors, prosecutors, and experts about how the crisis really began when big pharmaceutical companies pushed for doctors and the government to embrace their drugs.

And so ends Lopez’s not entirely naive support for legalization. It’s not that he’s against reform (though he never mentions decriminalization), but arrives at the conclusion based on his life experiences that the opioid crisis must be stopped.

At National Review, David French links approvingly to Lopez.

As German Lopez lays out in a thoughtful extended piece at Vox, opioid prescriptions increased as the federal government pushed the “pain as the fifth vital sign” campaign and as pharmaceutical companies aggressively marketed opioids like OxyContin. Opioid prescriptions skyrocketed and addiction rates increased, and as addiction increased, so did overdoses. To be clear: Not all these new addicts were the actual patients. Simply put, families and communities were suddenly awash in narcotics, with extraordinarily potent drugs filling medicine cabinets from coast to coast.

Notably, this suggests a problem with big pharma pushing Oxy with a government assist, a very different problem than junkies and crack whores. But the connection is made clear as the dots of pharma opioids created addicts, who then took to the streets. And ultimately died.

And now, as virtually every American knows, we face a national crisis. In 2016 drug-overdose deaths increased 11 percent over 2015’s already-high number. A stunning 52,404 Americans lost their lives. To compare, that’s almost 15,000 more than died in car crashes and roughly 16,000 more than died to guns, including homicides and suicides.

The numbers don’t quite jibe with the chart, as terms get conflated a bit, but they’re still serious numbers.

This isn’t the first time we’ve had an opioid epidemic, though it was called heroin the last time around. The difference is heroin is what poor people shoot, while opioids are the pills handed out by docs to people with health insurance who live in houses with picket fences. There is a parallel of sorts, as crack was vilified by myth while coke was what cool people snorted in the bathrooms at Studio 54.

French, like Lopez, goes to the visceral description of the problem, the sort that tugs at heart strings and leave the mind behind.

In other words, opioids are monstrous inventions that overpower the human will on a mass scale. There are no “rational actors” among addicts, and the substances are extraordinarily addictive. Do you know an opioid addict? Then you’ve seen them slide slowly away from reality.

This is how the War on Drugs started in the first place, the sad tales of uncontrolled death and destruction, long on emotion and devoid of thought. And with the Gertrude caveat, the call to action is made:

That’s not to say that fighting the war on drugs means winning the war on drugs. It may mean that we do nothing more than contain the problem, preventing it from spiraling out of control even further. And, as Lopez notes in Vox, arguing against legalization isn’t the same thing as arguing against reform, including reforming the way in which the criminal-justice system deals with drug offenders. There is much room for creativity and thoughtfulness in dealing with the crisis. I see no room for broader availability and greater ease of access.

No one who has any substantive knowledge about what heroin did to people would suggest that it should be legalized. There has never been such a thing as a social heroin user. Both Lopez and French employ the tools of hysteria, the language of crises and epidemics, to argue against legalization. Who argued for legalization of heroin? Who would be that ignorant?

But their Gertruding aside, the reaction to these cries in the opioid wilderness will be met by guys like Sessions, and maybe you, to leap to the most simplistic response, and that will be the good ol’ War on Drugs. No one could be so naive (sorry, German) as to believe that screams about an epidemic will be met with the cautious response of decriminalization and reform, the reduction in current ineffective yet draconian policies like mandatory minimums and zero tolerance.

No one who has a clue about drugs ever argued for the legalization of heroin. Yet, we have consensus that the solution no one sought can’t be allowed because of an epidemic. Now that both sides agree, the toilet will get flushed again with bipartisan support, and the tepid reminder that the most obvious answer failed will go swirling down the bowl.

*This is something worth re-emphasizing: most of the “crime and law” writers at online media outlets are young, have no legal education and have no experience in the system. This is akin to your nephew, Skippy, who majored in journalism and minored in gender and sexual perversion studies, getting a writing job that paid so little that no one with an expectation of eating in the future would take it, and becoming your criminal law guru. There’s a reason their bios tell you next to nothing about them. There is next to nothing to tell.

22 thoughts on “Welcome Back, Drug War

  1. Patrick Maupin

    Decriminalization, as its ever been practiced, and perhaps as it ever could be practiced, is a half-assed measure. If it’s not problematic to possess ‘x’ but illegal to manufacture or distribute ‘x’, how can the possessor be sure of the qualities of the ‘x’ it possesses?

    There has never been such a thing as a social heroin user.

    No, but some of them are in significant pain, and some (maybe a high) proportion of the deaths are directly attributable to bad dosing.

    the pills handed out by docs to people with health insurance who live in houses with picket fences.

    Doctors are terrible gatekeepers. For every doc who hands out hydrocodone like it was candy, there are another two docs who the feds have scared so shitless they won’t even give out cough syrup.

    No one who has any substantive knowledge about what heroin did to people would suggest that it should be legalized.

    That’s just one brand of feelz. Here’s another:

    No one who has any substantive knowledge about how bad undiagnosed pain can get would suggest that the government should be allowed to regulate substances that remediate pain.

    1. SHG Post author

      How to “adjust” the relative solutions between those docs too scared to prescribe to chronic pain sufferers and those handing out pills in mills is a serious problem in need of difficult solutions and choices. The cries of “epidemic” make those difficulties moot, as crises demand immediate, forceful and palpably ineffective solutions. And those are always the ones most palatable to America, since something must be done!!!

      1. Patrick Maupin

        How to “adjust” the relative solutions between those docs too scared to prescribe to chronic pain sufferers and those handing out pills in mills…

        It may be easy for a member of one guild to rationalize that members of another guild should fulfill a gatekeeper function, but whether that should even happen is part of the question, not an immutable assumption.

        The cries of “epidemic” make those difficulties moot, as crises demand immediate, forceful and palpably ineffective solutions.

        Yes, that crisis needs to be unmanufactured before any progress can be made.

        1. SHG Post author

          When it comes to crimes. my guild wins. I have no clue when a doc should write a script for a ten year supply of oxy, but like lawyers, docs should practice their guild with integrity rather than fear or favor.

          1. Patrick Maupin

            There is no question that in the vast majority of cases, people will do much better when they consult a guild member. But access to the courts is not strictly reserved to those wealthy and smart enough to employ a lawyer.

            1. SHG Post author

              So, there’s always Judge Judy. No guild member needed, but there’s a fair to middlin’ chance she’s going to engage in a microaggression before you explain the thing about the fringes on the flag.

  2. Robert

    “No one who has any substantive knowledge about what heroin did to people would suggest that it should be legalized.”

    That is simply not true at all. Plenty of people — fully aware of such things — have argued that it should be legalized anyway, on the grounds of individual liberty.

    Do you think suicide should be legal? Or should it be treated as a crime, with failed attempts resulting in criminal prosecution of the individual in question?

    I am going to assume you have “substantive knowledge” about what suicide does to life of the individual in question.

    Do you have any substantive knowledge about what suicide does to the individual in question?

    1. SHG Post author

      You make a baseless assertion, then leap orthogonality into suicide. Get help. And no, suicide is not illegal. Assisting may be, attempting may be, but suicide is not. Can you guess why?

      [Ed. Note: I trashed your subsequent comment. This will not devolve into a thread all about you or suicide.]

      1. Rendall

        “You make a baseless assertion, then leap orthogonality into suicide.”

        Ugh, yes, he did not argue the case very well. The Fallacy Fallacy might assert that he’s wrong in every single respect. But…

        “No one who has any substantive knowledge about what heroin did to people would suggest that it should be legalized.”

        There are in fact interesting arguments proposed by health policy people to legalize, or at least decriminalize, heroin and other so-called dangerous drugs for public health reasons, separate from any arguments about the social costs of prohibition and philosophical points about personal autonomy. Don’t take this precis as the pinnacle of this premise, though. I, too, will argue badly.

        * Legalization does not have to mean an unregulated free-for-all.
        * Regulating the quality of drugs would alleviate casualties due to overdosing and impurities.
        * There is some evidence that the arrow of cause of drug addiction is from difficulties in life, rather than the reverse. That a life free of trouble except for the demon drug addiction is a myth. i.e. Drug addiction is a symptom of something else.
        * Portugal legalized all drugs, and, counter-intuitively, their rate of drug use plummeted. Other examples of decriminalization in

        “There has never been such a thing as a social heroin user.”

        Anecdotally, I have a successful friend (an actual friend, not a “friend”) who has used heroin occasionally and recreationally for decades. Go figure. Maybe he’s the only one who has ever existed or will ever exist, but after all it only takes one talking pig to prove that pigs can talk, innit?

        1. Rendall

          Meant to finish: ” Other examples of decriminalization in…”

          with “… Amsterdam and Switzerland have been successful in reducing addictions.” But the evidence is mixed.

          1. SHG Post author

            Decriminalization is different from legalization. Which is also different from substantially regulated. There’s a spectrum between Drug War and legalization. Also, Holland and Switzerland are culturally very different than here (and different from each other). Good experiences don’t necessarily travel well to different cultures.

        2. SHG Post author

          The key word in the top quote is “substantive.” Theory is nice, but spend some quality time with junkies. Portugal is an interesting question, though whether their experience translates to here is a serious question. The problem with such questions is that a lot of damage can happen while seeking an answer.

          As for your friend, I stand corrected. There is one. Shitty odds, but I believe you.

  3. Steve H.

    Did you really write “…pharma opioids created addicts…” mine host? I appreciate the need for brevity within the larger context of your essay, but such oversimplifications of addiction are dangerous rhetorical concessions, and the statement seems out of character for you.

    Of note, Case and Deaton* make the argument that the rise in US opioid use and morbidity may be just one component of increases in “deaths by despair” that are curiously specific to a large poorly aging US demographic. It’s a fascinating read, and provides insights that Sessions et al. need to internalize before waging war on their neighbors.

    *Case A, Deaton A. Rising morbidity and mortality in midlife among white
    non-Hispanic Americans in the 21st century. Proc Natl Acad Sci U S A. 2015 Dec
    8;112(49):15078-83. doi: 10.1073/pnas.1518393112. Epub 2015 Nov 2. PubMed PMID:
    26575631; PubMed Central PMCID: PMC4679063.

    1. SHG Post author

      On a post like this, every word pinches somebodies buttocks. But as you note, brevity is necessary, so I short-cut some complex issues to get to the point. My bad.

  4. B. McLeod

    So, we had a “war on [some kinds of] drugs,” but we’re surprised when it had no effect on another kind of drugs pushed through a huge regulatory hole, via mass-marketing. Maybe instead of broadening the war we just need to shut down the mass marketing.

  5. Michael Lockard

    Scott

    I’m on the Drug Task Force in my State after being appointed by Governor as a representative of Homeland Security, and that data source of your graph shows things scarier than what readily jumps out from the NIH, and a quick glance shows a clear picture. However, the picture is misleading when the number are calculated

    Prescription Drug (non-opioid): The death rate from 1999-2015 shows a 295% increase
    Opioids Analgesics: The death rate from 1999-2015 shows a 461% increase
    Benzodiazepines: The death rate from 1999-2015 shows a 675% increase

    That last category (Benzodiazepines) has a higher death rate percentage increase from 1999-2015 than all three listed above, and also a higher multiyear increase over “illicit drugs” as a whole, cocaine, and heroin.

    I just throw this out is because those of us on the Governors Task Force meet weekly, and the news I just posted is new. The government is focusing on “opioids” when there is a resonable argument to be made that perhaps examining benzo’s should be dragged into the reviews and discussion.

    Sorry of too long, but I’m willing to write a longer paper to you for future use by you, complete with Federal and State data. Opioid abuse is #1 on the mids of people, but they are kinda (missing the forest for the trees”

    1. SHG Post author

      Appreciate the info. Much of this is too muddled to seriously parse for accuracy, and the concern of conflating different drugs/problems/issues is strong and dangerous. Without sound data and the desire to find real answers, we’re doomed to repeat old mistakes.

  6. lee

    But Scott, if it saves ONE child from drug addiction, it is worth it, right???

    Counterpoint – Portugal total decriminalization.

    “Drug use has declined overall among the 15- to 24-year-old population, those most at risk of initiating drug use,” (From an article I can’t link to)

    1. SHG Post author

      There are many approaches worthy of serious consideration, but we’ll never get there when people are screaming epidemic and crisis. You can’t hear “reform” over all the shrieking.

    2. Patrick Maupin

      If there’s less money to be made pushing pills, there’s less incentive to be a pusher. Both for the street vendors and for the doctors, who can explore alternative pain therapies if they’re not spending all their time writing prescriptions while looking over their shoulders for the feds.

  7. billmcwilliams

    There are videos which show U.S. troops patrolling Poppy fields in Afghanistan. “The Politics of Heroin In
    SE Asia” exposed our government’s involvement in the Heroin business way back in about 1970. Nothing has changed. Drug laws facilitate the neutralizing of uncooperative cartel leaders.
    As long as there’s an agenda for unfunded covert operations, drug smuggling and distribution will continue.

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