Most Ohio and Pennsylvania counties that flipped from Obama to Trump are wracked by heroin.
To my fellow Democrats who still blame the recent loss on an basket of deplorable racists, bigots, misogynists, xenophobes, and so on. Think about this.
A new analysis by historian Kathleen Frydl looks at the strong correlation between the opioid painkiller and heroin epidemic — which led to a record number of overall drug overdose deaths in 2014 — and the counties in Ohio and Pennsylvania that swung from President Barack Obama in 2012 to Trump in 2016. Both of these states were crucial to Trump’s victory on Election Day.
These people have lived through “Compassionate Conservatism”, “A Safer World and a More Hopeful America”, “Fired up! Ready to go!”, “Forward”, and then…. faced with “Make America Great Again” and “I’m With Her”, they went with the former, rejecting the later. And can you blame them?
They are the forgotten America. Their depression, their isolation is only relived with self medication with powerful opiates. NO amount of job training, education, hard work or discipline makes any difference. And both parties for almost a generation have ignored them.
The standard issue candidates from the standard issue parties have offered the same standard issue lip service and nothing else.
I don’t blame then for voting for Trump anymore than I blame the cancer patient weeks into their stage four diagnosis to try anything, even something that is probably toxic. After all, what do they have to lose?
Our party needs to act quickly here, choose new leadership and a new direction because when Trump fails to deliver (and I see absolutely no way for him to do so), we must be ready with a real option, real hope, and guaranteed change.
Post hoc, ergo propter hoc
Correlation implies causation
Both imply that people are desperate. I think there’s a correlation.
And it shouldn’t take an appeal to “good politics” to pay attention to a deadly epidemic.
You know what will *not* help the drug epidemic? Taking away people’s access to health care.
Look, politics is politics, and it’s tough and not fair and not beanbag. But we should not pretend there isn’t a huge disconnect between policy substance and the way the propaganda game gets translated into votes. Trump and the GOP are bad news for people suffering from this epidemic.
People need jobs; and better ones than they have. Obama and the Democrats kept as many jobs in the MIdwest as they could. But politics being what it is, you rarely get rewarded for what you do; only for what you promise.
So far, Trump is looking to cut health care costs and my hunch is that he views heroin addiction as a weakness, not anything related to illness of disease. He has stated that his remedy is to cut the supply of illegal drugs entering the country. All that is going to do is raise the price of drugs that the addicted will find ways to pay, with more crimes, prostitution, and other social ills.
Donald Trump’s brother died of addiction, and Donald has spoken about how Freddy Jr.’s struggles and eventual death has led Donald to go full-abstinence on alcohol and drugs.
Maybe Mr. Trump sees his late older brother as weak. Maybe he sees him as sick. Maybe he doesn’t connect his brother’s struggles to the struggles of the addicts across America. Maybe only to the white ones, or the rich ones.
I think this is an area where Donald Trump likely has his own opinion, and it will come out in time.
Trump argued in 1990 that the only way to win the War on Drugs was to legalize drugs and use the tax revenue to fund drug education program.
But the same Trump did this in 1991: Trump traveled to Capitol Hill to tell a congressional committee that he thought they should raise taxes on the rich. Reagan tax cuts should be abandoned, he said; a top rate of 50% or 60% would be better for the country.
Clearly anything is possible.
Too much “health care” contributed to the problem to begin with. I think this is one of the under-looked reasons for why Appalachia has swung hard right in recent years: Medicaid and disability fueling the opiod crisis by happily funding the pill mills. When people see the social safety net destroying their communities, they’re perfectly happy to vote for politicians who promise to shred it.
Health care “on the cheap” is just funding the pill mills…..but that’s not the fault of health care, it’s a reflection of capitalism.
Blame the opioid / heroin crisis on medicaid paying for treatment? How about Big Pharma pleading guilty to lying to the medical community about the addiction level of a “new” kind of pain med?
Dovetailing with Eric Lesser’s piece, this is a crisis affecting communities all over the state and was the number 1 issue voters in every community I worked in were concerned about when I canvassed with them. Not abortion rights, not social issues, not even immigration or education but the opioid crisis. This was true in Somerville, true in Scituate, in Salem, down the Cape. In Fitchburg and Chelsea and Leominster and Holyoke and Chicopee. Time for all our policy makers to fix it because if they don’t, good people will die.
The opioid crisis was and is manufactured by the pharmaceutical companies. Prescription pain meds were marketed to physicians with false information about addiction consequences by the manufacturers beginning in the 1980s. This was a business plan not an accident and has been proven in court, if what I’ve read about it is to be believed. Who knew that the principals of Purdue Pharma thought William S Burroughs’ idea that heroin was the ultimate capitalistic product was a jolly good idea? Who knew that his fictional ghoul Dr Benway would be their role model? I’m sorta kinda surprised that Don the Con hasn’t named one of Purdue Pharma’s chief execs to a “public health” job yet.
As for drug policy, I usually write, “Portugal, Portugal, Portugal” because that country decriminalized most drugs, including heroin, in 2001 and reduced the harm from drug use, overdoses, HIV and other needle-borne diseases, considerably. It astonishes me that their example comes up so infrequently in the discussions in the USA.
The richest newcomer to Forbes 2015 list of America’s Richest Families comes in at a stunning $14 billion. The Sackler family, which owns Stamford, Conn.-based Purdue Pharma….making the most popular and controversial opioid of the 21st century — OxyContin……Purdue, 100% owned by the Sacklers, has generated estimated sales of more than $35 billion since releasing its time-released, supposedly addiction-proof version of the painkiller oxycodone back in 1995.
Opioid abuse is a huge issue. But the epidemic is not driven by the legitimate users. I do not take opioids, but I have had chronic pain for most of my adult life. My pain clinic has never had a patient overdose, while overdoses are a daily occurrence in the community. If you look into the research, about 1% of patients prescribed opioids will become addicted (which is not the same as dependent — every daily user will become physically dependent).
My local pharmacy runs out of the most common opioids every month. According to my Pharmacist, they receive a quota that is based on DEA regulations, not actual need. Think about that — patients with actual prescriptions are being turned away, because we somehow think that this will stop abuse. This has been going on for years.
The medical use of opioids is already very tightly controlled. For this reason, the street price of opioid medications is very high. If there is a “gateway” effect to opioid medications, it is the need for serious addicts to seek out a cheaper way to feed their addiction… which is where cheap heroin comes into the picture.
There is an epidemic of opioid abuse, there is no doubt about that (and I agree about the Portugal model). But for people in need of pain control, we seem to be slowly eroding access and choice.
…I agree that opioids must be available for some chronic pain situations and the fact you have chronic pain and are not using opioids indicates there are other alternatives. But you really have to research the 1% figure you cited. It has been taken out of context since it appeared as a blurb in a medical journal in the 1980s.
I am looking at more recent research than that 1996 study. Apparently the addiction rate was even less than I had recalled:
Of course there are many other pain treatments. Opioids are hardly a panacea. And there will be a huge amount of disagreement, even within the medical profession, regarding which treatment is best. But my point here is that personal medical decisions should never be something that is up for political debate.
I am a Catholic. The only reason I am pro choice is that I believe in an individual constitutional right to medical choice. Freedom should apply even to medical treatments that you may not agree with. It should be up to the patient and doctor to decide what is best… not bloggers or politicians.
We’ve been doing this sort of research for years and the rates come out the same, for people with actual pain. Doctors in the 1950’s knew that when morphine was administered for actual and acute pain addiction rates were miniscule. There are some who, in fact, have theorized that addiction rates for people who take opioids absent acute pain are reversed for danger of addiction: on the order of 1% won’t get addicted. (I remember reading about this in a news mag back in the 90’s, but that particular article hasn’t made it to the internets… else I’d cite it) Pain and neuro-pathways being in a complex dance of expression and suppression of other neuro-chemicals. Or, put another way, the profound impact upon pain is equally profound when taken for “pleasure”.
Simply getting a prescription for a drug is not the same thing as administering the drug… which was the term formerly used for do ‘Doctor’ stuff upon the human body… I think the insurance quest for shorter hospital stays and a greater belief in, and reliance upon, bio-chemistry is the primary driver in this I suggest that Doctors should be more vigilant with scripts, and with following upon on ‘administering’ drugs that alleviate acute pain.
Public health policy is slanted against recuperation, partly because human bodies don’t heal at uniform rates and the expense cannot be costed out efficiently. Ask any woman who has given birth – being able to rest a day or two and heal is SO 19th Century.
Dangerous opiates have become the lovely parting gifts for all surgeries. I had major surgery in 2014, and was given pills AND scrips when leaving the hospital. I ASKED not to be given them, but the hospital mandated it. I disposed of both (properly) as discomfort is not pain – for one thing, I also take ANOTHER barbituate-type drug for a chronic medical disability, so the effect on me could be exaggerated, if not fatal. But most would have enjoyed the better sleep, etc., and could easily become addicted.
Are the gateway drugs to this epidemic.
People in need of pain control need alternatives.
We consume 80 percent of the entire global supply of prescription painkillers.
Why?
Follow the money. Big Pharma does not get rich when doctors prescribe meditation, acupuncture, rest. And speaking of rest, that “rest” lowers our productivity rate, and Wall Street needs us working more so that the .1% can stay afloat.
I would ask that when the state finally crafts a response to this epidemic, that it considers all types of heroin users, not just those which are prompting this “call to action” – i.e. the kids of well-to-do suburban voters.
Heroin has been a problem for a long time in this state, but it has been mainly restricted to poor neighborhoods of color, and has been used by people who usually wind up in jail because of it. That means, if there is going to be treatment offered, it needs to be done in a way so that it isn’t just inherently available to well-to-do families but out of reach for others (i.e. pay $1,000 for treatment for your son/daughter).
I would also like to mention that urban communities are being impacted another way by this – as new drug rehab facilities are being created, they are mostly being created in poor urban communities. Due to the Dover Amendment, anyone can buy an a house and turn it into a rehab center – and many times state dollars are used to do this.
No one is buying houses in suburban neighborhoods – they are buying them in neighborhoods which are already struggling. Look at this example – one of the higher priced houses in Springfield, an amazingly restored mansion, was purchased by someone who lives in another community for use as a group home for people with substance abuse problems. Although the home will likely not cause any problems to the neighborhood directly, it serves as a repellent for that neighborhood because if given a choice, most people do not want to live near a group home for people with substance abuse problems, no matter how well-run it is.
Since we are creating these centers in response to the increasing number of suburbanites who are now hooked on heroin, shouldn’t we try and get the centers distributed in a more fair way than using housing values?
Urban areas also have better transportation networks, and the centers are located near more people.
But yes, the cost shifting is very much a rural-to-urban situation, be that city Boston or Springfield.
That is a common argument, but the counter-argument I am putting out there is that locating a treatment facility primarily in poor urban areas is an issue of environmental justice (aka environmental racism), similar to how other undesirable facilities are often dumped in poor urban areas using the same justifications.
The impact of the placement of such facilities on neighborhoods should be considered by the state and addressed via policy, especially when state and federal dollars are being used. And especially when additional facilities are being built to house an influx of suburban drug users. Having to drive 15 more minutes to a suburban facility should not be the determining factor for placement.
It certainly makes sense to locate such facilities where they are most needed.
Right – since the heroin epidemic is striking communities across the spectrum, we should place treatment facilities in all communities.
From the Herald’s Bob McGovern Friday….
Insys execs charged with bribing doctors
“Federal prosecutors have brought racketeering charges against former top executives of a pharmaceutical company for allegedly bribing doctors across the country to prescribe a fentanyl-based pain medication to patients.
Six former Insys employees, including the former chief executive, Michael L. Babich, were arrested yesterday for their role in an alleged scheme to coerce doctors across the country to prescribe the company’s Sybsys product, according to U.S. Attorney Carmen M. Ortiz’s office. Sybsys is a fentanyl spray intended for cancer patients, according to prosecutors…”
http://www.bostonherald.com/news/local_coverage/2016/12/insys_execs_charged_with_bribing_doctors
quick solution to the heroin epidemic. It’s cheap. The cartels have invested in it because weed is increasingly unprofitable for them. Interdiction is a joke.
People in recovery often describe addiction as a disease, but I would take it one step farther: substance abuse spreads like a disease. Once it gets into a population, it attacks those who lack immunity. Heroin addiction is very much like anti-biotic resistant diseases. We have to fight this as best we can, but it’s going to be hard. It’s an ecological as well as a medical problem.
I keep track of my former students, including those who have died from heroin overdoses. I’ve lost count of those. A student I had last year overdosed and died on November 8 this year. He had moved somewhere in Eastern Massachusetts, but continued to visit his friends here. I’d been at a meeting for him last year. He had had some mental health issues in addition to experimenting with heroin and Xanax. His parents were at best ineffectual, and I feared him being addicted to heroin. I didn’t expect his death.
Do I understand correctly that opiates include both strong illegal heroin and legal prescriptions which get overused or abused? If so it might be helpful to keep separate any stats as well as making sure our solutions fit each category separately.
is both illegal heroin and prescriptions. Many people start on the latter and end up on the former. The prescription drugs are a true gateway drug.
I think the “opiate crisis” term represents the de-ghettoization of heroin.
The cost of prescription drugs is prohibitively expensive ($80 a pill) for any but the richest addict. You can buy a bag of heroin for less than $10.
Also confusing the issue is the fact that fentanyl (said to be 50x more potent than heroin) is an additive to heroin. My understanding is that overdose deaths due to fentanyl-laced heroin is more so that regular heroin.
We have two parties in Washington that see the rest of us not as fellow humans to be helped, but rather as crops to be harvested. The misery that they are willing to wreak for a few pieces of silver is astonishing.
Until we take our country back, the numbers of those who turn to the needle to relieve their misery will only increase. Our hospitals, prisons, and morgues will be bursting at the seams.