July 30, 2023 - 8:00am
Over 100,000 people died by drug overdose last year, preliminary statistics from the CDC show. That death toll, essentially unprecedented in American history, is driven by the rise of the synthetic opioid fentanyl, a far-deadlier cousin of heroin responsible for the lion’s share of the fatalities. The problems are new and dramatic, and media stories in recent days have drawn attention to the crisis. So why are politicians acting like everything is fine?
Take the Biden administration’s response. In the Government’s 2022 National Drug Control Strategy, the bible of its drug policy approach, it aims for a 13% reduction in deaths by overdose. If achieved, this would be only slightly below 2020 figures. To reach that unambitious goal, the administration mostly plans to continue what it has been doing up until now, only at greater scale.
Further evidence the Government struggles with policy creativity comes in its response to the emergence of xylazine, the horse tranquilliser filtering into the opioid supply. Despite having years to prepare a response — xylazine has been an issue in some places since at least 2018 — its proposal earlier this month mostly offers plans to make plans. New tests and tools will be developed, new treatment capacity created. How? Who’s to say.
Of course, the Biden administration is not alone in failing to do enough on the drug crisis. Congress has taken a few steps, primarily expanding the availability of the drug treatment medications buprenorphine and methadone, and the overdose-reversing drug naloxone.
These are vital steps, and worth applauding. But it’s hard not to see them as band-aids. Naloxone access does not significantly reduce overdose death. And moderately expanding the availability of medication-assisted treatment does little when people are not being identified for and aggressively shifted into treatment, by court order if necessary.
There’s a classic line from an old episode of The Simpsons, in which a distressed character cries out, “We’ve tried nothing, and we’re all out of ideas!” A similar dynamic applies to the drug crisis: we’ve tried very little, and ideas are not forthcoming.
This lack of action is arguably because policymakers still haven’t internalised the monumental scale of the crisis. For decades, policy was concerned with preventing the health harms associated with drug use and addiction. Treatment systems were patchwork, funding sparse, and most attention was dedicated to what are basically philosophical questions: what addiction is, whether drugs should be illegal or legal, and so on.
It is important not to get bogged down in such disputes amid an unprecedented crisis. Drugs constitute the leading cause of death among Americans under 50: asking about their philosophical status is missing the point.
Rather, policymakers need to make unprecedented commitments to treating addiction and deterring drug use. The former means continuing to expand funding for treatment, medication-assisted and otherwise, but also working with municipalities to identify those most at risk of overdose and proactively getting them into treatment, before they take the dose that kills them.
The latter means communicating clearly and unambiguously to the public that the drug supply is poisoned, and that no amount of drug use is safe. It means shutting down open air drug markets and going after drug dealers who kill their clients.
Such steps may stem the ever-rising tide of deaths. What’s apparent is that what we’re doing now isn’t working. And until policymakers understand that, no change will be possible.
Charles Fain Lehman is a fellow at the Manhattan Institute and contributing editor of City Journal.
CharlesFLehman
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Subscribe. . . and if you no longer have a societal philosophy that you believe would inspire anyone, does it matter if large numbers check out?
. . . and if you no longer have a societal philosophy that you believe would inspire anyone, does it matter if large numbers check out?
Is anyone surprised in the least by this? The problem is only tangentially a political problem, although despair over politics is one of many symptoms looking for a cure. The society itself is sick. And Democrats, with their essential secular humanism ( aka atheism ) have no answers. Pregnant? Kill your baby. Loaded with student debt? Shove it off on taxpayers, including your peers who couldn’t afford to attend expensive colleges. Oppressed? Yell and scream and burn things to the ground. You deserve to be heard. Not happy with the gender you were born with? Butcher your body and then demand that everyone else recognize you as what you are not, including competing against those whose gender is genuine.
This is the Democrat “social justice” agenda. Fentanyl is just a pimple on the face of this grotesque distortion of what it means to be trulynhuman.
Is anyone surprised in the least by this? The problem is only tangentially a political problem, although despair over politics is one of many symptoms looking for a cure. The society itself is sick. And Democrats, with their essential secular humanism ( aka atheism ) have no answers. Pregnant? Kill your baby. Loaded with student debt? Shove it off on taxpayers, including your peers who couldn’t afford to attend expensive colleges. Oppressed? Yell and scream and burn things to the ground. You deserve to be heard. Not happy with the gender you were born with? Butcher your body and then demand that everyone else recognize you as what you are not, including competing against those whose gender is genuine.
This is the Democrat “social justice” agenda. Fentanyl is just a pimple on the face of this grotesque distortion of what it means to be trulynhuman.
But so-called liberals still pontificate along the lines of ‘it’s my body and my business what I put into it’ while young men kill each other in gangs, at least partly fuelled by drug dealing. BUT if it feels good, do it yada yada yada….
And so-called conservatives often advocate a revival of the War on Drugs, where people go to prison for decades over drug crimes and still might not quit, because the poison follows them to prison.
Was this problem a slight one under Trump?
I don’t know if I’m a so-called conservative, or indeed the extent to which Donald Trump is, but I would certainly advocate for increased jail time for drug offenders, and a “re-criminalization” of drugs.
What’s lost in the hand-wringing about jail times for allegedly minor drug offenses is that most of those people face or sooner or later will face other serious charges, including violent offenses.
This is not to say there aren’t other measures we might take to control the border, lessen corruption in various agencies and increase social cohesion in order to defend against drug abuse, etc.
What we don’t need is decriminalization, normalization, and more funds for the “treatment” and “harm reduction” industries.
A punitive pipe dream. We already incarcerate more people per capita than any nation. Assuming it made sense to do so, you still couldn’t build enough additional prisons to house all the addicts who’ve committed related crimes of possession and petty theft. And a higher percentage of nonwhites who commit the exact same offenses will go to jail, and for longer, just as they have in the past and still do.
Do you think incarcerating addicts (not dealers mind you) in their thousands and hundreds of thousands will help with the social cohesion you mention? What if both mom and dad have the chemical itch?
A punitive pipe dream. We already incarcerate more people per capita than any nation. Assuming it made sense to do so, you still couldn’t build enough additional prisons to house all the addicts who’ve committed related crimes of possession and petty theft. And a higher percentage of nonwhites who commit the exact same offenses will go to jail, and for longer, just as they have in the past and still do.
Do you think incarcerating addicts (not dealers mind you) in their thousands and hundreds of thousands will help with the social cohesion you mention? What if both mom and dad have the chemical itch?
I don’t know if I’m a so-called conservative, or indeed the extent to which Donald Trump is, but I would certainly advocate for increased jail time for drug offenders, and a “re-criminalization” of drugs.
What’s lost in the hand-wringing about jail times for allegedly minor drug offenses is that most of those people face or sooner or later will face other serious charges, including violent offenses.
This is not to say there aren’t other measures we might take to control the border, lessen corruption in various agencies and increase social cohesion in order to defend against drug abuse, etc.
What we don’t need is decriminalization, normalization, and more funds for the “treatment” and “harm reduction” industries.
And so-called conservatives often advocate a revival of the War on Drugs, where people go to prison for decades over drug crimes and still might not quit, because the poison follows them to prison.
Was this problem a slight one under Trump?
But so-called liberals still pontificate along the lines of ‘it’s my body and my business what I put into it’ while young men kill each other in gangs, at least partly fuelled by drug dealing. BUT if it feels good, do it yada yada yada….
The sound bite of the headline is valid enough but fentanyl death increased massively under Trump too and now it is a massive public mental and physical health crisis with a certain runaway momentum of its own.
Show me where conservative or populist-right-wing (Trumpist) governments are handling this well in deep-red states and cities. Some of the worst opioid self-slaughter is happening in poor and rural America, not merely the obvious progressive metropolises.
I’m serious, I’d like to know what is working and where, and see us be willing to try what we haven’t tried that seems to make sense. And forbear to point fingers at one side or the other as if there is a simple solution that we already have the collective will and heart to accomplish without placing more heart and skin of our own into the game.
*You can downvote me but are unable to show me what is working in Republican-majority areas and local governments. I’m not saying there isn’t anything, I’m saying: point me to it. I am not highly partisan nor someone who is deaf to all persuasion.
But while the big progressive strongholds like New York City and San Francisco are indeed a nightmare of homelessness, addiction, mental illness, and crime right now, rural America has a huge opioid problem too, in predominantly-white, heavily Republican places like Appalachia and small Midwestern towns.
Just as it was not all Trump’s fault when the opioid use and overdose problem massively worsened under his administration, this further worsening is not all on Biden. Stop the blame game, seek consensus solutions.
To urge people to walk away from it, don’t you in effect need a new social contract or indeed a new country?
You mean to declare that America is hopelessly divided? Could be but I don’t accept that. I’d say we need an updated renewal of our ancestral social contract, with a balance of rights and responsibility to ourselves and each other.
As a dual citizen I could technically flee to Canada, but I have a lot of love for the good-old/bad-old USA. And Canada (and the UK) seems to be getting pretty torn apart from within too.
I don’t know how hopelessly divided. But it looks like the US has no compelling offer to huge numbers of its citizens.
There is a minority for whom drugs are a real problem and they shouldn’t take anything at all, since it becomes a crutch for all their issues.
But, the majority are less committed and take drugs for other reasons, chief among them boredom / disillusion with what’s on offer in life. ie, there’s no compelling enough option. ie, that puts her in a situation where she decides she won’t take a drug, because it’ll stop her doing X thing that’s way more interesting than being high.
Canada
Someone once said on Reddit, ‘There is a deadly sameness and blandness to Canada that I found eerie and I’ve visited all over the country.’
The comment struck me, as someone I know who migrated there from the UK at age of 22, said almost the exact same thing same to me decades ago. At the time I was considering migrating there, and his assessment (by that time he’d been in Canada 35 years) really put me off.
I was used to thinking of Australia as boring, but I wonder if Canada is even more so.
I don’t know how hopelessly divided. But it looks like the US has no compelling offer to huge numbers of its citizens.
There is a minority for whom drugs are a real problem and they shouldn’t take anything at all, since it becomes a crutch for all their issues.
But, the majority are less committed and take drugs for other reasons, chief among them boredom / disillusion with what’s on offer in life. ie, there’s no compelling enough option. ie, that puts her in a situation where she decides she won’t take a drug, because it’ll stop her doing X thing that’s way more interesting than being high.
Canada
Someone once said on Reddit, ‘There is a deadly sameness and blandness to Canada that I found eerie and I’ve visited all over the country.’
The comment struck me, as someone I know who migrated there from the UK at age of 22, said almost the exact same thing same to me decades ago. At the time I was considering migrating there, and his assessment (by that time he’d been in Canada 35 years) really put me off.
I was used to thinking of Australia as boring, but I wonder if Canada is even more so.
You mean to declare that America is hopelessly divided? Could be but I don’t accept that. I’d say we need an updated renewal of our ancestral social contract, with a balance of rights and responsibility to ourselves and each other.
As a dual citizen I could technically flee to Canada, but I have a lot of love for the good-old/bad-old USA. And Canada (and the UK) seems to be getting pretty torn apart from within too.
I’d say a good economy would help more than anything our lawmakers are capable of producing.
And yet, “Giuliani Time” in NYC was a good time, compared to now. Not that he accomplished anything later on in Distrito Federal, Mexico, for example. . .
Bloomberg Time was comparatively good too. I agree that a better economy would help some, but think our malaise is far deeper, running through boom and bust cycles alike. Top-down lawmaking of national campaigns to End Overdoses, or Trafficking, or Homelessness, Murders, Runaway Rents, etc. won’t do much without more community and civic engagement. Required national service of 1-2 years for everyone by age 25?
Bloomberg Time was comparatively good too. I agree that a better economy would help some, but think our malaise is far deeper, running through boom and bust cycles alike. Top-down lawmaking of national campaigns to End Overdoses, or Trafficking, or Homelessness, Murders, Runaway Rents, etc. won’t do much without more community and civic engagement. Required national service of 1-2 years for everyone by age 25?
Massively? What does that even mean? And by the way, Trump was trying to solve the problem (i.e. close the border) and Biden was trying to unsolve the problem (i.e. open the border). There’s no comparison between someone who wants to fix the issue and someone who is trying to unfix it.
But under Trump opioid deaths increased and the scale of the addiction problem became far worse, vastly so (or is that another common and apt enough adverb you’ll object to?). Despite his wretched lack of success with the opioid crisis, you credit Trump with good intentions but deny them to Biden with his similar “scorecard”: an entrenched problem grown severely worse.
The credit you grant Trump and deny Biden may have more to do with your own prejudicial preferences than anything real. “Trying to unfix it”–what does that mean?
Whatever was tried or intended, do you think Biden inherited a national fentanyl situation that was being fixed? And if so, how so–that is: By what logic or metric is that the case?
As I point out above, the percentage increase in deaths per age-adjusted population from synthetic opioids other than methadone for 2013-2016 (Obama) was 620% (1.0/100,000 to 6.2/100,000) and for 2017-2020 (Trump) was 198% (9.0/100,000 to 17.8/100,000)
As I point out above, the percentage increase in deaths per age-adjusted population from synthetic opioids other than methadone for 2013-2016 (Obama) was 620% (1.0/100,000 to 6.2/100,000) and for 2017-2020 (Trump) was 198% (9.0/100,000 to 17.8/100,000)
But under Trump opioid deaths increased and the scale of the addiction problem became far worse, vastly so (or is that another common and apt enough adverb you’ll object to?). Despite his wretched lack of success with the opioid crisis, you credit Trump with good intentions but deny them to Biden with his similar “scorecard”: an entrenched problem grown severely worse.
The credit you grant Trump and deny Biden may have more to do with your own prejudicial preferences than anything real. “Trying to unfix it”–what does that mean?
Whatever was tried or intended, do you think Biden inherited a national fentanyl situation that was being fixed? And if so, how so–that is: By what logic or metric is that the case?
To urge people to walk away from it, don’t you in effect need a new social contract or indeed a new country?
I’d say a good economy would help more than anything our lawmakers are capable of producing.
And yet, “Giuliani Time” in NYC was a good time, compared to now. Not that he accomplished anything later on in Distrito Federal, Mexico, for example. . .
Massively? What does that even mean? And by the way, Trump was trying to solve the problem (i.e. close the border) and Biden was trying to unsolve the problem (i.e. open the border). There’s no comparison between someone who wants to fix the issue and someone who is trying to unfix it.
The sound bite of the headline is valid enough but fentanyl death increased massively under Trump too and now it is a massive public mental and physical health crisis with a certain runaway momentum of its own.
Show me where conservative or populist-right-wing (Trumpist) governments are handling this well in deep-red states and cities. Some of the worst opioid self-slaughter is happening in poor and rural America, not merely the obvious progressive metropolises.
I’m serious, I’d like to know what is working and where, and see us be willing to try what we haven’t tried that seems to make sense. And forbear to point fingers at one side or the other as if there is a simple solution that we already have the collective will and heart to accomplish without placing more heart and skin of our own into the game.
*You can downvote me but are unable to show me what is working in Republican-majority areas and local governments. I’m not saying there isn’t anything, I’m saying: point me to it. I am not highly partisan nor someone who is deaf to all persuasion.
But while the big progressive strongholds like New York City and San Francisco are indeed a nightmare of homelessness, addiction, mental illness, and crime right now, rural America has a huge opioid problem too, in predominantly-white, heavily Republican places like Appalachia and small Midwestern towns.
Just as it was not all Trump’s fault when the opioid use and overdose problem massively worsened under his administration, this further worsening is not all on Biden. Stop the blame game, seek consensus solutions.
American towns no longer have centres where anyone encounters anyone else much, so it’s largely invisible?
Still, you’ll see people wasting away in front of strip malls and bus stops, in public parks and so on. If you remain in your gated community you might avoid seeing the deadly blight, true, but I think part of scale of the problem is that many do not see homeless or poor drug addicts as full fellow Americans, in some cases even as full fellow human beings.
Yeah, I should qualify ; ‘no longer encounters them as anything other than momentary roadside scenery’.
Now that, for the most part, is too true.
*I do engage with people in distress and sleeping rough, but I estimate that to be partly because I used to be among them, for a few months about 20 years ago. Other folks who’ve never sniffed living on the street engage with them too. Not the norm.
Now that, for the most part, is too true.
*I do engage with people in distress and sleeping rough, but I estimate that to be partly because I used to be among them, for a few months about 20 years ago. Other folks who’ve never sniffed living on the street engage with them too. Not the norm.
Yeah, I should qualify ; ‘no longer encounters them as anything other than momentary roadside scenery’.
Still, you’ll see people wasting away in front of strip malls and bus stops, in public parks and so on. If you remain in your gated community you might avoid seeing the deadly blight, true, but I think part of scale of the problem is that many do not see homeless or poor drug addicts as full fellow Americans, in some cases even as full fellow human beings.
American towns no longer have centres where anyone encounters anyone else much, so it’s largely invisible?
How can you say the philosophical questions are irrelevant? If you don’t know why people in such massive numbers need to escape existence, how can you treat it? Just say no isn’t a viable solution. I saw an investigation into usage and a couple who knew very well their stash might have been laced with tranc went ahead and smoked it anyway. On camera!! That kind of despondency indicates a national crisis at the core of our society that requires a broader approach than pamphlets and individual treatment, neither of which are likely to work long term.
How can you say the philosophical questions are irrelevant? If you don’t know why people in such massive numbers need to escape existence, how can you treat it? Just say no isn’t a viable solution. I saw an investigation into usage and a couple who knew very well their stash might have been laced with tranc went ahead and smoked it anyway. On camera!! That kind of despondency indicates a national crisis at the core of our society that requires a broader approach than pamphlets and individual treatment, neither of which are likely to work long term.
The figures for drug overdose deaths in the US 2001-2021 are in NCHS Data Brief 457, December 2022. A couple of points: the synthetic opioid crisis took off in 2013, since when overdose deaths (per head of population) due to that class have doubled roughly every two years. There was a slight dip in 2017, resuming the upward trend in 2018. They are now responsible for about 2/3 of all drug overdose deaths. So three administrations have failed to have much effect, and indeed the overall death rate has been growing for at least the last 20 years.
However, to dismiss the debate about viewing it as a criminal versus health question as “philosophical” misses the point. An administration has to decide how to tackle a problem, and deciding which levers to pull is a reasonable first step.
Meanwhile, here in the UK, the death rate from drug misuse is running at about a fifth of the US rates, with no evidence of a dramatic rise in opiods, although there is sustained rise in heroin and cocaine.
The figures for drug overdose deaths in the US 2001-2021 are in NCHS Data Brief 457, December 2022. A couple of points: the synthetic opioid crisis took off in 2013, since when overdose deaths (per head of population) due to that class have doubled roughly every two years. There was a slight dip in 2017, resuming the upward trend in 2018. They are now responsible for about 2/3 of all drug overdose deaths. So three administrations have failed to have much effect, and indeed the overall death rate has been growing for at least the last 20 years.
However, to dismiss the debate about viewing it as a criminal versus health question as “philosophical” misses the point. An administration has to decide how to tackle a problem, and deciding which levers to pull is a reasonable first step.
Meanwhile, here in the UK, the death rate from drug misuse is running at about a fifth of the US rates, with no evidence of a dramatic rise in opiods, although there is sustained rise in heroin and cocaine.
Perhaps it was a mistake to declare a ‘War on Drugs’? That metaphor only works if you can win battles and that clearly isn’t happening.
On the other hand tobacco use and, I think, routine drunkness seem to have reduced. Perhaps legalisation, taxation, and education are the way to go for street drugs? It’ll take a long time to work through society and there’s no snappy slogan for political use, but still…
A plausible and practical suggestion, for that reason already far more useful than: “But the Other Side started/worsened it first!”.
*However, de-criminalization of “hard drugs” hasn’t had the intended effect in Portland, at least not yet. Note how many among NYT’s left-leaning commenters are fed-up and frustrated too…
https://www.nytimes.com/2023/07/29/us/portland-oregon-fentanyl-homeless.html?searchResultPosition=1
Quite so. But there is (or should be) quite a difference between de-criminalization and legalisation.
De-criminalization signals that harmful behaviour may continue without penalty. Legalisation implies more order and supply of clean drugs, and the taxation can help run the addiction services. Neither option guarantees anything like 100% clean up, indeed setting an acceptable limit on the amount of failure is what separates such things from the unwinnable ‘War on Drugs’.
Good clarification. Still, full legalization does bring its own risks, and it remains to be seen what that would look like with “hardcore narcotics”. (We could look to the 19th century, when opium and cocaine were available at the druggist). Not an entirely safe or straightforward answer either, but worth exploring given the current nightmare.
Good clarification. Still, full legalization does bring its own risks, and it remains to be seen what that would look like with “hardcore narcotics”. (We could look to the 19th century, when opium and cocaine were available at the druggist). Not an entirely safe or straightforward answer either, but worth exploring given the current nightmare.
Quite so. But there is (or should be) quite a difference between de-criminalization and legalisation.
De-criminalization signals that harmful behaviour may continue without penalty. Legalisation implies more order and supply of clean drugs, and the taxation can help run the addiction services. Neither option guarantees anything like 100% clean up, indeed setting an acceptable limit on the amount of failure is what separates such things from the unwinnable ‘War on Drugs’.
A plausible and practical suggestion, for that reason already far more useful than: “But the Other Side started/worsened it first!”.
*However, de-criminalization of “hard drugs” hasn’t had the intended effect in Portland, at least not yet. Note how many among NYT’s left-leaning commenters are fed-up and frustrated too…
https://www.nytimes.com/2023/07/29/us/portland-oregon-fentanyl-homeless.html?searchResultPosition=1
Perhaps it was a mistake to declare a ‘War on Drugs’? That metaphor only works if you can win battles and that clearly isn’t happening.
On the other hand tobacco use and, I think, routine drunkness seem to have reduced. Perhaps legalisation, taxation, and education are the way to go for street drugs? It’ll take a long time to work through society and there’s no snappy slogan for political use, but still…
Why all the fuss?
It’s only Darwinian self-selection after all so what is the problem?
I couldn’t help thinking the same about the other recent piece about those people who choose not to reproduce!
I don’t think you should blame Darwin for your Malthusianism.
Time for another New Poor Law methinks!
Time for another New Poor Law methinks!
I couldn’t help thinking the same about the other recent piece about those people who choose not to reproduce!
I don’t think you should blame Darwin for your Malthusianism.
Why all the fuss?
It’s only Darwinian self-selection after all so what is the problem?
Here’s a thought; send someone to jail for trafficking drugs and send someone to treatment for possession of drugs.