Dumb Government Crackdown on Prescription Opioids is the Real Cause of Fentanyl Crisis

As some of you might already know, I detest those who double, triple and quadruple down on a belief system which has clearly failed the test of reality. With that in mind, let us talk about one of the most dumb and disastrously ideas still being vigorously pursued by governments around the world- but especially in USA. If you have spend enough time reading news in past decade, you will have come across multiple articles decrying the terrible suffering and death toll from opioid addiction and overdoses. However, in almost every single case, the presstitutes writing these pieces blame everything from China, Mexico, Big Pharma, Liberals, Conservatives, White Working Class to gangs of swarthy people for something which they, at best, only share a fraction of the responsibility. More importantly, they almost never take a cold and rational look at the real factors and actors driving this problem.

And let me clear about something else, this is a real and still growing problem with over 100k recorded opioid overdose deaths during 2021, in USA alone. This number does not include the number of deaths due to methamphetamine, cocaine and alcohol which have also risen sharply in past decade. For comparison, this is almost twice the total death toll suffered by USA during the entire Vietnam War. Alternatively, this is almost twice the annual death count caused by HIV in the late 1980s and early 1990s, before effective multi-drug treatment became available. Today the leading cause of death among Americans between 18-45 is Opioid (usually Fentanyl) overdose. Note that this number would be much higher if Narcan (Naloxone) kits to treat overdoses were not readily available. The death toll of overdoses has been a major contributor to declining life expectancy figures seen in USA seen during past few years.

Clearly we faced with a serious and systemic problem of drug overdoses and other problems caused by large scale drug use. But how did things reach this point? Why weren’t things as bad in.. say.. the 1970s, 1980s or even 1990s as they are now? What is behind the massive increase in drug usage and overdoses seen nowadays? As mentioned previously, conventional explanations for this blame everyone from China, Mexico, Big Pharma and everyone else except what is really driving this problem. But before we go there, let us be honest about the patterns of drug use among people- in any society. As some might know, the real spectrum of drug users is quite broad and ranges from the experimenters, occasional users, recreational users, regular users to heavy users and addicts. The important relevant fact to note here is that most users are not heavy users or addicts.

Let us now be honest about why people use drugs in the first place and what makes more people use them or do so more frequently. To make a long story short, anything beyond experimental or occasional drug use is due to people being unhappy or not content with their current lives. That is why rates for all types of drug use (from alcohol to opioids) goes up with increasing rates of chronic unemployment, economic precarity, loss of personal agency, social atomization, loss of community etc. This is why coexisting mental illness is an another factor for drug use. Genetic susceptibility to “addictive behaviors” is, by far, the least important factor determining gross rates of drug use. In other words, most drug users are not magically or “genetically” destined to do drugs. Environment, not “genetics”, is the most important variable.

With that in mind, let us explore why opioid (and other drugs) usage and overdoses started going up during the 1990s. What event or set of events could have occurred during that decade which started this ball rolling? Note that drug overdoses have occurred at every point in history and did so during the “golden age” of USA- aka 1950s and 1960s- but were far less common during those decades, even when adjusted for population size. The answer as to why it first began in the 1990s comes down to the rise of neoliberalism- specifically the beginning of its negative effect on the white working class. Prior to that, chronic unemployment due to nascent neoliberal policy of outsourcing mostly hit the black working class- causing the ‘crack’ epidemic of late 1970s-early 1990s. The mid-1990s were the first time it started to affect the white working class- though it was initially restricted to those without a college education.

Even so, drug overdoses were a rather uncommon problem till the mid 2000s, because the full impact of the problems caused by neoliberal economic (and social) policy has still truly hit the White Working, and increasingly Middle, Class. While presstitutes like to blame the promotion of prescription opioids by Big Pharma starting in mid-1990s for the current problem, it is noteworthy that prescription opioids never caused anywhere near the rates of overdose deaths caused by other drugs. Sure.. you can blame them for pushing their drugs in economically depressed areas with lots of poor working class people without jobs- but the number of deaths attributed to them is rather low when compared to the astronomical number of pills that were prescribed, taken or sold on the streets. I would argue, instead, that it was the crackdown on prescription opioids along with a rapidly worsening economic situation which led us to the current situation. But how can I be so sure about that connection?

If you look at Figure 2 closely, you might notice that the death toll due to opioids, methamphetamine and cocaine overdoses started to rise at around the same time- in 2013 or 2014. Isn’t it odd that the rate of overdoses and use for three different types of drugs would start going up at around the same time. What could have caused this coincidence? Here is a clue- government regulations and policies in response to the prescription opioid “crisis” along with crackdowns on small-scale meth labs in USA made it much harder to divert prescription opioids and stimulants in this country. The demand however kept on growing and was promptly met by drug labs in China and Mexico who started making synthetic opioids and stimulants on an industrial scale. It also helped that drugs such as Fentanyl and Methamphetamine are potent, cheap to make and easy to smuggle into USA.

This createde a real problem for Opioid users, since Fentanyl is 100x more potent on a weight basis than Morphine or Heroin- and drug dealers are not sticklers for making sure each tablet or dose contains the right amount of chemical. While the same issue has also caused an significant increase in deaths due to stimulants such as Methamphetamine, that drug is significantly less potent than Fentanyl and mild-to-moderate overdoses are far less likely to be lethal. Nonetheless, we can see that a transition from diverted legal Opioids to far more potent synthetic Opioids made and distributed without any control has had a profoundly negative effect on the constantly increasing pool of drug users. And this brings us to another problem with the rapid increase in Fentanyl’s share of the informal Opioid market in USA.

You might remember that, earlier on in this post, I had said something to the effect of heavy users and addicts being a minority among all users. Well.. as long as legal but diverted Opioids were easy to obtain, the majority of users were much less likely to overdose because they were taking precise and standardized doses. Once unregulated Fentanyl and other potent synthetic Opioids became the norm, even occasional users end up with same (or higher) risk of overdose as heavy users and addicts. But why hasn’t all this excessive death from overdoses caused people to stop doing drugs? Well.. because the rest of their lives are shit. As mentioned in the fourth paragraph of this post, people do drugs because they are chronically unhappy with their current lives. In the case of Western countries, especially USA, this is largely due to many negative long-term effects of neoliberalism on individuals and society.

People who live in a system with chronic unemployment, economic precarity, poor job security, social atomization, loss of community and no realistic hope for a better future under current status quo are a massive and growing market for drugs such as Opioids and stimulants. There is a reason why areas in USA with the worst drug problems voted so overwhelmingly for Trump in 2016 and 2020. Even that lying clown was a much better bet than establishment hacks such as Hillary Clinton or Joe Biden. In some ways, this is very similar to the high rates of alcoholism prevalent in USSR during the 1970s and 1980s- which saw two decades of economic stagnation and slow unravelling of the system. This is also why poor people in places such as India, SE Asia, South America etc are far less likely to abuse drugs. Even if they lack material things, they have family, children, friends, community and a lot of informal support networks. They also have a realistic hope for a better future, which is now all but gone for those in the working and middle class of developed countries.

What do you think? Comments?