Hard Pill To Swallow: Mapping A Response to the Opioid Crisis

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“You came for us at birth with pills in hand
Told us we were unbalanced, told us you had a plan
Another institution, another padded cell, another induced psychosis, another hell.

You can run, you can hide but never close your eyes
Beware the sands of time, they’re on our side.”

-Tragedy

In the last several weeks, it was announced that people in the United States are now more likely to die from an opioid overdose than from a car accident. While this revelation is staggering, the opioid and overdose crisis in the US has been building for some time, claiming the lives of over 200 people per day according to US government tracking, and impacting communities across the country. Wanting to know more about the growing crisis, how the State is both responding to it in rhetoric as well as policy, and how communities are responding on a grassroots and autonomous level, we caught up with Codi, an anarchist and someone that works with people in recovery as an opioid specialist, on top of being someone with an intimate understanding of the crisis from her own lived experiences.

During our conversation we cover a lot of ground. We start off looking at some of the causes of the widespread use of opioids, which was primarily pushed by doctors at the bequest of large pharmaceutical corporations starting in the late 1990s. With many Americans working jobs that often involve repetitive motions; whether sitting at a desk, the turning of a wheel, or standing for long periods of time in a retail store, the medical solution to pain for millions of people has became prescription to opioids.

But this reliance on legal opioids has also led to an explosion of overdoses, addiction, and people over time seeking harder drugs on the streets. With the introduction of synthetic opioids like fentanyl, (which according to the Center for Disease Control is 50 to 100 times more powerful than morphine), overdoses have continued to sky rocket. As one report wrote:

Drug overdose deaths in the US topped 72,000 in 2017, according to new provisional estimates released by the Centers for Disease Control and Prevention (CDC). This staggering figure translates into about 200 drug overdose deaths every day, or about one every eight minutes. The new CDC estimates are 6,000 deaths more than 2016 estimates, a rise of 9.5 percent.

As studies have shown, cities and regions hit the hardest by the opioid crisis are those that have failed to recover from the economic collapse of 2009 and the continuing degradation of corporate neoliberalism. As one report stated, being in poverty assured that a person was, “Over twice as likely to have has an opioid use disorder.”

Hit hardest have been places in the Midwest, New England, and across Appalachia. As one report from the federal government wrote:

Opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states. The Midwestern region saw opioid overdoses increase 70 percent from July 2016 through September 2017.

But while people died, became addicted to opioids, and then hit the streets to find something even stronger, the big pharmaceutical companies recorded record profits. As one report concluded:

[T]he three companies involved in the distribution of opioids in Missouri and across the country reaped extraordinary profits. According to the report,“[E]ach recorded 2017 revenue in excess of $125 billion and ranked within the top 15 companies on the 2017 Fortune 500 list.”

As the crisis has grown, politicians in both parties have jumped at the opportunity to use it as a talking point in recent political campaigns, however have largely done nothing to offer tangible aid to those in desperate need of programs and support. Legislation passed in the September of 2018 focused largely on more money for law enforcement and not on recovery.

This means billions for police to become further militarized along with more people in prison, and in the case of cities like Baltimore, an epicenter of drug sales that supply rural regions such as in the nearby Virginas, in means police in a wide area attempting to crack down against largely black communities, in response to a rise in opioid overdoses in what are often largely working and middle class white communities. Trump (and Democrats) have also used the threat of the importation of drugs like fentanyl to call for the drastic militarization of the US/Mexico border.

While this ‘tough on crime’ response mirrors that of the State’s answer to the crack-cocaine epidemic that destroyed African-American communities (largely due to the US government flooding them with drugs in order to raise money to send the anti-Communist ‘Contras’), the fact that it is being referred to at all as a crisis that needs to be combated it evident that so many white people are dying of overdoses.

This contradiction lays bare the inability of the State to address the overdose crisis across the board and shows that its only interest is in maintaining an increasing level of counter-insurgency against the poor broadly but against black and brown populations specifically. Ultimately, such policies seek to play on the fears of reactionary white workers, but in the end offer no tangible benefits or solutions to the crisis at hand, other than the knowledge that police are kicking in less doors of whites than they are African-Americans or Latinos.

The crisis also highlights other realities and contradictions of American capitalism: a medical industry more interested in profit than human lives, an economic system that produces sick and injured people in need of medication to be able to function, and a government that sees a drug crisis as an opportunity to increase counter-insurgency techniques and mass incarceration.

With these realities in mind, we end our conversation by discussing what a grassroots, community based, and autonomous response to the crisis might begin to look like. Using the concepts of harm-reduction and programs like needle-exchange as a reference point, we flesh out these ideas, while talking about basic things that people can begin to do, like attending trainings on overdose prevention and learning to use the overdose prevention drug, Narcan.

Correction: This interview states that one can overdose on fentanyl just by touching it, where many doctors dispute this claim.