An Historic Parallel For the Wall and Opioids
As you are aware, the President addressed the nation last night on the subject of the border wall. There is plenty of commentary to go around. Most of it struck me as a humdrum repetition of the kind of things he’s been saying in speeches and on Twitter. But I was struck by one particular section:
Our southern border is a pipeline for vast quantities of illegal drugs, including meth, heroin, cocaine, and fentanyl. Every week, 300 of our citizens are killed by heroin alone, 90 percent of which floods across from our southern border. More Americans will die from drugs this year than were killed in the entire Vietnam War.
He then went on to use the cost of the opioid epidemic to justify the wall, saying that the wall will pay for itself by ending the opioid epidemic.
Now there are several problems with this paragraph. As the AP points out, most drugs are smuggled through legal ports of entry and a wall will not help with that. And much of the illegal fentanyl is manufactured in this country (Trump previously blamed China for the fentanyl problem when it suited him). But hearing it last night, I was struck by an historical parallel.
A lot of people have drawn a comparison to the ongoing opioid epidemic and the crack epidemic of the early 90s. The comparison isn’t perfect, but it is eerie. For a while, crack addicts and crack wars made our inner cities into hellholes. There was despair that we might never emerge from it. People were dying by the thousands from crack itself and the violence connected with it. The chaos was one of the biggest reasons we created the Office of National Drug Control Policy and the position of Director of National Drug Control Policy, better known as the “Drug Czar”.
In the midst of this, P.J. O’Rourke interviewed a doctor who treated crack patents. The following is from Parliament of Whores:
“Realistically,” I said, “what can be done about drugs?”
“Realistically?” said Dr. Galanter, “we’re going to end up doing what we’re doing. Nobody has done much except follow the guy ahead of him. The point is making sure you don’t look bad.”
“What would you do if you were given the drug-czar job?” I asked,
“I mean, besides not take it?”“I’d make a big splash about something that was basically a side issue, such as assault rifles” (which is exactly what the first drug czar, William Bennett, did), “then wait for things to get better on their own and take credit for it” (which is exactly what the first drug czar did).
Things do get better on their own. Nothing, not even government,
keeps getting worse forever. Dr. Galanter estimated that the crack problem would burn out after about ten years. “Because the people who take crack will be,” he explained, “dead.”
This exchange was remarkably prescient. Crack is still a problem, of course, but not nearly the devastating epidemic it was in the late 80’s and early 90’s. It did burn itself out, to some extent. But while it was doing so, politicians scrambled to use the crisis to pass all kinds of polices — usually under the guise of “fighting crime” — so that they could credit those policies when things got better. Gun control, harsher prison sentences, “broken windows” policing, etc. were all pushed as solution to the drug problem and its related crime problem. But even at the time, I realized that the goal was not to solve those problem; the goal was to use the crisis to get long-desired policies through. And the urgency was because if the problem got better, the support for those policies would erode.
A decade later, we saw the same passion play after 9/11. A bunch of liberty-crushing policies like mass surveillance that Congress had refused to authorize during the crack epidemic were repackaged and passed to fight terrorism. And when the unique alignment of circumstances that caused 9/11 failed to happen again, the anti-terror forces claimed it was because of their policies.
The opioid epidemic is vast, tragic and complex. I won’t pretend to be an expert on it but like most vast complex problems, it has many causes and no easy solutions. Drug companies were a fun and easy target for a while but federal efforts to crack down on prescription opioids only made people turn to black market opioids, which has made things worse. There is a lot of hysteria, including the demonization of fentanyl, which is incredibly dangerous but also incredibly necessary to controlling pain in hospitals. A lot of solutions have been proposed but … in my heart, I sometimes think these will only help on the edges. We should do them. But we should also be aware that our ability to save people from themselves is limited. This is a problem that may not solve. Or, like the crack epidemic before it, it may just have to burn itself out after it has killed enough of our fellow citizens.
Seen in that light, the President’s comments become much more sinister and awful. He’s trying to leverage the ongoing opioid epidemic into support for his wall. It almost certainly won’t help. But once the problem gets better — and it will probably start to get better at some point — he’ll claim credit for it. It is, once again, a mad scramble to get a policy passed before things get better (in this case, both on their own and through smaller, less ballyhooed policy changes that will help on the edges).
Of course opening up more drug treatment centers, increasing reimbursement rates for drug treatment and making drug treatment a standard part of health care which is universal would actually do something concrete. It wouldn’t solve the problem of course, but it would take some positive steps.Report
These aren’t bad ideas. As long as we keep our expectations reasonable.Report
And yet a vast amount of political will is expended every year trying to do exactly that.Report
Eh, the fenatyl problem is mostly hitting deplorables.
There’s plenty of reason for dems to not spend political capital on it.Report
To late they have been spending capital on just those people for at decades now. It was D’s who have been pushing for spending more a drug treatment and increasing the money we spend on treatment. Drug treatment is reimbursed at a much lower rate than mental health care so workers are paid shite and many places struggle to stay in business. And then there is that getting health care to more people thing.Report
Oh come on.Report
Weird how the Democrat’s passed a Medicaid expansion that largely helped deplorables in red states…if their state would “just take the damn money” (TM Harley Race).Report
I read a book a while ago positing that the white, rural deplorables are irredeemably worthless, lazy trash, who are never going to let honest work distract them from booze, sex, and drugs. It didn’t say this in so many words, but the clear implication was that replacing them with immigrants, including the ones from shithole countries, would be a huge improvement. I know it sounds like racist garbage, but it made a compelling case.
It was called Hillbilly Elegy. You might have heard of it.Report
Even by your standards, this is super D-Minus trolling. The Democrats are the ones that passed the ACA and suffered ingratitude for it. They are also the ones who advocate for needles exchanges (if only sometimes), and for the drug whose name I am forgetting.Report
There are absolutely things that would help – providing legal access to less-strong opioids (which, in the age of fentanyl and its analogs, might even class heroin as “less strong”) of known purity and dosage would help people avoid overdose. There’s even decent evidence that it helps many users improve other aspects of their lives – get housing, decent food, employment, even reduce their use of drugs once the sources of distress like homelessness, food insecurity, and unemployment are held at bay.
But it would take real willingness to stick one’s political neck out.Report
That’s the problem isn’t it? No one ever got unelected running to the Right on drugs. It’s only recently that running to the left on the issue hasn’t been political suicide.Report
The majority of illicit drugs are smuggled in through valid legal ports:
https://www.motherjones.com/kevin-drum/
They are placed in shipping containers and other hidden places hoping that no one catches them. Some might come across the border sneakily but not much. There is also bribery of officials so they turn the other way. My Evidence professor did a stint at the Justice Department. She told us about how the Feds were trying to figure out why the Sherriff’s race in one small, rural county (in Georgia I believe) had so much competition. Turns out it was because the cartels like to use a rinky-dink landing strip in the county to smuggle in drugs. Every one was fighting for the position so they could be on the take.Report
This is great piece. Oddly enough, a recent twitter conversation with Michael Drew got me thinking along the same lines.
One quibble
I think it’s still going to take years for things to get better, and by that time Trump will be out of office.
(I.e. George H W Bush gave his crack speech in Sept 89, and the visible drop in crime wasn’t fully apparent until 96 or 97.)Report
As the AP points out, most drugs are smuggled through legal ports of entry and a wall will not help with that. And much of the illegal fentanyl is manufactured in this country (Trump previously blamed China for the fentanyl problem when it suited him).
Even if this wasn’t true, didn’t Trump already switch from a concrete wall to metal slats?
Fun fact about metal slats…you can hand things through them.Report