If you’re like me, you’ve probably heard something about an opiate epidemic in the United States. But if you’re like me, you might have no idea how bad that epidemic really is. More than a quarter of a million Americans have died from overdoses in the last 15 years, and the problem is getting worse. And yet many of us know nothing about it.
I’ve heard bits and pieces about the problem in various places. As the candidates for the 2016 election have made appearances in various towns, people have asked about the heroin epidemic–and that’s part of the problem, because it’s not really a heroin epidemic per se. As an opiate, heroin certainly plays a role, but prescription drugs are at least as common as heroin, if not more common. And notably, the prescription pad is generally where this epidemic originates.
Hooked by the Prescription Pad
Doctors writing prescriptions are probably to blame for one of the more odd and interesting aspects of this epidemic: It’s running rampant through communities of white Americans, particularly middle-class and upper middle-class whites, but is much less problematic in communities of color. That runs counter to stereotype and past patterns of drug addiction1, and experts point to racial stereotype and bias as the likely explanation.
Put simply, doctors are statistically less likely to write opioid prescriptions for black patients. Studies suggest that doctors worry about black patients becoming addicted or selling their prescription drugs on the street. White patients trigger no such concern, and many critics believe doctors have been much too quick to prescribe opiates for white patients. In effect, racial bias has shielded the black community from a devastating epidemic.
In response to the perceived over-prescription, a movement arose to limit or stop opioid prescriptions entirely, but this is partly blamed for pushing Americans hooked on prescription opioids like vicodin and oxycontin toward illegal opioids like heroin. VICE recently ran a good piece about the consequences for patients with chronic pain who believe they need opiates. When their doctors refuse to continue the prescription, many turn to illegal drugs. Some simply suffer through the limitations of daily pain; others commit suicide.
A personal aside here: In 1995, I fractured a vertebra in my back, and my physician at the time wanted to send me home with a 30-day morphine prescription. A nurse cautioned my parents that at the end of a month I would be a “screaming addict,” and so my parents balked and instead I got 30 days worth of enormous ibuprofen tablets. One more reason to appreciate their judgment.
Life in the Bubble
I finally woke up to the severity of America’s opioid problem thanks to The United States of Anxiety, a joint production of WNYC and The Nation magazine. I highly recommend the podcast, which not only touches on the addiction issue, but other matters of race and class that have led the US to the situation we find ourselves in today.
One of the points made on that program is about the way we today live within “echo chambers,” physically and intellectually isolated from those who differ fro us, and how that can create a bubble in which we are unaware of issues affecting other communities. I’ve long recognized that phenomenon in politics, but the idea that it would lead to a hidden epidemic killing hundreds of thousands of Americans is startling.
One expert points to the fact that the epidemic has been ongoing since about 2001, and yet President Obama barely mentioned it until 2015. The reason, he suspects, is that the President himself is in a bubble, and he just didn’t know about it.
That’s astounding, and immensely problematic. But it’s hard for me to be too judgmental, when I myself had no idea.
On this same subject I’d also highly recommend you check out an episode of the NPR podcast Embedded, which takes listeners inside an HIV outbreak in Indiana linked to abuse of the prescription opioid Opana. It’s pretty dark, but as I listened I found myself questioning whether drug companies are deliberately producing presciption opioids with the intent of addicting users.
- The crack epidemic of the 1980s, for instance, was generally seen as a black problem, but the use of cocaine (of which crack is just one form) was consistent across all races; white people just tended to use powdered cocaine more frequently than crack. The way this particular epidemic was represented in the media is another illustration of the way race shapes the way Americans perceive reality. ?
As the third and final debate of the 2016 Presidential Election concluded last night, it was clear to anyone that Donald Trump’s collapse was complete. After a performance in which he threatened to end 215 years of peaceful transition of Presidential power, vascilated between condemning and admiring Vladimir Putin, and lashed out at the last minute by labeling Hillary Clinton “such a nasty woman,” even the most die-hard conservative commentators had to admit that he’d lost.
Except, perhaps, Rudy Giuliani, who has transformed from America’s mayor to America’s greatest sycophant.
But Trump’s catastrophic collapse is not his alone. Certainly the election is far from over, but polling data shows that barring some unforeseen development, Hillary Clinton will win the election in a landslide so dramatic that the Democrats will likely take the Senate and possibly–even in spite of prohibitive gerrymandering–the House. As one could tell watching Bill Kristol practically collapse into tears on Morning Joe, the Republican Party is in dire straits, done in by an identity crisis and a fundamental sickness of which Donald Trump is a symptom, not a cause.
It didn’t have to be this way.
Only a scant 22 months ago, the Republicans were picking up massive gains in every body of government, from Congress to Gubernatorial mansions to state and local offices. As the 2014 election set records for low turnout, Tea Party Republicans seemed the only people motivated to go to the polls and signify their disapproval of President Obama and his policies.
But was it really ever about his policies? Trump’s rise provides evidence for something many on the left, myself included, have been saying since the earliest days of the Tea Party: That their energy and anger was never really about taxes or sovereignty or the Constitution, it was about race, white nationalism, and xenophobia. This was clear from the start to anyone who paid attention; people claiming to be driven by tax policy didn’t know anything about actual tax policy; what they “knew” was that President Obama was an African Muslim bent on taking their guns and destroying America.
This is the energy Donald Trump seized, and rode past 17 other candidates, all of them (arguably) more qualified than him, to the Republican nomination, despite the party establishment’s best efforts to stop him.
But why? Why couldn’t the Republicans trust their voters to choose policy and electability over racism and xenophobia, to save them from certain doom at the hands of Donald “The Groping Narcissist” Trump?
Simple. Because Republican policy has been broken for years, so broken that to get voters to support them, the GOP built a coalition of hate and fear. But as the population of people to be feared has grown, and more people added to the list, that coalition has found themselves outnumbered and incapable of winning the important elections.
Republicans knew as early as the 1960s that they could not win elections on the merits of their policies. The roots of Donald Trump’s rise are in Richard Nixon’s “Southern Strategy,” which used coded rhetoric and stoked latent Confederate resentment after the Civil Rights Era to win white racists to the Republican Party. Nixon replaced Johnson’s War on Poverty with a War on Drugs, which was only ever really a war on black communities.
By the 1980s it was Ronald Reagan, telling the story of a fictional “inner-city welfare queen,” playing on racism to get poor whites to vote against welfare programs from which they benefitted; but racism alone was not enough to win every election, so in the late 1970s and early 1980s the Republicans formed a pact with the so-called “Moral Majority,” the American theocratic movement that feared gays, abortion, and atheists.
Muslims, who through the 70s and 80s took a back seat as villains to the Soviets, would have to wait until the end of the Cold War to be labeled as the greatest enemies of the state, and while murmurs of white anxiety about Mexican immigrants were heard, it would not be until the 1990s, when recession made the job-destroying consequences of Republican policy vividly apparent, that white conservatives began pointing fingers at Mexico and the need for southern border security.
But the predominantly white population on which these tactics worked was ever shrinking as a percent of voting population, and as culture shifted and LGBTQ Americans gained mainstream acceptance the GOP lost one of their wedge issues. Republicans had a wake-up call in 2012, and in the miniature identity crisis that followed considered the need to alter immigration and jobs policies to appeal to Latinx Americans, soften on anti-LGBTQ initiatives, and otherwise shift to invite a wider section of America’s increasingly diverse voting base.
Instead, the party went the other way, intensifying their rhetoric until they alienated even those relatively few diverse voters who still aligned with them. Rather than work to embrace minority populations (who, combined, now constitute a majority of Americans) the Republicans advanced new voting requirements to prevent those minorities from voting, a desperate and despicable ploy to preserve the power of their alliance just a little bit longer.
Many experts cited Republican fears about alienating their base, and the need to win local and primary elections dominated by Tea Party voters. The implied assumption there, however, and one that I believe is correct, is that softening would not successfully attract new voters because Republican policies are fundamentally flawed. This is why there are no more Rockefeller Republicans, and almost no more of Bush’s “compassionate conservatives.” The only way to get people other than the most wealthy corporate elite to vote against their own self-interest and to support the Republican party is to appeal to their hatred and bigotry.
And so the GOP candidates and party establishment finds themselves now, cursed with a candidate who cannot win–and whose catastrophic candidacy seems poised to drag the entire party down with it–as the inevitable product of a machine they created.
The only solution? If the Republican Party wants any chance at winning major elections in the future, it must evolve. The United States is never going back to the way things were in the 1950s, and it is past time that one of our two major parties stop pretending otherwise.
Our immigration system is antiquated and broken, and voters will embrace realistic, reasonable immigration reform. Closed borders and isolationism are neither practically feasible nor appealing to Americans who embrace our diversifying culture. No more mythology about immigrants bringing crime and drugs; reforming the way ICE approaches immigration enforcement and transforming it into something humane and decent would win a lot of votes.
No more “tough on crime” laws. Mandatory minimums and three-strikes laws are devastating to communities and carry a huge tax burden to enforce. In recent years, the curtain has been drawn back to reveal the ugly reality of American law enforcement. Modern policing is oppressive and incompatible with any party that claims to value a small government that doesn’t intrude in people’s lives. Put forward meaningful reforms on law enforcement, including community policing and sentencing guidelines.
While you’re at it, bring the War on Drugs to a definitive end. The idea is totally compatible with the core values of reducing regulation, shrinking government, and minimizing tax-funded public expense. The War on Drugs costs Americans billions every year, it destroys families and communities, and it doesn’t do anything to prevent drug abuse. Legalize drugs, tax their sales (Republicans prefer use taxes to income taxes, right?) and use the revenues to fund rehabilitation and education that might actually solve drug abuse problems–like the catastrophic opioid epidemic that generally already begins with the legal use of prescription drugs.
Abandon the anti-science stance that allows you to deny climate change is an existential crisis, and bring the same energy and enthusiasm to that problem that the GOP does to all other matters of national security. Stop allowing corporations to pretend carbon emissions aren’t the problem, and instead work with them to incentivize solutions.
It’s time to reevaluate all Republican policies, but especially the most hard-line, because the beliefs to which you cling hardest are the ones with the least rational justification. Trickle-down does not work, that’s a proven fact. Christianity has never been our official religion, and it never will be, so stop trying to force it on us. The Second Amendment affords Americans the right to self-defense, but right now Americans need defense from the Second Amendment.
All of these reforms would change the GOP from an out-of-touch relic that relies on trickery and manipulation to achieve any power, and provide a viable second party alternative to voters who feel frustrated by our broken political system. Would they alienate the racist white voters who have come to define the Republican Party? Abso-fucking-lately they would. The GOP would need to be prepared for a lot of angry phone calls, bigotry, and death threats of the variety those on the left currently receive on a daily basis. You’d probably also see a number of GOP politicians jump ship to become independents or join the Liberarian Party.
But that’s okay; embracing meaningful changes in policy would attract conservative-leaning voters who right now align as reluctant Democrats, or feel totally disenfranchised. In all likelihood, a GOP that kept to conservative principles while embracing science and realistic policy measures would lure bright centrist politicians away from the Democratic Party to replace fringe Tea Party extremists who jump ship.
And perhaps most importantly, such changes would again provide the American voter with two viable parties from which to choose. As a very left-leaning Democratic voter myself, I desperately want a reasonable and attractive Republican Party to force my politicians to work hard and put forward real solutions to our problems.
Will the Republican leadership see it this way? Almost certainly not. For one thing, appeals to racism have been so intrinsic to the party for so long that many of the officials themselves are racists. Others are corporate shills who aren’t interested in doing work that actually benefits the country, just the next rhetorical trick that will keep Americans voting against their own self-interest. My expectation is that the GOP will keep on the same path, maybe even further intensifying their rhetoric, until their victories are limited only to the whitest and most bigoted state and local offices, and congressional districts so gerrymandered they look like the letters of some alien language.
But wouldn’t it be nice if Trump were the last of the racist Republians? If Nixon’s Southern Strategy was finally laid on the ash-heap of history, as they say, and America entered 2017 with two rival political parties ready to face the realities of the 21st century instead of trying to turn back the clock?
Human progress moves slowly; that’s a fact. In government, in the United States, it is almost incentivized to move slower still. But Donald Trump and his catastrophic, embarassing bid for the Presidency is a death knell for the Republican Party. The question is whether it can reinvent itself and rise, or be itself consigned to the ashes.
Photo: Wikimedia Commons
No one looks forward to accusing a national celebrity, a candidate for President, of rape or sexual assault. No one WANTS to be in the national media talking about a violation of their body, to be asked probing questions that violate their privacy, to be called a liar and an opportunist and a slut.
No woman in the country is ignorant to the experience of such an accusation, even when her abuser is not famous. Your life becomes defined by the worst thing that ever happened to you, your identity buried beneath that of the person who violated you. And for every woman who came forward and was believed, there are dozens, hundreds maybe, who came forward and were ignored.
My parents’ house is far enough from public utilities and any neighbor houses that they often have difficulty just getting cellular service, so a public wifi network with a signal as strong as their home wifi seemed impossible.
But this was shortly after Comcast, their ISP, cable, and phone provider, forced my mother to switch out her modem and router (which I’d chosen and installed for her) for a new Comcast-owned 2-in-1 gateway.
That part of the story is questionable enough. For years I had insisted they own their own equipment, both because it ensured better quality hardware and less tampering from Comcast and because they could avoid the nonsense monthly rental fee that meant they’d essentially be purchasing the crappy Comcast hardware anyway. Continue Reading
If you’re like me, you have zero intention of seeing 13 Hours, Michael Bay’s new right-wing fantasy porn flick. Maybe, like me, you’ve sat through four incomprehensible Transformers movies (owing to a borderline masochistic need to stay up on pop culture) and thought, “The only thing that could possibly make these worse is if they carried a more overt and deceptive endorsement of Republican conspiracy theory.”
However, like me you might have concerns about the effect it might have on our upcoming election. So I give you a handy guide to the coded messaging of 13 Hours, from Matt Gertz at Media Matters, the hero who watched this thing so we won’t have to. Continue Reading
The Big Short is my favorite movie of the 2016 Awards Season*. I feel a little bad saying that, in light of yesterday’s Oscar nominations and their slate of white, white (blonde) faces, and the fact that The Big Short is, well, short on both women and minority actors. But the fact is I watched it through twice, and would happily sit through a third viewing. The film is alternately funny and gutting, the cast is pretty much universally brilliant, and the directing–from Adam McKay, who brought us films like Anchorman, Anchorman 2, and Funny or Die’s The Landlord–is impressive, avant-garde without being distracting, and making a complicated subject accessible.
* Okay, it’s tied with Mad Max: Fury Road, but since that came out over the summer it doesn’t really feel like an Awards Season movie.
Not too accessible, mind you. Despite the sidebar scenes in which celebrities like Selena Gomez, Anthony Bourdain, and Margot Robbie (in a bubble bath) break the fourth wall and explain complicated financial structures in layman’s terms–one of the film’s more unique and amusing contrivances–I frequently found myself leaning in so I could follow the fast-paced dialogue about derivatives, mortgage-backed-securities, credit swaps, and so on.
The Big Short is far from the first film about the 2008 Financial Crisis, but it might be the best combination of sweeping and accessible. Too Big to Fail captured the moves and conversations happening inside the banks and the Federal Reserve, and films like 99 Homes capture the human cost across the nation, but The Big Short takes a wider scope and time period to show the viewer what happened, through the eyes of a handful of professionals who predicted the crash. Continue Reading
Time again to look back at another year and the entertainment media it produced. Rather than do a bunch of entries with different top things, I thought I’d cover it all in one post–and I’m not even going to explain why I like all the things I do, I’m just giving you the list and you can draw your own conclusions. Continue Reading
After it was announced that yet another killer cop was going to walk without so much as a trial, Roxane Gay put out a suggestion for an editorial cartoon. I’m not sure I can fairly describe this as “collaboration,” but whatever it is, I was excited to be part of it.
It’s a weird/shitty thing about drawing editorial cartoons that you sometimes do your best work in response to the worst things happening in the world, but that’s the nature of the art form. It’s not often you get a chance to impress someone you really admire, and as awful as this verdict (and this day) are, it felt really good to hear she liked it.
There’s a second version with a word balloon, and at first I didn’t know which I liked better. The more I look at it, the more I prefer this version.
A friend shared this on Facebook this morning. It’s a compelling image, right? On the left, sepia-toned Americana: The classic farmer, in the field with his felt hat and his overalls. On the right, the modern farmer, his bright yellow hazmat suit protecting him from the dangers of his monster crops.
But of course, it’s pure deception. Continue Reading