King of Pain
The fentanyl crisis in America started when a highly addictive drug used in hospital settings became the latest and most dangerous pain killing opioid that pharmaceutical companies marketed for prescription. Americans were already hooked on opioids, often sold by pill mills just off the highway. The crackdown on these pill mills and the over-prescribing of opioids, along with the legalization of marijuana in some states, motivated drug cartels to shift their focus to the now surging demand for illegal fentanyl. “Old supply chains moved heroin from poppy fields to central markets in major U.S. cities; traffickers in the 2010s built new supply chains bringing synthetic products such as fentanyl sourced with chemicals from China to American consumers wherever they lived — including the rural areas and small towns struck by the opioid crisis. Which is to say: fentanyl traffickers were responding to consumer demand. They did not create it. The opioid crisis initially struck white areas not because of a conspiracy to destroy heartland America. Rather, it was a devastatingly ironic result of white Americans’ privileged access to the medical system. Physicians’ willingness to recognize and treat their pain opened their communities to pharmaceutical companies’ flood of opioids.” Given this brief history, it will not surprise you to learn that the best way to fight the fentanyl crisis is not by using the US military to bomb small boats near Venezuela. In fact, bombing other supply routes (like the ones actually being used to traffic in fentanyl) won’t work either. Killing pain is notoriously hard. Killing painkillers is even harder. “In a world where people and goods circulate freely, there will always be ways for a tiny powder to travel with them.” David Herzberg drops a few truth bombs about our strategies, past and present, in the NYT (Gift Article): I Am a Drug Historian. Trump Is Wrong About fentanyl in Almost Every Way. (In fairness, he’s not the first politician to fit that description when it comes to the war on drugs.) “American politicians have long been drawn to more emotionally satisfying stories like the ones where foreign traffickers are to blame for the decline of rural and small-town America. Again, drugs are not unique: The MAGA movement has many other such morally simplifying stories, about Big Pharma’s vaccines as the cause of chronic disorders or about tariffs as a magical solution to unemployment. These stories may serve the needs of politicians, but they can’t fix the actual problems.”
+ Judge formally approves opioid settlement for Purdue Pharma and Sackler family members who own the company.
+ For some more background in this issue, I recommend the books American Pain by John Temple and Empire of Pain: The Secret History of the Sackler Dynasty by Patrick Radden Keefe. Also, Don Winslow’s article: El Chapo and the Secret History of the Heroin Crisis.
