It didn’t take long for America to conquer both prescription pain pills and the sea of good old William S. Burroughs-worthy street heroin that followed. But what happens when you eliminate a drug and leave the people to whom life without it is an unthinkable ordeal?
In our current case, you get a hockey-stick spike in overdose deaths steep enough to impress the CFO of any venture-backed startup. You get the fentanyl crisis—the true name and nature of the debacle that has already spiked well out of anyone’s control.
Buried in the sea of bad news that washed over America before Labor Day, the Centers for Disease Control and Prevention released drug-overdose death statistics from 2016. And it’s bad: 64,000 people died from an overdose last year, up 22 percent from 2015, which was itself a record-setting bad year.
Drug overdoses now kill more Americans than car crashes, HIV/AIDS and guns.
As the New York Times reported, overdoses have been and will remain the leading cause of death for Americans under 50 for the foreseeable future, an apocalypse already worse than the AIDS epidemic at its nadir.
But the absolute worst is yet to come.
More than 20,000 people died from an overdose of synthetic opioids in 2016, and deaths from fentanyl and other synthetic opioids doubled year-over-year from 2015 to 2016. So far this year, in many counties where the crisis is most acutely felt, deaths in 2017 are well on their way to outpace 2016’s total, in some cases by double digits.
In a very American way, much of the blame for this butcher’s bill has been placed overseas.
After American pharmaceutical companies flooded the market with prescription pain pills and created a generation of opiate-dependent Americans, it was Mexican heroin dealers who exploited the ensuing gap in the market once the pill mills were shut down. What limited success there’s been in stemming the flow of heroin from across the country’s southern border has been lost and forgotten in the steady flow of synthetic opioids, ordered (by Americans) via the dark web and delivered—by the U.S. mails—from labs somewhere in China, according to the government.
Fentanyl is now becoming so mainstream that at least one state is using it to conduct executions. As The Marshall Project first reported, Nevada will use a drug cocktail containing fentanyl to carry out a lethal-injection execution.
On the one hand, it’s a logical and practical solution to the legal and supply-chain problems that have thwarted capital punishment across the country. With fentanyl laying innocent people low at astounding rates, why not use an opioid overdose to provide a swift end to the condemned? On the other, much larger hand, the irony at play—an unsolvable crisis is also an easy fix to one of the uglier institutions in our democracy—is worthy of Kafka.
“You got something that’s killing hundreds of people a day across the United States, and you got prisons who can’t get death penalty drugs, so they’re turning to the drug that’s killing hundreds of people across the United States,” explained Josh Bloom, a chemist and scientist with the American Council on Science and Health, in an interview with CNN. “This sounds like an article from the Onion.”
These numbers quantify what should have already been painfully obvious to anyone giving this crisis a moment’s thought: The solution is not a law-enforcement one, nor is the problem supply-driven. It’s a question—and a crisis—of demand.
There have been some efforts at demand-side approaches. Some communities have been distributing overdose-reversal drugs like Narcan. In San Francisco, police are equipped with Narcan kits. But this is a literal bandaid over a spurting wound. If an opiate user survives a fentanyl overdose today, there’s no guarantee that the same will happen tomorrow.
In Vancouver, a limited study showed that when drug users were able to test their drugs and discover whether or not their bags contained fentanyl, drug overdoses went way, way down. It bears mentioning that most of that data came from a safe-injection site, something no American city can officially claim.
It also bears mentioning that activists in Vancouver, long one of the worst cities in Canada for drug overdose deaths, have begun distributing free or near-free marijuana products in an effort to stop opiate deaths. They did this after viewing data that showed where cannabis is available, opiate deaths dropped by one-third.
That data came from studies in America, where cannabis remains in the exact same category as heroin.