Friday, June 25, 2021

Overdoses are up political interest is down

Needlessly racialized but dealing with a topic which should be dominating our national politics but which only receives an occasional reference.  Deaths from drug overdoses, disproportionately from Chinese manufactured fentanyl.  From In pandemic, drug overdose deaths soar among Black Americans by Claire Galofaro.

We have a lot of vociferous and contentious debate about gun violence (some 19,000 deaths per year).  This is a popular partisan debate.  We have a little discussion about the rising suicide rate (45,000).

And we have virtually no discussion about the 92,000 overdose deaths in 2020.  Up from 52,000 in 2015.  The rise has been inexorable year-by-year and largely due to fentanyl.

Just as crack cocaine and heroin deaths were largely associated with the black community, fentanyl overdoses have so far been largely concentrated in the white population.  But that now seems to changing.

It was September, and as the COVID-19 pandemic intensified America’s opioid addiction crisis in nearly every corner of the country, many Black neighborhoods like this one suffered most acutely. The portrait of the opioid epidemic has long been painted as a rural white affliction, but the demographics have been shifting for years as deaths surged among Black Americans. The pandemic hastened the trend by further flooding the streets with fentanyl, a potent synthetic opioid, in communities with scant resources to deal with addiction.

In the city of St. Louis, deaths among Black people increased last year at three times the rate of white people, skyrocketing more than 33%. Black men in Missouri are now four times more likely than a white person to die of an overdose.

There is a lot of blather attempting to make this a race issue instead of the human tragedy it is.  There are no points for having the higher addiction rates or overdoses.  Galofaro outlines a timeline which seems plausible but which I have not seen laid out so cleanly before.  

Some researchers believe the nation is entering a fourth wave. The drug supply is so messy and unpredictable that people overdosing have multiple drugs in their system: dangerous cocktails of fentanyl, a depressant, and stimulants like cocaine and methamphetamine.

Maybe.  The unexpected disruption of drug supply chains owing to Covid restrictions leading to increased overdoses due to unfamiliarity with the product quality is an intriguing insight.  

A lot of illicit fentanyl is manufactured in Wuhan, China, where COVID-19 was first unleashed. Lockdowns initially disrupted the supply, said Vanda Felbab-Brown, a Brookings Institute fellow who studies trafficking.

In St. Louis, the drug trade became even more chaotic: People who used to know where their drugs were coming from no longer did. Fentanyl for a time was hard to find, and some turned to less-potent heroin.

But the Chinese laboratories rebounded and resumed shipping the chemicals to Mexico, where cartels process them, Felbab-Brown said. Pandemic border closures presented cartels with added incentive to traffic fentanyl: It is incredibly potent and profitable. The equivalent of a trunkful of heroin or cocaine can be carried across the border in a small suitcase.

And here is the rub.  Why are we not talking about the tragedy and impact of the loss of nearly 100,000 people a year and instead focus our political energies on controlling long guns which account for 750-1,000 of gun deaths.  All our time on 1,000 nearly no time on the 100,000 are dying from dug overdoses.  

My guess is that this is a partisan problem where both parties have backed themselves in untenable positions.  The Republicans are most associated with the get tough on crime strategies of the late nineties when violent crime peaked.  It has plummeted since then.  Did broken windows policing and three-strikes legislation cause the decline?  The correlation is clear and strong but the causation a little more unclear.

The two approaches drove down violent crime but never really "solved" drug addiction.  That is a third rail which no one wants to touch because there don't seem to be clearly effective solutions which are also politically expedient for either party.  

I don't think the Republicans want to be associated with the Just Say No days though they do campaign on tough on crime.  

For Democrats it is as nasty briar patch as for Republicans.  They are famously weak on crime which doesn't play well in an era of rising crime.  The racializing of the drug overdose catastrophe also complicates the management of their various factions.  They don't want to be seen to be over-solicitous of white victims when blacks were the clear victims of the three-strikes legislation which many Democrats supported.

And for both parties there is the China card.  As Afghanistan is a primary source of opium, it appears that China is the global leader in provision of fentanyl.  If true, and data is underreported, then it has been a markedly successful war on the US.  Six divisions of Americans are dying each year without China doing anything particularly overt.  The US lost less than a third of a division during the entirety of the Normandy Landings.  

And for either policy, while dealing with China's Pacific ambitions, trying to get cooperation on Covid-19 origins, cybersecurity attacks, patent theft, etc. why would you want to throw Fentanyl into the mix of issues to be dealt with?

For most people it is obvious - Because it is killing nearly 100,000 Americans a year.  For politicians it is less obvious.  The War on Drugs is tainted.  The probability of cooperation from China low.  The possibility of being besmirched from a race angle is increasing.  The 100,000 deaths are underrepresented among the Mandarin Class.  Why invest political capital? is, I suspect, a self-answering negative.

As an ordinary American I feel incredibly frustrated by the lack of seriousness and humanity among some of the key members of our two major parties.  Yes, it is a hard problem and could be politically ruinous to any individual politician.  But it is already ruinous to 100,000 Americans each year.  


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