Saturday, March 11, 2017

Hidden Costs

Christopher Caldwell's survey of the opioid epidemic, featured in the latest issue of First Things, has understandably been getting a lot of attention.  Caldwell explores the personal and social costs of opioid epidemic rocking many communities in the United States.  The death-rate from opioids currently far exceeds the death-rate from the headline drugs of other crises:
A heroin scourge in America’s housing projects coincided with a wave of heroin-addicted soldiers brought back from Vietnam, with a cost peaking between 1973 and 1975 at 1.5 overdose deaths per 100,000. The Nixon White House panicked. Curtis Mayfield wrote his soul ballad “Freddie’s Dead.” The crack epidemic of the mid- to late 1980s was worse, with a death rate reaching almost two per 100,000. George H. W. Bush declared war on drugs. The present opioid epidemic is killing 10.3 people per 100,000, and that is without the fentanyl-impacted statistics from 2016. In some states it is far worse: over thirty per 100,000 in New Hampshire and over forty in West Virginia.
As Caldwell notes elsewhere in his story, four times as many Americans died from overdoses in 2015 as died from gun homicides that year.

Federal data shows how quickly deaths from heroin and opioids more generally have skyrocketed over the past decade.  Heroin deaths across the nation jumped from around 2,000 in 2006 to about 12,000 by 2015.  The number of deaths from opioid overdoses has over doubled since 2004.  The number of overall drug overdose deaths has over doubled since 2002.

The causes of this increased rate of opioid abuse are complex.  Caldwell suggests that the normalization of increasingly powerful opioids by the medical community played a role, as did an influx of cheap heroin.  The story also frames the opioid crisis in the context of broader socioeconomic forces that have battered many communities.

Of course, we cannot measure the current opioid epidemic only in terms of lives lost.  Drug addiction can be lethal, but its costs can also be measured in other ways--in broken families, frayed communities, daily struggles, grappling with despair, and the haunting of personal disappointment.  All these things suggest that drug abuse remains a serious civil issue.