Opioids on the Rise Again Under Imperialism
On 26 October 2017, U.$. President Trump declared the opioid epidemic a public health emergency. The declaration should lead to more federal funding for grants to combat opioid abuse.(1) As we explain below, this epidemic disproportionately affects euro-Amerikans. Trump linked his campaign to build a wall along the current Mexican border to the battle against this epidemic, despite the fact that prescription painkillers are at the root of it. This is consistent with the Amerikan government's solution for drug problems created by imperialism. For the crack epidemic of the 1980s Amerika responded with mass incarceration of New Afrikan men as the solution. As opioid addiction continues a steady rise, Trump offers further militarization of the border.
Opioids have been used by humyns for thousands of years both medicinally and recreationally, with many periods of epidemic addiction. Use began with opium from poppies. Morphine was isolated in 1806. By the early 1900s heroin was promoted as a cure for morphine addiction in the United $tates, before being made illegal in 1924. There was a lull in heroin use during the 1980s, when cocaine and crack overshadowed it. Various prescription pain killers began to come back into vogue in the 1990s after the "Just Say No!" mentality was wearing off. Since then, use and abuse has been on a steady rise, feeding a new surge in the use of heroin as a cheaper alternative. This rise, in the economic centers of both the United $tates and China, is directly linked to capitalism.
While K2 is one dangerous substance plaguing U.$. prisons these days, partly due to its undetectability, opioids are by far the biggest killer in the United $tates, and we expect that is true in prisons as well. Drug overdoses surpassed car accidents as the number one cause of accidental deaths in the United $tates in 2007 and has continued a steady rise ever since. The majority of these overdoses have been from opioids.(2)
While the increase in deaths from opioids has been strong across the United $tates, rates are significantly higher among whites, and even higher among First Nations. One reason that use rates are lower among New Afrikans and Latin@s is that it has been shown that doctors are more reluctant to prescribe opioids to them because they are viewed as more likely to become addicted, and Amerikan doctors see them as having a greater pain threshold.(3)
We did see some evidence of this trend in the results of our survey on the effects of drugs in U.$. prisons. The most popular answer to our question of whether certain groups did more drugs in prison than others was no, it affects everyone. But many clarified that there was a strong racial divide where New Afrikans preferred weed and K2, while whites and usually Latin@s went for heroin and/or meth. Some of these respondents said that New Afrikans did less drugs.(4) A couple said that New Afrikans used to do less drugs but now that's changing as addiction is spreading. In states where K2 has not hit yet (CA, GA, CO) it was common to hear that whites and "hispanics" (or in California, "southern" Mexicans) did more drugs. The pattern of New Afrikans preferring weed and K2 seemed common across the country, and could have implications for strategies combating drug use among New Afrikans compared to other groups. In particular, stressing that K2 is completely different and more dangerous than weed could be part of a harm reduction strategy focused on New Afrikans.
If prison staff were doing their jobs, then we would expect rates of both overdoses and use in general to be lower in prisons. But we know, and our survey confirmed, that this is not the case (78% of respondents mentioned staff being responsible for bringing in at least some of the drugs in their prison). In hindsight, it may have been useful to ask our readers what percentage of prisoners are users and addicts. Some of the estimates that were offered of the numbers using drugs in general were 20-30%, 90%, 75%, and many saying it had its grips on the whole population.
Deaths from opioids in the general U.$. population in 2015 was 10.5 per 100,000, double the rate in 2005.(5) This is higher than the rates in many state prison systems for overdoses from any drug, including Florida, Georgia, Illinois, Ohio, Texas and Pennsylvania that all reported average rates of 1 per 100,000 from 2001-2012. California was closer at 8 per 100,000 and Maryland exceeded the general population at 17 deaths from overdoses per 100,000 prisoners.(6) At the same time, prison staff have been known to cover up deaths from overdoses, so those 1 per 100,000 rates may be falsified.
In our survey of ULK readers, we learned that Suboxone, a drug used to treat opioid addiction, is quite popular in prisons (particularly in the northeast/midwestern states). Survey respondents mentioned it as often as weed as one of the most popular drugs, and more than heroin. Suboxone is actually used to treat heroin addiction. And while it is not supposed to be active like other opioids, it can lead to a high and be addictive. It is relatively safe, and will not generally lead to overdose until you combine it with other substances, which can lead to death.
Prescription drugs are not as common as other drugs in most prisons, according to our survey. Though in some cases they are available. We received a few responses from prisons where prescription drugs prescribed by the medical staff seemed to be the only thing going on the black market. Clearly there is variability by facility.
Two Paths to Recovery
The increases in opioid abuse in the United $tates has been staggering, and they cause a disproportionate amount of the deaths from drug overdoses. About 10% of opioid addicts worldwide are in the United $tates, despite only being less than 5% of the world's population.(7) At the same time, only about 1% of people in the United $tates are abusing opioids.(8) This is not the worst episode in U.$. history, and certainly not in world history.
Around 1914 there were 200,000 heroin addicts in the United $tates, or 2% of the population. In contrast, some numbers for opium addicts in China prior to liberation put the addiction rate as high as 20% of the population around 1900, and 10% by the 1930s. That's not to dismiss the seriousness of the problem in the United $tates, but to highlight the power of proletarian dictatorship, which eliminated drug addiction about 3 years after liberation.
Richard Fortmann did a direct comparison of the United $tates in 1952 (which had 60,000 opioid addicts) and revolutionary China (which started with millions in 1949).(9) Despite being the richest country in the world, unscathed by the war, with an unparalleled health-care system, addicts in the United $tates increased over the following two decades. Whereas China, a horribly poor country coming out of decades of civil war, with 100s of years of opium abuse plaguing its people, had eliminated the problem by 1953.(9) Fortmann pointed to the politics behind the Chinese success:
"If the average drug addiction expert in the United States were shown a description of the treatment modalities used by the Chinese after 1949 in their anti-opium campaign, his/her probable response would be to say that we are already doing these things in the United States, plus much more. And s/he would be right."(9)
About one third of addicts went cold turkey after the revolution, with the more standard detox treatment taking 12 days to complete. How could they be so successful so fast? What the above comparison is missing is what happened in China in the greater social context. The Chinese were a people in the process of liberating themselves, and becoming a new, socialist people. The struggle to give up opium was just one aspect of a nationwide movement to destroy remnants of the oppressive past. Meanwhile the people were being called on and challenged in all sorts of new ways to engage in building the new society. There was so much that was more stimulating than opium to be doing with their time. Wimmin, who took up opium addiction in large numbers after being forced into prostitution in opium dens, were quickly gaining opportunities to engage at all levels of society. The poor, isolated peasants were now organized in collectives, working together to solve all kinds of problems related to food production, biology and social organization. The successful struggle against drug addiction in China was merely one impressive side effect of the revolutionizing of the whole society.
In contrast, in the capitalist countries, despair lurks behind every corner as someone struggles to stay clean. The approach has ranged from criminalization to medicalization of drug addiction as a disease. "Once an addict, always an addict", as they say. Always an individualist approach, ignoring the most important, social causes of the problem. That drug addiction is primarily a social disease was proven by the practice of the Chinese in the early 1950s, but Western "science" largely does not acknowledge the unquestionable results from that massive experiment.
It is also worth pointing out the correlation between drug abuse and addiction, and capitalist economics specifically. Whether it was colonial powers forcing opium on the Chinese masses who had nothing, in order to enslave them to their economic will, or it is modern Amerikan society indulging its alienation in the over-production of prescription pills from big pharmaceutical companies marketing medicine for a profit.
And now, opioid addiction is on the rise again in capitalist China after decades. A steady rise in drug-related arrests in China since 1990 are one indicator of the growing problem.(10) As more profits flowed into the country, so have more drugs, especially since the 1990s. We recently published a review of Is China an Imperialist Country?, where we lamented the loses suffered by the Chinese people since the counter-revolution in 1976. It goes to show that when you imitate the imperialists, and put advancing the productive forces and profits over serving the people, you invite in all the social ills of imperialism.
In China drug addiction has now become something that people fear. Like it did with its economy, China has followed in the imperialists' footsteps in how it handles drug addiction. Chinese policy has begun treating addicts as patients that need to be cured to protect society. Rather than seeing those who give up drugs as having defeated the oppressor's ways, they are monitored by the state, lose social credibility, and have a hard time getting a job.(11) Under socialism, everyone had a job and no one needed recreational drugs to maintain themselves mentally. The path to combating drug addiction and abuse is well-established. Attempts under imperialism that don't involve liberatory politics of the oppressed have little to no effect.