Brian Britigan
In 2011, the Centers for Disease Control warned that overdosesinvolving prescription painkillers had reached “epidemic levels.”
That same year, the Office of National Drug Control Policy released a plan to curb prescription drug abuse. It focused on opioids and involved four components: education, monitoring, disposal, and enforcement. Over the next few years, state and federal officials cracked down on “pill mills” and “doctor shoppers,” yet the number of opioid-related deaths continued to rise.
By 2015, heroin-related overdose deaths had outpaced those linked to prescription painkillers. In 2017, the overdose rate continued to climb, with synthetic opioids—especially fentanyl—now claiming the highest death rate.
One could use this data to argue that the “War on Drugs” is failing. To do so, however, would misinterpret the purpose of the so-called drug war.
Drug prohibition and its enforcement have long been tied to the villainization of vulnerable populations. In 1982, Ronald Reagan famously declared a War on Drugs, as Nixon had done before him. The militant “war” that followed targeted crack cocaine in black, urban neighborhoods suffering the consequences of his cuts to financial assistance programs, while the penalties for using powdered cocaine favored by whites were far less severe.
Now, in what Maria McFarland Sánchez-Moreno calls a “different twist” on an old war, Donald Trump is tying the current drugs scourge to the immigrant population likely to suffer under his administration’s policy goals. Sánchez-Moreno is executive director of the Drug Policy Alliance, a national advocacy group based in New York City.
“It’s just very easy to pin the overdose crisis on immigrants,” she tells The Progressive, “and then say that you’re doing something about it by going after immigrants.”
Trump found fans of his anti-immigration politics in the white, rural counties where the collapse of industry has led to economic decline and desperation. Part of his message has been to blame the opioid epidemic and economic decline on immigration and immigrants.
“It’s just very easy to pin the overdose crisis on immigrants.”
“For decades, open borders have allowed drugs and gangs to pour into our most vulnerable communities,” Trump pontificated during his State of the Union address on January 30. “They’ve allowed millions of low-wage workers to compete for jobs and wages against the poorest Americans. Most tragically, they have caused the loss of many innocent lives.”
Such rhetoric conveniently funnels the conversation about opioids away from complex, evidence-based solutions and toward support for Trump’s policy proposals on immigration and other pet issues.
“It is an effort to rally his base and look tough in response to a problem that is affecting large numbers of people,” Sánchez-Moreno says. “And it’s a way to go after groups that are already marginalized and stigmatized.”
In April, Trump signed a memo ordering National Guard troops to the Mexico border “to stop the flow of deadly drugs and other contraband, gang members and other criminals, and illegal aliens into this country.”
“This is all lies and misdirection, and it’s an effort to scapegoat a vulnerable community that he and his base don’t like anyway,” says Sánchez-Moreno. “We know that people crossing the border illegally are not the ones bringing the drugs in. We know that often drugs come in through official points of entry.”
Even if the United States were to build a border wall and stop all immigration, she says, “you’d still have drugs coming into the country, or being manufactured here. There are ways around every enforcement measure.”
But Trump’s drug war is not actually about drugs.
Like past drug war rhetoric, the Trump Administration’s immigration-focused solution to the opioid epidemic has nothing to do with evidence-based solutions, and everything to do with the policies important to him and his base.
Trump has promised to “expand opportunities for proven treatments” for addiction issues, but is skimpy with details and mute when it comes to the most-effective known harm-reduction strategies, like syringe exchange and supervised injection sites. What’s needed is increased funding for and access to health care, which is not a part of Trump’s agenda.
Trump has also merged his anti-opioid lip service with pro-life advocacy. When announcing in October that he would treat the country’s opioid use as a state of emergency, he spoke of babies born exposed to opioids in utero—the modern-day spin on the “crack baby.”
And, at his State of the Union address, Trump told the “Baby Hope” story—about a police officer who observed a pregnant woman on the street preparing to inject heroin and then adopted her baby. Many reproductive rights activists were horrified.
“The pregnant woman is just a stand-in,” says Lynn Paltrow, executive director of National Advocates for Pregnant Women. She lists questions the President did not address: “Who is she? Why is she homeless? Was her pregnancy consensual? Where could she have gone for help?”
Trump merged his anti-opioid lip service with pro-life advocacy.
The point of the anecdote wasn’t to access what may have gone wrong in this situation but to make a case for increased punishment.
Media reports on “babies born addicted” are linguistically incorrect— babies aren’t capable of the behaviors that define addiction. And opioid withdrawal in newborns is more treatable and manageable than commonly believed. Undue stigmatization of mothers with addictions can interfere with their ability to get pre- and postnatal medical care, for fear of punitive responses. It can also cause criminal justice interventions.
This January in Montana, the Big Horn County Attorney’s Office announced “an immediate crackdown policy of civilly prosecuting any expecting mothers found to be using dangerous drugs or alcohol.” This included “asking the public to report any known instances of pregnant females using drugs or alcohol” by calling a hotline. The office pledged to “seek an order of protection restraining a pregnant female from any non-medically prescribed use of drugs or alcohol” and pursue incarceration “to incapacitate the drug or alcohol-addicted expecting mother,” should she refuse.
“In all the years I’ve been working on these issues, I’ve never seen a prosecutor endorse a total surveillance state [of pregnant women],” Paltrow said of Big Horn County’s announcement.
Pregnant women are similarly targeted by enforcement efforts around the country. Prosecutors sometimes pursue charges against pregnant women who use drugs, even in the absence of laws that give them the authority to do so. In Pennsylvania last year, prosecutors charged a thirty-year-old woman named Kasey Dischman with aggravated assault against an unborn child, after she overdosed while seven months pregnant. The charges were later deemed contrary to law and dismissed.
In the last months of 2015, newspapers and bloggers alike began commenting on a so-called gentler drug war taking form. Heroin had hit the suburbs, and outlets like The New Yorker fixated on the white “addicts next door.”
The language suggested that heroin had spread to an unlikely user population (and into an unlikely place). The media gravitated to images of “unlikely” heroin addicts with blond hair and pom-poms, with a “good family” to offer quotes about empathy and the need for treatment.
But Sánchez-Moreno says the actual approach to drug addiction remained punitive. “It’s very clear there is no softer, gentler war on drugs in law enforcement response,” she says. “To the contrary, it’s a doubling down.”
Although data are not available on the numbers prosecuted, media mentions of prosecutions for drug-induced homicides increased 300 percent, from 363 news articles in 2011 to 1,178 in 2016, according to a report by the Drug Policy Alliance. It listed a number of states that were aggressively prosecuting drug-induced homicides and expanding their use of drug laws.
And the people being targeted are often the individuals most likely to call for help in the case of an overdose—friends, acquaintances, partners, and family members. Last year in Florida, Christopher Williams called 911 for help when his eighteen-year-old friend began overdosing. Williams had allegedly helped her obtain what turned out to be fentanyl. He was charged with manslaughter when she died.
Such prosecutions make it less likely that other drug users will seek medical attention in similar situations.
The reality, Sánchez-Moreno says, is that those prosecuted for drug offenses are often drug users themselves, small-time dealers selling to support their own habit. They are not involved in massive cartel operations. These prosecutions predate the Trump era, but are in step with his tough-fisted approach to enforcement.
In March, Trump called for the death penalty for drug dealers. “We can have all the blue-ribbon committees we want, but if we don’t get tough on drug dealers we’re wasting our time,” he told an audience in New Hampshire, which has a high overdose rate. “And that toughness includes the death penalty.”
In May, Attorney General Jeff Sessions backed this tough talk up with a memo that encouraged prosecutors to pursue the death penalty for drug dealers.
In March, Trump called for the death penalty for drug dealers.
“To combat this deadly epidemic, federal prosecutors must consider every lawful tool at their disposal,” Sessions said, “This should also include the pursuit of capital punishment in appropriate cases.”
This is all part of a larger enthusiasm for punishment as a response to the opioid epidemic. In Pennsylvania, a county coroner announced he would begin classing overdose deaths “homicides” in 2016. Last year in Illinois, an overdose death sparked a social media campaign of posts reading “Kill Your Local Heroin Dealer.”
But getting ever-tougher toward people who use and sell drugs could do more harm than good.
“We know that harsher sentencing has never worked in the past. What makes people think that it’s going to do anything now?” Sánchez-Moreno asks. “It’s just going to lead to a series of really harmful consequences that will overwhelmingly affect people of color, not because they use more drugs, and not because they deal more drugs, but simply because they have traditionally been the targets of policing.”
Additionally, arresting dealers can potentially make drugs more dangerous by disrupting the regularity of the supply chain. Users may turn to new and unfamiliar sellers; dealers may carry smaller, more dangerous quantities of drugs like fentanyl, which is more potent than heroin at smaller doses, and therefore easier to conceal.
Prosecuting dealers can cause fluctuations in purity that can be dangerous to users, a problem made worse by the U.S. Drug Enforcement Administration’s decision to implement a blanket ban on fentanyl analogues. Banning analogues of synthetic drugs and novel psychoactive substances (new substances that are unstudied and poorly understood versions of their banned chemical cousins) has opened the door to new fentanyl compounds, including carfentanil, which is vastly more potent.
As product potency has become increasingly unpredictable, deaths from fentanyl have risen, along with deaths from combinations of opioids and benzodiazepines, such as Xanax. Xanax can enhance the effect of heroin, and may be sought out in situations where heroin is expected to be weak.
That the War on Drugs functions to protect Americans from the harms of drugs is a foundational lie. When we take a closer look at how the Trump Administration and those before it have leveraged punitive drug measures for specific political aims, it’s clear: the War on Drugs is operating exactly as it was meant to.
The War on Drugs is operating exactly as it was meant to.
But it doesn’t have to be that way. The opioid epidemic—which has shifted the public discourse toward more compassionate, evidence-based solutions—offers a fresh chance to insist on better approaches.
“We have an opportunity now to get things right, to move toward a more health-based approach to problematic drug use,” Sánchez-Moreno says, “It’s critically important that as we do that, we be very conscious of who is going to benefit and who is getting hurt by law enforcement response.”
Kristen Gwynne is a New York-based reporter covering criminal justice and drug policy.