November 3, 2017

Trump’s War on Opioids Won’t Work—But California Knows What Will

The U.S. rate of deadly drug abuse is 7.5 times higher than that of the 24 other wealthiest countries in the world. / Photo by John Moore, Getty Images

More compassionate drug policy reforms in California have resulted in a drug death rate 40 percent below the national average.

By Mike Males / 10.31.2017
Former Professor of Sociology
University of California, Santa Cruz

When it comes to drug abuse, there’s the United States. Then there’s the rest of the world.

The U.S. rate of deadly drug abuse is 7.5 times higher than that of the 24 other wealthiest countries in the world, accounting for four-fifths of all drug deaths among developed nations.

Last week, President Donald Trump belatedly acknowledged the “worst drug crisis in American history.” His “emergency declaration” amounted to little more than bluster, however, stopping short of declaring a national emergency that would free up significantly more federal funding. Meanwhile, the war on drugs continues apace: Another 1.5 million people were arrested in 2016 for drug-related crimes; 300,000 people remain in state and federal prisons on drug offenses; and Attorney General Jeff Sessions has been chomping at the bit for an escalation of the drug war.

We need urgent answers, but one of the questions that’s not being addressed in the current crisis is this: Why does the United States suffer out-of-control epidemics massively endangering Americans and feeding violent global drug networks that serve our habits, while other countries have been better able to control them?

That trend has long been obvious. As far back as 1992, as politicians, police, and media reporters demonized inner-city crack-cocaine users, pharmaceuticals caused half of the rising toll of illicit-drug deaths and “White adults over age 25 comprised two-thirds of all drug deaths but just one-third of all drug arrests.” Despite that figure, most media and political attention—and harsh policing—was focused on the smaller crack epidemic that disproportionately affected Black neighborhoods.

Today, Whites ages 25 and older constitute nearly three-fourths of the hugely increased drug death toll, according to the CDC. Tunes are changing. Older White drug abusers are “victims” meriting treatment and policy reform, not imprisonment.

America’s official policies have proven catastrophic, exploiting Americans’ destructive double standard splitting “deserving, innocent” populations from “undeserving, menacing” ones. A “powerful theme in the American perception of drugs,” the late professor David Musto of the Child Study Center at Yale University wrote in 1991, is the “linkage between a drug and a feared or rejected group within society.”

In this worldview, “acceptable” drugs like alcohol used by “respectable” populations like older Whites are defined as benign. This raises another disturbing secret: In addition to the 55,400 Americans killed by illegal-drug overdoses in 2015, alcohol overdoses killed another 33,200—72 percent of them non-Hispanic Whites. The highest and fastest-rising rates of alcohol deaths (as for drug deaths) are among middle-aged Native, White, and Black populations.

The vast dimensions of America’s addiction crisis have been ignored and distorted for so long that designing workable policies at this late date seems beyond official capability, much less in the Trump era. But there have been some hopeful developments in California, a state that has occupied both extremes of the drug crisis.

In the 1960s and ’70s, California’s rates of drug arrests and deaths from illicit drugs were staggering, double to triple the national average. By 2016, the state’s rate of drug arrests had fallen to only slightly above the national average and its rate of drug deaths had fallen to 40 percent below that level.

In between, in the 1980s and ’90s, California led the drug war, arresting some 4.7 million people for drug offenses, one-fifth the national total. By 1998, California imprisoned 40 times more people for drugs than in 1980. However, evidence mounted that get-tough policing only worsened drug abuse. Courts were mandating against prison overcrowding. In 1999, California shifted away from arrest and incarceration and toward decriminalization and community-based treatment. Imprisonments for drug offenses plunged 90 percent through 2015.

While California displays the best trends of any state in deaths from illicit drugs, there’s a big generational catch: Californians ages 45 and older die from and get arrested for illicit drugs at much higher rates, and younger Californians at much lower rates, than their respective counterparts elsewhere, according to FBI and CDC data.

Younger Californians are composed of higher Latino and Asian populations with high proportions of recent immigrants. California teenagers in particular—now allowed decriminalized access to marijuana the same as adults—show sharply lower crime, drug offenses, violence, shootings, suicides, school dropout, and unwanted pregnancy rates than before drug policy reforms.

The opioid crisis is dividing the problem-solvers from the problem-exploiters. Those exploiting the crisis are pushing the same old rhetorical campaigns and policing crackdowns targeting immigrants, young people, and urban minorities. This in spite of the fact that just 8 percent of America’s drug deaths involve persons under age 25, and 20 percent are people of color. Blaming scapegoats is the only thing drug warriors know to do, a major reason America suffers endless, worsening drug crises.

In contrast, the problem-solvers face a difficult challenge. Questioning why the U.S. suffers such extreme social epidemics raises complex, uncomfortable issues: The persistence of extreme poverty afflicting African and Native Americans; the self-segregation of older White populations into angrier, resentful, self-destructive enclaves; the exacerbation of crises by privatized political and medical interests that profit from addiction; the dereliction of leaders who exploit racial and generational divisions instead of identifying problems and solutions; and the dismaying lack of empathy that bitterly divided Americans display for one another.

Unfortunately, we’re not at the stage where leaders can say the obvious: Let’s study younger people in diverse, reform-minded states with heavy immigration like California to see why their drug death levels are so low. That would be a terrific start.