Forget the ‘war on drugs’ or laying all blame on pharmas, this epidemic exists because millions live in a world without hope, certainty and structure.
The number one killer of Americans under the age of 50 isn’t cancer, or suicide, or road traffic accidents. It’s drug overdoses. They have quadrupled since 1999. More than 52,000 Americans died from drug overdoses last year. Even in the UK, where illegal drug use is on the decline, overdose deaths are peaking, having grown by 10% from 2015 to 2016 alone. The “war on drugs” continues – but it’s a war we’re losing.
Most drug-related deaths result from the use of opioids, the molecules that are marketed as painkillers by pharmaceutical companies and heroin by drug lords. Opioids, whatever their source, bond with receptors all over our bodies. Opioid receptors evolved to protect us from panic, anxiety and pain – a considerate move by the oft-callous forces of evolution. But the gentle impact of natural opioids, produced by our own bodies, resembles a summer breeze compared to the hurricane of physiological disruption caused by drugs designed to mimic their function.
Most street opiates (including heroin) are now laced or replaced with fentanyl – the drug that killed the singer Prince – and its analogues, far more powerful than heroin and so cheap that drug-dealing profits are skyrocketing at about the same rate as overdose deaths. The UK’s National Crime Agency said that traces of fentanyl have been found in 46 people who died this year. Users don’t know what they’re getting and they take too much. Fentanyl is recognised as a primary driver of the overdose epidemic.
Society’s response has been understandably desperate but generally wrongheaded. We start by blaming addicts. Then we blame the pharmaceutical companies for developing and marketing painkillers. We blame doctors, for overprescribing opiates, which pressures them to underprescribe, which drives patients to street drugs – cheaper, home delivery via the internet, and zero quality control. We say we’re going to reignite the war on drugs, recognised by experts as a colossal failure from the 1930s onward. We also continue to view addiction as a chronic brain disease, so the benefits of education, social support, psychological intervention, and personal empowerment receive far too little attention. Yes, addiction involves brain change, but ongoing medicalisation does little to combat it.