Before President Trump called for a punitive response to the opioid epidemic, he should have considered the way that Oklahoma is dealing with the crisis.
The Journal Record panel discussion on the opioid disaster didn’t seem like it was happening in Oklahoma City. OK, it was held at the KOSU NPR station and it featured experts from the state Department of Mental Health, which has established a long record of excellence in the face of severe underfunding. But, I remembered our cruel and primitive response to the crack epidemic of the 1980s. I wasn’t prepared for our state’s cultural change “from viewing addiction as a moral flaw to seeing it as a brain disease.”
I certainly wasn’t expecting Republican Attorney General Mike Hunter’s policy of “aggressively suing the pharmaceutical companies that mislead physicians into thinking opioid medications were safe for long-term use and not addictive.” Hunter and former federal judge Michael Burrage are seeking compensation for Oklahoma’s share of the $78.5 billion per year costs of the epidemic that Big Pharma helped unleash. Oklahoma is joining with neighboring states “to prevent excess opioid supply from moving across state lines, and to crack down on doctor- and pharmacy-shopping.”
Before hearing the presentations, I embarrassed myself by prejudging the victims of the corporate malfeasance. I had seen the way that the rapid deindustrialization, spurred by the Reagan administration’s supply-side economics, wiped out the hopes of my African-American neighbors, and how that despair helped fuel the crack epidemic. I then witnessed the medical malpractice known as the “Just Say No” campaign, which treated addiction as a simple condition to be conquered by willpower. For the next generation, I saw the continuing harm inflicted by the War on Drugs.
I also recalled the New York Times and the Washington Post reports on the stretches of the country where life expectancies were declining sharply for disproportionately white, undereducated, middle aged Americans who felt abandoned. Oklahoma is one of the states that has been hit the worst by these “deaths by despair.” Noting the correlation between the places where life expectancy was dropping the most, and the Trump political base, I speculated that the loss of hope was contributing to the epidemic. In doing so, I was borrowing some of the “blame the victim” mindset that was embarrassingly close to the prejudging which resulted in the punitive response to crack abuse.
In subsequent discussions with outstanding mental health providers, I was told to not be too hard on myself for jumping to that conclusion. Some cited the Times and Post coverage of the shocking increase in death rates. There is truth to my snap judgment that the loss of hope, as well as the loss of community, was a contributing factor. Also, Oklahoma is tied with West Virginia and Montana for children surviving multiple traumas, and that leads to self-medication.
On the other hand, I should keep my eye on the ball. It was the pharmaceutical industry that manufactured the narrative that produced a tragedy that Dr. Jason Beaman compared with the HIV/AIDS crisis. As Judge Burrage explains, the industry made false representations to doctors “to prescribe opioids so pharmaceutical companies could line their pockets with billions of dollars.”
Neither was I wrong in noting the contrast between the treating crack addiction like a “moral flaw” as opposed to a “brain disease.” Today’s enlightened response is in large part due to the way we naturally help people who we know, as opposed to the way inner city blacks were objectified. But, the state of the medical art has advanced greatly in the last thirty years, and Oklahoma experts are learning from and contributing to the global understanding of addiction.
I was then invited to Catalyst Behavioral Services, which treats the whole person. Catalyst began as a nonprofit storefront and is now one of the area’s largest public sector service providers. Catalyst learned from providers on the coasts when developing their holistic methods, peer recovery and support therapies, in addition to medical treatments to reduce cravings and prevent withdrawal symptoms.
Catalyst also schooled me on why it had been hard to move beyond the simplistic rejection of medically assisted treatment. Powered by the cliché that you can’t fight drugs with drugs, systems had treated the drug abuse, not whole human beings.
It is tragic that we waited for the deaths of so many white Americans before having a national conversation on treatment, and Trump’s statement shows that the discussion must continue. However, Oklahoma has been at the forefront of helping to create the conditions which allowed for such devastation. They range from tax breaks for eliminating good-paying jobs to mass incarceration of nonviolent offenders to deregulating our economy to the point where Big Pharma was free to contribute to more than 59,000 deaths, nationally, in one year. But, now our Red state is also part of the solution.