I’ve been teaching a course on the Global Drug Trade this year, and my class recently covered the opioid crisis, including the emerging drugs of fentanyl and carfentanyl. If you haven’t heard of these drugs before, you might want to read German Lopez’s Vox article “How an elephant tranquilizer became the latest deadly drug in the opioid epidemic.” While the epidemic exists in the United States, these drugs are causing havoc in British Columbia, Canada. What is distinct about these drugs is that they are not only dangerous to the user, but also first responders. The crisis has been so serious that it has caused people to rethink how we deal with illegal drugs in a profound manner.
In my class there was a great deal of discussion of whether the broader opioid epidemic is being covered differently in the media because many people using these drugs are middle class, white and older. They are also distinct, my students noted, in that most people who become addicted do so because they received a prescription for the drugs legally. There is no question but that major corporations have pushed these drugs, as this wonderful John Oliver piece describes. The epidemic has deepened, because when people have difficulty accessing legal opioids they have turned to heroin.
What is to be done? For many of my students, this issue touched close to home, as they knew people who had been affected, in both rural and urban communities. Many, many people told heartbreaking stories of how addiction had destroyed the lives of their parents, siblings, neighbors and even customers. Reading some of the responses left me feeling shaken. Overall, my students argued that these drugs became so widespread because of ignorance. It was all to easy to visit the E.R. and receive far more opioids than you were likely to need to manage pain. More than one student recounted their personal experiences in which they felt that doctors were pushing these medications upon them. My students wanted to see the companies that played a role in beginning the opioid epidemic (such as Purdue Pharma) taking a lead in public relations campaigns to warn about their dangers. My students also wanted to see diversion programs created (such as the LEAD program in Seattle) that would move addicts into treatment as an alternative to incarceration. My students also stressed that these options had to be made equally available to people who were not middle class and white. There was no consensus on legalization, including from the students whose lives had been most affected by these drugs. Most students, however, did believe that what was most needed was a public health response to the crisis. And that had to start with doctors taking responsibility for prescribing opioids less frequently, at lower doses, and for shorter periods.
As I mentioned above, John Oliver has a wonderful piece on the opioid epidemic, which is well worth viewing: “Opioids: Last Week Tonight with John Oliver (HBO).” Oliver balances tragedy with humor, to describe how corporations helped to create this terrible problem. I also recommend this Frontline video, “Chasing Heroin,” although it contains disturbing scenes and grim content. This link probably won’t work outside of North America, or at least it didn’t for me in Amsterdam. Lastly, there are some powerful pieces about the crisis in British Columbia, Canada:
Crawford Kilian, “Carfentanil: The Drug War goes Nuclear,” The Tyee, 9 September 2016.
Natalie Clancy, “There’s definitely blood on the premier’s hands’: B.C. government fails to deliver fentanyl crisis fix” CBC News online, Sep 10, 2016
Natalie Clancy,, “’A small Band-Aid on a big cut’: Vancouver firefighters race to revive fentanyl addicts,” CBC News online, Sept., 13, 2016. Please be warned that this article contains some graphic images and information. I have included it here because it is a powerful piece to understand the experience of first responders in British Columbia. Let us hope that similar scenes aren’t reproduced in other cities throughout North America, as some people are warning.
Shawn Smallman, 2017