The Opioid and Trump Addictions: Symptoms of the Same Malaise

Photograph Source: GeoTrinity (Wikimedia Commons) – CC BY-SA 4.0

The journalist and author Sam Quinones became aware of it even before the 2016 election, when he saw those Trump/Pence yard signs all over opioid country. Within days of Trump’s electoral victory, he published the disturbing story, as did the historian Kathleen Frydl under the apt title, “The Oxy Electorate.”

Donald Trump did very well, much better than Mitt Romney had in 2012, in the areas hardest hit by a raging drug epidemic. Indeed, one could describe the main opioid victims in exactly the same demographic terms that pundits use to characterize the core of Trump’s electoral support: non-Hispanic, mostly working-class whites without a college education living in rural areas and small cities. The opioid and Trump addictions, the one individual and the other collective, are symptoms of the same malaise.

For one, they are driven by sane powerful economic forces, gainfully employed in afflicting a vulnerable population. The rapacious, unregulated capitalism of the kind that now shapes the Trump agenda prepared the ground of the opioid crisis in Appalachia, the Midwest Rust Belt, and elsewhere by engendering the inequalities and hardships that drive so many to despair.

Marketing that despair with its blockbuster drug OxyContin, Purdue Pharma, the company of the notorious Sackler family, is widely credited with setting off the opioid epidemic in the late 1990s. By 2018, there were over 50,000 deaths a year from overdoses of organic and synthetic opioids.

Perhaps it is fitting that the narcotic delusions peddled by Purdue Pharma and other companies are effects of the equally fictional and criminally fraudulent practices they have devised to progressively expand the number of users. Purdue Pharma launched OxyContin by falsely claiming to doctors and patients that the drug was weaker than morphine and, as hardly euphoric, it was not likely to be addictive.

Pumping opioids into communities in amounts hugely disproportional to the local population became a common practice of the industry, affording lucrative returns also to over-prescribing doctors and clinics, some of then essentially “pill-mills” liberally dispensing the drugs on little or no medical pretext. As alleged by the plaintiffs in recently unsealed court documents from 2006-2012 concerning suits brought by over one hundred state and local governments against the whole supply chain, some of your favorite national retailers—Walgreens, CVS, and Walmart—were in on the racket

The overall effect is a veritable economics of affliction: on the supply side, big corporations making unseemly amounts of money by flooding these markets with ever-increasing quantities of ever-higher doses of opioids; on the demand side, poor people without health insurance for whom pain-killing pills are the cheapest and quickest way to alleviate their suffering.

According to the common wisdom and several sociological studies, the main reason that communities hit by the opioid crisis are also addicted to Donald Trump is the economic distress that underlies both. These people once knew better days, but industries left and mines closed, and they were left with “bullshit jobs” or none at all, only poverty and disaffection.

Yet according a sophisticated analysis that appeared last year in JAMA, “socioeconomic conditions” account for only about two-thirds of the Trump-opioid connection—which is to say, the economic decline is not sufficient to explain it.

Then again, many equally precarious Black and Hispanic communities elsewhere in the country have neither turned massively to Trump or to opioids. Clearly there is something different about the culture of opioid country.

What is immediately different for indigent people in rural Kentucky or the Mahoning Valley of Ohio is that so far as they are concerned, they didn’t simply lose their jobs, the Blacks got them–because the Government favors Blacks.

As Sean Mcewee reported in Salon during the 2016 campaign, these Trump supporters experienced their pain as discrimination and victimization. “Racism is the real driver of Trump’s success,” he wrote, ”social pain is understood through the lens of racial animus.” Mostly it was Blacks but it could also be Mexicans, or immigrants, or foreigners; in other contexts, the victimized people expressed equal opportunity animus toward Muslims, gays, lesbians, coastal elites, Harvard, and Washington. Beyond the economic decline that set it off, the threat was existential: as if their whole way of life were an endangered cultural species.

A decades-long history of radical change in social norms, backed by judicial decisions, largely by-passed the heartlands, leaving people there to experience their deteriorating economic situation as all-round cultural discrimination— orchestrated by the powers to the benefit of others. The cultural revolution that began in the 1960s brought women’s liberation, gay liberation, sexual liberation, Roe v. Wade, and a Civil Rights Act that made the way for a Black man to become president of the United States.

And even as these new norms undermined traditional values of the heartlands, many were imposed and sanctioned by federal law—“the government.” It was enough to bring opioids together with making America great again, the former obliterating the present and the latter restoring the past. It made Donald Trump the opiate of the masses.

Marshall Sahlins is the Charles F. Grey Distinguished Service Professor emeritus of anthropology at the University of Chicago. His books include: Stone Age Economics, The Western Illusion of Human Nature and On Kings (with David Graeber).