During the 2016 presidential election, the opioid crisis caught the spotlight as one of the central issues for voters in the Midwest and Northeast. But the recent Republican Primary in New Hampshire left voters feeling dissatisfied with how the candidates plan to address the issue.
Former President Donald Trump once called New Hampshire a “drug infested den.” His main policy proposal? To deploy military force and fire missiles at clandestine drug labs in Mexico. Throughout the 2024 primary campaign, Trump is indistinguishable from the many candidates who challenged him and have since fallen like dominos. Former New Jersey Gov. Chris Christie was one of the few Republican candidates who spoke to the pain and loss felt by millions of families, and he supported major investments in drug education and treatment. Meanwhile, Florida Gov. Ron DeSantis and former South Carolina Gov. Nikki Haley both echoed Trump’s rhetoric.
Anyone who factually knows anything about drug policy and the causes and conditions of substance use disorder considers “bombing Mexico” to be a deeply unserious idea, one that would do next to nothing to treat addiction and save American lives. Throughout the 2024 election, the fentanyl crisis will no doubt be on the minds of voters, and there must be more on offer than belligerent and empty rhetoric coming from both sides of the aisle. Both Republican and Democratic presidents have failed to appropriately respond to America’s drug crisis. We need tangible solutions that address both the supply and demand side of this deadliest drug crisis in American history.
During the last 12-month period for which data is available, roughly 74,000 people died from fentanyl-related overdoses alone. That’s nearly double the total number of deaths for all drugs combined ten years ago. With the rise of synthetic stimulants and newer, even deadlier opioids, America is on track for another horrific year. The worst part: many of these deaths are preventable.
So why aren’t more being prevented? There is no single answer, just as there is no single solution to this vastly complicated crisis. Part of the problem: We’re stuck in the past. The 21st century drug epidemic is no match for 20th century drug policies. We’re living in a brave new world, and we must adapt to it. If we don’t, we risk losing even more Americans.
The central factor that explains this unprecedented surge is the synthetic drug supply. Driven by technological advances and economic forces, synthetic drugs have taken over the drug market. Illegally manufactured fentanyl is several times more potent than morphine and heroin, and it kills tens of thousands of people every year while harming our families and communities. Synthetic drugs are completely different from crop-based drugs of the past like heroin and cocaine. Since fentanyl sold on the street is synthetic, that means any amount that’s seized can be quickly replaced by rogue chemists working in underground laboratories. This makes the job of border agents and law enforcement infinitely more difficult, if not impossible. In fact, by taking on this impossible mission, they’re being set up for failure.
On the surface, it makes sense to want to seal our borders and make them “fentanyl proof,” so this deadly drug can’t be trafficked. But because fentanyl is so potent, that means the quantity of it being smuggled into America is tiny. Research suggests the amount of fentanyl consumed in America is in the single digit metric tons. That means all the fentanyl consumed in the U.S. can fit in just one 20-foot cargo container. “To put that in perspective, the U.S. imports more than 1,000,000 metric tons of avocados each year from Mexico,” writes drug policy experts Jonathan Caulkins and Peter Reuter in Scientific American. More than 22 million cargo containers arrive in America by land and sea annually. Trying to find just one that contains fentanyl is beyond looking for a needle and a haystack.
Still, federal law enforcement and border patrol are working overtime. In 2023, the Drug Enforcement Administration seized more than 78.4 million fentanyl-laced pills and nearly 12,000 pounds of fentanyl powder. That’s an enormous amount. And yet, during that same year, the Centers for Disease Control and Prevention estimates more than 110,000 people will have died from a drug overdose. I don’t believe this means we just give up. It means we must work smarter, not harder. Caulkins and Reuter suggest that law enforcement still has a crucial role to play. Rather than relying on them to achieve mission impossible, let them do what they do best: go after violent criminals and money laundering operations that fund the leaders of violent trafficking organizations.
And that’s just on the supply-side of the drug epidemic, which typically involves foreign policy and diplomatic relations with other nations. There’s so much more we can be doing at home to save the lives of Americans.
On this front, we know where to start. We must understand that substance use, addiction, and drug overdoses are symptoms of bigger problems in our society. I believe America’s drug epidemic is connected to our “loneliness epidemic.” Even before the COVID-19 pandemic, roughly half of U.S. adults reported higher levels of loneliness. Technology has radically changed how we interact with the world and those around us. Many of us can work from home and get food and groceries delivered right to our door, all without ever having to leave the house and see people.
What does this have to do with drug overdoses? We know that when the overdose reversal drug naloxone is made more accessible, that more people stand the chance of overdose survival. But naloxone can only work if someone is there to administer it. People who are unconscious and overdosing cannot save themselves.
Moreover, more Americans might be feeling lonely, and using drugs to cope, because they feel unsatisfied and unfulfilled by life. As a person in long-term recovery, I know my own addiction stemmed from the inability to connect with others. At the height of my addiction, I felt lonely even when I was surrounded by friends and family who cared for me.
We live in the oldest democracy and wealthiest nation on the planet. But for too many people, life is hard. Every day is a challenge and a struggle to survive. We know that being unhoused, uninsured, and unemployed are major risk factors for addiction and health complications. We know that when treatment is made more affordable and accessible, more people will seek it. But our health care system is too expensive and leaves far too many people without access to vital services. We know that young people respond to drug education that speaks to their reality and gives them more tools than “Just Say No.” Young people are the future of this country, and we must invest in quality, evidence-based drug education. Education and prevention are critical tools in this fight — and we are not using them enough.
Lastly, we know that stigma and harsh judgment keep people hiding in the shadows. We need more compassion for those who are suffering. We know all these things work. And though progress is being made, there is so much more we can be doing. It’s time we get unstuck from the past, put the rhetoric behind us, and get realistic about the path forward to end this health crisis.
Ryan Hampton is a national addiction recovery advocate and author of two books on the overdose crisis: “American Fix” and “Unsettled.” His third book “Fentanyl Nation” will be released by St. Martin’s Press in September 2024.