Opioids, Overdose, Abstinence—A Historically Deadly Combination

Editor’s Note: Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University.

We have told ourselves the “opioid crisis” is an exception to past drug scares. In the past century, the narrative goes, we relied on law enforcement and punishment to curb widescale drug use, but our country now has turned over a new leaf—one centered on public health and compassion. Had it not been for Purdue Pharma, a uniquely bad actor, the spread of addiction and overdose deaths would have never occurred.

None of this is true. Rhetorically, yes, smart politicians now deemphasize the punishment aspect in public speeches. But law enforcement plays a greater role than ever before in regulating the use of drugs—from the zealous policing of some people who use illegal drugs to expansive prescription monitoring programs and from the detailed cataloging of the dosage of Americans’ medications to DEA to threats to doctors who fail to obey their dictates. Such strict and exacting regulations often leave elderly patients and patients with chronic pain out in the cold unable to secure necessary drugs. Yet, at the same time, prohibitionist drug control measures have also done little to stop the proliferation of black-market drugs.

Far from being a deviation, this has long been the norm and with often devastating results. Regardless of your thoughts about current events, this post will let us look back and travel to the past to try to clarify why overdose deaths continue to increase now despite a dramatic recent decrease in opioid prescriptions. And why this situation unlikely to change under current conditions. For about the last century, the United States government has abided by a philosophy that seems to prioritize drug abstinence and the strict policing of drug use at the expense of saving lives. To investigate this continuity, I will briefly examine two episodes: a 1930s critique of an early version of the war on drugs and the government’s opposition to needle exchanges during the AIDS epidemic of the 1980s.

Points Hudson Title Card Opioids
Left: A 10 milligram OxyContin pill. Source: Wikimedia Foundation.

Read more

Self-Help Isn’t The Solution; It’s The Problem

Editor’s Note: Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University. 

Screenshot 2019-12-31 at 11.00.39 AM

The sober curious movement (or “new sobriety”—the branding comes in a variety of flavors) is less a coherent philosophy or sound medical advice and more of a marketing campaign, hawking self-help merchandise and thousand-dollar yoga retreats, along with run-of-the-mill solipsism. It is an online phenomenon, fluent in the language of Instagram, elevated by media-types who share similar well-to-do backgrounds and sensibilities. It is hash-taggable psychobabble meant to solve cosmopolitan ennui and stay-at-home malaise. Its fans are not only upper class but also ultra-fit, photogenic 30-and-40-somethings ready-made for television. 

Scratching the surface, you discover that the day-to-day problems of sobriety-curious enthusiasts aren’t what most of us would classify as problems. And as for solutions, it features primarily simple adjustments like not carrying into adulthood the same level of alcohol consumption you did as an undergraduate. I can’t imagine the people quoted in these stories as real; they are much closer to Arrested Development or Schitt’s Creek characters. Even that comparison might be generous. 

A reporter comparing “mindful drinking” (lots of terms for the same thing) to AA’s anonymity found, “No longer is the topic of sobriety confined to discreet meetings in church halls over Styrofoam cups of lukewarm Maxwell House. For these New Abstainers, sobriety is a thing to be, yes, toasted over $15 artisanal mocktails at alcohol-free nights at chic bars around the country, or at “sober-curious” yoga retreats, or early-morning dance parties for those with no need to sleep off the previous night’s bender.”

Read more