The Washington PostDemocracy Dies in Darkness

Doing the same thing about overdoses and expecting different results

In April, law enforcement officials in Alameda County, Calif., home of Oakland, seized 92.5 pounds of fentanyl after discovering a fentanyl manufacturing lab. About two pounds of the drug has the potential to kill 500,000 people.


That was the title of a Senate Homeland Security and Governmental Affairs Committee hearing back in 2016. With opioid abuse wreaking havoc on the country, we were finally going to get to the root of the nation’s deadly obsession with mood-altering drugs.

“There is something going on here that we, as a nation, are devouring drugs — prescription and illegal drugs at rates not seen in humanity — not seen anyplace else on the planet Earth,” said Sen. Cory Booker (D-N.J.).

He wanted to know why.

Cheryl Healton, founding dean of the School of Global Public Health at New York University and a witness at the hearing, replied: “That is a very difficult question. Why do we use drugs? Humans have been using mind-altering substances for —”

Booker interrupted. “This is not a human problem,” he said. “It is an American problem.”

Fentanyl's deadly surge

In the six years since that hearing, the opioid epidemic has morphed into a fentanyl-fueled catastrophe. It’s the worst drug epidemic in the nation’s history. No other country is experiencing anything nearly this awful. In 2021, more than 100,000 Americans died of drug overdoses — more than 80,000 of them from opioids, including prescription pain pills and fentanyl, according to an estimate released by the National Center for Health Statistics.

Surely, there must be something that’s driving the demand.

Edwin Chapman, a cardiologist and specialist in addiction medicine, treats opioid, heroin and fentanyl addicts at his office in Northeast Washington. He says the driver is pain — from being injured or losing a loved one to gun violence or being displaced and left homeless by gentrification.

“We have people dealing with a lot of traumas,” Chapman said. “And because of our unique form of capitalism, you could lose your job in a heartbeat and find yourself struggling to survive on the streets.”

Why is fentanyl so dangerous?

The opioid epidemic that ravaged residents in red states such as Ohio, Pennsylvania and Kentucky was precipitated by jobs lost when coal mines and auto assembly plants closed, and other jobs were shipped overseas to cut costs.

That squares with an assessment by Nora Volkow, director of the National Institute on Drug Abuse. In part because of the coronavirus pandemic, many people have become depressed, anxious and lonely, she said. Not only will such mental health issues persist, self-medicating with illicit drugs is likely to make them worse.

Some psychiatrists have become alert to a worst-case scenario, called “suicide by opioid.” People who can no longer tolerate the pain of depression deliberately overdose on fentanyl.

Of the billions of dollars earmarked for disrupting the drug supply line and reducing demand, I haven’t heard of anything being set aside to deal with the hopelessness and despair that seem built into the American way of life. Nothing to stop the pain of becoming homeless or losing a job because of an economic system that operates to take money from the working class and funnel it to the rich.

Eradicating poverty and gun violence is not in the plans to stem people’s need for drugs to cope with life in a dog-eat-dog nation. With America’s highly toxic stress levels, worship of materialism and increased isolation from those who are not carbon copies of yourself, it’s little wonder we are gobbling up soul-killing opioids as fast as the drug cartels can move them.

Adding insult to the injury, the District — the nation’s capital — has one of the highest rates of fentanyl overdose deaths of any city. This should be the model city for the nation, not a national tragedy.

Instead, Black Washingtonians suffer.

“We observed an alarming and sustained acceleration of opioid-related mortality within the non-Hispanic Black population of Washington DC that far exceeded the level and rate of increase within the non-Hispanic white population, and which was driven by recent increases in synthetic opioid deaths,” a team of researchers led by Mathew V. Kiang wrote in a New York Academy of Medicine publication.

“In 2019, the observed opioid-related mortality rate among Black DC residents was 11.3 times higher than white DC residents, resulting in 56.0 more deaths per 100,000 (61.5 vs. 5.5 per 100,000),” the report said.

That’s part of what makes this substance-abuse problem a uniquely American problem — deeply rooted racism.

The authors of the report call for uniquely American solutions.

Those include culturally tailored drug prevention programs for the Black community, including providing prevention and treatment services through faith-based organizations. “Public health interventions should address the impact of the opioid overdose crisis on the Black population specifically in the context of historical experiences of racial discrimination, violations of trust by the health care system, and other barriers to care,” they wrote.

This is what Booker was trying to get at during the Homeland Security Committee hearing. Get beneath the surface, take a hard look at how people are being mistreated in this country. People in pain will seek relief even if it kills them — and even kill themselves so that they never hurt again.

“I am tired of us spending billions and billions of dollars — trillions of dollars, as a country — not dealing with the real root cause of the problem,” Booker said.

With a million lives lost to drug overdoses so far in the 21st century, and more epidemics surely to come, we should all be tired of doing the same old things and expecting different results.