Pandaemonium

THE OPIOID CRISIS AND THE EXPLOITATION OF PAIN

Pills

This essay, on the opioid crisis in America, its roots and its lessons, was published in the Observer on 1 September 2019 under the headline ‘America’s opioid catastrophe has lessons for us all, about greed and racial division’. (I have restored a couple of paragraphs that I had to remove for reasons of space in the Observer.)


‘We’ll build a wall to keep the damn drugs out.’ So insisted Donald Trump at a rally last year to launch the White House’s initiative to stop opioid abuse. For Trump, at the heart of America’s opioid crisis lie open borders, illegal immigrants and foreign drug cartels.

Brad Beckworth, an Oklahoma state attorney, takes a different view. The drugs to which so many in the state are addicted, he told a court in July, ‘didn’t get here from drug cartels. They got here from one cartel: the pharmaceutical industry cartel.’

The court agreed. Last week, it ordered the pharmaceutical giant Johnson & Johnson to pay $572m in compensation for running a ‘false and dangerous’ sales campaign that had created an unprecedented epidemic of addiction in Oklahoma.

America’s opioid crisis is stark. Both the use and abuse of prescription opioids – painkillers such as OxyContin and Vicodin – have, since the 1990s, rocketed. Last year, 211m opioid prescriptions were handed out in the US. At its peak in 2012, that figure stood at 255m – 81 prescriptions for every 100 residents. In 2016, a fifth of all deaths among Americans aged 24 to 35 were due to opioids. Opioid-caused deaths have been a major factor in life expectancy falling for three years in a row.

Foreign drug cartels have certainly exploited the epidemic, smuggling in heroin and Chinese-made opioids such as fentanyl. But they are relatively minor players in comparison with the US drug companies that, between 2006 and 2012, saturated America with 76bn oxycodone and hydrocodone pills alone. It resulted in nearly 100,000 deaths. In 2016, one million Americans were using heroin. Eleven times as many misused prescription opioids, more than 2 million of whom had become addicted; 80% of new heroin users started out misusing prescription painkillers. Insofar as drug cartels are playing a role in the opioid crisis, it is because pharmaceutical companies created a market for them.

Big Pharma relentlessly pushed the sales of opioids, even when they knew of its harm. A series of court cases against drug companies have revealed their cynicism. ‘Keep ’em comin!’, a sales executive at a drug wholesaler emailed a national account manager for Mallinckrodt, America’s largest manufacturer of opioid pills. ‘Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are. . .’

The highest death rates from opioids have been in rural communities in West Virginia, Kentucky and Virginia.  In Norton, Virginia, an old coal-mining town of about 4,000 people, drug companies shipped in 306 pain pills for every man, woman and child every year between 2006 and 2012. The town’s Walmart alone received more than 3.5 million opioids. The death rate from prescription opioid overdoses in Norton was 18 times the national level.

The relationship between Big Pharma and US doctors can only be described as corrupt. Official figures show that last year 627,000 doctors received between them more than $2.1bn in what are called ‘general payments’ – payments unrelated to research. The total paid to doctors and hospitals by drug companies was more than $9bn. Unsurprisingly, the greater the payments, the more willing doctors were to prescribe opioids.

Big Pharma’s relationship with lawmakers is equally rotten. Between 2006 and 2015, drug companies and their advocate organisations spent more than $880m on lobbying. They contributed to the campaigns of more than 7,000 candidates for state-level offices. And they secretly funded ‘independent’ patient groups to advocate on their behalf.

There is, however, more to the story of the opioid crisis than venal drug companies. It is an indictment of a health system built on profit, a political perspective that encourages the medicalisation of social problems and a racialised ‘war on drugs’.

The roots of the crisis lie in the 1980s and Ronald Reagan’s policy of corporate deregulation. Drug companies, led by Purdue Pharma, the corporation owned by the Mortimer and Raymond branches of the Sackler family, took advantage with aggressive marketing campaigns to convince doctors and regulators of the need for, and the safety of, a new class of opioid analgesics. Drugs previously used primarily for patients with cancer or a terminal illness became a routine prescription.

It wasn’t just marketing skills that drove this shift. This was an era of deindustrialisation, mass job losses and the breakdown of communities, particularly in white rural areas such as West Virginia, and in the rust belt of the midwest, many of the areas that later became ‘Trump country’. These communities were targeted by drug companies. The answer to poverty, social dislocation and political disillusionment became opioid pills. Between 1991 and 2011, painkiller prescriptions in the US tripled.

The problem was exacerbated by America’s insurance-based healthcare system. Insurance companies insist on the cheapest solution to any problem. And pills are cheap. In Japan, doctors treat acute pain with opioids in 47% of cases; in America, the figure is 97%.

Dozens of Prescription Pill Bottles

Then there is the question of race. It’s no coincidence that the opioid epidemic has devastated largely white, working-class and rural communities. It was a conscious strategy by pharmaceutical companies to avoid the taint of being associated with inner cities, black communities and illicit drug use.

Deregulation took place at the same time as the launch of the ‘war on drugs’, a war waged against foreign drug dealers and within African American urban communities. The consequence was more intensive and repressive policing, greater social inequality, mass incarceration of black men – and a social narrative about ‘drug-infested ghettos’.

David Herzberg, author of Happy Pills in America, a cultural history of America’s relationship to drugs, observes that for more than a century there have been two parallel discussions about drug use. Psychoactive drugs used largely by middle-class whites are classified as ‘therapeutic’ and ‘medicines’ and subject to light-touch regulation. Those used by non-whites and the poor are deemed ‘illegal’ and sanctions are enforced through harsh policing. Trump’s rhetoric about foreign drug cartels and illegal immigrants is merely the latest expression of the historic tendency to view the problem of drugs through a racial lens. And while blacks have been the main victims of this, the opioid crisis shows how a racist perspective can affect poor whites, too.

It is tempting to see the opioid crisis as a peculiarly American issue. There are features of the story that are unique to America. But many aspects, from the tendency to treat social issues as medical problems to the racialisation of the ‘war on drugs’, have wider relevance too, not least to Britain.

Perhaps the most important lesson to learn is that turning health into a money-making machine inevitably has tragic consequences. Supporters of the free market, and of its extension into areas such as health, suggest that privatised services are more efficient. The reality is that when the primary goal is profit, not social need, corruption gets built into the system. The actions of companies such as Purdue and Johnson & Johnson are contemptible. They also follow the logic of the market.

6 comments

  1. damon

    It’s a pity this article wasn’t open to Comments is Free on the Guardian site, as some other opinions on it would have been interesting. It’s such a complex subject that I have to nod through much of Kenan’s analysis.
    The race side of it though left a couple of questions. Why does so much come down to degrees of melanin in people’s skin?
    I mean, could this actually be true? “It was a conscious strategy by pharmaceutical companies to avoid the taint of being associated with inner cities, black communities and illicit drug use.”
    Maybe it was a correct and honest decision to keep these dangerous prescription drugs out of neighbourhoods that were already being ravaged by the crack epidemic. So not a racist decision, but a wise one maybe. (I really don’t know). I’m pretty convinced that always bringing in skin colour into everything is an oversimplification.
    It has to be more than just that.

    John McWhorter is definitely a guy to follow when it comes to such things.
    https://mobile.twitter.com/JohnHMcWhorter/status/1154009957949476869

    I also don’t get why the words “drug-infested ghettos” are put in quotation marks like that.
    They have been a huge and very real issue all over the country in nearly every American city for decades.
    Coming from Europe, it’s a real shock to see whole parts of cities so run down and abandoned looking like some of them are. They only seem to improve as neighbourhoods as gentrification takes place and new people move in.
    Which isn’t really a solution to the underlying problems.

    • I mean, could this actually be true? “It was a conscious strategy by pharmaceutical companies to avoid the taint of being associated with inner cities, black communities and illicit drug use.”

      Yes. It could actually be true. in fact it is true. You can begin by reading the Herzberg book I mentioned in the article. Or perhaps read this. Or this. Or this. Or this.

      Maybe it was a correct and honest decision to keep these dangerous prescription drugs out of neighbourhoods that were already being ravaged by the crack epidemic.

      So you think it was a ‘correct and honest decision’ to push ‘dangerous prescription drugs’ into white neighbourhoods? You’re so caught up with the idea of drugs being a ‘black’ issue that even in response to an article about a major crisis of drug addiction in white communities, you want to minimise the problem because it doesn’t fit in with your particular racial narrative.

      So not a racist decision, but a wise one maybe. (I really don’t know).

      If you don’t know, perhaps you should do some reading and research, rather than blindly make suggestions for which you have no evidence.

      I’m pretty convinced that always bringing in skin colour into everything is an oversimplification.

      You’re not opposed to ‘bringing in skin colour into everything’. In comment after comment over months you have talked constantly and disparagingly of ‘black culture’ or ‘black ghettos’. What you oppose is any claim of racism. There’s only one thing worse than seeing racism where there isn’t any. And that’s not seeing racism where there is.

      John McWhorter is definitely a guy to follow when it comes to such things.

      So, what does McWhorter have to say about the opioid crisis?

      I also don’t get why the words “drug-infested ghettos” are put in quotation marks like that.
      They have been a huge and very real issue all over the country in nearly every American city for decades.
      Coming from Europe, it’s a real shock to see whole parts of cities so run down and abandoned looking like some of them are.

      Yes, drugs with black inner city communities have been a major problem. The facts show, however, that a higher proportion of the white population dies from heroin overdoses than of the black population. The opioid epidemic within white populations in largely rural areas is a far greater problem than the drugs issue in the inner cities. Between 1999 and 2015, overdose deaths for blacks increased by 64%; for whites by 240%.. 63% of all overdose deaths are from prescription opioids). The impact on white rural communities has been devastating. What drugs have done in these areas, in terms of communities, social bonds, infrastructure, etc, is worse than in many inner cities. But this is rarely recognized because people have a racialised view of the drugs problem. You’re a classic example – you don’t recognize the problem because you are so caught up with the idea of ‘drug-infested ghettos’. It’s you who is obsessed with race, an obsession that makes you blind to the facts.

      • damon

        “You’re not opposed to ‘bringing in skin colour into everything’. In comment after comment over months you have talked constantly and disparagingly of ‘black culture’ or ‘black ghettos’. What you oppose is any claim of racism. There’s only one thing worse than seeing racism where there isn’t any. And that’s not seeing racism where there is.”

        I once asked you if you’d ever heard of John McWhorter. I think it would have been around 2010 at “The Battle of Ideas” event in London. You said you hadn’t. I’d been reading him for several years by then – and still look up his latest pieces. So maybe I am “race obsessed” as you say.
        Or maybe I’ve just got some views on a complicated and often misdiagnosed issue.

        I don’t know if you’ve ever gone into cultural issues like this one at all for example.
        The pressure that some black young people face, to conform to “cultural norms” or face some censure for behaving in an “out group” manner. It’s kind of important.

        “The Origins of the ‘Acting White’ Charge
        School integration yielded a disturbing by-product: a psychological association between scholastic achievement and whiteness.”
        https://www.theatlantic.com/ideas/archive/2019/07/acting-white-charge-origins/594130/

        That kind of view is not going to go down well with the modern left, and the black left particularly.
        Maybe it’s because I’m white and a bit of a “Gammon” that I need to be extra careful in what I say on race issues to avoid being accused of speaking out of turn – about things that shouldn’t be my business.
        I don’t agree with that though ….. anymore than I’d say that you Kenan need to prove you’re not just parroting ideas like all the other BAME Guardian opinion writers. Even though nearly all of them are constantly pretty terrible in what they serve up in their opinion pieces when discussing race.
        Gary Younge has written well sometimes, particularly about his time in the USA – but even he does some terrible pieces too. I won’t just put you in that “BAME Guardian writer” bracket Kenan, but I’m sure a lot of more casual readers who don’t know your body of work so well, will.
        Just like I’ll quickly get accused as being a “race obsessed white bloke” very early on.

        But I do have to say, that you have sounded a bit like the SWP or Black Lives Matter in many of the things you’ve said on race. Like the Independent article listing all the cases of black deaths in police custody, and cases like that of the shooting of Cherry Groce.
        I’m not saying you’re like Al Sharpton (I’m really not saying that), but he is an extreme example of someone who gets it very wrong around these issues and actually makes things worse.
        So I was very pleased to see John McWhorter’s good friend Glenn Loury calling him out in the New York Times a couple of weeks ago.

        John and Glenn have been doing great Youtube podcasts together for over ten years btw. They are really worth seeking out. That I’ve been a “fan” of theirs for years may prove that I’m “race obsessed”.
        But only if you are inclined to be very quick to falsely assume other people’s motives.

        On the deaths in police custody in England, it’s not always about police racism. Even though Operation Black Vote etc would always portray it as such. It might only be police incompetence – like with the Cherry Groce shooting for example. The policeman admitted he fired his gun in error. He panicked – and one of the reasons he was so nervous he said – was that the police felt they were in a really dangerous environment. Not just entering the flat but the neighbourhood too.
        So yes, it was police incompetence, but also you’ve got to blame other factors too. Why did policemen fear going on operations in Brixton in 1985?
        And if he was a criminal, you have to blame the young man the police were going to arrest.
        He brought armed police to his mother’s door.

        I have tried to explain some ideas I have about much of the race stuff we encounter as being actually rather artificial. I’ve obviously failed in getting through to you what I’ve been trying to say.
        About the fakeness of the whole black youth subculture, where you see ideas of blackness being portrayed through music and videos, and then onto the school playgrounds and the after school buses and outside chicken shops in the evening.
        My point is that it’s all artificial. Or “Larping” (which means roll playing I believe). But it’s all human too. It’s the way we very flawed humans unfortunately behave when faced with difficulty and too much nuance and possibility. It’s sort of inevitable and is the way that the lowest common denominator often comes out on top and becomes the way things generally are.

        I’m actually very forgiving of poor human behaviour though. And that’s why it’s easy to see what I say as being “soft on racists”. I can understand why flawed humans don’t take very easily to great change in their lives. And something like the Windrush era migrations to the U.K. from the Caribbean and South Asia did cause great change locally and caused years of people getting used to it.
        It’s hardly surprising that the 1970s police forces were racist. It was our culture back then. The police didn’t know any better. They found it difficult to deal with these new people who often behaved in a different way to what people were used to. Rastafarian’s smoking marijuana being just one issue which caused a lot of aggravation. Our police overreacted, but why wouldn’t they?

        I tried to explain something like that when I was in Turkey (and I obviously failed).
        There I was trying to say how Turks would find it very difficult to become as multicultural as we in the Western white countries are expected to become. They have new minorities living there – quite a few Africans in Istanbul and Izmir, but they are never going to allow subcultures to grow up there in the way they do in the West. The moment any of those African young men start behaving like “The Woolwich Boys”, there would be trouble I think. From the police, but also from Turkish society locally.

        I’m in Valencia right now, and it’s surprisingly got a very low percentage of new immigrants.
        Most maybe from South America it looks like, but it still feels about 95% Spanish.
        It would be a totally different city if it had a similar population mix to London’s.
        If some of these suburban neighbourhoods in Valencia were like East Ham, Harlesden and Tottenham, they would be unrecognisable to what they are like now. Would it greatly change the feel of the city?
        It feels remarkably relaxed btw. None of the young people seem antisocial.

        Final point, and something that makes me smile. Even the security guards at the central library here carry truncheons and handcuffs. Can you imagine such a thing in England?
        Security guards at the shopping mall have guns.
        What are they going to do – shoot people?
        The idea that our British police are too violent is such a joke really.
        We’ve got the softest police in the world almost. Along with Ireland.

  2. damon

    I’m going to have to reject much of what you said there – but will have to see if I can explain it half decently as I sit down and write this now.
    I think a basic problem is that we’re coming at things from different sides. I’m trying too hard maybe to put forward difficult to understand and difficult to describe ideas of race and racism. It’s not that I’m “obsessed with race” like you say, but just that I take a different view to you. You also talk about race a great deal and I’ve been mainly replying to things that you have said. Just places where I disagree.
    This is you in the Independent in 1995. Did you not change your view much since then?
    https://www.independent.co.uk/voices/too-many-killings-to-ignore-1526160.html

    Do you ever look back and think that you got things wrong in the past?
    Northern Ireland perhaps? I admit I got that wrong for a while. Do you ever do the same?
    When I read your take on stories like that of Clinton McCurbin, who died while being arrested in Wolverhampton in 1987, I find myself reacting against the SWP/RCP spin put on such events which sound so extreme left wing and from a different time. The police arrested him, put him in a chokehold (like they do and are trained to do) and he died. It’s very unlikely that they set out to kill him …… and the police involved were just workers in uniform.
    So it was you who was making that a racial issue in my opinion.

    Anyway, on the opioid crisis. What’s worse, a city ghetto full of drugs and crime, or a rural county location where the drugs problems maybe worse, but are not so obvious and intense? Rural poverty and social problems are hidden in a way that blighted places like the parts of Cleveland I’ve driven through are not.
    One side of Gary Indiana was so run down and neglected looking, with people hanging about like it was a major “hood” situation. And the violence is probably worse than in some hidden away place in West Virginia.
    Do you not follow how many people are getting shot in Chicago?
    So there’s more to it than just the harm the drugs are doing to the people who are using them.
    The doctors knew that many those strong opioid tablets put into a ghetto area, would quickly end up for sale in the illegal drugs market. The same thing may happen in rural areas too, but not to the same degree perhaps.

    They’ve been oversubscribing those drugs in the U.K. too by the sounds of it.
    It would be interesting to hear what the doctors had to say about why they did it so much in the US.
    I’m sure you’re right about it being an easier and cheaper option. I don’t have any problem with any of that side of your argument. Just the race factor. Why always just call it race when it’s far more than skin colour?
    It’s race and culture. With culture being the biggest factor. That’s why the term “racist” is so inadequate.
    When people show prejudice on what seems to be racial grounds, the real prejudice is probably not against the person’s skin colour, put a prejudice about the person’s perceived culture and manner.
    I’ve already mentioned on here (twice I think) the book by Elijah Anderson called “Code of the Street – Decency, Violence, and the Moral Life of the Inner City”.

    What I think’s going on here Kenan is, that I’ve read that and think there’s a lot of really good stuff in it, and you’re still looking at things like an RCP street activist from thirty years ago.

    The book opens with a chapter called “Down Germantown Avenue” and is about a journey down this long road which goes from a distant leafy suburb of Philadelphia, several miles into the city centre, passing through middle class and working class neighbourhoods, and then finally through (or past) the worst Philadelphia ghetto.
    I’ll link to it below as it’s really worth reading. He describes how the culture of the street changes as you travel along it. Form polite and easygoing in the mostly white distant suburb at its western end, to getting rougher and more “street” as you travel down into the more working class part, and finally through the last bit, towards the city centre, which is a bit of a war zone. The reason you think I’m “race obsessed” (I think) is that I tend to agree more with him and John McWhorter.

    https://slought.org/media/files/elijahanderson_codeofthestreet.pdf

    • ’It’s not that I’m “obsessed with race” like you say, but just that I take a different view to you. You also talk about race a great deal and I’ve been mainly replying to things that you have said. Just places where I disagree.’

      Perhaps you should go back and read your responses to previous posts on Pandaemonium such as that on Meghan Markle, or on homelessness. On whatever issue I write, your comments always return to the question of race, immigration or ‘black culture’. Take your two comments here. This was an article about the opioid crisis. You’ve barely addressed that issue at all. Rather, you want to talk about inner cities and ghettos and what you seem to see as the real drugs problem. You imagine that you’re criticising people (including me) for talking about race. In fact that appears to be all you want to talk about. That is why I wrote that you are ‘obsessed’ with the issue.

      What you don’t like is whenever someone mentions ‘racism’. I’ve barely mentioned it in this article. But for some reason the fact that I mention the strategy of pharmaceutical companies in targeting white communities – and the fact that the opioid crisis is a crisis largely within white communities – seems to irk you. Sorry, those are the facts. If you want to show me why my argument is untrue – and provide the evidence to back up your argument – please do so. Otherwise, your condemnation of anyone who mentions a racist practice or policy – whether or not it is true – is little more than a fixation. Yes, people often see racism where there is none, and they should be condemned. So should those who refuse to see racism where it exists.

      ’This is you in the Independent in 1995. Did you not change your view much since then?’

      Sure, I stand by that article. Though, again, what that has to do with the opioid crisis in America today, I have no idea.

      ’What’s worse, a city ghetto full of drugs and crime, or a rural county location where the drugs problems maybe worse, but are not so obvious and intense? Rural poverty and social problems are hidden in a way that blighted places like the parts of Cleveland I’ve driven through are not.’

      Again, you are trying to minimise the opioid crisis because it doesn’t fit your image of what a drug problem is like. I don’t think you understand the sheer depth of the epidemic in America. So, let me repeat some facts (all of which I’ve already mentioned, thogh you seem to ignore them). Over the past 20 years almost 100,000 people have died from opioid overdoses. 63% of all overdose deaths are from prescription opioids. In 2016, one million Americans were using heroin. Eleven times as many misused prescription opioids, more than 2 million of whom had become addicted. 80% of new heroin users started out misusing prescription painkillers. A higher proportion of the white population dies from heroin overdoses than of the black population. Between 1999 and 2015, overdose deaths for blacks increased by 64%; for whites by 240%. And so on.

      Whole areas stretched across the Aplachaians, the Midwest, parts of the South, and a number of western states are being devastated. Here’s some reportage in the Washington Post from Norton, West Virginia:

      The grim death toll has been accompanied by a shredding of families, with many children being raised by grandparents or by foster parents because the biological parents have died, are in jail, or have lost parental rights because of drug abuse.

      “The kids I’m taking in — it’s all due to drugs now. Before, it was neglect,” said Crystal Miller, 32, a foster parent in a nearby town who has adopted three children and has four biological children.

      Sara Ring, Norton’s director of social services, said she frequently removes children from unsafe living conditions. She said she was shocked when she first took the job in 2014 and realized how often drugs were the source of the family dysfunction.

      “These kids are dirty, and they’re hungry, and a lot of it ties back to drug use,” she said. “Once a parent starts using drugs and becomes addicted to drugs, that becomes their number one priority.”

      Ring said there’s no drug rehab facility in Norton, and many people with addiction are too poor to receive treatment at a private facility about an hour away. When someone does get clean, they almost invariably return to the same kind of situation that first fostered and sustained the addiction.

      And again:

      Joseph Fawbush, Norton’s mayor said opioids have devastated his town.

      “Our jails are overflowing, a high percentage of children now have to be raised by their grandparents, and our court system and emergency services are strained,” Fawbush said.
      .
      The analysis shows that McDowell County in the southern part of West Virginia along the Appalachian Mountains ranked second for rate of death from prescription opioids from 2006 through 2012.
      .
      In that period, the per capita death rate was 13 times higher than the national average in a county where drug companies shipped 96 pain pills per person per year. West Virginia also had the highest opioid death rate in the nation during this period.

      Grappling with the epidemic, the McDowell County sheriff and others from the county came to Washington last year to meet with officials in Congress and the White House about the crisis and the lack of treatment resources.

      “They have pumped a bunch of pills in here. It’s such a bad situation,” said Cecil Patterson, 64, a McDowell County commissioner and coal miner. “Every family has been affected by this. It’s just overwhelming what’s going on here.

      The irony, as I observed in the article, is that the racism that sees drugs primarily as a problem of black ghettos has led to the plight of white communities being ignored.

      ’The doctors knew that many those strong opioid tablets put into a ghetto area, would quickly end up for sale in the illegal drugs market. The same thing may happen in rural areas too, but not to the same degree perhaps.’

      Apart from straightforward prejudice, what evidence have you that ‘The same thing may happen in rural areas too, but not to the same degree’? All the evidence shows the illegal drugs trade in white areas are as bad, if not worse, than in black areas, and in rural areas as bad as in inner cities. The problem has nothing to do with people being white or black, and everything to do with the nature of drugs and of drug addiction. You, however, do seem to see it in black and white terms – for you the ‘real’ problem are the ghettos and its inhabitants who can’t trusted with ‘strong opioid tablets’. Who is being obsessed by race here? How is your viewpoint – and your refusal to facet the facts – not a case of looking at the issue entirely through a racial lens?

      ’Just the race factor. Why always just call it race when it’s far more than skin colour?’

      Are you suggesting that the opioid crisis is not a problem that mostly affects white communities? Are you denying that deaths rates from heroin overdose is higher within white populations? Are you challenging the evidence that pharmaceutical companies targeted white communities? If so, please provide your evidence (and that doesn’t mean what you saw driving though ‘blighted parts of Cleveland’).

      As I’ve already said, you’re not opposed to viewing everything through a racial lens. You do that all the time. What you’re opposed to is someone saying ‘Actually, the problem is not to do specifically with black ghettos, or black culture, but with social and medical policy, and with the nature of drugs and drug addiction.’

      ’When people show prejudice on what seems to be racial grounds, the real prejudice is probably not against the person’s skin colour, put a prejudice about the person’s perceived culture and manner.’

      First, I have no idea what this has to do with the opioid crisis. Second. it’s the argument that racists have always used, whether expressing prejudices against Jews, Chinese, blacks or Muslims – ‘I’m not racist, I just object to their culture/way of life/faith’, etc. I’m sorry to see you go down that path, too.

  3. damon

    “I have no idea what this has to do with the opioid crisis.”

    OK, that’s a very fair comment. When you are talking about one thing for 90% of an article, and just mention something about something else (which I might perceive as not being quite right), then I shouldn’t really make too much of a focus on it. You implied that the way they prescribed the opioid drugs was racist and you put the words “drug-infested ghettos” in quotation marks – but I shouldn’t have questioned you too much about that small aspect of it.

    One difficulty (for me) will be, that if subjects are always “compartmentalised” like that, so to speak, then it’s difficult getting down to tackle some underlining themes that can run through people’s writings, because they are often not the main focus of the subject that day. But they still run through the narratives, especially in a newspaper like the Guardian, where it’s presumed that much of the readership will already agree with these underlying ideas.

    At no time am I trying to underplay the problems in white rural areas that this prescription drug use epidemic has had. I’m sure it’s every bit as bad as I’ve been reading. But I never introduced the idea of race into the subject, you did with those couple of lines you wrote. Now maybe you’re right and there’s too much I don’t understand on the subject, but I also know that race is one of the most wrongly written about subjects that there is in the whole world of political ideas.

    It’s a shockingly misunderstood or “misdiagnosed” subject. Hardly anyone gets it right – just in my opinion of course. And while I’ve read your views on it, and they can be better than some (many) – you’re still too close to some of the people who are getting it wrong I find.
    The RCP used to march through the streets, with someone on the loud hailer chanting “British Police – Racist Police”. Which was pretty crass and stupid looking back at it now. I hope you agree.
    The people from Spiked and those that turn up at Claire Fox’s big annual event seem to have moved on from those times too and take much more nuanced views of such things today.
    Not fully of course. They’re still in denial about what they got wrong about Northern Ireland (which was shockingly bad) – and they are still generally for open borders, but at least they have the discussions and debates and take in the wider views.

    On the last comment you made – about what I say about people and their racist views and why they may think like that. I think I’m only describing a reality. Don’t blame me for that.
    If a white family in Tower Hamlets balk at the idea of sending their primary school age child to the local school which is 98% Bangladeshi Muslim, it’s probably not just the skin colour of the other children that might be a concern to them. The same goes for them schools in Birmingham where the Muslim parents have been outside protesting about the pro-gay teaching curriculum.

    I’m pretty sure if it was ever possible to do a survey of people who had become “white flight” statistics and they were asked about why they moved, it wouldn’t be just about their intolerance of seeing people with darker skin living around them. It would be more than just that.
    Which is not to say that their other reasons were not also prejudiced and narrow minded, but I always try to see the fuller picture, not just narrow it down and call it racism.

    But the main point I take from your reply above, is that I shouldn’t “pick up” too strongly on things said that aren’t the main subject of the argument. Which is pretty hard though. Imagine how hard people on the left would find doing it the other way. Listening to a right winger (or Donald Trump) dropping in lines that they had a big issue with, but weren’t the main subject he was talking about.
    Actually, with the new woke left, one misstep or word out of place anywhere, ever, will be held up and denounced in the strongest terms.

    So if you just mention in one article, the dreadful Yarl’s Wood women’s detention centre for example, but are actually mainly talking about something else, then I shouldn’t be replying in a long post about Yarl’s Wood.
    It is hard though. Much of the left’s anti-racism world view is built on top of some rather weak arguments I think.
    It becomes like a fast moving express train. Something that exists in its own right and is very hard to stop or challenge.

    But picking at it and disagreeing with bits of it will soon get you labelled as a racist or something.
    How can I as a white guy, argue against Simon Woolley and Lee Jasper? And why would I want to?
    Even when they produce that awful “racist” poster they made before the Brexit referendum.
    The one which had “a skinhead” on one end of a seesaw, and a mild looking Asian woman sitting on the other end of it and he was pointing an aggressive finger at her and looking hateful.
    That was Woolley’s Operation Black Vote, but to make a big objection to it makes you sound like a loser. And a racist maybe. But I really hate it when arguments are built upon false assumptions. When did anyone last see a skinhead? The skinhead was actually a “racist dog-whistle” for the middle aged white blokes with bald heads (like me).

    In my most recent posting, I seem to have entered the wrong link. The one about Al Sharpton – and Glenn Loury writing about him in the New York Times. Here’s the correct link.

    But as you might say, what’s that got to do with the opioid abuse issue?
    I could say maybe that Al Sharpton has a lot to do with every issue that touches on race in America.
    But I still get your point.

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