New research shows that Democrats' struggles in communities struggling with fentanyl addiction had little to do with economic theory or messaging — simply put, it was a lack of political attention. The spread of fentanyl in the United States has become a veritable myth, comparable to stories about other drugs such as crack. The substance is so highly concentrated that even tiny doses can intoxicate large numbers of people: a small salt shaker can supply an entire neighborhood, and two truckloads can supply a country of 330 million people for an entire year.
In the 1980s, accounts of the crack trade often intersected with the historical migration routes of African Americans. For example, the Chambers brothers reportedly hired their relatives from the Arkansas Delta to distribute drugs in Detroit apartment buildings, effectively resorting to human exploitation. These stories were easily used by politicians for racial demonization, similar to how the fentanyl trade is used today to stigmatize migrants crossing the Rio Grande border.
In the 1980s, accounts of the crack trade often intersected with the historical migration routes of African Americans. For example, the Chambers brothers reportedly hired their relatives from the Arkansas Delta to distribute drugs in Detroit apartment buildings, effectively resorting to human exploitation. These stories were easily used by politicians for racial demonization, similar to how the fentanyl trade is used today to stigmatize migrants crossing the Rio Grande border.
Like many such reports of illegal activity, these stories, usually coming from law enforcement, have the character of tabloid noir. While they are probably factual, they are difficult to corroborate. In the context of fentanyl, they take on special significance for U.S. policymakers trying to make sense of the country's political turmoil, which seems incompatible with the overall image of a stable and prosperous society.
The fentanyl epidemic points to hidden problems — instability, violence and suffering — that are not visible on the surface, even with low unemployment. Not only Republicans, but Democrats like Marie Gleisenkamp Perez of Washington, D.C., point out that about 40 percent of babies at one of the largest hospitals in her district are born to parents addicted to fentanyl.
Summertime during the 2024 presidential campaign will, in my opinion, be the year of fentanyl. This drug is considered the third wave of the opioid epidemic, following the abuse of prescription drugs like OxyContin and heroin.
A unique feature of fentanyl is its high lethality: since 2008, the number of overdose deaths in the U.S. has more than doubled, and is now nearly seven times higher than it was in the early 1980s. This fact explains why immigration has become such an important topic for Trump — his recent statements have emphasized drugs and violence rather than jobs.
The fentanyl epidemic points to hidden problems — instability, violence and suffering — that are not visible on the surface, even with low unemployment. Not only Republicans, but Democrats like Marie Gleisenkamp Perez of Washington, D.C., point out that about 40 percent of babies at one of the largest hospitals in her district are born to parents addicted to fentanyl.
Summertime during the 2024 presidential campaign will, in my opinion, be the year of fentanyl. This drug is considered the third wave of the opioid epidemic, following the abuse of prescription drugs like OxyContin and heroin.
A unique feature of fentanyl is its high lethality: since 2008, the number of overdose deaths in the U.S. has more than doubled, and is now nearly seven times higher than it was in the early 1980s. This fact explains why immigration has become such an important topic for Trump — his recent statements have emphasized drugs and violence rather than jobs.
The presence of fentanyl may also explain why a segment of society is so concerned about crime in places with low homicide rates and why some politically independent young voters have darker views than one might expect based on economic data because their friends — young people — are being victimized.
I recently came across an economic paper that has been hotly debated this year, though not yet officially published. The study, by Carolina Arteaga of the University of Toronto and Victoria Barone of Notre Dame, focuses on a specific problem: the effects of the opioid epidemic have been particularly acute in areas that have also suffered from depopulation and deindustrialization, as well as shocks from NAFTA and China. The social and political consequences of drugs are difficult to separate from the more general economic decline.
In documents made public as part of lawsuits against Purdue Pharma, Arteaga and Barone found that in the mid-1990s, marketing of OxyContin initially targeted communities with high rates of cancer. The idea was to create an image of the drug as a remedy for the terrible pain experienced by cancer patients, and then promote it as a more general pain reliever.
Arteaga and Barone hypothesized that by studying communities with different levels of cancer incidence, while controlling for economic hardship and social unrest, it might be possible to isolate the impact of opioids on a community from more general economic decline. The researchers noted that two Appalachian regions could face similar challenges, but if one had high cancer rates, it would receive a disproportionate risk of initial opioid exposure, which would then be reflected in differences between regions. The study design was called «ingenious» by Times columnist Thomas Edsall earlier this year.
Arteaga and Barone found that the social impact of the opioid epidemic was significantly worse in regions with high cancer rates. What was bad everywhere became worse in places where OxyContin began to proliferate. By 2012, opioid use in targeted areas was over 50% higher than comparable regions, and the number of deaths from these drugs was twice as high. By 2020, residents of these hotspots were 10% more likely to apply for food stamps and social assistance.
Arteaga and Barone hypothesized that by studying communities with different levels of cancer incidence, while controlling for economic hardship and social unrest, it might be possible to isolate the impact of opioids on a community from more general economic decline. The researchers noted that two Appalachian regions could face similar challenges, but if one had high cancer rates, it would receive a disproportionate risk of initial opioid exposure, which would then be reflected in differences between regions. The study design was called «ingenious» by Times columnist Thomas Edsall earlier this year.
Arteaga and Barone found that the social impact of the opioid epidemic was significantly worse in regions with high cancer rates. What was bad everywhere became worse in places where OxyContin began to proliferate. By 2012, opioid use in targeted areas was over 50% higher than comparable regions, and the number of deaths from these drugs was twice as high. By 2020, residents of these hotspots were 10% more likely to apply for food stamps and social assistance.
Although Arteaga and Barone are not experts on U.S. politics — both hail from South America — in the course of their work, they noticed that many economists wondered about possible policy implications, given the dramatic nature of the other effects. They analyzed and found that communities that Purdue Pharma representatives singled out in the mid-90s for high cancer rates began to support the Republican Party more strongly in House, gubernatorial and presidential elections.
Even compared to other regions that also leaned Republican and were subject to economic hardship, communities targeted by sales representatives — the epicenters of the opioid problem — supported Republicans by an additional 4.6% in 2020 House elections. In the face of intense partisan rivalry, this was a noticeable effect, as if the trade representatives had left traces of red paint that are still visible 28 years later in the devastated neighborhoods where they worked.
Speaking with Arteaga and Barone via Zoom, Arteaga noted, «It wasn't obvious that the opioid epidemic would be associated with Republicans». In polls over the years, respondents did not blame either party for the crisis. However, she identified two reasons why the hardest-hit regions leaned so clearly toward the Republican Party.
The first reason was that the economic hardship of white working-class Americans was an important theme for Republicans. The second reason was simpler: «The conservative media talked about it a lot more» — she explained.
Even compared to other regions that also leaned Republican and were subject to economic hardship, communities targeted by sales representatives — the epicenters of the opioid problem — supported Republicans by an additional 4.6% in 2020 House elections. In the face of intense partisan rivalry, this was a noticeable effect, as if the trade representatives had left traces of red paint that are still visible 28 years later in the devastated neighborhoods where they worked.
Speaking with Arteaga and Barone via Zoom, Arteaga noted, «It wasn't obvious that the opioid epidemic would be associated with Republicans». In polls over the years, respondents did not blame either party for the crisis. However, she identified two reasons why the hardest-hit regions leaned so clearly toward the Republican Party.
The first reason was that the economic hardship of white working-class Americans was an important theme for Republicans. The second reason was simpler: «The conservative media talked about it a lot more» — she explained.
Arteaga and Barone analyzed the mentions and found that the opioid epidemic was discussed significantly more often by right-wing outlets than others. Despite criticizing Fox News for using these topics for demagoguery, it's important to note that the channel did pay attention to what was happening.
Many post-election materials called for the Democratic Party to take a more centrist stance or break with the neoliberal system. However, the Democrats' failure on fentanyl-related issues was more likely the result of a lack of political attention. The narrative that Arteaga and Barone present is not about blaming more liberal migration controls at the southern border for the fentanyl crisis.
Bernie Sanders could rightly point to the ongoing suffering over opioids as a result of Purdue Pharma's actions. But as with other crises that have hampered the Biden administration — the withdrawal of troops from Afghanistan, the influx of migrants, and post-pandemic inflation — Democrats ignored the opioid issue for too long, treating it as partisan hysteria, and realized too late that people are genuinely concerned.
Many post-election materials called for the Democratic Party to take a more centrist stance or break with the neoliberal system. However, the Democrats' failure on fentanyl-related issues was more likely the result of a lack of political attention. The narrative that Arteaga and Barone present is not about blaming more liberal migration controls at the southern border for the fentanyl crisis.
Bernie Sanders could rightly point to the ongoing suffering over opioids as a result of Purdue Pharma's actions. But as with other crises that have hampered the Biden administration — the withdrawal of troops from Afghanistan, the influx of migrants, and post-pandemic inflation — Democrats ignored the opioid issue for too long, treating it as partisan hysteria, and realized too late that people are genuinely concerned.
This summer, while there was a Kamala Harris rally at Temple University (Philadelphia), there was a much smaller J. D. Vance event featuring family members of addicts. (Vance's mother, Beverly Aikins, struggled with opioid addiction for years, and the experience was an important part of his political history) It was a somber event — the couple shared the grief of losing their addicted daughter and blamed Democrats. Before the election, many wondered: is this really the perspective through which most Americans view our outwardly prosperous country?
The reason why the war on drugs is of such interest is that its illegal nature makes it a hidden force — the effects can be seen, but often only over time or indirectly. The people who first notice changes in the drug trade are often the most vulnerable.
To understand the social pressures caused by drugs, economists and policymakers alike need insight: they need to take into account inaccurate perceptions of the drug world and the racial biases that attend them, and to recognize that something important is really happening in the fog of myths.
The reason why the war on drugs is of such interest is that its illegal nature makes it a hidden force — the effects can be seen, but often only over time or indirectly. The people who first notice changes in the drug trade are often the most vulnerable.
To understand the social pressures caused by drugs, economists and policymakers alike need insight: they need to take into account inaccurate perceptions of the drug world and the racial biases that attend them, and to recognize that something important is really happening in the fog of myths.
