Correction: drug overdose deaths did not decline from 2018-2019 in the U.S.; the absolute number of deaths increased from 2000-2017, was relatively stable from 2017-2019, and then increased dramatically in 2020.
Unlike McWhorter, I am a doctor, but I’m not a pathologist so I don’t want to common on the specific cause of death question that he raised.
However, I am an addiction doctor and a public health physician, and if it’s true that this week’s subject died of his addiction and not by being asphyxiated by a police officer, it has a number of important implications. It still reflects a widespread failure of public policy. It doesn’t exclude racism as being some part of the analysis. And it illustrates to an even greater extent how detached media narratives are from reality.
Drug overdose deaths were on the decline for a decade before 2020, but increased dramatically (~50% nationally) during that year for obvious reasons. America was never doing a great job with the addiction problem, but the lockdowns and other restrictive measures harmed the people dealing with addiction in many ways. In the most direct sense, many of them lost access to medical treatment and turned to the streets for drugs just as fentanyl was being seeded throughout the American drug supply, vastly increasing the lethality of street drugs. People also lost their jobs, their education, and were separated from families and social networks. Economic deprivation and social isolation were disastrous for everyone, but they were especially harmful to people who were already struggling. The doom-driven news and constant government and media lies likely contributed to an atmosphere of despair.
The George Floyd moment is often cited as a turning point for people who realized that when public health authorities who previously demanded that everyone stay inside and locked down suddenly approved of disorderly and usually maskless public gatherings. But how’s this for irony: what if, instead of being murdered by a racist police officer, what if George Floyd actually died *because of public health*?
A neighbor attends AA. During 2020, AA facilitators were afraid members might secretly meet inside someone’s home - then get in trouble if neighbor calls police to report “unfamiliar voices next door during Covid shutdown.”
Are you sure that drug overdose deaths were on the decline for the decade before 2020? Data from the National Institute on Drug Abuse, unless I'm misinterpreting Figure 1 from this report, suggest that drug overdose deaths have been rising steadily since 1999:
Lockdowns probably made things worse. Figure 1 shows a 51% increase in drug overdose deaths between 2019 (70.630) and 2021 (106,699).
A recent US News & World report article said that new forms of illicit opioids that are more potent than fentanyl are emerging so the problem could easily worsen:
Economists Anne Case and Angus Deaton (a Nobel laureate) began talking about growing numbers of "deaths of despair" almost 10 years ago. They weren't taken seriously at first, but nobody doubts them now. Public health officials have a role to play when it comes to reducing the number of drug overdose deaths, but people with other types of expertise need to be involved as well.
This is a good comment. I was thinking of the state I was in at the time (https://kiprc.uky.edu/sites/default/files/2022-06/KY%20Drug%20Overdose%20Deaths%20Annual%20Report%202021.pdf), but even there I was not strictly correct, as overdose dropped slightly two years before COVID but then increased slightly the year before. Kentucky was doing better than the nation as a whole at the time. Regardless, what I wrote was not correct, and I stand corrected on the statistical point. However, the available data as you’ve cited them still support the policy point I was making: overdose deaths increased dramatically relative to existing trends during the COVID era.
I personally witnessed Anne Case and Angus Deaton present at NIH several years ago, giving a compelling talk on deaths of despair. A questioner (presumably an NIH researcher) sneered at them for talking about problems that affected “white men”. At the time, I was surprised by the level of immaturity and hate in that response
That was unfortunate because our response to public health problems shouldn't change depending upon the race or gender of those who seem to be most affected. Racializing the opioid problem was shortsighted because more recent data shows that overdose death rates for blacks, especially black men, are higher than those for most demographic groups:
Correction: drug overdose deaths did not decline from 2018-2019 in the U.S.; the absolute number of deaths increased from 2000-2017, was relatively stable from 2017-2019, and then increased dramatically in 2020.
Unlike McWhorter, I am a doctor, but I’m not a pathologist so I don’t want to common on the specific cause of death question that he raised.
However, I am an addiction doctor and a public health physician, and if it’s true that this week’s subject died of his addiction and not by being asphyxiated by a police officer, it has a number of important implications. It still reflects a widespread failure of public policy. It doesn’t exclude racism as being some part of the analysis. And it illustrates to an even greater extent how detached media narratives are from reality.
Drug overdose deaths were on the decline for a decade before 2020, but increased dramatically (~50% nationally) during that year for obvious reasons. America was never doing a great job with the addiction problem, but the lockdowns and other restrictive measures harmed the people dealing with addiction in many ways. In the most direct sense, many of them lost access to medical treatment and turned to the streets for drugs just as fentanyl was being seeded throughout the American drug supply, vastly increasing the lethality of street drugs. People also lost their jobs, their education, and were separated from families and social networks. Economic deprivation and social isolation were disastrous for everyone, but they were especially harmful to people who were already struggling. The doom-driven news and constant government and media lies likely contributed to an atmosphere of despair.
The George Floyd moment is often cited as a turning point for people who realized that when public health authorities who previously demanded that everyone stay inside and locked down suddenly approved of disorderly and usually maskless public gatherings. But how’s this for irony: what if, instead of being murdered by a racist police officer, what if George Floyd actually died *because of public health*?
A neighbor attends AA. During 2020, AA facilitators were afraid members might secretly meet inside someone’s home - then get in trouble if neighbor calls police to report “unfamiliar voices next door during Covid shutdown.”
Are you sure that drug overdose deaths were on the decline for the decade before 2020? Data from the National Institute on Drug Abuse, unless I'm misinterpreting Figure 1 from this report, suggest that drug overdose deaths have been rising steadily since 1999:
https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
Lockdowns probably made things worse. Figure 1 shows a 51% increase in drug overdose deaths between 2019 (70.630) and 2021 (106,699).
A recent US News & World report article said that new forms of illicit opioids that are more potent than fentanyl are emerging so the problem could easily worsen:
https://www.usnews.com/news/health-news/articles/2023-09-05/new-opioids-are-joining-the-illicit-drug-supply-and-theyre-more-potent-than-fentanyl
Economists Anne Case and Angus Deaton (a Nobel laureate) began talking about growing numbers of "deaths of despair" almost 10 years ago. They weren't taken seriously at first, but nobody doubts them now. Public health officials have a role to play when it comes to reducing the number of drug overdose deaths, but people with other types of expertise need to be involved as well.
This is a good comment. I was thinking of the state I was in at the time (https://kiprc.uky.edu/sites/default/files/2022-06/KY%20Drug%20Overdose%20Deaths%20Annual%20Report%202021.pdf), but even there I was not strictly correct, as overdose dropped slightly two years before COVID but then increased slightly the year before. Kentucky was doing better than the nation as a whole at the time. Regardless, what I wrote was not correct, and I stand corrected on the statistical point. However, the available data as you’ve cited them still support the policy point I was making: overdose deaths increased dramatically relative to existing trends during the COVID era.
I personally witnessed Anne Case and Angus Deaton present at NIH several years ago, giving a compelling talk on deaths of despair. A questioner (presumably an NIH researcher) sneered at them for talking about problems that affected “white men”. At the time, I was surprised by the level of immaturity and hate in that response
Thanks for the clarification and for sharing what you observed during Case and Deaton's presentation at NIH.
As you noted, many people thought the opioid epidemic was a "white" problem. This NPR report from 2017 illustrates the point:
https://www.npr.org/2017/11/04/562137082/why-is-the-opioid-epidemic-overwhelmingly-white
That was unfortunate because our response to public health problems shouldn't change depending upon the race or gender of those who seem to be most affected. Racializing the opioid problem was shortsighted because more recent data shows that overdose death rates for blacks, especially black men, are higher than those for most demographic groups:
https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-raceethnicity/?dataView=1¤tTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
https://www.pewresearch.org/short-reads/2022/01/19/recent-surge-in-u-s-drug-overdose-deaths-has-hit-black-men-the-hardest/