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Digital Subscriptions > Boston Review > Racist Logic > How Race Made the Opioid Crisis

How Race Made the Opioid Crisis

IN MARCH 2018, President Donald Trump delivered a forty-minute speech about the crisis of addiction and overdose in New Hampshire. Standing before a wall tiled with the words “Opioids: The Crisis Next Door”, Trump blankly recited the many contributors to the current drug epidemic, including doctors, dealers, and manufacturers. Trump droned on mechanically until he reached a venomous crescendo about Customs and Border Protection’s seizure of 1,500 pounds of fentanyl. He brightened as he shifted focus to three of his most hated enemies, first blaming China and Mexico for saturating the United States with deadly synthetic opioids, then moving seamlessly to what he considered one of the great internal threats: “My administration is also confronting things called ‘sanctuary cities’”, Trump declared. “Ending sanctuary cities is crucial to stopping the drug addiction crisis.”

Like so many of Trump’s proclamations, this rhetoric is sheer political fantasy.

Since the late 1990s, yearly rates of overdose deaths from legal “white market” opioids have consistently exceeded those from heroin. According to the Centers for Disease Control and Prevention, between 1999 and 2017, opioid overdoses killed nearly 400,000 people with 68 percent of those deaths linked to prescription medications. Moreover, as regulators and drug companies tightened controls on diversion and misuse after 2010, the American Society of Addiction Medicine determined that at least 80 percent of “new heroin users started out misusing prescription pain killers.” Some data sets point to even higher numbers. In response to a 2014 survey of people undergoing treatments for opioid addiction, 94 percent of people surveyed said that they turned to heroin because prescription opioids were “far more expensive and harder to obtain.”

In the face of these statistics, the claim that the opioid crisis is the product of Mexican and Central American migration—rather than the deregulation of Big Pharma and the failures of a private health care system—is not only absurd, but insidious. It substitutes racial myth for fact, thereby rationalizing an ever-expanding machinery of punishment while absolving one of the most lucrative, and politically influential, business lobbies in the United States. This paradoxical relationship between a racialized regime of illegal drug prohibition and a highly commercial, laissez-faire approach to prescription pharmaceuticals cannot be understood without recourse to how racial capitalism has structured pharmacological markets throughout U.S. history. The linguistic convention of “white” and “black” markets points to how steeped our ideas of licit and illicit are in the metalanguage of race.

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Paperback, 130 pages Racist Logic tackles how racist thinking can be found in surprising—and often overlooked—places. In the forum's lead essay, historian Donna Murch traces the origins of the opioid epidemic to Big Pharma's aggressive marketing to white suburbanites. The result, Murch shows, has been to construct a legal world of white drug addiction alongside an illicit drug war that has disproportionately targeted people of color. Other essays examine how the global surrogacy industry incentivizes the reproduction of whiteness while relying on the exploited labor of women of color, how black masculinity is commodified in racial capitalism, and how Wall Street exploited Caribbean populations to bankroll U.S. imperialism. Racist logic, this issue shows, continues to pervade our society, including its nominally colorblind business practices. Contributors not only explore the institutional structures that profit from black suffering, but also point the way to racial justice. Forum Lead essay by Donna Murch. Responses by Max Mishler, Britt Rusert, Julie Netherland, Helena Hansen, David Herzberg, Michael Collins, Julilly Kohler-Hausmann, Jonathan Kahn, L.A. Kauffman, and Donna Murch. Essays Peter Hudson, Jordanna Matlon, Alys Weinbaum, and Richard Ford.