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Public Policy Made Americans the Biggest Consumers of Opioids in the World

RACIAL CAPITALISM, this forum has shown, is a powerful analytical tool. It provides a framework robust enough to account for the racial logic of the opioid crisis, the Trump-era War on Drugs, and the country’s punitive turn. The responses to my essay expand its reach even further, offering multiple points of departure for enriching the narrative. Our conversation highlights the power of integrating public health scholarship and activism with writings on mass incarceration and the drug war. It was not until I attempted to suture together different threads of this story, drawing on both schools of thought, that I saw how much the narrative arc of drug prohibition changes in light of the recent history of Big Pharma.

The core paradox of the opioid crisis is how extreme criminalization of a racialized, illicit drug economy underwrote and enabled the larger project of licit drug deregulation. The United States is simultaneously the largest incarcerator of people convicted of using and selling drugs and the largest consumer of legal (and illegal) narcotics in the developed world, by far. Although Americans make up only 5 percent of the world’s population, they consume over 80 percent of the world’s opioids. Public policy has enabled the steady growth of pharmaceutical consumption as multiple iterations of the drug war raged on. And of course, as in all aspects of U.S. society, race functions as the structuring principle, in this case dividing the aboveground and netherworld of drug business. As Britt Rusert notes in her response, “We continue to live in a world made by Reagan, one where corporate empowerment both benefits from and reinforces racial regimes of punishment.”

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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.