The Opioid Epidemic Is A "Very American Crisis"

By Kelly Burch 04/10/19
A breakdown America's history with opioids and how it evolved into the crisis it has become.
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Opioid use disorder has its roots in the powerful biological processes that opioids tap into, but there are also cultural factors that make Americans particularly susceptible to opioid addiction, both now and in the past, according to one journalist. 

“Our culture has gotten so good at marketing and that marriage of capitalism and marketing and medicine has been perfected here in America, for good or bad,” Ramtin Arablouei, one of the hosts of the NPR podcast Throughline, told Rolling Stone. “That has made it a very American crisis.”

Arablouei and his cohost, Rund Abdelfatah, followed American’s use of opioids starting with morphine in the 1800s. 

“There was a recurring question of whose pain is taken as ‘real pain’ and how do we address it?” Abdelfatah said. “There was definitely a gender bias in the 19th Century around treating pain; there was a racial bias, and a lot of these biases remain in different forms today.”

Morphine was prescribed to Civil War soldiers, and later used to treat ailments ranging from cramps to cough. 

“When the war ended, not only do you have a lot of soldiers addicted, but you have this new drug introduced into American life,” Abdelfatah said, pointing out that doctors often prescribed morphine to women, who were thought to be weaker and thus have a lower pain tolerance. 

When doctors began to realize that morphine was addictive, they turned to heroin as a "safer" alternative. It was even advertised as a medication that was safe for children, Arablouei said.

“It’s fascinating how in-your-face it is, and it shows the evolving attitude we and the advertising community have had toward opiates in our culture,” he said.

When heroin was criminalized in 1924, opioids became a law enforcement issue, particularly in communities of color. This reflects the way that racist policies have affected the war on drugs in modern America. 

“There tends to be a more aggressive response to drug epidemics—as in, more criminalization—when it happens in communities that are urban, black or brown. That tends to be the historical pattern,” said Arablouei.

“You see that play out with heroin, when the problem plays out underground. And you can see that today: a lot of attention is paid to the opioid crisis, and there’s a lot more empathy from politicians than you saw from them toward, say, the heroin epidemic [in urban communities], or the crack epidemic in the Nineties.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.