Drug Crisis – Fresh Perspective

Sometimes, we hear about a social concern, so often, we get numb. We hear the national debt is at a record $28.7 trillion, homicides up, border open, and wonder what it means. While it means poor leadership, some issues scream for attention – and fresh perspective. The drug crisis is one.

In short, America is in throes of the worst human carnage wrought by illegally trafficked, widely abused drugs in our nation’s history. Words fail, so let me draw a picture. Better yet, you draw. 

Imagine that you are looking at a cube, sides wide as this page. Now imagine the side facing you is an “x and y” axis, running from zero (bottom left) up to 100,000. Along the bottom, imagine years running from 1989 to 2021, 32 years. Are you with me? 

Now start in the lower-left corner, where zero meets the year 1989. More accurately, in 1989, the real number was 5,035, so notch up a little. That is about 1/20th of your up-down. You may ask, 5,035 what?  Answer: Lives lost to overdoses.  

In 1989, then-President George Herbert Walker Bush – and our nation – were aghast because more than 5,000 young Americans had overdosed. The biggest drugs were cocaine, crack, heroin, and marijuana, some synthetics, not much meth. 

In that year, “current use” (past 30 days) was down from 23 million in 1985 to 14.5 million, based on vigorous prevention, treatment, and law enforcement. Still, overdoses were high. See, e.g., National Drug Control Strategy. 

President GHW Bush – in September of 1989 – delivered an Oval Office address, describing it as a “drug crisis.” Gallop polls showed nine-out-of-ten Americans agreed. See, Presidential Address on National Drug Policy; MANY IN POLL SAY BUSH PLAN IS NOT STRINGENT ENOUGH. 

So, that was 1989.  A bipartisan effort, beginning with Ronald and Nancy Reagan and the Anti-Drug Abuse Act of 1988, creating the first Office of National Drug Control Policy (ONDCP), picked up steam. After GHW Bush, Bill Clinton in 1993 lifted ONDCP to cabinet rank. 

That year, four drugs created a ladder to addiction, which ended in 5,035 overdoses – making a national crisis. The fear was that use, addiction, crime, and overdoses would grow. 

Look at the cube again. Go across the bottom to 2020, at the far right. Go up the left side to near the top, 96,000. That is where we are today, 96,000 overdoses. If you draw a line from the lower left to upper right, we have witnessed a 20-fold or 1,900 percent increase in 30 years. 

Today, we lose 32 times as many Americans annually as on 9-11, 39 times as many as service members lost over 20 years in Afghanistan. Is that not a crisis?   

Look again at your cube. Note that – while our scale only goes to 100,000 – 192,000 parents lost a child to drugs, 384,000 grandparents, countless siblings, friends, teachers, aunts, uncles, kids. That does not account for deaths from drugged driving, drug-induced suicide, crime.  That would take half a dozen cubes. 

But stay with our cube. Knowing overdoses went from 5,035 to 96,000, tip the cube toward you. Now imagine the face you see is a graph of types of drugs that produced those overdoses, with years along the bottom from 1989 to 2021, number of drug types running up the left side. 

What do you see?  You see that in 1989 overdoses came from roughly four or five drug types, while today – according to authorities – the drug types producing overdoses run into the hundreds if you count small molecular shifts and retail names, thousands. 

Today, we have countless synthetic opioids, carfentanil, acetyl fentanyl, butyryl fentanyl, beta- hydroxythiofentanyl, furanyl fentanyl, 4-fluoroisobutyryl fentanyl, acryl fentanyl, and U-47700 to other fentanyl-related substances. We have meth and amphetamine-type substances, high-potency synthetic marijuana, GHB, MDMA, LSD, and PCP, Ketamine and Kratom to psilocybin, Rohypnol, and over-the-counter drugs like Loperamide and DXM – not to mention an abundance of high-purity heroin, cocaine, crack, and domestic marijuana.  

In short, the face of the cube you are looking at starts with few drug types in 1989 and goes to exponentially higher numbers in 2021, a line again from lower left steep to the upper right. What was a crisis with four or five drugs in 1989 – is today an army of potential kid-killers. 

If you flip the cube toward you again, you are on a fresh side. What is here? This is the potency curve – call it likelihood of death from elevated potency. In 1989, even with seemingly high overdoses, prices were relatively high and purities lower.  

Between 1989 and 2021, while tracking individual drug purities is hard since they are now cut, combined, and redefined, what happened for every drug type was that price fell, purity rose. 

The reason: As availability and indifference grew, so did use, addiction, and overdoses, as well as drug types. Competition for addicted buyers starts with price, ends with elevated purity. The effect is deadly. 

On this side of the cube, low purity – heroin maybe four percent – jumps to near 90 percent as synthetics and other drugs get more deadly. The curve again goes from low purities in 1989 up to the high purity, upper right. Some drugs are so dangerous now; they cannot be handled. 

Flip the cube once more to side four. Here, with years along the bottom, the chart states legalizing drugs. In 1989, ONDCP said, “legalizing drugs would be an unqualified disaster.” Yet by 2021, 20 states had legalized THC, Oregon legalized heroin and cocaine use, California considering synthetics. In short, the legalization curve has also been steep. 

So, taken as a whole – what have we? An outsized crisis, killing nearly 100,000 young people a year, innumerable drug types, potencies out of control, legalization rampant. 

What does it mean? It means we now face a genuine crisis, need a fresh perspective. A moral nation does not indenture future generations nor kill them by tens of thousands with indifference. Yet that is what we are doing, why action is overdue. And that is on us.