This epidemic of opioid addiction and death that we are living in is not the result of the use of opioids per se, but by society’s response to this use. What the “War on Drugs” has accomplished has been to turn what is a chronic but treatable, manageable, disease into an epidemic of addiction and death.
The tactics used to “win” this war are those based on the belief that if the supply can be cut off, if enough drugs are interdicted, if those who sell them are incarcerated, then this will drive the price of these opioids to the point that we will stop using them. This is the basic economics of demand. As the price of a commodity increases, demand for that commodity decreases. But there is a flaw in this reasoning. There is more than one type of economic demand.
The prohibitionist belief is based on what is called elastic demand. With this type of demand relationship, as the price increases there is some proportional decrease in the consumption of the commodity. Just as an example, let’s say the price of peanut butter increases. The amount of peanut butter consumed would fall in some proportional relationship to the increase in price. The demand is elastic. The goal of the supply side demand reduction efforts is to drive the price of opioids so high that we will no longer buy them or at least reduce greatly the amount we buy.
Those who attempt to reduce the supply of opioids are not considering that there is a different type of demand. This demand is inelastic demand. With inelastic demand as the price increases the amount of the commodity consumed remains relatively stable. Just as a hypothetical, let’s say that there is a famine and this causes the price of food to increase. No matter how high the price, the proportional decrease in food consumed will be mitigated by the fact that we have to have food to live. We will sacrifice all other commodities to continue to buy food.
“Stop incarcerating us, stop stigmatizing us, and give us the power that has been taken from us by these prohibition laws”
The supply side prohibitionists believe that if they can produce a severe increase in price that it will drive demand down because we will “choose” not to buy such a high priced commodity. And they will have won the war on drugs. But the logic of supply side tactics is based on the archaic belief that opioid addiction is a moral failing, that it is caused by a lack of willpower, and that if we really wanted to, if we really needed to, we could stop. And they believe they can force us to do so. But they have used these tactics since this war was declared and what we have is not a decrease in use but an epidemic of opioid addiction and death.
The prohibitionists are ignoring the science. And the science is clear. The intake of these opioids over months and years alter the structure of the brain at a cellular, molecular level, and these alterations make these opioids more important for our survival than food. We starve for them. We will sacrifice all other commodities so that we can end that starvation. And this is why we do the things we do in our addiction. We don’t do them because we “choose” to do them. Survival is not a choice. It is inelastic.
People say that we are powerless over our addiction. But that is a lie. We are not powerless but we appear to be because the prohibitionist laws of this country rob us of our power. This is evidenced by the fact that if we are allowed access to syringe exchanges we will use them and avoid contracting and spreading HIV and HepC. If given access to naloxone we will save our friends and they will save us. If we had access to Safe-Injection Facilities, we would use them and not die. If we had access to effective treatments such as methadone and buprenorphine on demand, without the monetary and restrictive polices now in place, we would use them and if they didn’t work for us, if we had the option of heroin or hydromorphone treatment we would use those. And stay well and alive. If given the opportunity we will make decisions that improve our health and allow us to function as productive members of this society. But the prohibitionist policies of this country rob us of that power.
With any other chronic illness in this country our society works to provide services that mitigate the harms of the illness and, thus, allow the person to function in our society. If someone has diabetes we give them new syringes, insulin, glucometers; if someone has COPD we give them medications, oxygen, pulmonary therapy; if a person suffers with Parkinson’s or Multiple Sclerosis we provide them with medications, physical therapy, motorized wheel chairs, and so on. Now, if we removed these services, would they not be powerless over their disease?
Give us the chance. Give us the opportunity to make decisions that mitigate the harms of our illness for us and for society and we will make these decisions. But we have to have the opportunity to do so. Stop incarcerating us, stop stigmatizing us, and give us the power that has been taken from us by these prohibition laws; provide us with the services that we accord to others that are living with a chronic disease and the myth of powerlessness will be seen as just that. A myth.
The AIDS epidemic was brought under control through science, treatment, and activism. We can do the same with this opioid epidemic. If society will recognize that we are suffering from an illness and instead of trying to eliminate this illness through incarceration and stigmatization and work to mitigate the harms that occur not because of the illness, but because of society’s response to it, then we can stop this epidemic. And by doing so we could save so many lives. We could save so many families from the devastating pain of losing the one they love. But to do so, we have to view opioid addiction not as a crime but, rather, as what it is: a disease of brain structure and function.
This is a chronic disease but, as with other chronic diseases, it is a treatable and manageable one. If our society will understand that the major harms come not from the disease itself, but from the laws that criminalize it, then we can begin to make the changes necessary to bring this epidemic under control.
The way to win this war is to stop waging it.