The Cure for the Opioid Epidemic

Independence, employment go hand in hand
By Fergus Hodgson
Fergus Hodgson
Fergus Hodgson
Fergus Hodgson is the founder and executive editor of Latin American intelligence publication Econ Americas. He is also the roving editor of Gold Newsletter and a research associate with the Frontier Centre for Public Policy.
October 2, 2018Updated: October 3, 2018

Idle hands are the devil’s playground, and opioids are wreaking havoc on the unemployed underclass of the United States.

The good news is that a viable solution is at hand, and it doesn’t require throwing more taxpayer money and law enforcement at the problem.

Rather, a genuine solution—as opposed to stop-gap fixes that paper over the problem—will require Americans to recognize the scale and sources of the crisis. Many of the most vulnerable and dejected among us have fallen through the cracks and need our help, before they join the list of those who have gone too soon.

Historic Proportions

As stated by the President’s Commission on Combating Drug Addiction and the Opioid Crisis, we are witnessing “the most devastating drug epidemic in our nation’s history … [with] devastatingly high death rates.” That is far from hyperbole. More people now die from opioid overdoses, 115 per day, than from car accidents.

Not only is the scale catastrophic, but it is also trending upward. Between 2000 and 2015, deaths due to overdoses quadrupled, according to Center for Disease Control and Prevention. The death tally during those 15 years reached a half-million Americans.

Deaths stemming from synthetic opioids such as fentanyl doubled in a single year, between 2015 and 2016, and recent data suggests the epidemic continues to spread throughout the United States, particularly in the Rust Belt. West Virginia, New Hampshire, and Ohio have the highest overdose death rates, but opioids are now so ubiquitous that they are turning up in West Coast shellfish tested for contaminants.

An expert panel surveyed by STAT, a life-sciences and medical publication, suggests the rate of deaths could “spike to 250 per day,” and they don’t see any abating in the near future.

Why Now?

The rise of opioids as a widely prescribed and popular pain medication dates back to 1980, although there was some approved use in the 1970s, as well.

Poorly informed producers and physicians latched onto and profited from the burgeoning opioid market, with little understanding of their powerful addictive capacity. From 1991 to 2011, opioid prescriptions nearly tripled, and celebrity physician Dr. Drew Pinsky has described this pattern as irresponsible and shortsighted.

Opioids do work as painkillers, perhaps too well. They help many people with chronic pain to lead normal lives. However, since the body builds up a tolerance and needs higher doses, users are particularly vulnerable to physical and psychological dependence. Once addicted, treatment must be long-term, and the chance of relapse is high.

Ohio man gets help after overdosing
Local police and paramedics help a man who is overdosing in the Drexel neighborhood of Dayton, Ohio, on Aug. 3, 2017. (Benjamin Chasteen/The Epoch Times)

Further, synthetic opioids offer vastly higher potency, 80 to 100 times stronger than morphine. Their affordability and availability, through both formal and informal channels, has been a game-changer, since they increase the likelihood of overdose and death.

Not Just Anyone

Upon close examination, the opioid problem “is an employment problem,” as noted by Adam Millsap of the Center for the Study of Economic Prosperity and Individual Opportunity at Florida State University. Those struggling economically, particularly the unemployed and poorly educated, are much more likely to succumb to the temptations and risks of opioids.

“Joblessness and despair go hand-in-hand,” Millsap says. He adds that “economists have linked depressed labor markets to higher male mortality rates, partially driven by drug and alcohol abuse.”

Not only does underemployment signal a higher likelihood of addiction and overdose, new research—Defeating Dependency: Work First—indicates employment combined with treatment is the best ticket out. Scott Wetzler of the Montefore Medical Center, writing for the Washington-based American Enterprise Institute, explains that “employment is associated with positive outcomes … and unemployment is associated with relapse.”

Contrary to popular belief, he adds, “many substance abusers can engage in work-related activities.” Wetzler, who works with substance abusers on public assistance, claims that treatment without either employment or a path to it can have deleterious effects. The “artificial insulation from the expectations of day-to-day life” withdraws the person from a productive routine, personal responsibilities, and healthy socialization.

Work, on the other hand, “can enhance self-esteem and pride through accomplishment … and create new pro-social peer groups to support abstinence.” The person who is struggling then has more people on his side who want to see him succeed and contribute.

Prickly Prohibition

Celebrating the benefits of employment is easy. Promoting employment and supporting people to make the transition into the labor force require a great deal of care and foresight.

One can come at the underlying problem of idle hands and broken social lives from many directions. A common refrain is to advocate a police crackdown on the opioid suppliers and users, but that does little to address why people demand the drugs in the first place.

Advertising restrictions, elevated taxes, and outright prohibitions on items widely prescribed for medical reasons are always going to struggle. They exacerbate the presence for black-market and dirty sources, which already abound. That is why Canadians have gone to the extreme measure of providing clean heroin to addicts in treatment.

Arthur Rizer of the R Street Institute and Square One Project for justice-reform advocates limited-government restraint. He explains that the United States already suffers from the “overcriminalization of human behavior” with laws “that create traps for the innocent but unwary” and “yield little or no benefit to public safety.”

Worse, criminal records seal “off opportunity for those returning to society,” particularly in the case of employment, which can rest on occupational licensing, a driver’s permit, and stable housing. The very people who most need employment, therefore, are the ones who too often find it inaccessible.

The Nitty-Gritty

The Trump administration has already made positive steps in the right direction, at least in terms of the lower national employment rate and its response to the findings of the President’s Commission. That includes advocating recovery support such “housing and employment services.”

Any state services, though, must include “incentives for abstinence,” in Wetzler’s words. “A substantial minority of substance users … can engage in work-related activities and reach financial self-sufficiency … and substance-use treatment programs must make work a priority.”

A soft treatment mandate, such as “the threatened loss of some monetary or earning benefit for noncompliance with treatment or abstinence,” has been shown to be effective. Wetzler also strongly recommends against allowing substance abusers to classify themselves as having a disability, which would infer that they have a permanent barrier to employment.

Prevention, however, is the best cure. There remain an array of options for both opening up the labor market and better preparing people for satisfying, sustainable roles.

Policy changes to encourage work and lessen the burdens on employers—such as lower payroll taxes and fewer medical-insurance and occupational-licensing mandates—may seem disconnected to the casual observer. However, they offer promise for those who need it. Any opportunity to allow people to get to work and start or join businesses is a winner. For example, entry-level opportunities are crucial for those struggling to find work and establish order in their lives. That is one reason why a lower or no minimum wage would be to a jobseeker’s benefit.

On the flip side, no one wants to hire someone lacking skills and motivation. American education, from the bottom up, needs room to innovate with vocational programs to prepare people for the knowledge economy. Automation and international trade mean soft skills are increasingly more important relative to manual labor, and Secretary of Education Betsy DeVos is well aware of this trend, as an advocate for school choice and voucher programs.

The opioid crisis can’t be ignored, but that doesn’t mean a knee-jerk reaction will help. The availability of synthetic opioids has come during a time of economic upheaval and fallen into the hands of those struggling. The sensible response, which offers a lasting antidote, is to enable opportunities and prepare people to realize them, negating their vulnerability to begin with.

Fergus Hodgson is the founder and executive editor of Latin American intelligence publication Antigua Report. 

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.