Making a Murderer: Empty threats in Trump’s misdirected opioid war

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For more than a year, Donald Trump paid lip service to victims of the opioid crisis. As he grandstanded to his base about the problem, more than 100,000 people died of drug overdoses in what he labeled a “public health emergency” even while he chose not to release any additional funds for this emergency. And even though Congress finally included in its late-February budget deal $6 billion to address the epidemic, the President has adopted a Philippines-style law-and-order approach that he says now includes seeking the death penalty for drug dealers.

Let’s forget for a moment the plainly racist legacy of the failed War on Drugs. Let’s also ignore how costly and ineffective the death penalty is, with 88 percent of criminologists agreeing it does not act as a deterrent. There are a number of other ethical problems with Trump’s opioid approach. His fixation on the supply-side source of the epidemic has routinely included scapegoating Mexico, an obvious target that fits seamlessly with his “build The Wall” movement that’s rallied on all varieties of xenophobia since his early campaign days.

But building a wall or otherwise tightening security between the U.S. and Mexico is likely to have little effect on the continuing trend of overdoses. For one, according to the Center for Disease Control and Prevention, nearly half of opioid deaths in 2016 were the result of prescribed opioids not including those categorized as illicit such as fentanyl or heroin. If Trump wants a scapegoat for these deaths, he’s going to have to target the doctors who are likely practicing patient-centered care to those in pain. That’s not to say prescribing doctors are blameless in this epidemic, but it does highlight the quandary of confounding substances when speaking of opioid deaths using blanket terminology.

Secondly, as a foreign source, Mexico is often just an intermediary, with China producing the majority of fentanyl coming into the U.S. Far from the image of contraband smuggled into the U.S. through a loose Mexican border, the internet and dark web provide easy access to fentanyl that can be shipped directly to U.S. consumers and forego the type of drug dealer Trump has made a target of his opioid war.

Another ethical problem with Trump’s supply-side preoccupation is that it diverts funding that could be better spent on the root of the problem: the biochemical processes that cause dependence, overdose, and death from consumption. Naloxone, a medication that blocks the effects of opioids, was developed over 50 years ago and according to the CDC, tens of thousands of overdoses have been reversed using it. The fact that we are relying on science from 1961 should be evidence enough that developing more advanced pharmacokinetic solutions to opioids should be a priority. From 2014 to 2016, the price for a package of Naloxone increased from $690 to $4,500. If Trump is serious about preventing opioid deaths, addressing access to lifesaving treatments should be his most immediate concern.

Demonizing drug dealers is easy, plays well with the public, and draws a clear “us versus them” dichotomy. But the more nuanced reality is that many street dealers are addicts themselves and dealing is often a last resort to fund unsustainable chemical dependence. By the time many addicts have resorted to selling, it’s because they’ve been unable to maintain jobs, have lost control of their lives, and have reached the near-end of an unmanageable cycle. Threatening them with the death penalty is not a tenable solution and only increases stigma that might prevent them from seeking help. Further, it’s a vacuous warning when so many of the actual “dealers” are just dark-web commerce sites that deliver directly to consumers’ doors through the postal service.

With $6 billion to spend on the opioid problem, the repetitive Band-Aid of law enforcement and execution of drug dealers shouldn’t be the articulated priority of the Trump administration. Only funding science to develop interventions and medications to treat addiction and prevent overdose deaths can stop the opioid epidemic at its root.

– Tyler

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Outside the ballot box

When federal election results are being tallied on the evening of November 8th, the votes of nearly 6 million American citizens will be missing as a result of systematic disenfranchising laws that disqualify ex-convicts from voting. The majority of states in the U.S. enforce some penal restrictions on voting: In the most egregious cases, Florida, Iowa, and Kentucky permanently bar all people with felony convictions from voting while Alabama, Mississippi, Arizona, Nevada, Wyoming, and Tennessee permanently disenfranchise at least some ex-criminals. As you can see in this interactive state-by-state map of disenfranchising laws, the only states that do not restrict voting for ex-offenders are Vermont and Maine.

The practical implications of these laws are problematic for representative democracy, while the ethical grounds on which they stand call into question why they were imposed in the first place. The biggest and most obvious problem is that for those who have been convicted and are no longer incarcerated, being stripped of voting rights provides another barrier to reintegration and civic engagement already made difficult by challenges that exist in obtaining gainful employment, stable housing, and societal acceptance.

Proponents of disenfranchising laws argue that ex-criminals have forfeited their rights by engaging in activity that runs contrary to the goals of a lawfully-functioning society. Let’s put aside for a moment that not all those who are convicted and serve time are even guilty of the crimes for which they’ve been charged. This is a big problem, but we’ll assume that most who are sentenced are guilty and even so we can dismantle the arguments behind the practice of disenfranchising.

The next logical problem here is that no state strips voting rights for all types of illegal activity so instead we have a system in which some crimes lead to disenfranchisement while others don’t, even in instances when the alleged threat to the public good is nearly identical. Proponents would like to believe severity is commensurate with consequences, but the arbitrary nature of the justice system means that isn’t necessarily the case. For instance, a driver in Iowa cited thrice for operating a vehicle under the influence receives a felony sentence and is permanently barred from voting even after release. An equally unsafe driver who similarly violates traffic laws and is charged with reckless endangerment or excessive speeding while sober will not face the same disenfranchisement despite that their behavior is a similar threat to the safety of the public and can reasonably be assumed to result in the same outcome (property damage, injury or loss of life, etc).

This arbitrary lineation and disenfranchisement violates the bioethical principle of justice, described by Stanford Medical as the concept of fair distribution of resources (or in this case, consequences) among society. In the case of the drunk drivers versus reckless drivers, states make their best guess at what constitutes impairment, with the majority thresholds falling around a .08 blood alcohol concentration (BAC). Our understanding of neurobiology, tolerance, toxicity and metabolism, however, recognizes that this is an inexact science and a nondrinker with an even lower BAC may be significantly impaired while someone with a higher tolerance is able to maintain homeostasis and normal functioning well over the .10 mark. This is an unfortunate inexactitude but realistically necessary as a preventive mechanism for deterring drunk driving.

However, the permanent disenfranchisement that happens for one but not the other makes no sense through the lens of the justice principle. It also makes no sense from a penal perspective, because disenfranchisement is unlikely to be an effective deterrent against such crimes since the consequences are often years in the future.

There are myriad reasons why a repealing of disenfranchisement laws results in a more just, equitable, and most importantly, democratic society. Permanent barring of voting is a counterproductive and oppressive practice that discourages reintegration and erects insurmountable barriers to representation that no free citizen should be without.

– Tyler