The first thing I did when I opened this article was search for "rat", and was happy to see it there. From the comments I saw I had a hunch it might be: I recently finished a really powerful chapter in the book "Chasing the Scream: The First and Last Days of the War on Drugs" which describes an experiment involving rats that ostensibly shows that addiction isn't about the chemical, but rather it's about the environment and feeling alone.
But that chapter also discussed the broader challenge of escaping the view point entrenched in a generation that has only known addiction as a direct result of chemical action. And a huge part of this article, at least the first half or so I got through, painted this chemical action picture:
"The molecules derived from it have effectively conquered contemporary America." and it kept going on and on, to describe all the effects in wondrous terms, which seems to just reinforce what the book I've been reading claims are already a societal level view points.
I'm by no means qualified to speak about addiction from a public health stand point, nor do I really understand the pharmacological action of any drugs. But this book highlights many experiments or studies that indicate our current thinking is ass backwards, only to have the work squashed and funding ripped away. Now, I cannot stop but seeing these threads in most content produced regarding the drug war or opioid crisis. It'd be nice to know for sure, but it has become very difficult to even entertain the bullshit that politicians are still peddling w.r.t. to the drug war and realistic solutions.
In addition to rat park[0], there's also been an amazing study wrt to Viet Nam vets[1]. Only 5% of soldiers relapsed to heroin use in the first year of returning home. Compared to a traditional 90% relapse rate when addicts treated in the US return to their homes.
Environment and social setting is known to be important for addiction (along with basically everything else in perception and behavior, e.g. compensatory responses [1]), I think it's just a matter of how long it takes for scientific nuance to go mainstream.
The simplified picture is still often the chemical picture, imo, for 2 reasons: 1) the public forgets that the brain is an organ that obeys physical laws, and that behavior and perception depend entirely on the brain. 2) Ok, yes, environment is important, but how is that represented in the brain? It's still physiological, which inevitably includes chemicals.
It definitely seems like a mix. I've been addicted (to the point of losing thousands and thousands) to gambling in the past - looking for a way out, something to change things financially - but alcohol or narcotic drugs did nothing for me. But I knew other people in the same situation whose relief came - more destructively, more difficult to recover from - from the drugs.
Rather than place the blame on a lack of structure, community or spirituality, I see this as just a natural consequence of a system optimised at every turn for economic output.
I've heard a lot about a singularity doomsday scenario where a paperclip-maximising AI realises people are much less useful as paperclip constructors than they are as paperclip ingredients. Surely it can't be so hard to see that the productivity-maximising AI that we've cobbled together out of economic rather than electromechanical components is slowly realising it doesn't need us anymore either?
The truth is the economy soon won't have any use for poor whites other than consuming the output of rich whites. The last bastions of unskilled and semi-skilled labour are being automated or sent overseas (to be automated there). I'm really curious to see what America's 3.5 million truck drivers do when they lose their jobs over the next ten years. I guess we'll teach them to code?
But don't feel too sorry for them; the rising tide of productivity caught poor blacks before that, and all the hamster-wheeling busywork of the middle class is up next. Managers and decision-makers will stay above it right up until they realise abstraction cuts both ways. It'll just be the quants at the end, tweaking the last few parameters and getting the lights on the way out.
I think most of the world at least tries to keep the economic AI from being in charge of everything. It's hard because it keeps buying our politicians, but even so there's a sense that it should be serving our values, not the other way around. We might work with it, respect it even, but we don't trust it.
The USA is pretty strange in this sense, because somewhere along the line a huge chunk of the population got convinced that if they just leave everything to the paperclip AI it'll take care of them. And, for a time, it will, and the people who work hard to make paperclips get rewarded, and the people who start paperclip factories get rewarded more still. But, inevitably, you're not a paperclip, and your value is incidental in this system.
Faced with that, then, your only options are to find a system where people have value independent of their productivity, make being valueless palatable, or just go die quietly somewhere. It's probably not so surprising that, in the absence of the former option, the latter two are becoming increasingly popular.
And, I guess, not so surprising that the paperclip worshippers are particularly unconcerned with mental health and sensible drug policy. Still pretty gross though.
I've been talking with my brother a lot about this recently, especially as a function of the overall decrease of 'meaning' in the world. I think it goes back even further, to the advent of postmodernism in the throes of World War I. They were the first lost generation, but I don't think they were the last. The death of modernism and the accompanying assault on the bastions of objective meaning (as discussed in the article, Religion, Jingoism, and Community by way of Tribalism) is in some sense a healthy thing, as 'objective' meaning is too often used as false justification to do battle with other, contradicting 'objective' meaning. But it hasn't been replaced with anything. And the intervening years have only weakened it further. Maybe we had a brief sputter of national identity again with World War II, but the atomic bomb saw to that, and Vietnam finished the job (in America, at any rate). And now we're drifting in a world without objectivity. And what do you work for when the only objective truth is death, and the end of your accomplishments? Some people seem to be able to answer this question for themselves, some cannot.
We thought as well that this may be why there are so many people engaged rabidly in the consumption of fiction these days; it seems to me just as much a symptom of a broader crisis of meaning as opiods may be. A fictional world is readily graspable; you can wrap your whole head around the whole thing. And meaning is easily found in the simplified moral space that these simulations are often constructed under. It seems to me just as much a salve for the meta-crisis of meaninglessness as a drug, in some sense.
I don't mean to ascribe any moral right or wrong to any of this; in fact, that's the whole thrust of it. It's harder and harder to know what moral right and wrong are.
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EDIT: it's been pointed out that I should probably be less careless throwing a word like "objective" around: I mean it only in the sense of mass perceived objectivity. If a society agrees on it, it's as close to objectivity as we seem to be able to get. Substitute it for "Societal Consensus", if it pleases you, but I think the brain treats them as one and the same.
What if our pandering to rugged individualism has simply lead us to create a society where institutions, instead of providing a level playing field, reward those that have already won and punish those that have not?
Buy a million dollar house? Write off the cost of financing it. Get injured and not be able to work for a year? Huh, not sure someone with that kind of resume gap is the kind of person that we want to hire.
Then we wring our hands about why a frustrating, alienating society frustrates and alienates people.
Only a very disingenuous reading of history would lead to the conclusion that our society is less "objective" than the past.
What has been lost is widespread confidence and faith in those institutions that previously served as the pillars of society -- the church, the king and the nobility. Now people are completely on their own for their worldview. What's become abundantly clear is that people are very, very bad at constructing useful or reliable models of the world. Left to their own devices the people will readily embrace all sorts of nonsense, the more extreme the better. Some will turn to drugs and some will turn to ranting about crisis actors and some will turn to video games.
None of this is a cause for concern. These people's lives are still orders of magnitude better than those enjoyed by people just a century ago. A life wasted playing video games for 12 hours a day still beats one wasted slaving away for 12 hours a day on the farm.
What is disconcerting is that the "poison" is seeping into the vital and core institutions and systems that contribute to our extraordinary quality of life. The author is concerned about the suicide rate (which impressively continues to break new records every year) but what should really be frightening is the extraordinary poor governance that Americans have enjoyed for the past 20 years. (Seriously, trillions of dollars flushed down the drain on completely pointless wars.) When the real engine of American prosperity sputters out we will have much more significant and difficult problems than a bunch of dumb, bored kids getting high on dope.
I've been reading "Sapiens" and one of the recurring themes is the idea humanity's success is built on the ability to create useful fictions to bind large groups to a goal or cause. I think we are struggling with that in the first world as we give up religion without a clear replacement fiction that reassures people someone will be there if they get sick and when they die. In addition, we are discovering some groups have (for want of a better term) weaponized fiction to achieve their goals.
I liked it all a lot better when that last sentence lived entirely in the fiction of people like Warren Ellis and not in reality.
You may be interested in reading Man's Search for Meaning by Viktor Frankl, which says (roughly speaking, and after Kierkegaard) that the striving to find a meaning in life is the primary motivating force in the lives of people, and its frustration creates an existential vacuum that leads to boredom, distress, depression, aggression, addiction, and the rest. He would agree that there has been a sort of crisis of meaning since around the middle of the last century, loss of religion and other societal conventions having a lot to do with it.
I think what you regard as "people engaged rabidly in the consumption of fiction" he might interpret as people living passively, bored and confused, abdicating a sense of responsibility for their own lives. I think he is a precursor to the Neil Postman line of cultural criticism, if anyone's looking for more books.
Man's Search for Meaning is a short and compelling book, he describes a way forward that doesn't involve resurgent nationalism or religious fundamentalism, and I've gotten a lot out of it personally.
Your comment about the rabid consumption of fiction these days hits home for me personally. In this "golden age" of television, with more high quality entertainment than anyone can possibly consume, I've begun to feel that my media consumption is more compulsive escapism than casual enjoyment.
I find Pitirim Sorokin's classification of societies as either ideational (spiritual) or sensate (materialistic) helpful in understanding where we are. I strongly believe the evidence points to our modern civilization being in the late stages of sensate decline. Science and technology has brought enormous benefits to the world but has utterly devastated the individual dignity of man, leaving only meaningless pleasures to provide any motivation for living. I think we will soon (100 years?) see a cultural shift back towards immaterial values and purposes higher than the satisfaction of our sensory desires. The question in my mind is whether that shift happens before or after our current civilization destroys itself.
I'll be the one to bring up Jordan Peterson, I guess. To attempt to synthesize his views:
1. Even if you start from a position of complete nihilism, you can recognize that pain (both physical and psychological) is real and that you don't like it.
2. You can observe that people who perceive their life as meaningful are more likely to be capable of persevering in the face of extreme pain and suffering. So in a sense meaning is "more real" (stronger) than pain. (I don't get much out of the "more real" aspect, but I think it's part of Peterson's attempt to find harmony between rationality and religion.)
3. Even if/though meaning is completely subjective, you can derive meaning from taking steps toward a goal, specifically a positive vision for your own life that you've imagined in great detail (and ideally written down), including how you want to affect the people around you and the wider community. Having a vision of the life you want to avoid (Hell) is good, too.
4. Your goal (life vision) will change as you move toward it, but that's a good thing because it means you're learning and expanding your horizon.
Peterson and some colleagues created a kind of self-help course based on this sort of thing called Self Authoring and he often cites the positive outcomes it had when they researched it using college students (higher grades and lower dropout rates).
I think he would say that the societal malaise you're talking about is essentially Nietzsche's death of God and that you can draw a line from that loss of a foundation to the horrors of the 20th century (Peterson would probably just say "the gulags"; he sees more of a danger from "radical leftism" in contemporary society than fascism). The above could perhaps be described as his alternative to attempting to address the lack of a social firmament through some totalistic ideology, which has in the past led to pathological totalitarian states like Hitler's Germany and Stalin's USSR.
> It's harder and harder to know what moral right and wrong are.
Morality isn't about what is right or wrong. You need to get past that. There are plenty of situations where there is no right answer and an individual is forced to choose between two wrongs.
Morality is what an individual ascribes to be proper or improper and it is very fluid. An individual's morality is influenced by everything from the situation to the people around them. They may inherit their sense of morality of another person or group but morality is still a personal choice.
We tend to think that everyone shares the same morality and so it becomes confusing when we encounter situations where our moral beliefs are at odds with others and we're in the minority. It doesn't help that the moral code ascribed to by a community might be completely different from the one the next town over.
I think almost all problems we discuss every day: political divide, millennial job prospects, student loan debt, drug crises can be traced to wealth inequality. At it's core, all these problems evolve from unfettered capitalistic pursuits. The middle man taking their cut of student loans and having no means to resolve that debt through bakruptcy. No growth jobs that offer no safety net. For profit schools, prisons and healthcare allowing those at the top to accumulate wealth by depriving more people of what was once considered a community benefit. We yell that the other side has it wrong while owners of gun manufacturers escape any civil liability and providers of medicare admin routinely overbill, then pay fines less than the wealth accumulated. Opiates provide an opportunity to escape what seems unescapable. I am not sure the answer but the framing is continually wrong.
I agree with just about all of what you said. So many bad things are tied to this. Crime rate. Horrible educational results and environments (I worked in Baltimore schools as a contractor and it's one of the saddest experiences I ever had and I'm a combat vet).
One thing to remember though about the war on drugs and especially the opiate crisis is that it was also largely a creation of the CIA who learned it from the Brits who had been doing it as far back as the opium wars. Black markets provide black money budgets not overseen by Congress, and the CIA really hates oversight (they prefer overlook committees). The main opiate crisis in particular stems from Vietnam, where generals would play along for a cut while the CIA had drug operations all over including Laos, etc. They'd then ship it back and sell it specifically in the inner (mostly black and other minority) city.
The same thing is true of this opiate crisis. The war in Afghanistan has massively increased poppy production (which the taliban had outlawed) while US forces would eradicate weed crops they allowed poppy fields, and low and behold, the vast majority of the heroin, etc now in America can be traced (Chem analysis) right back to Afghanistan. I promise you it's Vietnam on repeat, and the CIA has their hands all over it.
Of course south America is the same. Behind every top cartel member is a CIA man pulling their strings, and look at the destruction they are wreaking on the border towns. The death toll of civilians is higher than allied casualties in OIF!
It's just like Iran contra. Since lots of the time they don't want to pay full price, the Intel agencies will ship arms to them as well.
It's high time for a new church committee!
The problem is the surveillance engine is so pervasive, which enables the blackmail and extortion system, just about every senator or congressman who pushed back would be quickly compromised.
This is the real deep state, in the Peter Dale Scott sense of the term, and it must be addressed if we are going to strike at the root of many of our problems, instead of hacking at the branches.
I disagree with just about everything you said and would argue nearly the opposite: too much state involvement in education, healthcare, and the economy is to blame for the deteriorating society.
Children are forced to conform to the state's schooling program from a very early age, and those who fail to do so are labeled as such with bad grades and trips to the school office. They are humiliated in front of their peers and feel powerless and dehumanized. This record follows them through their entire schooling career. The religious and cultural traditions of their parents are ridiculed by the authority figures at school. School zones keep poor children out of good schools.
Wealth inequality will naturally arise in any system, but when gains go to the politically-connected or well-lobbied, then the state is artificially enriching those at the expense of others. This is not the functioning of capitalism but rather of cronyism and corruption.
Student loans are out of control precisely because the government got in the business. Higher education costs are out of control because of the excess money from the student loans.
The job prospects suck because of excess regulation in the economy. Entrepreneurs are not able to innovate as well due to so much red tape. Occupational licensing sets up barriers at all levels of the workforce, enriching the incumbents and limiting competition. Healthcare is so overrun with regulation it's laughable to mention the word "market" in the same sentence. Those are barriers put in place of market forces by the state.
The drug epidemic is merely the result of all these forces put together.
Singapore has one of the world's highest income inequalities and faces virtually none of those problems. Distilling it down to "income inequality" is reductionist, political scapegoating.
> I think almost all problems we discuss every day: political divide, millennial job prospects, student loan debt, drug crises can be traced to wealth inequality.
I would put one caveat on this: it's due to wealth inequality that doesn't come from having created more wealth. All of the examples are of people not creating wealth, but accumulating it by transferring it from other people to themselves. That kind of wealth inequality is bad not because wealth inequality is bad in itself, but because our society as a whole needs people to be creating wealth in order to continue to exist; so if all of the smart, talented people find they can get more wealth by transferring it from others instead of creating it, our society will eventually collapse.
"It’s been several decades since Daniel Bell wrote The Cultural Contradictions of Capitalism, but his insights have proven prescient. Ever-more-powerful market forces actually undermine the foundations of social stability, wreaking havoc on tradition, religion, and robust civil associations, destroying what conservatives value the most. They create a less human world. They make us less happy. They generate pain."
This articulates the feelings/observations I've been mulling over recently. Also the idea of opiate abusers being a self-selecting group of the "failed" areas of society was something I hadn't thoroughly considered. Very interesting. If opiates caused a more distinct rise in violet crime, would public policy be forced to respond similar to the other drug epidemics? (Though I might argue that those epidemics were just replaced with this one, yielding quieter and more easily ignored victims.)
> ever-more-powerful market forces actually undermine the foundations of social stability, wreaking havoc on tradition, religion, and robust civil associations
Is there an actual example of this? I can't think of a single one.
while that quote is interesting, it also posits progressivism as the culprit, and by allusion, points to conservatism as the solution, but that’s plainly wrong.
it must be taken as a given that change (i.e., progress) will happen. you can thank the 2nd law of thermodynamics for that. so then the perspective must shift from “can we keep the world the same as we imagine it to have been in the past (while ignoring all the bad parts and negative consequences)?” to “how do we deal with a changing world, adapt to it, and focus our efforts toward positive change?” we just don’t get to sit still. life only happens in the gap between order and chaos.
the quote i prefer is
“The oxytocin we experience from love or friendship or orgasm is chemically replicated by the molecules derived from the poppy plant. It’s a shortcut — and an instant intensification — of the happiness we might ordinarily experience in a good and fruitful communal life. It ends not just physical pain but psychological, emotional, even existential pain.”
this articulates a mechanism by which opioid addiction lodges itself in the failed corners of society. so how do we fix that? it’s not by considering addicts criminals. the “war on drugs” experiment has proven that doesn’t work. instead, we need to accept the social responsibility of creating “losers” in the first place. we need to progress to the next level of societal structure that redirects folks back into meaningful and purposeful lives.
i think the stage might be set to move to a kind of globally-aware localism. that is, having people focus on their microcommunities (the 5-10 block radius around where we live in cities, a bit bigger in less dense areas). how do we organize homes, schools, businesses, offices, services, etc. in ways that reinforce our ties to each other rather than two-dimensional celebrities and fantasies of far-off wealth and fame that make you feel like you’re losing? but also use technology to learn from those far-flung places to improve your own lives locally. you only need a few people around you appreciating your efforts to get plenty of oxytocin to forget about the hard opioids.
I would argue that the public school system is the strongest force in weakening "tradition, religion, and robust civil associations." Much of the schooling experience is designed to suppress individuality and encourage conformity to the state's ideals. And of course capitalism (the non-crony type) doesn't really play any role in the public school system.
> "And so we wait to see what amount of death will be tolerable in America as the price of retaining prohibition. Is it 100,000 deaths a year? More? At what point does a medical emergency actually provoke a government response that takes mass death seriously? Imagine a terror attack that killed over 40,000 people. Imagine a new virus that threatened to kill 52,000 Americans this year. Wouldn’t any government make it the top priority before any other?"
This is a very good point and really puts it into perspective. Overall this is an excellent essay. I also really like how he addresses the physical affects of opioids, rather than just saying it gets you "high".
In the grand scheme of things, 100,000 deaths is a non-event for a government representing over 300,000,000 constituents. Almost 6 times that many people die from both cancer and heart disease each year. Where it becomes a problem for governments is when there's bad PR. They focus their attention on terrorism because it commands the national attention, not because it's a significant threat. While the abuse of opioids is no doubt a problem, it's getting government attention now because of media scrutiny, not because it absolutely needs to be solved by government.
Humans are terrible at estimating risk. We seem to do it by attributing it to the ease which we can recall an incidence of something similar happening. This may have worked well when we were part of small tribes, but it's terribly adapted to a world where every unusual, capricious event is is broadcast nationally and the mundane, common dangers receive very little media attention.
You can see this with the current debate over guns. Now I favor the liberal position of drastically increasing gun control, but only around 11,000 people are murdered with guns each year and another 22,000 or so kill themselves. That's around a 1/30,000 chance of being the victim of gun violence. Those deaths may be largely unnecessary, but we should still have the perspective to realize that they're not a significant threat to our health.
In America, the distribution of deaths has an (at least) equally significant effect as the number of deaths, at least up to a point where the number gets particularly huge.
The distribution effect is often ignored by non-US reporting about various "social maladies" (stupid term, but gets the idea across) in the country: the US is surprisingly internally divided not just in politics, but in empathy. There's often a nation-tribalist effect of "people are dying not in my (city|town|state|area|demographic|politcal party); I consider those deaths sad, but no sadder than someone dying in another country", which I think is important and often overlooked.
It's actually a foolish quote. What can the government do in the face of tens of thousands of people essentially choosing to kill themselves? It could jail them, but our culture is moving towards one where doing that to drug users is frowned upon. So what option does it have?
Putting the onus on the government to solve this problem goes against the very essence of this piece. If social fragmentation is truly the cause of the opioid crisis, then government intervention will by like putting a mud wall in front of a raging river.
This is bad, really bad, but just wait til our roads are filled with self-driving trucks and the remaining factories with robots then the fentanyl party will really begin unfortunately.
It is fantastic that OpenAI is attempting to address the more dire threats of a rogue AI, but there's a big near term threat already staring us in the face and seemingly zero leadership here in the United States aware of the crisis that will arrive in the next decade or so. And what passes for leadership has absolutely no concrete plan to get us past it.
When I met the friend who taught me about heroin, I figured she was "high as a kite" because she chattered from topic to topic like a butterfly. She called back a few days later, and started to invite me into her world. I didn't know anything about the street pharmacy, except that cannabis had been helpful for another friend to get her alcohol use under control.
She said she'd relapsed on cocaine because of severe depression, then shortly later on heroin -- supposedly to treat her high blood pressure (from smoking cocaine). I think really she was just lonely. A chapter in Gabor Maté's book is titled Through a Needle, a Soft, Warm Hug [0].
She was going to the methadone clinic daily when we met. If she couldn't get to the clinic by the 11am closing, she'd have to order heroin from her street pharmacist. It was almost as if the clinic had contempt for its clients -- their business was to be their clients' legal dealer.
Four months after she'd begun to teach me about her world, I decided she didn't actually like it that much, and began to express disapproval at her self-medication strategies. She tried sticking with her old drug world, but she liked me more than the drugs. At about six months we had a nice time frying donuts (coconut oil is a treatment for compulsive alcohol use, and makes for tasty donuts). Two days later she called to say that she "wished [she] wasn't a drug addict". The next day, "I SHOULD ONLY USE SUBSTANCES WHICH ARE LEGAL! Alcohol is legal, [tcj_phx]..." (me: doh! progress, I'll take it), the following day, "I hate methadone, I hate everything about it..." Essentially what I did was a months-long pace... then lead (hypnotic technique).
The most important interventions to end the present "opioid epidemic" (artificial) is to provide a legal supply of clean heroin, safe injection sites, and protecting addicts from the criminal justice system.
Sullivan starts out highlighting how America is exceptionally afflicted by opioid abuse, but goes on to unconvincingly weave a bunch of unexceptional factors into his explanation.
Smartphones, TV, video games, online porn: they're in every developed country. They can't be the explanation for what's different about America. Decline of religiously-derived meaning? Most developed countries' populations place less importance on religion than Americans. Factory jobs squeezed by automation and cheap offshore labor? Canadian manufacturers have access to the same robots as American firms, and Canada has been a member of the World Trade Organization as long as the US has.
Inter-temporal comparisons also show that it doesn't make sense to blame the American opioid crisis on the decline of manufacturing jobs. The number of American manufacturing jobs peaked in the 1970s. "Rust belt" became a common term in the 1980s. But the opioid crisis is much more recent.
At least we are moving past the scape goats and taking a thoughtful, considerate look at what is actually happening.
I regularly have long conversations about this with my mother, a nurse in Louisville, KY and steadfast American patriot. She is at a loss of any explanation these days. I am torn when we talk about it because I know her pride in our country is a big part of her, but it doesn’t rest with what she is seeing. Watching her spirit shift into curiosity then skepticism has been difficult to witness. She wants to blame someone but she no longer believes that someone is out there.
I was the first to blame the drug companies (they certainly warrant blame) but there are other factors to consider that are addressed in this article that I failed to previous realize. Worth the 15-20 minutes to read.
As a Heroin addict that hasn't used in over 5 years, I believe the emptiness of Materialism was as instrumental in my addiction as the richness of spirituality has been in my recovery.
Really brilliant and well-written article. The analysis of the uniqueness of American society is really well-done as well. American hyper-individualism, work ethic, and atomic self-oriented lifestyle leads people to seek their own meanings, which leads to tremendous suffering when community network is destroyed and when there's no available work to do.
Don't have any sources available, but as an European it's strange how prevalent opioids are in the States for what are seen as "regular" medical interventions. I remember having a discussion with a US redditor, telling him/her that even though I had 3 or 4 teeth extracted during the last 10 or so years I've never been prescribed opioids (the extractions were done by different doctors, in different clinics), I've always managed the post-extraction pains with Nurofen-like drugs and I was quite ok (and I don't think of myself as a particular "pain-resistant" guy, quite the contrary). There were other redditors in the same thread (I remember one from Germany) who had had the same experiences as me. So, all things considered, these numbers don't surprise me at all.
Personally, I just don't "get" the high of opiods. My experience has been entirely medical -- morphine after surgery, and the usual vicodin/percocet/whatever pills after injury or tooth extraction.
Different people react to them differently. Some people, like me, they make physical pain recede, but nothing else. Some people, they make feel groggy or sick, and they don't like them. (My grandmother was like this -- she disliked the grogginess from the Brompton's Mixture more than she disliked the pain of her terminal cancer. She only took it once or twice.)
And some people, one dose and it's "Where have you BEEN all my life!!!!"
An interesting line of research might be -- why the difference in reaction to opiods? Why do some people get the "WOW! I LIKE that!!" reaction, while others don't?
Loved the way the article was written. I read a lot of long-form articles and have a few favorite writers. Is anyone aware of a service that will track individual writers and give an alert when they post something new? Sort of like an RSS feed for an individual writer, regardless of where their new article is posted.
This whole piece is a good example of how fine writing can hoodwink you. Garbage analysis from start to finish.
"Unlike in Europe, where cities and towns existed long before industrialization, much of America’s heartland has no remaining preindustrial history, given the destruction of Native American societies. The gutting of that industrial backbone — especially as globalization intensified in a country where market forces are least restrained — has been not just an economic fact but a cultural, even spiritual devastation."
From time immemorial, people---especially cultural critics and journalists---have blamed social phenomena on culture, the era's degradation, political changes or something else they are interested in anyway. It flatters you for your command of politics and history: turns out all that stuff you read about because it interests you is actually solidly causative in explaining something important. What a nice coincidence.
I am pretty sure that when the history of this era is written by real social scientists, what they will decide is much more technical and boring...having little to do with the topics that capture our attention for other reasons (manufacturing jobs and trump's election in this case). For example: a bunch of new opioids had been invented, which insurance paid for and doctors prescribed. Large amounts of heroin were available at low prices from increasingly competent and seamless sellers. In what world would these phenomena take place and the amount of addiction not increase?
I used to live in England. There is not as much of a crisis there although there is plenty of economic hardship, loss of manufacturing jobs, etc. The difference is that the NHS won't pay for everybody to load up on a thousand pills, and England is an island where you can't easily smuggle in tons of heroin.
Sometimes the article really veers into the absurd. Consider this passage:
"A huge boom was kick-started by the Civil War, when many states cultivated poppies in order to treat not only the excruciating pain of horrific injuries but endemic dysentery. Booth notes that 10 million opium pills and 2 million ounces of opiates in powder or tinctures were distributed by Union forces. Subsequently, vast numbers of veterans became addicted — the condition became known as “Soldier’s Disease” — and their high became more intense with the developments of morphine and the hypodermic needle. They were joined by millions of wives, sisters, and mothers who, consumed by postwar grief, sought refuge in the obliviating joy that opiates offered."
Right here Sullivan offers a total explanation for why everyone got addicted to painkillers: the government was literally manufacturing them and giving them in massive quantities. But that's not literary enough, so he turns around and fabricates something out of whole cloth:
"the epidemic of the late 1860s and 1870s was probably more widespread, if far less intense, than today’s — a response to the way in which the war tore up settled ways of life, as industrialization transformed the landscape, and as huge social change generated acute emotional distress. This aspect of the epidemic — as a response to mass social and cultural dislocation — was also clear among the working classes in the earlier part of the 19th century in Britain. As small armies of human beings were lured from their accustomed rural environments, with traditions and seasons and community, and thrown into vast new industrialized cities, the psychic stress gave opium an allure not even alcohol could match."
Ah so it was the "psychic stress" of industrialization. So losing manufacturing jobs causes addiction, but also so does gaining them. Interesting that manufacturing jobs are such a powerful explanation in an era when our president is constantly banging on about manufacturing jobs. Suppose we hadn't industrialized at that time; I'm pretty sure people still would have gotten addicted given how many free opiates they were getting. In that case Sullivan probably would have said, "The rural isolation of Americans...the soul-crushing vicissitudes of farming born alone...caused Amercians to take refuge in opiates."
Also worth remembering Andrew Sullivan is serially wrong.
[+] [-] noahdesu|8 years ago|reply
But that chapter also discussed the broader challenge of escaping the view point entrenched in a generation that has only known addiction as a direct result of chemical action. And a huge part of this article, at least the first half or so I got through, painted this chemical action picture:
"The molecules derived from it have effectively conquered contemporary America." and it kept going on and on, to describe all the effects in wondrous terms, which seems to just reinforce what the book I've been reading claims are already a societal level view points.
I'm by no means qualified to speak about addiction from a public health stand point, nor do I really understand the pharmacological action of any drugs. But this book highlights many experiments or studies that indicate our current thinking is ass backwards, only to have the work squashed and funding ripped away. Now, I cannot stop but seeing these threads in most content produced regarding the drug war or opioid crisis. It'd be nice to know for sure, but it has become very difficult to even entertain the bullshit that politicians are still peddling w.r.t. to the drug war and realistic solutions.
[+] [-] foxbarrington|8 years ago|reply
[0] https://en.wikipedia.org/wiki/Rat_Park
[1] https://www.npr.org/sections/health-shots/2015/01/05/3718949...
[+] [-] lamename|8 years ago|reply
The simplified picture is still often the chemical picture, imo, for 2 reasons: 1) the public forgets that the brain is an organ that obeys physical laws, and that behavior and perception depend entirely on the brain. 2) Ok, yes, environment is important, but how is that represented in the brain? It's still physiological, which inevitably includes chemicals.
[1] http://nobaproject.com/modules/conditioning-and-learning
[+] [-] majormajor|8 years ago|reply
[+] [-] jaredhansen|8 years ago|reply
http://slatestarcodex.com/2017/10/25/against-rat-park/
[+] [-] njwi332|8 years ago|reply
[+] [-] arprocter|8 years ago|reply
[+] [-] sgentle|8 years ago|reply
I've heard a lot about a singularity doomsday scenario where a paperclip-maximising AI realises people are much less useful as paperclip constructors than they are as paperclip ingredients. Surely it can't be so hard to see that the productivity-maximising AI that we've cobbled together out of economic rather than electromechanical components is slowly realising it doesn't need us anymore either?
The truth is the economy soon won't have any use for poor whites other than consuming the output of rich whites. The last bastions of unskilled and semi-skilled labour are being automated or sent overseas (to be automated there). I'm really curious to see what America's 3.5 million truck drivers do when they lose their jobs over the next ten years. I guess we'll teach them to code?
But don't feel too sorry for them; the rising tide of productivity caught poor blacks before that, and all the hamster-wheeling busywork of the middle class is up next. Managers and decision-makers will stay above it right up until they realise abstraction cuts both ways. It'll just be the quants at the end, tweaking the last few parameters and getting the lights on the way out.
I think most of the world at least tries to keep the economic AI from being in charge of everything. It's hard because it keeps buying our politicians, but even so there's a sense that it should be serving our values, not the other way around. We might work with it, respect it even, but we don't trust it.
The USA is pretty strange in this sense, because somewhere along the line a huge chunk of the population got convinced that if they just leave everything to the paperclip AI it'll take care of them. And, for a time, it will, and the people who work hard to make paperclips get rewarded, and the people who start paperclip factories get rewarded more still. But, inevitably, you're not a paperclip, and your value is incidental in this system.
Faced with that, then, your only options are to find a system where people have value independent of their productivity, make being valueless palatable, or just go die quietly somewhere. It's probably not so surprising that, in the absence of the former option, the latter two are becoming increasingly popular.
And, I guess, not so surprising that the paperclip worshippers are particularly unconcerned with mental health and sensible drug policy. Still pretty gross though.
[+] [-] dmreedy|8 years ago|reply
We thought as well that this may be why there are so many people engaged rabidly in the consumption of fiction these days; it seems to me just as much a symptom of a broader crisis of meaning as opiods may be. A fictional world is readily graspable; you can wrap your whole head around the whole thing. And meaning is easily found in the simplified moral space that these simulations are often constructed under. It seems to me just as much a salve for the meta-crisis of meaninglessness as a drug, in some sense.
I don't mean to ascribe any moral right or wrong to any of this; in fact, that's the whole thrust of it. It's harder and harder to know what moral right and wrong are.
---
EDIT: it's been pointed out that I should probably be less careless throwing a word like "objective" around: I mean it only in the sense of mass perceived objectivity. If a society agrees on it, it's as close to objectivity as we seem to be able to get. Substitute it for "Societal Consensus", if it pleases you, but I think the brain treats them as one and the same.
[+] [-] maxerickson|8 years ago|reply
What if our pandering to rugged individualism has simply lead us to create a society where institutions, instead of providing a level playing field, reward those that have already won and punish those that have not?
Buy a million dollar house? Write off the cost of financing it. Get injured and not be able to work for a year? Huh, not sure someone with that kind of resume gap is the kind of person that we want to hire.
Then we wring our hands about why a frustrating, alienating society frustrates and alienates people.
[+] [-] dnomad|8 years ago|reply
What has been lost is widespread confidence and faith in those institutions that previously served as the pillars of society -- the church, the king and the nobility. Now people are completely on their own for their worldview. What's become abundantly clear is that people are very, very bad at constructing useful or reliable models of the world. Left to their own devices the people will readily embrace all sorts of nonsense, the more extreme the better. Some will turn to drugs and some will turn to ranting about crisis actors and some will turn to video games.
None of this is a cause for concern. These people's lives are still orders of magnitude better than those enjoyed by people just a century ago. A life wasted playing video games for 12 hours a day still beats one wasted slaving away for 12 hours a day on the farm.
What is disconcerting is that the "poison" is seeping into the vital and core institutions and systems that contribute to our extraordinary quality of life. The author is concerned about the suicide rate (which impressively continues to break new records every year) but what should really be frightening is the extraordinary poor governance that Americans have enjoyed for the past 20 years. (Seriously, trillions of dollars flushed down the drain on completely pointless wars.) When the real engine of American prosperity sputters out we will have much more significant and difficult problems than a bunch of dumb, bored kids getting high on dope.
[+] [-] tclancy|8 years ago|reply
I've been reading "Sapiens" and one of the recurring themes is the idea humanity's success is built on the ability to create useful fictions to bind large groups to a goal or cause. I think we are struggling with that in the first world as we give up religion without a clear replacement fiction that reassures people someone will be there if they get sick and when they die. In addition, we are discovering some groups have (for want of a better term) weaponized fiction to achieve their goals.
I liked it all a lot better when that last sentence lived entirely in the fiction of people like Warren Ellis and not in reality.
EDIT: Sapiens, not Simians.
[+] [-] fishtank|8 years ago|reply
I think what you regard as "people engaged rabidly in the consumption of fiction" he might interpret as people living passively, bored and confused, abdicating a sense of responsibility for their own lives. I think he is a precursor to the Neil Postman line of cultural criticism, if anyone's looking for more books.
Man's Search for Meaning is a short and compelling book, he describes a way forward that doesn't involve resurgent nationalism or religious fundamentalism, and I've gotten a lot out of it personally.
[+] [-] kldavis4|8 years ago|reply
I find Pitirim Sorokin's classification of societies as either ideational (spiritual) or sensate (materialistic) helpful in understanding where we are. I strongly believe the evidence points to our modern civilization being in the late stages of sensate decline. Science and technology has brought enormous benefits to the world but has utterly devastated the individual dignity of man, leaving only meaningless pleasures to provide any motivation for living. I think we will soon (100 years?) see a cultural shift back towards immaterial values and purposes higher than the satisfaction of our sensory desires. The question in my mind is whether that shift happens before or after our current civilization destroys itself.
[+] [-] evunveot|8 years ago|reply
1. Even if you start from a position of complete nihilism, you can recognize that pain (both physical and psychological) is real and that you don't like it.
2. You can observe that people who perceive their life as meaningful are more likely to be capable of persevering in the face of extreme pain and suffering. So in a sense meaning is "more real" (stronger) than pain. (I don't get much out of the "more real" aspect, but I think it's part of Peterson's attempt to find harmony between rationality and religion.)
3. Even if/though meaning is completely subjective, you can derive meaning from taking steps toward a goal, specifically a positive vision for your own life that you've imagined in great detail (and ideally written down), including how you want to affect the people around you and the wider community. Having a vision of the life you want to avoid (Hell) is good, too.
4. Your goal (life vision) will change as you move toward it, but that's a good thing because it means you're learning and expanding your horizon.
Peterson and some colleagues created a kind of self-help course based on this sort of thing called Self Authoring and he often cites the positive outcomes it had when they researched it using college students (higher grades and lower dropout rates).
I think he would say that the societal malaise you're talking about is essentially Nietzsche's death of God and that you can draw a line from that loss of a foundation to the horrors of the 20th century (Peterson would probably just say "the gulags"; he sees more of a danger from "radical leftism" in contemporary society than fascism). The above could perhaps be described as his alternative to attempting to address the lack of a social firmament through some totalistic ideology, which has in the past led to pathological totalitarian states like Hitler's Germany and Stalin's USSR.
[+] [-] fsloth|8 years ago|reply
I would look in ways american society puts more pressure on individuals, than, say , scandinavian societies do.
I would look to economic and not existential issues.
I think the article nailed it when it pointed out america has no experience of pre-industrial culture at large.
[+] [-] cptskippy|8 years ago|reply
Morality isn't about what is right or wrong. You need to get past that. There are plenty of situations where there is no right answer and an individual is forced to choose between two wrongs.
Morality is what an individual ascribes to be proper or improper and it is very fluid. An individual's morality is influenced by everything from the situation to the people around them. They may inherit their sense of morality of another person or group but morality is still a personal choice.
We tend to think that everyone shares the same morality and so it becomes confusing when we encounter situations where our moral beliefs are at odds with others and we're in the minority. It doesn't help that the moral code ascribed to by a community might be completely different from the one the next town over.
[+] [-] thomzi12|8 years ago|reply
[+] [-] chrisgd|8 years ago|reply
[+] [-] arca_vorago|8 years ago|reply
One thing to remember though about the war on drugs and especially the opiate crisis is that it was also largely a creation of the CIA who learned it from the Brits who had been doing it as far back as the opium wars. Black markets provide black money budgets not overseen by Congress, and the CIA really hates oversight (they prefer overlook committees). The main opiate crisis in particular stems from Vietnam, where generals would play along for a cut while the CIA had drug operations all over including Laos, etc. They'd then ship it back and sell it specifically in the inner (mostly black and other minority) city.
The same thing is true of this opiate crisis. The war in Afghanistan has massively increased poppy production (which the taliban had outlawed) while US forces would eradicate weed crops they allowed poppy fields, and low and behold, the vast majority of the heroin, etc now in America can be traced (Chem analysis) right back to Afghanistan. I promise you it's Vietnam on repeat, and the CIA has their hands all over it.
Of course south America is the same. Behind every top cartel member is a CIA man pulling their strings, and look at the destruction they are wreaking on the border towns. The death toll of civilians is higher than allied casualties in OIF!
It's just like Iran contra. Since lots of the time they don't want to pay full price, the Intel agencies will ship arms to them as well.
It's high time for a new church committee!
The problem is the surveillance engine is so pervasive, which enables the blackmail and extortion system, just about every senator or congressman who pushed back would be quickly compromised.
This is the real deep state, in the Peter Dale Scott sense of the term, and it must be addressed if we are going to strike at the root of many of our problems, instead of hacking at the branches.
[+] [-] clarkmoody|8 years ago|reply
Children are forced to conform to the state's schooling program from a very early age, and those who fail to do so are labeled as such with bad grades and trips to the school office. They are humiliated in front of their peers and feel powerless and dehumanized. This record follows them through their entire schooling career. The religious and cultural traditions of their parents are ridiculed by the authority figures at school. School zones keep poor children out of good schools.
Wealth inequality will naturally arise in any system, but when gains go to the politically-connected or well-lobbied, then the state is artificially enriching those at the expense of others. This is not the functioning of capitalism but rather of cronyism and corruption.
Student loans are out of control precisely because the government got in the business. Higher education costs are out of control because of the excess money from the student loans.
The job prospects suck because of excess regulation in the economy. Entrepreneurs are not able to innovate as well due to so much red tape. Occupational licensing sets up barriers at all levels of the workforce, enriching the incumbents and limiting competition. Healthcare is so overrun with regulation it's laughable to mention the word "market" in the same sentence. Those are barriers put in place of market forces by the state.
The drug epidemic is merely the result of all these forces put together.
[+] [-] naeemtee|8 years ago|reply
[+] [-] pdonis|8 years ago|reply
I would put one caveat on this: it's due to wealth inequality that doesn't come from having created more wealth. All of the examples are of people not creating wealth, but accumulating it by transferring it from other people to themselves. That kind of wealth inequality is bad not because wealth inequality is bad in itself, but because our society as a whole needs people to be creating wealth in order to continue to exist; so if all of the smart, talented people find they can get more wealth by transferring it from others instead of creating it, our society will eventually collapse.
I think Pg had an essay about this a while back.
[+] [-] ArcticUnicorn|8 years ago|reply
This articulates the feelings/observations I've been mulling over recently. Also the idea of opiate abusers being a self-selecting group of the "failed" areas of society was something I hadn't thoroughly considered. Very interesting. If opiates caused a more distinct rise in violet crime, would public policy be forced to respond similar to the other drug epidemics? (Though I might argue that those epidemics were just replaced with this one, yielding quieter and more easily ignored victims.)
[+] [-] maratd|8 years ago|reply
Is there an actual example of this? I can't think of a single one.
[+] [-] unknown|8 years ago|reply
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[+] [-] clairity|8 years ago|reply
it must be taken as a given that change (i.e., progress) will happen. you can thank the 2nd law of thermodynamics for that. so then the perspective must shift from “can we keep the world the same as we imagine it to have been in the past (while ignoring all the bad parts and negative consequences)?” to “how do we deal with a changing world, adapt to it, and focus our efforts toward positive change?” we just don’t get to sit still. life only happens in the gap between order and chaos.
the quote i prefer is
“The oxytocin we experience from love or friendship or orgasm is chemically replicated by the molecules derived from the poppy plant. It’s a shortcut — and an instant intensification — of the happiness we might ordinarily experience in a good and fruitful communal life. It ends not just physical pain but psychological, emotional, even existential pain.”
this articulates a mechanism by which opioid addiction lodges itself in the failed corners of society. so how do we fix that? it’s not by considering addicts criminals. the “war on drugs” experiment has proven that doesn’t work. instead, we need to accept the social responsibility of creating “losers” in the first place. we need to progress to the next level of societal structure that redirects folks back into meaningful and purposeful lives.
i think the stage might be set to move to a kind of globally-aware localism. that is, having people focus on their microcommunities (the 5-10 block radius around where we live in cities, a bit bigger in less dense areas). how do we organize homes, schools, businesses, offices, services, etc. in ways that reinforce our ties to each other rather than two-dimensional celebrities and fantasies of far-off wealth and fame that make you feel like you’re losing? but also use technology to learn from those far-flung places to improve your own lives locally. you only need a few people around you appreciating your efforts to get plenty of oxytocin to forget about the hard opioids.
[+] [-] clarkmoody|8 years ago|reply
[+] [-] pwaivers|8 years ago|reply
This is a very good point and really puts it into perspective. Overall this is an excellent essay. I also really like how he addresses the physical affects of opioids, rather than just saying it gets you "high".
[+] [-] curun1r|8 years ago|reply
Humans are terrible at estimating risk. We seem to do it by attributing it to the ease which we can recall an incidence of something similar happening. This may have worked well when we were part of small tribes, but it's terribly adapted to a world where every unusual, capricious event is is broadcast nationally and the mundane, common dangers receive very little media attention.
You can see this with the current debate over guns. Now I favor the liberal position of drastically increasing gun control, but only around 11,000 people are murdered with guns each year and another 22,000 or so kill themselves. That's around a 1/30,000 chance of being the victim of gun violence. Those deaths may be largely unnecessary, but we should still have the perspective to realize that they're not a significant threat to our health.
[+] [-] zbentley|8 years ago|reply
The distribution effect is often ignored by non-US reporting about various "social maladies" (stupid term, but gets the idea across) in the country: the US is surprisingly internally divided not just in politics, but in empathy. There's often a nation-tribalist effect of "people are dying not in my (city|town|state|area|demographic|politcal party); I consider those deaths sad, but no sadder than someone dying in another country", which I think is important and often overlooked.
[+] [-] meri_dian|8 years ago|reply
Putting the onus on the government to solve this problem goes against the very essence of this piece. If social fragmentation is truly the cause of the opioid crisis, then government intervention will by like putting a mud wall in front of a raging river.
[+] [-] scottlegrand2|8 years ago|reply
It is fantastic that OpenAI is attempting to address the more dire threats of a rogue AI, but there's a big near term threat already staring us in the face and seemingly zero leadership here in the United States aware of the crisis that will arrive in the next decade or so. And what passes for leadership has absolutely no concrete plan to get us past it.
[+] [-] tcj_phx|8 years ago|reply
She said she'd relapsed on cocaine because of severe depression, then shortly later on heroin -- supposedly to treat her high blood pressure (from smoking cocaine). I think really she was just lonely. A chapter in Gabor Maté's book is titled Through a Needle, a Soft, Warm Hug [0].
She was going to the methadone clinic daily when we met. If she couldn't get to the clinic by the 11am closing, she'd have to order heroin from her street pharmacist. It was almost as if the clinic had contempt for its clients -- their business was to be their clients' legal dealer.
Four months after she'd begun to teach me about her world, I decided she didn't actually like it that much, and began to express disapproval at her self-medication strategies. She tried sticking with her old drug world, but she liked me more than the drugs. At about six months we had a nice time frying donuts (coconut oil is a treatment for compulsive alcohol use, and makes for tasty donuts). Two days later she called to say that she "wished [she] wasn't a drug addict". The next day, "I SHOULD ONLY USE SUBSTANCES WHICH ARE LEGAL! Alcohol is legal, [tcj_phx]..." (me: doh! progress, I'll take it), the following day, "I hate methadone, I hate everything about it..." Essentially what I did was a months-long pace... then lead (hypnotic technique).
The most important interventions to end the present "opioid epidemic" (artificial) is to provide a legal supply of clean heroin, safe injection sites, and protecting addicts from the criminal justice system.
[0] https://news.ycombinator.com/item?id=16023802
(Yesterday's post about adoption-trauma is relevant too: https://news.ycombinator.com/item?id=16443667 )
[+] [-] philipkglass|8 years ago|reply
Smartphones, TV, video games, online porn: they're in every developed country. They can't be the explanation for what's different about America. Decline of religiously-derived meaning? Most developed countries' populations place less importance on religion than Americans. Factory jobs squeezed by automation and cheap offshore labor? Canadian manufacturers have access to the same robots as American firms, and Canada has been a member of the World Trade Organization as long as the US has.
Inter-temporal comparisons also show that it doesn't make sense to blame the American opioid crisis on the decline of manufacturing jobs. The number of American manufacturing jobs peaked in the 1970s. "Rust belt" became a common term in the 1980s. But the opioid crisis is much more recent.
[+] [-] arprocter|8 years ago|reply
[+] [-] gt_|8 years ago|reply
I regularly have long conversations about this with my mother, a nurse in Louisville, KY and steadfast American patriot. She is at a loss of any explanation these days. I am torn when we talk about it because I know her pride in our country is a big part of her, but it doesn’t rest with what she is seeing. Watching her spirit shift into curiosity then skepticism has been difficult to witness. She wants to blame someone but she no longer believes that someone is out there.
[+] [-] jacobush|8 years ago|reply
[+] [-] thecheops|8 years ago|reply
[+] [-] KarenSatantsby|8 years ago|reply
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[+] [-] JudasGoat|8 years ago|reply
[+] [-] jdtang13|8 years ago|reply
[+] [-] DyslexicAtheist|8 years ago|reply
this is quite a mouthful and horrid if true. would like to see some sources for this claim
[+] [-] paganel|8 years ago|reply
[+] [-] mikevp|8 years ago|reply
Different people react to them differently. Some people, like me, they make physical pain recede, but nothing else. Some people, they make feel groggy or sick, and they don't like them. (My grandmother was like this -- she disliked the grogginess from the Brompton's Mixture more than she disliked the pain of her terminal cancer. She only took it once or twice.)
And some people, one dose and it's "Where have you BEEN all my life!!!!"
An interesting line of research might be -- why the difference in reaction to opiods? Why do some people get the "WOW! I LIKE that!!" reaction, while others don't?
[+] [-] jatsign|8 years ago|reply
[+] [-] lewis500|8 years ago|reply
"Unlike in Europe, where cities and towns existed long before industrialization, much of America’s heartland has no remaining preindustrial history, given the destruction of Native American societies. The gutting of that industrial backbone — especially as globalization intensified in a country where market forces are least restrained — has been not just an economic fact but a cultural, even spiritual devastation."
From time immemorial, people---especially cultural critics and journalists---have blamed social phenomena on culture, the era's degradation, political changes or something else they are interested in anyway. It flatters you for your command of politics and history: turns out all that stuff you read about because it interests you is actually solidly causative in explaining something important. What a nice coincidence.
I am pretty sure that when the history of this era is written by real social scientists, what they will decide is much more technical and boring...having little to do with the topics that capture our attention for other reasons (manufacturing jobs and trump's election in this case). For example: a bunch of new opioids had been invented, which insurance paid for and doctors prescribed. Large amounts of heroin were available at low prices from increasingly competent and seamless sellers. In what world would these phenomena take place and the amount of addiction not increase?
I used to live in England. There is not as much of a crisis there although there is plenty of economic hardship, loss of manufacturing jobs, etc. The difference is that the NHS won't pay for everybody to load up on a thousand pills, and England is an island where you can't easily smuggle in tons of heroin.
Sometimes the article really veers into the absurd. Consider this passage:
"A huge boom was kick-started by the Civil War, when many states cultivated poppies in order to treat not only the excruciating pain of horrific injuries but endemic dysentery. Booth notes that 10 million opium pills and 2 million ounces of opiates in powder or tinctures were distributed by Union forces. Subsequently, vast numbers of veterans became addicted — the condition became known as “Soldier’s Disease” — and their high became more intense with the developments of morphine and the hypodermic needle. They were joined by millions of wives, sisters, and mothers who, consumed by postwar grief, sought refuge in the obliviating joy that opiates offered."
Right here Sullivan offers a total explanation for why everyone got addicted to painkillers: the government was literally manufacturing them and giving them in massive quantities. But that's not literary enough, so he turns around and fabricates something out of whole cloth:
"the epidemic of the late 1860s and 1870s was probably more widespread, if far less intense, than today’s — a response to the way in which the war tore up settled ways of life, as industrialization transformed the landscape, and as huge social change generated acute emotional distress. This aspect of the epidemic — as a response to mass social and cultural dislocation — was also clear among the working classes in the earlier part of the 19th century in Britain. As small armies of human beings were lured from their accustomed rural environments, with traditions and seasons and community, and thrown into vast new industrialized cities, the psychic stress gave opium an allure not even alcohol could match."
Ah so it was the "psychic stress" of industrialization. So losing manufacturing jobs causes addiction, but also so does gaining them. Interesting that manufacturing jobs are such a powerful explanation in an era when our president is constantly banging on about manufacturing jobs. Suppose we hadn't industrialized at that time; I'm pretty sure people still would have gotten addicted given how many free opiates they were getting. In that case Sullivan probably would have said, "The rural isolation of Americans...the soul-crushing vicissitudes of farming born alone...caused Amercians to take refuge in opiates."
Also worth remembering Andrew Sullivan is serially wrong.
[+] [-] microcolonel|8 years ago|reply
https://www.acsh.org/news/2018/02/14/dear-cdc-what-will-you-...
[+] [-] unknown|8 years ago|reply
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[+] [-] Angostura|8 years ago|reply