Addiction in the Time of Fentanyl How Fear Mongering Aids the Opioid Epidemic

Wri en by Hannah Rose Bridges

Illustrated by Saxon Anderson

It seems like every genera on has their own de ning drug crisis. At the advent of the 20th century, fear of reefer madness spread across the na on like wild re. During the 1960s and 70s, psychedelics became synonymous with hippie degeneracy and the era of ee love. In the 80s, crack was whack, and by the end of the 90s, heroin was no longer chic. But if the 2000s and 10s were a halcyon daze of club drugs, Xanax, and uit- avored schnapps, then the 2020s are shaping up to be a brutally bad hangover.

In April 2022, the DEA announced that the number of opioid overdoses in the United States had spiked to an allme high (no pun intended) during the previous year. In response to these ndings, Florida State A orney Ashley Moody urged President Joe Biden to classify illicit variants of fentanyl as “weapons of mass des uc on” capable of decima ng the popula on in ways comparable to 9/11 and the Vietnam War.1

Moody’s inappropriate use of hyperbole aside, drugrelated deaths have indeed been on the rise. According to the CDC, synthe c opioids like fentanyl, oxycodone, and other painkillers are responsible for the largest number of overdose fatali es na onwide.2 Between 2019 and 2020, deaths caused by fentanyl increased om 1,667 to 2,622 in Florida alone—a whopping 58% escala on.3 In a 2021 report, Florida DCF found that 72,277 adults met the diagnos c criteria for Opioid Use Disorder across Orange, Seminole, and Osceola coun es, accoun ng for about 5% of the combined adult popula on.4 With all of that in mind, the demand for harm reduc on ou each, along with scien cally sound methods of addic on eatment, is greater now than ever before.

Yet if the current opioid epidemic is so pressing, why are government o cials and rehabilita on providers so reluctant to take proac ve measures to mediate it? A common adage within the harm reduc on movement is that “every overdose is a policy failure.”5 As the Na onal Harm Reduc on Coali on states, the phrase “harm reduc on” includes any sort of s ategy that aims to “reduce the nega ve consequences [of] drug use,” based on the belief that there will always be a popula on of people a emp ng to use drugs.6

In the mains eam media, harm reduc on is most commonly associated with public health e orts like needle exchange programs, naloxone clinics, or safe injec on sites which aim to “meet people where they’re at.”7 Regarding these services speci cally, bureaucrats like State A orney Moody claim that advoca ng for safer drug use instead of prohibi on actually “empowers addic on,” calling harm reduc on ou each a “reckless” and “deadly” prac ce.8

Moody’s perspec ve operates on many awed assump ons: 1) It presumes that all users would choose total abs nence over drugs if they were provided with eatment, 2) it concludes that a lack of safe is a realis c deterrent for drug use, and 3) it proclaims that the punishment for addic ve behavior should be death. What cri cs fail to grasp is that no ma er how many rehabs, jails, or Narco cs Anonymous groups exist in any given ci , there will always be people in ac ve addic on who are more willing to modify, rather than cease, drug consump on.

Beyond “s eet level” services like the ones men oned above, harm reduc on also spans the wider gamut of care. One promising, evidence-based solu on to opioid dependency comes in the form of medica on assisted eatment or MAT, a category of FDA-approved drugs heralded as the gold standard of eatment for Opioid Use Disorder.9

MAT reduces the nancial, social, and physical harms of addic on by stabilizing a user onto a steady regime of safe, low-dose opioids. Prescrip ons like buprenorphine and methadone in the United States (or a varie of medicines in other coun ies) are used to eat dependence on illegal drugs by “normalizing brain chemis y, blocking the euphoric e ects of opioids, and relieving physiological cravings.”10 ese medica ons are safe to use for months, years, or even a life me, and have been clinically proven to signi cantly reduce the need for costly inpa ent detoxi ca on services.

Compara vely, the for-pro t addic on “recovery” indus y lags far behind when it comes to pa ent success. Less than a third of inpa ent rehab programs o er buprenorphine or methadone, perhaps due to the fact MAT reduces the need for long-term ins tu onaliza on in lockdown s le facili es. A study published in the Na onal Library of Medicine found that “most pa ents with opioid in the chemical sense, such a eatment is not the same as “giving drugs to drug addicts,” as the State A orney irresponsibly insinuates.14 Given the compara vely abysmal sta s cs surrounding cold-turkey abs nence, however, most clinicians would agree that these nega ve a tudes do li le to mo vate people toward recovery. It becomes even more harmful when these beliefs ickle down to vulnerable people who need accurate, unbiased advice about alterna ves to adi onal “pseudoscien c” 12 step programs.15

If MAT is such a clinically bene cial eatment, why is it not being more prevalently u lized? Unsurprisingly, there is s ll a large amount of s gma surrounding MAT due to the aforemen oned misinforma on. Ul mately, aming these life-saving drugs as “basically the same” as substances like fentanyl ignores the reali of physical dependence and downplays the compara ve danger of other drugs. In a medical system where one ip to rehab can cost upwards of six gures, ins tu onaliza on should not be the only line of eatment, nor the norm. Notably, State A orney Moody has yet to target any of the “underregulated,” pro t-oriented facili es throughout Florida that prey on the desperate.16

Despite her impassioned le er to the con ary, Moody has done li le to meaningfully combat the overdose crisis within Florida. As the failed “War on Drugs” has shown, addic on do not receive MAT a er discharge,” and that 90% of those pa ents relapsed on illicit opioids within the rst year.11 Over a quarter of that gure relapsed on the rst day out, a end colloquially referred to by rehab pa ents as “

e

Florida Shu e.”12

Even in rehab centers that do u lize MAT, the eatment is o en pa onizingly touted as a “comfort drug” prescribed only during the rst few days or hours of opioid withdrawal. For reference, medical consensus states that such a small period of MAT does not adequately mediate the risk of relapse and overdose, and that the average eatment me “spans om months to years” depending on the pa ent’s unique situa on.13

S ll, a common theme within many circles is that these medica ons are simply the “lesser of two evils.” Although buprenorphine and methadone are narco cs fear mongering about drug abuse in order to jus fy increased communi policing and a greater securi presence at the southern border does nothing to stop deaths here and now. In the words of physician and anthropologist Eric Reinhart, we already have a “mass casual event” in our coun y, and it’s because “we’ve been inves ng almost all our resources into policing systems and military suppression of illicit substances. It doesn’t work.”17

However, by improving survival and reducing relapse, harm reduc on e orts and MAT put eatment back into the hands of the individual. Most importantly, they give chemically-dependent people the abili to live independent, self-directed lives. at’s what should be the focus when we talk about the opioid epidemic. No hypothe cal horror stories about fentanyl are needed 

Wri en by Robert Rands

Designed and Illustrated by Jeanie Liang

Poli cal polarisa on seems to be worsening, not only in the Uni d S s, but across the globe. I wro this to express the urgency of our situa on and the need for a solu on before ca s ophe ensues. If we ke the me to lis n to the other side, then things do not have to be so a ocious. We must work towards be ring our na on and our world, coopera ng rather than gh ng each other at every ont as a result of the dangerous dichotomy in gra d into the s ucture of our poli cal sys m.

“ e view om here is beau ful.”

“It certainly is,” he quietly agreed. ey stood, shoulder to shoulder, atop the roof of an an que colonial building that was salvaged om the mes of the American Revolu on. It was not a very beau ful building: the red bricks wrapping around the perimeter were a ociously bland; the double-hung windows burrowed into the building with their dull, grey monotony; two brick chimneys pro uding om opposite sides of the roo op. e bleak maroon door in the façade would be welcoming no one tonight except for two young, curious souls. e s ucture was clinging onto bygone days, forgo en philosophies, and fading fundaments. e only new addi on was a re escape due to regula ons.

In the twilight they watched the tenuous cirrus snakes slither into the ci . Each wispy, sinuous rep le seemed to have two heads. ey savoured the silence. e wind picked up and sliced through them with the knives of late winter’s chill.

“Hey Marcy, do you see that?” He pointed towards the small crowd gathering below on the brick-pathed s eet, blanketed in the same dreary auburn colour as the building.

“I’ve got two eyes of my own, right?” she giggled. “Woah, look at that!”

Most of the crowd carried ags, signs, and horns. ey marched down the s eet like an army platoon with a mission. More people arrived and joined the gathering—reinforcements. Eventually, their march was halted by another crowd.

“Mercury, who are those people?” she asked curiously.

“I don’t know, but that is a lot of red and blue,” he calmly replied.

Both crowds bore a single colour—red or blue—and only that colour. e wind picked up. e Blue Crowd arrived om the opposite end of the s eet. Everything there was coloured di erently; their side looked as though an ar st spilled a bucket of azure paint onto everything. Despite the stark con asts between both sides, they both expressed the same dreariness.

When the Red Crowd stopped, noises echoed through the s eet.

“What do you think they’re saying?” Marceline asked.

“I don’t know, but the atmosphere is a bit foreboding,” he responded. “Perhaps we should do something about this.” e Red Crowd pierced their ags into the road. e Blue Crowd reciprocated the gesture. ey formed a par on across the s eet while bits of bricks ew around them. A chunk hit someone, and they began yelling. at single yell was the spark that ignited the powder keg of insolence. More people yelled, some even screamed at each other. Some people were blaring their horns; others were ba ling to wave their sign higher than anyone else. e two iends gazed at this spectacle for a bit, much like how one stares at a car accident or some other thing that is equally interes ng and horrible.

“Nah, everything seems ne,” she assured him.

“What is so important to them that they must act like savages?” e two were quiet for a few minutes. ey were spectators in a sport they could not understand. e wind picked up. Marceline and Mercury felt the chill impale them through their grey woollen clothing. Smoke-coloured clouds were imminent; they shrouded the colourful spectacle of waning twilight with their gloom.

“I couldn’t hope to tell you, but I uly hope they sort out their situa on. I can’t make out what the signs read or what any of them are saying, but there is no reason to behave like this,” he said as he analysed the Crowds.

“ ey act like fools, hoping to force others to y the same colour that they y. What neither side realises is that this is not a monochrome world. ere are plen of colours out there. Some may not be for all of us, but I know that we all can y several colours—we have two hands, a er all.” He waved his hands around to imitate ying a ag. “It is a colourful world. If either side could stop to behold it, they would see it, too.”

“You look like a luna c. Philosophy, colours, hands,” she mocked as she waved her hands around, too. “But seriously, I hope they gure things out.” e Crowds devolved into a violent disarray. Everyone fought to wave their sign the highest and blare their horn the loudest, even if it meant pu ng down someone om their own side. Haymakers were thrown in every direc on and pickets jabbed into people, while a con uence of blue and red blood owed through the s eet and coalesced in ont of the dated building. ey would mix, but not blend.

“Me too,” he sighed sombrely.

“Is there anything we can do?”

“Not at this point. I think they must learn to see other perspec ves and have a civil discourse if any of this is to get be er.”

“And what if they don’t? What if we’re the only ones that can x this situa on? Is standing idle while the world burns the right way to go about this?” she asked.

“I—I don’t know,” Mercury stu ered, at a loss for an answer. “What do you suppose we do?”

“I don’t know, either.” e inferno split. One part blue, the other red. ey did not mix. A tsunami of ames swept across the s eet, bringing every building that it touched down into the divisive hell om which the re originated.

BOOM! e sound of an explosion thundered throughout the s eet. Someone had s uck a gas line. Neither of the Crowds reacted to the sight of the ames growing around them; they maintained their gh ng. Eventually they were swallowed by the blaze.

“Stop staring and let’s get out of here!” She grabbed his hand and led him to the re escape. He was hypno sed by the beau fully hideous calami .

He came to his senses a er they descended the re escape.

“Sorry, it was so en ancing. I don’t know why,” he said with awe.

“We can talk about this later, but we really need to go!” She moved with urgency and tugged him along like a child. ey narrowly escaped the harrowing inferno and reached safe outside of ci limits. Only piles of ash were le . e blue and red ames had decimated the ci . ough they were separate, they had accomplished this together 