The rural United States has suffered a variety of drug epidemics, and the Opioid Crisis is just the most recent. One of the earliest drug epidemics was smoking tobacco – tobacco is one of the original cash crops, and it has been enjoyed throughout the world since it was first produced and exported by colonizers in the Americas in the 17th century.
When Coca-Cola first hit the scene as a cocaine-laced remedy, it was originally enjoyed by those living close to places that could afford to enjoy the concoction. Later, meth, in the form of diet pills, became and remained a popular supplement through the 70s, when the injectable version became the preferred method of use, and the legal version disappeared from the shelves.
At the end of the 70s and through the early 90s, the United States’ most infamous drug addiction crisis at that time took hold with devastating effects up and down the East Coast. The Crack Epidemic left a trail of broken families, blood, and a huge population of non-violent offenders sitting in jail for extended periods of time.
Since meth and heroin use exploded in popularity in the early 90s, the rate of overdose-related deaths began to climb, and then skyrocketed in the year 2000. We’re still in the midst of the Opioid Crisis, and unlike the previous drug epidemics, the Opioid Crisis isn’t concentrated among poor, non-white people and white women living in the suburbs, or in the inner-city. This crisis heavily focuses on working-class white people living away from urban centers.
Granted, this population has long been vulnerable to alcohol abuse – moonshine is a legendary spirit, produced illegally by people all over the world. But in 1990, the number of opioid overdose deaths was a fraction of what it is today, and it continues to rise. This is the age of the Opioid Crisis, and in 2015, opioid overdose deaths were up over 600% from what they were in 1990, and in 2017, opioid overdoses killed more people than AIDS, gun violence, and traffic accidents combined. This means that around 150,000 people died of overdoses in just 2017 and 2018.
The crucial turn for the Opioid epidemic was in 2013 through 2014, during which opioid overdose deaths more than doubled. Most of these deaths happened in New England, and some of them in the MidWest, and most of the people passing away were young, white, and male. But how did this happen? The answer is a simple one that also explains why there are markedly fewer people of color living with addiction to methamphetamines.
Doctor’s Orders
As the United States was still pulling away from the Crack Epidemic, doctors all over the United States were looking squarely at the victims of the epidemic – the sweeping majority of them were Black or Latino, which, to many doctors, meant that keeping potentially addictive substances out of the hands of patients of color was a responsible thing to do. As a result, doctors prescribed opioid painkillers to their White patients.
Opioids have been used for millennia as a pain reliever. One of the most powerful pain relievers of all time, opium, has been in use since the first civilizations cropped up around its native Mediterranean Sea. As time wore on, opium poppy, the source of the raw material, was processed to create opiates like morphine and opium, and eventually heroin, all for varying degrees of severe pain.
Opiate drugs have a long and well-documented history of addiction, no matter which group is using it, but this wasn’t something that doctors in the 90s shared with their patients, whether it was because they didn’t know, or because information at the time simply wasn’t taught to these doctors. Whether or not this is true isn’t important, but the fact that all of the prescriptions for opioid painkillers created a new generation of addicted people certainly is.
The doctors, writing opioid prescriptions to patients for their pain, believed they were prescribing a powerful pain reliever with excellent benefits. To make matters more dire for young white people living in rural areas, these painkillers were the key to keeping patients comfortable: much of rural America is woefully lacking in drug addiction specialists, therapists, and rehabilitation facilities. Thus, powerful medicine is often a rural doctor’s best chance of providing the kind of healing that their patients deserve. The ease of the prescription, the low numbers of medical professionals, and the tendency on the part of doctors in the 90s to assume that the face of addiction is that of a Black or brown person are all reasons for the rising number of opioid deaths in the nation. Rehabilitation for drug and alcohol addiction, though, can help anyone who is able to make it into a facility.
Heroin and Fentanyl
Heroin deaths in rural America have risen steadily and surely since the 1990s, and heroin overdose is one of the most common reasons for opioid overdose death today. The rise in heroin overdose deaths is part of the disastrous opioid epidemic – in fact, studies have concluded that a person who abuses prescription opioids is highly likely to later become addicted to heroin, which produces a similar high for a lower price. Never forget that opioid prescription drugs, common though they might be, are very expensive – some medicines can cost hundreds of dollars per pill, putting a person living with addiction in a difficult financial position.
Enter heroin – a cheaper, extremely dangerous cousin of commercial opiate painkillers. Heroin use spreads so quickly because addiction can occur in as little as one to two uses. Heroin is powerful, powerfully addictive, and relatively easy to get. With prescription opioid abuse at an all-time high, it makes sense that people would eventually seek out heroin, an alternative that can be obtained with half of the effort as prescription painkillers.
Even scarier than the powerful heroin is Fentanyl, a synthetic opioid that offers the same effects as heroin, but in a much smaller dose. Like heroin, Fentanyl makes the user feel blissful and euphoric.
During that crucial time in 2013 and 2014, Fentanyl abuse became a public health concern, with the people most vulnerable to its wiles already living with addiction to opioid drugs. Rural areas are some of the first to experience the worst of economic depressions; the 2008 financial crisis was never fully resolved in much of the country, creating a unique class of stressors for people living in rural areas. With so many people dying, it is extremely important to check in with friends and family members. You never know who is having a difficult time, and considering all available options.
