To Succeed, Beto O’Rourke Needs a More Nuanced Perspective on the Opioid Crisis
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To Succeed, Beto O’Rourke Needs a More Nuanced Perspective on the Opioid Crisis

O’Rourke touted the misguided standard narrative surrounding opioid use, but did introduce ideas that need more discussion.

Presidential candidate Beto O’Rourke recently held a small rally at Keene State College in New Hampshire. The memorable topic of discussion was the drug war, as O’Rourke discussed racial disparities in drug prosecutions and the recent explosion of opioid overdoses in New Hampshire.

O’Rourke is reasonable for promoting marijuana legalization to address racial injustice, but his characterization of the opioid crisis is terribly uninformed. O’Rourke advocated jailing Purdue Pharma executives, claiming “the vast majority of those addicted to opioids today began with a legal prescription, and those [Purdue] executives understood the addictive properties of [OxyContin] and did not share that with the public, and not a single one of them has done a single day in jail.” But that claim lacks proper context.

Yes, most people addicted to opioids started with prescription opioids — but not from their doctors. About 78 percent of OxyContin addicts were never prescribed OxyContin, as the pharmaceutical opioids that often prelude addiction are usually diverted from legitimate sources and consumed by those already addicted to drugs. Purdue did advertise that OxyContin had a 1 percent addiction rate — but studies show that claim was actually conservative.

The notion that Purdue Pharma and opioid prescribing caused the overdose crisis is blatantly false. New Hampshire, for example, had almost no increase in opioid overdose deaths between 1999 and 2012, despite increasing opioid prescribing rates during the same period. But after doctors were coerced into reducing prescribing after being forced to participate in New Hampshire’s Prescription Drug Monitoring Program in 2012, overdose death rates tripled within five years.

Government officials and the media typically do not acknowledge that the Substance Abuse and Mental Health Services Administration has reported constant nonmedical (opioid) pain reliever use rates since 2002, which undermine any notion that the pharmaceutical industry caused more addiction. But this ignorance might be supported by the implications of the alternative narrative: If increases in opioid deaths were actually caused by a constant number of opioid users using more dangerous black-market substances after being cut off from their legal opioid prescriptions, the interventions to reduce prescribing by the government may be the real culprit of the crisis.

Although O’Rourke touts the misguided standard narrative surrounding opioid use, he did introduce ideas that need more discussion.

“[America] has the largest prison population on the face of the planet, disproportionately comprised of people of color, far too many there for possession of a substance that is legal in most states in this country, marijuana. And though Americans of all races and ethnicities use marijuana at the same rate, only some are more likely than others to be arrested, to serve time, to upon release be forced to check a box so that they are unlikely to get that job because of that past conviction, ineligible for student loans and scholarships to attend [Keene State] and better themselves. We need real criminal justice reform. We need to end the prohibition on marijuana,” O’Rourke said.

The data suggests he has a point.

Beto O’Rourke displayed much charisma announcing his presidential candidacy and is now considered a front-runner in the Democratic presidential primary race. But if O’Rourke wants to sustain his success, he will need a nuanced perspective of the opioid crisis that is devastating America.

A version of this column first appeared in the Washington Examiner