Letters from America: Opioids and Venezuelans.

datePosted on 08:22, August 3rd, 2017 by Pablo

I am on an extended stay in the US that will see me in several states and regions before my return to NZ in December. I decided that this is a good opportunity to write an occasional “Letters from America” series gathering together random thoughts on various aspects of US politics, society and culture. First stop is the East Coast of South Florida.

Late summer in South Florida is hot (over 30C daytime temps), humid (over 80 percent until the PM thunderstorms break the steam bath), and languidly quiet. Tourists are few and far between and the locals alternate hiding from the heat indoors with forays to the beach or pool.

The two items on my mind today are opioids and Venezuela. Since the latter might not seem to be an US relevant subject, let me start with it.

Venezuela is in the middle of a slow burning civil war sparked by deteriorating economic and social conditions caused by the incompetence, corruption and myopic power lust of the Maduro government that succeeded the father of the Boliviarian Revolution, Hugo Chavez, upon his death. Unlike many non-Venezuelan leftist commentators I have no time for Maduro and the petty authoritarian kleptocrats that surround him just because he opposes the US and the US opposes him.  He is just another prop in the endless right-wing arguments about how the Left cannot govern either competently or in a democratic way. As much as I loathe the Venezuelan oligarchy that has always been a disloyal opposition to the Boliviarians, I despair for the Venezuelan poor, working and middle classes who saw hope in the Revolution and have now had their aspirations terminally dashed under a barrage of water cannon, tear gas, sniper fire, rocks and molotovs. The root causes and official responses to the crisis are not just the work of external interference and internal agitators (sound familiar?).

Blame lies everywhere in Venezuela today, but no one will take responsibility and the regime has simply met its end with the last resort of dictators–repression. What comes after may be no better, or worse.

The reason that Venezuela is a social issue in South Florida as well as a political issue in the US is simple: there are over 100,000 Venezuelans living in South Florida, many recent arrivals as “refugees” from the Boliviarian regime. Many moved their capital and as much of their fixed assets to the US as they could (capital flight being a key indicator of political instability), bought property in a climate that is similar to that of their homeland, and struck up political alliances with the long-standing Cuban exile community. Like minds think alike, and the type of Cubans and Venezuelans who inhabit South Florida come from the reactionary-to-troglydite end of the political spectrum.

The union of Cuban and Venezuelan reactionaries, coupled with the money they bring into local, state and national politics, has been instrumental in turning the Trump administration’s approach to both countries in a backwards direction. The Cuban-Venezuelan lobbying bloc is staunchly pro-Trump. Not surprisingly, the restored relations with Cuba begun by the Obama administration have been partially rolled back, and the US has just announced asset freezes and other punitive sanctions against Maduro and members of his personal entourage wherever US jurisdiction applies. The White House has been at pains to note that Maduro joins Mugabe, Kim Jung-Un and Assad as the only heads of state sanctioned in this way, and the way in which the farcical and rigged constitutional referendum was held in Venezuela this past weekend was likened to assorted atrocities committed under Stalinism, Pol Pot etc. No mention of the US glad-handing the Saudis, Erdogan in Turkey or Egypt’s Abdel Fattah el-Sissi even as they engage in more egregious human rights violations than Maduro on a systematic basis. But hey, as a general rule politics in the US is about hypocrisy loudly masquerading as righteousness or indignation, so in that regard the White House sqwaking about Maduro (who again, is not a fit or suitable ruler for his country) needs to be taken with a grain of comparative salt.

There is a more sinister element in this “Venezuelafication” of South Florida. Although one of my pleasures in returning to SoFl is to have access to many Spanish-speaking radio and TV channels (including the legendary “Escandalo (Scandal) TV”), what pours out of the talk shows is an increasingly violent insurrectionary call to eliminate “traitors,” “dupes” and assorted others who are seen to enable or support the Cuban and Venezuelan regimes both at home as well as in the US. This has meshed with the alt-Right narrative about “libtards” and other usurpers of the White Christian social order because many of the Cuban and Venezuelan exiles are also virulent racists and classists who view the poor brown masses in their homelands as human vermin equivalent to those reviled by the US Right. And because the Cuban and Venezuelan regimes, whatever their faults,have  empowered brown people in their countries and removed some of the deep-seated social and institutional barriers to their success, the White Cubans and Venezuelans see red in more than one way.

What that has done is to compliment and expand the rhetoric of violence surrounding political debate in SoFl. And whereas it may have been true in the past that “an armed crowd is a polite crowd,” that presumed that the crowd in question had some basic shared notion of civility and proper comportment to fall back on when things got heated. Under Trump that is no longer the case and in fact the opposite is now openly encouraged: give no quarter to political opponents, hear, much less heed no argument from them, confront and attack them at all times using all means necessary to silence them.

Then add some Cuban and Venezuelan mouth frothing ranters with money and influence into the mix. The bottom line is that local and state democracy suffers when expat revanchists take center stage in it.

Were it that I was inclined to seek escape in prescription drugs because it would inure me to the dangers inherent in that trend. But others are not as averse as I.  Over 2 million Americans are addicted to prescription opioids (mostly Oxycontin, Vicodin and Methadone). Over 1000 people a day are hospitalised with opioid overdoses, and 100 people a day are dying of them. In 2015, the last year for full records, over 15,000 people died of opioid overdoses, with 183,000 having died between 1999 and 2015. In 2016 the estimated number of opioid overdose deaths jumped to over 59,000 people, the largest increase ever. Even so, the sale of prescription drugs has quadrupled, along with overdose deaths, during the 1999-2015 time frame. Why is this so?

The first cause is the proliferation of shady “pain clinics” in which unethical doctors hand out prescriptions for opioids like lollies. The process if simple: you walk into the clinic complaining of chronic pain of one type or another, you get a script in less than 10 minutes for a $30-40 fee, and the cycle continues after you leave the clinic and enter the pharmacy conveniently located either next door or a few storefronts down from the clinic (usually located in strip malls).  SoFl is awash with these places, and it is not a stretch say that it is easier to get one’s hands on opioids than it is cocaine, cannabis or other illegal drugs.

The second cause is the discounting of opioid prices in states and regions that have an opioid addiction problem. You read that right: pharmaceutical companies sell their drugs at cheaper prices in those regions where addiction rates are highest. What might these regions be? Well, pretty much all of those Red States that voted strongly for Trump, Florida included. Think Ohio, Indiana, Missouri, Arkansas, Pennsylvania, the Dakotas, West Virgina–if the state went strong for Trump, it is likely that the price of a Vicodin is less than that in a Blue State.

Who are the victims of opioid addiction? Again, the connection with Trump’s voter base is strong: predominantly white working class or unemployed/partially employed males aged 25-54 years (most of the figures used here are from the Center for Disease Control and Prevention–CDC).

In the face of these epidemic-sized addiction figures, the attorney generals of several states in which the problem is concentrated have filed class action suits against the pharmaceutical companies for their price discounting and targeted marketing of vulnerable populations. But resistance has already been met at the federal level, with GOP congress people rebuking those who would seek to interfere with market imperatives and the freedom of choice people have when it comes to self-medication.

The problem does not end there. The rise in addiction has in turn given rise to a thriving “rehab” industry in which addicts enter into so-called “sober homes” in order to detox. Trouble is, these sober homes are often no more than temporary way stations for addicts trying to kick the habit and pain clinics and pushers have been drawn to them like flies to poop. In many cases “sober homes” are nothing more than glorified shooting galleries, with the attendant rise in criminality associated with the phenomenon. Cities throughout the US but especially in SoFl, including the one I am in, have had to redraft zoning and occupancy laws in order to discourage these type of addiction parasites from continuing to profit from human misery.

So there you have it: a country whose internal political polarization is abetted by that imported from abroad, filtering into a society that in many places is awash in guns and prescription drugs unscrupulously  supplied by industries profiting from them. These same places provide the core demographic–the hard 35 percent–of Trump’s support base who are the ones who support his every move, including demands for regime change in Cuba and Venezuela and a turn against the notions of civility and democratic disocurse that previously served as the ideological myth that once bound the nation together.

The trouble for this “Deplorables” core, as well as the Cuban and Venezuelan exiles longing for a return to the pre-revolutionary past, is that Trump’s promises are nothing more than the prescription drug version of a pipe dream.

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