So, now we care about fentanyl

So, we sit here, shots have been fired, and, as we learn more about the evolving logic of the MAGA movement, we are to understand that they had a good reason - opioids were the primary concern all along. Great, the opioid epidemic in the United States is serious, and results in the needless loss of life for millions of people every year. So, how did it get here?

The narrative of foreign blame conveniently obscures a devastating reality: this crisis was largely manufactured at home. By 2013, nearly 80% of heroin users and 75% of those who struggle with Opioid Use Disorder (OUD) started with a prescription drug. This wasn't a crisis that crossed the border - it was born in American doctors' offices, fueled by pharmaceutical companies' profits, and enabled by regulatory failure.

The story begins with aggressive marketing campaigns by pharmaceutical giants who downplayed addiction risks while overstating opioids' effectiveness for chronic pain. Companies like Purdue Pharma didn't just sell pills - they sold a story to doctors and medical students, funding nonprofit organizations to influence prescribers' beliefs about opioids. They created an ecosystem where pain became the "fifth vital sign" in hospitals, fundamentally shifting medical culture toward aggressive pain management.

Meanwhile, the FDA's regulatory oversight crumbled. They approved opioids with broad indications, allowing promotion for common conditions where risks dramatically outweighed benefits. The revolving door between government regulatory agencies and the pharmaceutical industry raised serious questions about whose interests were really being protected.

Whatever they have the money right?

The results were predictable: doctors began prescribing opioids for conditions like back pain, often exceeding necessary quantities. The American healthcare system, with its emphasis on provider autonomy and fewer national regulations, created perfect conditions for over prescription. Cultural expectations about pain relief and entitlement to opioid treatment further fueled this fire.

It's a quick buck and allows us to "treat" people who can't afford anything else.

The targeting of Mexico and China as primary culprits in this crisis represents a dangerous misdirection. While international drug trafficking is certainly a serious concern, it arose largely in response to a market created by domestic policies and practices. The progression from prescription opioids to heroin and fentanyl wasn't inevitable - it was the predictable outcome of a system that prioritized profits over public health. You may note that I've left Canada off this list, it's because this country represent a tiny fraction of all fentanyl brought illegally into the United States, and, if we are being honest, is evidence that this is a farce anyways.

The proposed "solutions" to this crisis reveal a disturbing pattern - let's put on a show and continue to avoid real action. Current policy approaches continue to emphasize targeting supply-side "bad actors" while systematically dismantling the infrastructure needed to address demand and provide treatment.

Blame the suppliers in a land with infinite customers.

The proposed cuts to Medicare show that there is no real commitment to those struggling with Opioid Use Disorder (OUD). Access to medication-assisted treatment, which evidence shows is one of the most effective interventions for OUD, would become even more limited than it already is. In rural areas, where treatment options are already scarce, these cuts would effectively eliminate hope for many seeking recovery.

In a world with ever more bad ideas, the proposed "solutions" are just for visible manifestations of the crisis. The suggestion to round up homeless individuals - many of whom struggle with addiction - and relocate them to tent cities represents a return to failed policies of criminalization and forcible displacement. This approach not only violates basic human rights but also ignores decades of evidence showing that stable housing and community-based treatment are essential for recovery.

At least you won't have to see it right?

So, now we care about Fentanyl...not really, but none of this was ever about that anyways.