Creating a Domestic ‘Shithole’
By Prof. James Petras and Robin Eastman-AbayaGlobal Research, January 26, 2018
Url of this article:
https://www.globalresearch.ca/
Introduction
The
link between capitalism and drugs reaches back to the middle of the
19th century, when the British Empire forced their surplus opium crop
from their South Asian colonies into the Chinese market creating massive
demand from millions of addicts. The Chinese government, which had
banned the use and sale of opium, was alarmed at the growing social
chaos created by mass addiction and went to war with the Western powers
to halt the flood of drugs. Their defeat at the hands of the British and
their Chinese drug lord allies opened China to massive exploitation and
pillage for the next century. Chinese opium addicts were a tremendous
obstacle to organizing national resistance. In essence, the British East
India Company and its imperial protectors transformed China into the
history’s largest ‘shithole’ – until an earth-shattering revolution
broke the chains of addiction and degradation.
In the 21st century, a similar process of deterioration has been occurring internally in the United States. The
‘prescription opioid epidemic’ is ravaging American families,
neighborhoods, communities, cities and states – shredding the entire
fabric of US society, especially in rural, mining and former
manufacturing ‘rust belt’ regions. Hundreds of thousands of mostly
working class victims have died and millions of addicts, unable to
resist the destruction of their futures, have replaced a once powerful
labor force.
Official government studies estimate almost 700,000 deaths since 1999, based
on the scattered and incomplete coroner reports and death certificates
that characterize the state of vital statistics in the US. There is no
uniformity in data collection and no interest in developing a uniform
national system on which to formulate social policies. Most likely
additional hundreds of thousands of drug deaths have gone un-recorded or
attributed to ‘pre-existing’ medical conditions, suicides and accidents
– despite clear evidence of over-prescription of narcotics and
sedatives in the victims.
The
US opioid epidemic accounts in large part for the ‘declining numbers of
workforce participants among prime age workers’ according to Senate
testimony by Federal Reserve Chairwoman Janet Yellen, an
Obama appointee. An estimated 15% of US construction workers suffer
from substance abuse. The escalating costs of ‘Suboxone’ and other forms
of narcotic addiction treatment threaten to bankrupt the health plans
of several building unions. Shortages of qualified American skilled
building trade workers further allow employers to push for more
immigrant labor to fill the gap.
For
over 2 decades the escalating numbers of opioid overdose deaths were
ignored by both political parties, as well as by writers and academics
of the left and right. Doctors and hospital administrators were either
actively complicit or in denial. But more important the Federal Drug
Administration (FDA) continued to approve manufacture, marketing and
prescribing of highly addictive narcotics and sedatives to tens of
millions of American patients earning the pharmaceutical industry scores
of billions in profits despite the devastation. Between 1999-2014
pharmaceutical manufacturers were earning $10 billion dollars each year
in profits from the sale and distribution of opiates.
In
the following section, we will discuss the larger picture, including
the powerful socio-economic and political forces that have profited from
the addiction and killing of millions of Americans – past and present.
This deliberate policy, with strong neo-Malthusian overtones, has
decimated a sector of the US working class, rendered ‘surplus’ or
redundant by political-economic decisions of the American ruling elite.
In its wake, the prescription addiction crisis has turned large swathes
of the former manufacturing and mining sectors of the US into what the
current President Donald Trump would characterize as domestic ‘shitholes’ and populated by what his rival, Hillary Clinton,
callously derided as ‘deplorables’. In terms of rapid loss of life and
social stability, this population devastation mirrors the patterns seen
in countries subjected to US/EU neo-liberal economic dictates or to
US/EU imperial invasions.
The Addiction Power Elite
Today
there is a public frenzy among government officials clamoring for
hearings and legislation to address the opioid addiction crisis – with
the usual solutions of more imprisonment, expensive private addiction
treatment centers, volunteer ‘support groups’, self-help courses and
educational ‘Just Say No’ campaigns. No policy maker has dared suggest
educating the victims about the socio-economic trends and elite
decisions that devastated their lives and communities and sent them onto
the death spiral of addiction.
Image on the right is Former FDA Administrator David Kessler.
Recently
a few leftist journalists have attacked the pharmaceutical industry,
while others have cited the lack of oversight from the US-Federal Drug
Administration, asking for a few tepid reforms. The former FDA
Administrator David Kessler, who served under the
Clinton Regime from 1990 to 1997, belatedly condemned his agency’s
negligence over the mass destruction caused by unregulated prescription
of powerful narcotics, which he admitted after 10 years of silence was
‘one of the biggest mistakes in the history of modern medicine’,
(editorial NYT May 6, 2016).
While
hundreds of thousands of Americans have been killed by opioids and
hundreds more are dying every day (at least 65,000 in 2016), the US Left
and the Democratic Party focus on narrow gender identity issues and
cartoonish hearings over ‘Russiagate’ – Moscow ’s alleged plot to seize
control of the US Presidential election. While touting her experience in
health care reform, Candidate Hillary Clinton deliberately ignored the
opioid addiction crisis during her campaign except to characterize its
largely white lower class victims as ‘deplorables’ – ignorant racists
and buffoons – whom she implied deserved their misery and shortened
lives.
The
‘drug epidemic’ in the US is all about the current structure of power
and social relations in an increasingly oligarchic state amidst growing
class inequalities and immiseration. At its roots, American capitalism
in the 21st Century has degraded, impoverished and exploited US workers
and employees with increasing intensity over the past two decades.
Workers have lost almost all collective influence in the workplace and
in politics. Working conditions and safety have deteriorated – while
capitalists hire and fire at will. Salaries, pensions, health care and
death benefits have been slashed or disappeared.
The
deterioration of working conditions is accompanied by a marked decline
in social conditions: family, neighborhood and community life has been
torn asunder. Anxiety and insecurity are rampant among workers and
employees. In real terms, life expectancy in the affected areas has
dropped. Youth and worker suicides are skyrocketing. Maternal and child
mortality are up. American youth are 70% more likely to die before
adulthood than their counterparts in other rich countries. In 2016,
death rates for millennials (ages 25-34) rose to 129/100,000, with
35/100,000 deaths due to narcotic overdose. The carnage surpasses the
height of the US AIDS epidemic in the 1980’s. Rural and small town child
protective services are well beyond the breaking point with the
neglected and orphaned children of addicts. Neonatal intensive care
units are overwhelmed by the number of infants born into life
threatening acute opiate withdrawal crises due to their mothers’
addiction. Despite this grim picture, taxes for the rich are being
slashed and public services decimated.
Meanwhile,
the income gap between the working class and the oligarchs has widened
and a sharp class-defined health care and educational apartheid has
emerged. Children of the upper 20% have exclusive, privileged access to
elite universities based on family and ethnic ties. Elite families, who
have no need for ‘health insurance’ have access to the most thorough and
advanced medical services in the world. No physician would dream of
irresponsibly prescribing narcotics to a family member of an oligarch.
These
inequalities are deeply entrenched: Working people in the areas
affected by the opioid epidemic receive only cursory and inadequate, if
not incompetent, care from physician assistants and over-burdened
nurses. They are subjected to long waits in deteriorating emergency
rooms and rarely see a physician. Virtually none have regular family
physicians. If they are injured or suffer from pain, they are prescribed
long courses and large amounts of narcotic pain killers – opioids,
instead of the safer, but more expensive physical therapy and
non-addictive medications. This has occurred with the approval of the
FDA. Even rural high school students with sports injuries would receive
narcotics, despite the well-known increased susceptibility to addiction
among youth. Politically powerful ‘pain lobbies’, funded by the giant
pharmaceutical corporation, have pushed this trend for over two decades
creating huge profits for the billionaire pharmaceutical executives.
The
opioid killing fields of America have their origins and logic in the
convergence of several inter-related features of US capitalism. This was
due to the relentless pursuit of profits for the corporations and
elite, while turning the deindustrialized and agricultural parts of the
country into domestic ‘Third Worlds’.
First,
the capitalist class cut the production costs by limiting access to
quality health care for labor to increase their profits. In the US this
has led to millions of workers depending on cheap and available
prescription narcotics. Employer-provided insurance companies routinely
deny more costly non-narcotic treatment for injured workers and insist
on prescribing cheap opioids to get the workers back on the job. Cheap
opioids were tolerated by union health plans in the beginning to save
money, while union bosses looked the other way as thousands of workers
became addicts.
Secondly,
capitalists freely fire workers who are injured at work and seek
treatment, forcing workers to avoid sick leave and to rely even more on
opioids, like Oxy-Contin, which ‘Big Pharma’ falsely marketed as
non-addictive.
Thirdly,
capitalists profit immensely from the premature deaths by overdose and
related preventable causes among older workers because this lowers
pension costs and health insurance payments. Wall Street has brazenly
celebrated the billions of dollars of pension and health care
liabilities saved by the shortened life expectancy among US workers. The
drop in life expectancy and rise in premature death in the US resembles
the pattern seen in Russia during the first decades after the
dissolution of the Soviet Union and the rampant pillage by the US-backed
mafia oligarchs under Boris Yeltsin.
Fourthly,
capitalists are free to hire young replacement workers (eighteen to
thirty years old) as temporary labor at lower wages and without any
benefits. They are subject to the insecurities of contingent employment,
as part of the ‘gig economy’ (outsourcing to ‘self-employed’ workers
and employees). These overstressed workers, with no future, turn to
opioids to overcome physical pain and emotional stress – until they drop
out as slaves to addiction. This is the main reason for the declining
numbers of young workers available in the US – despite relatively high
employment levels.
Fifthly,
and to add a morbid insult to injury, the opioid death epidemic has
been a bonanza for the tissue and organ transplant industry, where
‘materials’ harvested from young overdose victims, including bones,
skin, cornea, tendons, heart valves, teeth and blood vessels are worth
tens of thousands of dollars per corpse. Organs harvested from
brain-dead overdose victims are valued in the hundreds of thousands of
dollars. And harvest companies and tissue brokers hover around hospital
emergency rooms like carrion birds waiting for news of new victims –
often contacting next of kin before the authorities. This bizarre
profiting from the completely preventable domestic deaths of US
capitalism recalls Jonathan Swift’s satiric ‘Modest Proposal’ for
British entrepreneurs to harvest the skin of the Irish Potato Famine
victims to make commercial items, like ladies’ purses!
In
sum, the structure and relations of contemporary US capitalism is the
general cause and beneficiary of the opioid epidemic. The inevitable
result is a rapid destruction of communities marginalized by capitalist
decisions. This has benefited capital by culling the surplus, and
potentially restive, population in a manner reminiscent of the British
Empire during the famines in India in the previous two centuries. Social
Darwinism and Neo-Malthusian rationales proliferate among the
oligarchs, politicians, medical professionals and even seep into the
language used by the public (‘survival of the fittest’) providing the
ideological justification for the carnage.
Specific Operative Power Elites Driving the Epidemic
Multi-billion
dollar pharmaceutical corporations manufacture and market narcotics and
highly addictive sedatives. Their agents manipulate the medical
community and lobby among the politicians for a ‘pain-free’ America.
The
producer of the leading commercial ‘gateway’ into addiction,
Oxy-Contin, is Purdue Pharmaceuticals. The company was founded and run
entirely by the Sackler family under the leadership of the recently
deceased Raymond Sackler and his brothers. They started by
manufacturing laxatives and ear wax, then introducing the highly
addictive tranquilizer, Valium, to finally producing and pushing the
most profitable prescription drug in history, Oxy-Contin in the 1990’s,
during President Bill Clinton’s ‘health care reform’ administration.
The
Sacklers set up an aggressive large-scale sales force to convince
physicians that their product was not addictive. They paid
physician-researchers to publish fraudulent data on the safety of
Oxy-Contin. These experts-for- hire in the burgeoning pain industry
received huge fees to peddle Sackler’s products. They peddled the notion
of American patients enjoying a completely ‘pain free’ existence –
touting the value of the highly subjective ‘pain scale’ as the fifth
vital sign in the assessment of all patients. The ‘pain scale’ never
caught on in other wealthy countries, where objective assessment
remained the primary basis for diagnosis and therapy. Interestingly, the
‘pain scale’ has been less frequently used with African American and
Hispanic patients, due largely to an inherent racism in US medicine that
views minorities as potential addicts and unreliable with prescribed
narcotics. As a result, African American and Hispanic patients were
largely spared the prescription narcotic addiction epidemic – where over
95% of overdose deaths were white, mostly working class. It was also
evident that African American patients presenting to emergency rooms in
severe pain receive far less care than their white compatriots – even
when their pain is a symptom of a serious life-threatening medical or
surgical emergency.
The
Sackler family’s net worth rose to over $14 billion dollars, according
the Forbes billionaires listing, while Purdue Pharmaceuticals reaped
over $35 billion dollars in profit from Oxy-Contin.
Meanwhile
scores of thousands of prescription addicts died each year and millions
sunk into addiction, ill health and degradation, dragging their
communities with them.
Following
Sackler’s example, other pharma billionaires joined in. Opioid pain
medication was so cheap to produce and had created its own
ever-expanding demand as teenagers raided grandmother’s medicine cabinet
in search of narcotics and poor workers lined up at ‘pill mills’.
Oxy-Contin and its siblings produced the highest profit margin in
pharmaceutical history – far exceeding the so-called block-buster drugs.
The
totally preventable and predictable devastation eventually led to
Purdue Pharmaceuticals being fined $634.5 million dollars in 2007 for
fraudulently covering up the addiction and overdose potential of
Oxy-Contin. The political influence of the Sackler family protected
their members from any accusation of misconduct or criminal conspiracy.
Their influence in elite political and judicial circles was
unparalleled.
Oxy-Contin
and other addictive drugs are still being mass produced, massively
prescribed and are contributing to the death of over 65,000 workers each
year. In response to the recent crack-down on prescriptions of
narcotics, millions of addicts have transitioned to cheap street heroin
and the dangerously potent illegal fentanyl to feed their craving.
Physicians provided the gateway to a life of street addiction, violence
and eventually death – while authorities throughout the United States
deliberately looked away.
The
second operative power elite are the medical professionals who
prescribed the drugs in an irresponsible and callous manner to millions
of American over the past 2-3 decades. They too have been largely spared
by the political and judicial system and even remain the ‘pillars’ of
local communities ravaged by drug addiction.
For
two thousand years, a guiding moral and professional principle in
medicine had been to ‘first do no harm’ in the course of treating a
patient. There has been a huge difference in the way working class and
elite patients are treated in the US . Thousands of physicians and other
medical professionals ignored the obvious addiction and deaths among
their lower and middle class patients and succumbed to bribes and greed
to promote opioids. Millions of patients and their family members have
been betrayed by this grotesque failure to address the addiction crisis.
The economic changes in medicine pressured many doctors in corporate
medicine to rush patients in and out of their offices with only cursory
examinations and prescriptions for multiple narcotics and sedatives.
Physicians allowed the for-profit goals of their corporate employers to
dictate how they served their patients – thereby betraying the sacred
trust. Many physicians relied on poorly supervised and over-worked
physician assistants and nurse practitioners to diagnose and treat
patients – already addicted to narcotics. It is easier and cheaper to
write a prescription than to thoroughly examine and properly treat a low
income patient. All accepted the corporate and capitalist ideology that
the addicts were the regrettable victims of their own inherent moral or
genetic degeneracy.
The
chain of causation went from systemic capitalist profiteering to
billionaire pharmaceutical corporations to hospital enterprises to
doctors and their poorly supervised staff.
The
principal political accomplice of death by addiction is the federal
government and elected representatives who accepted scores of millions
of dollars in ‘donations’ from the pharmaceutical lobby.
The
President and Congress, Democrats and Republicans ignored the epidemic
because they were bought off by their campaign donor-owners at ‘Big
Pharma’, the term used to describe the powerful pharmaceutical industry
and its lobby. Over the past twenty years, the political elite received
many millions of dollars in campaign funds from Big Pharma lobbies –
including politicians from states ravaged by prescription narcotics.
The
Federal Drug Enforcement Agency (DEA) allowed the overuse and
distribution of narcotics and then ignored the terrible consequences for
over 20 years. One cannot imagine US veterinarians and their regulators
noting the drug deaths of 3,000 family pets without quickly identifying
and correcting the situation, while the FDA, DEA and US elite ‘ignored’
the deaths of hundreds of thousands of poor and working class
Americans.
Finally,
after two decades, local politicians and state attorneys general saw a
new potential source of revenue with lawsuits against the offending drug
companies and major distributors. Some senators have sponsored hearings
but no decisive action has been taken over the carnage among the poor
civilian population. In 2010, the Pentagon and Senate Armed Services
committee held hearings on the huge increase in prescription drug abuse
overdose deaths among US military personnel and have taken some
effective measures to address the issue. At that time, US senators in
the hearings warned jokingly about the perils of upsetting ‘Big Pharma’.
Clearly, unlike the generals who need healthy soldiers, US capitalist
and politicians have had no interest in protecting working class
citizens – given the overall profits their addiction and deaths bring to
the elite.
Conclusion: What is to be Done?
The
prescription narcotic and subsequent illegal narcotic addiction
epidemic has become a million-person killing field – sowing havoc in the
poor and marginalized, de-industrialized working class communities of
the US. However the victims and their executioners, all have a name and
location within the capitalist system. The logic and the consequences
are clear.
Most
victims are working class, poor and lower middle class, and
overwhelmingly white: the low paid, young and old, the insecure and
under employed, and especially those without adequate or competent
health care.
Over
5 million are afflicted by prescription drug abuse or at least started
on the road to addiction via prescription narcotics. This is a truly
American Holocaust leaving multi-million family survivors. Scores of
thousands of children are living with elderly relatives or swept up into
foster homes and the over-burdened child welfare system.
The
executioners and their accomplices have become rich, elite
college-educated patrons of the most sophisticated arts and sciences.
They receive the best health care services in the world; rely on docile
but highly educated servants, nannies and cooks – many of whom are
immigrant. Most of all, they enjoy immunity from public censor and
prosecution. They are the politically well connected, perfectly dressed,
manicured, be-knighted dealers of death and despair.
The
addiction crisis is a part of the class war waged by the upper class
against the middle and lower classes of this country. The real, if not
stated, consequence of their trade has been to cull the population
rendered superfluous by elite economic and political decisions and to
destroy the capacity of millions of their victims, family members,
neighbors and friends to understand, organize, unify and fight back
against the onslaught for their own class interests. Here is where we
find a basis to approach a solution.
There
are historical precedents for the successful elimination of drug lords,
both elite and criminal and for bringing addicts back to productive
social life.
We
begin with the case of China : After a century of British-imposed opium
addiction, the Chinese revolution of 1949 took charge in arresting,
prosecuting and executing the war-lord opium “entrepreneurs”. Millions
of addicts were rehabilitated and returned to their communities, joining
the workforce to build a new society.
Likewise,
the 1959 Cuban revolution smashed the drug dens and brothels run by
brutal Cuban gangster oligarchs and death squad-leaders, together with
American mafia bosses, like Meyer Lansky. These thugs and parasites were forced to flee to Miami, Palermo and Tel Aviv.
The
first step in an effective class-conscious drug war in the US would
require the organization of mass movements, dedicated anti-drug lawyers,
physicians, medical personnel and community organizers, as well as
brave well-integrated educators and community leaders. A truly involved
national Center for Disease Control, not a mouthpiece for the corporate
elite, would be re-organized to collect quality national data on the
scope and nature of the problem and provide further bases for reversing
the trends of decreased life expectancy, increase child and maternal
mortality and epidemic preventable-premature deaths among workers.
The
second step would involve taking control of the prescription of
narcotics limited to the narrow indications recognized in other
industrialized countries (intractable cancer pain or short term
post-operative pain management) and developing a national data base to
track the prescription practice of physicians, nurse practitioners,
physician assistants and others. Those unwilling to reform their
practice would face arrest and severe prosecution. Heath care would be
patient centered, not profit oriented and the dictum ‘Primum non nocere’
would replace callous Social-Darwinism and greed in medical practice.
The
manufacturers and distributors, as well as the lobbyists and merchants
of deadly opioids, would be forced to pay for the devastation and face
prosecution.
The
process of restoring viability to drug-ravaged domestic ‘shit-holes’
created by the US capitalist elite finally would require attacking and
transforming the economic roots of the addiction crisis. It would
require replacing a system that sows pain and suffering among the
workers with one where the workers and their communities finally take
control of their lives. Professionals and intellectuals, rather than
viewing the victims from the point of view of the elite decision-makers,
will have to fully integrate their interests with those of the masses.
Successful
local struggles can build the political power base that transforms
‘studies’ and ‘critiques’ to direct action and electoral changes.
Outlawing
this revolting source of profit and scourge of thousands of communities
can weaken the power of the billionaire drug dealers and their
political allies.
Millions
of lives are at stake, they have their survival to win. Understanding
the root of this class centered affliction and mobilizing to reverse
this trend can have major consequences benefiting the widely dispersed
imperial and capital induced shit-holes of the world!
Disclaimer: The contents of this article are of sole responsibility of the author(s). The Centre for Research on Globalization will not be responsible for any inaccurate or incorrect statement in this article.
Copyright © Prof. James Petras and Robin Eastman-Abaya, Global Research, 2018
