Two recent discussions crystalized the important point that social despair, not economic despair, is the leading driver of our latest wave of drug problems. The opioid crisis is complex, as all the speakers at a recent American Enterprise Institute discussion noted, and the causes are multifaceted. There’s no doubt that there is an economic element.
But the consensus is not that economic despair is leading to drug addiction and overdose, rather that we’re facing a terrible social breakdown, and many people are lonely and isolated. They feel they are not needed. Yuval Levin, vice president of the Ethics and Public Policy Center, noted during the panel that this epidemic “is connected at some level with a collapse of connectedness, a loss of meaning, a loss of fulfillment in people’s lives.” Levin says all of this can be described “as an exhaustion or collapse of social capital.”
During the discussion, Utah Sen. Mike Lee, vice chairman of Congress’s Joint Economic Committee, introduced and discussed a recent report from the committee’s Social Capital Project, titled “The Numbers Behind the Opioid Crisis.” Two things stand out in the presentation and panel interview: the depletion of social capital, and the role of America’s prosperity in the drug epidemic. The two are connected, and although the panel did not elaborate on this point, a compelling argument can be made that as America’s economic capital increased, its social capital declined.
We’re No Longer Good at Enduring Hardship
Isolation is a kind of suffering. Yet our prosperity has stunted our ability to forebear difficulties, be they physical, spiritual, emotional, economic, or any other. So often, when we experience suffering in this imperfect world, our knee-jerk response as a society is to look for relief. Some of us turn to food to quiet our tormented souls, others drink themselves into a stupor, and still others turn to myriad forms of entertainment to fill the gnawing emptiness inside them. Our opulent society offers many ways to run away from our misery.
Within our country’s genetic make-up is the drive to make things better. In itself, it is a wonderful quality. Over time, it has made us an advanced and prosperous nation. Yet that same quality can be distorted, and in its corrupted form, it makes us impatient and unable to endure hardships, looking quickly for a fix and a way out. In the land of fast food we can barely tolerate being hungry. We are a society unpracticed in endurance; we know not how to sit still in the suffering.
So we do not suffer well, and likewise, we have a skewed sense of comfort. We tend to see comfort as a state rather than a process. Comfort comes in no small part from others ministering to you in a time of pain. It comes from the passage of time, and the shaping of one’s psyche and character in suffering.
One of the associated problems is that our society lacks a repertoire of healthy and realistic goals for relief, so it is not surprising that so many seek shortcuts—and turn to opioids—to experience relief, a sedative that convinces people in body and mind that it’s time for a well-earned rest. The ensuing “rest” can even take on a semblance of death (and far too often, actual death), what we imagine to be the finality of all earthly suffering.
Restoring Social Capital ‘Is a Generational Project’
Locating the leading cause of the drug epidemic in the social sphere is more complex, without quick and easy fixes. As Levin mentioned in the interview, “social capital is built up very, very slowly and gradually in people’s lives. It’s built up through the building up of habits, the building up of patterns of living, of expectations, it’s a matter of building up trust and of being trustworthy, of building up responsibility, of building up the habit of seeking help and offering help. These are things about character formation, and they require formative institutions. Those institutions are what we’ve been losing, but that means that bringing them back is a generational project…it’s going to take a long time and a lot of effort.”
In the meantime, people are getting hooked and overdosing at this very minute, and the public wants solutions. It feels more efficient to us to look to the federal government such quick solutions. But it’s not a matter of either/or. We can both start making social changes on the individual level right away, and we can push for policy changes.
Lee, Levin, and fellow panelist Sally Satel, a psychiatrist who works in a drug clinic, all mentioned concrete policy changes that help in this acute stage of this epidemic. Some of those are: changing the rules on prescribing medicine; diverting money to treatment and prevention policies; keeping fentanyl off the streets; empowering local institutions to manage welfare, social, and education policy; diverting more drug-related convicts to treatment and then to vocational programs; making medications (like methadone and suboxone) that can help fight addiction available more widely.
In my own state of Arizona, where we have a terrible epidemic of heroin abuse, the legislature unanimously passed, and Gov. Doug Ducey signed into law, the Arizona Opioid Epidemic Act on January 26. The bill caps new patient opioid prescriptions at five days’ worth of pills; caps dosage; institutes criminal liability for fraud; requires electronic prescriptions for opioids; provides naloxone kits to law enforcement officials and correction officers; sets aside $10 million to treat those who don’t have health insurance; and includes a Good Samaritan measure that shelters 911 overdose callers from arrest.
My state also keeps a real-time opioid data collection website. Arizona’s prescription opioid epidemic is manifestly aggravated by the black tar heroin that comes in from Mexico, and China White or “white heroin,” a street name for fentanyl. Another thing we need is more long-term treatment centers of the type Lee mentioned during the AEI event.
As my colleague Levin said at the AEI panel, we can change policy, enact laws, and spend money on treatment centers, and those are needed steps, to be sure, but at the end of the day we must commit to the laborious task of repairing our social fabric. That can begin right now with your next social interaction, whether it’s with a spouse, child, friend, or parent. Be trustworthy, be willing to suffer wrong, be willing to give more than you receive. Let your next social interaction be done in love.
