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As Report on “Despair in Rural America” documents: Opioids Can’t Kill the Pain of 40 Years of Post-Industrial Economy

By Angela Vullo

Oct. 6–According to two Ohio State University experts, “despair caused by the lack of jobs and hope is the greatest single factor in the growing opioid addiction crisis in rural Ohio.” Mark Partridge, SWANK Chair in Rural/Urban Policy and Mike Betz, Assistant Professor in the Department of Human Sciences , equate this despair with low wages and a failure to obtain the “American Dream.”

In their presentation at the Farm Science Review on September 21 in London, Ohio, entitled “Despair in Rural America”, Mark Partridge and Mike Betz detailed the connection between economic collapse and increasing drug addiction. In the process, they demolished the fake argument that it is merely the prevalence of prescription opioids that has caused the crisis, and opened the door to attacking the root cause of the epidemic by a restoration of a growing, agro-industrial economy. (See “Opioid Emergency Demands FDR-Style Measures now” )

Brookings Institution Details the Crisis

A Sept. 25 report issued by Brookings Institution updates the depth of the emergency being created by massive expansion of drug addiction sweeping the nation. “In 2015, 52, 404 people in the US died from drug overdoses. Adjusting for age, that equated 16.3 deaths per 100,000, more than 2.5 times higher than the rate in 2000 (6.2/100,000).” Brookings’ report was timed with the August announcement by President Trump that the opioid crisis is a national emergency.

Citing the President’s Commission on Combating Drug Addiction and the Opioid Crisis, Brookings wrote: “The average American would be likely be shocked to know that drug overdoses now kill more people than gun homicides and car crashes combined. “ Opioid deaths are four times higher than in 1999 and caused over 60 percent of all overdose deaths in 2015. Estimates for 2016 are worse. “Older, working-age adults and non-Hispanic whites experience faster than average increases in drug overdoses during the 2000s.”

The Brookings report also says that more than three-fourths of the nation’s counties reported at least 10 overdose deaths/100,000 people in 2015. Virtually every county experienced a drastic increase in addiction from 2000 to 2015, roughly two-thirds in rural America. The poor counties were hit the hardest. The rotted out economy is driving the addiction disaster. According to the Brookings study, “Among high poverty counties, with poverty rates from 20-40% or higher, 41 percent of those counties report increased drug deaths. Poor counties also lacked access to drug programs in many cases.”

Unfortunately, the Brookings study fails to identify the economic origin of the epidemic.

One aspect of the relationship between the epidemic and the economy has been posited by Alan Krueger, Professor of Economics and Public Affairs at Princeton University, and former Chairman of the Council of Economic Advisers under Barack Obama, who also consults with Brookings. He concluded that the results of increases in opioid prescriptions might account for 20 percent of the decline in the male labor force since 1999. In an article in New York Magazine on September 7, 2017, author Eric Levitz questions the order of Krueger’s analysis that opioid addiction leads to men leaving the workforce, and asks whether the job loss might have occurred first.

Ohio, A Center of the Epidemic

The above-cited Ohio study by Partridge and Betz strongly supports the conclusion that desperate economic conditions are driving the crisis.

In Ohio, there were 3,050 overdose deaths in 2015, with 58.2 percent of the deaths blamed on the use of fentanyl and its derivatives; fentanyl is an opioid 50 times stronger than heroin. “Researchers have found that looking at unemployment rates—for a 1 percent increase in the unemployment rate, the overdose death rate increases 3.6 percent. So you think about a country with a five-year jobless rate change of 3 percent, which during the Great Recession, isn’t out of the realm of possibilities, that could increase the overdose death rate by 10 percent,” Betz states.

He elaborates: “It’s not just the jobs, but the type of jobs you have. Good jobs, manufacturing jobs that were making $25/hour have gone away and have been replaced by retail jobs that are earning $12/hour.” Wages also affect this in “that for 1 percent decrease in wages, you see a 3.5 percent increase in overdose death rates. This number is even higher among rural whites.—it’s about 4.5 percent. So for rural whites, if there is a 3 percent decline in wages in the country, these could be almost a 25 percent increase in drug overdoses.”

Since the 1970s, the nation has downshifted from a manufacturing and infrastructure driven economy to a preponderantly low-wage, low-productivity services economy. 1972 represented the apogee of the Golden Century of American productivity, (See “The American Century of Economic Progress, 1870-1970” ) with real growth spurred by the Roosevelt recovery, the WWII war mobilization, and the Kennedy Space Program. That was all dismantled. Rust belt states like Ohio, Pennsylvania, Michigan, Illinois, and others have been devastated by this process. The shock waves coming out of this bomb-like devastation have now manifested themselves in suicide, alcoholism, and drug-besotted sub-cultures.

Partridge calls this condition the “Depths of Despair,” and reports that their recent study showed that, particularly among white middle age males, even life expectancy is falling for the first time in American history.

This rise in mortality, documented by Brookings scholars in 2017, highlights the severity of the healthcare crisis.

He compared the figures from Appalachian Ohio with Metropolitan Columbus, Ohio. Since 1980, the former had zero job growth versus 75% growth in the latter. The point is, he says, “This has especially hit my generation, where I am going to be 55. Coming out of high school in 1981 there was a real difference in the type and stability of jobs.”

Ironically, Betz reports that the supply of prescription drugs has quadrupled since 1999, with a huge increase in availability. Although he agrees that the increase in supply has increased the suicide and overdose rates, he argues that something else is going on – not just supply. “We call those demand side factors. Why are people demanding more drugs? When you look at the disparity between urban and rural suicide rates for both males and females, there is a striking contrast with rural young people killing themselves at twice the rate than in urban areas.” Not only are people taking prescription drugs, but the consumption of cheap, readily available heroin and fentanyl skyrocketed out of all proportion.

If one tours the former industrial heartland of Ohio, the aura of economic decline permeates the surroundings. An area once rich in resources, with iron, steel, and other manufacturing plants, has been turned into a rural wasteland, riddled with poverty and despair. Shuttered plants dot the landscape like tombstones. Not by coincidence, the same area abounds in deaths from all forms of drugs and alcohol. How many lives are buried along with those plants?

The entire Rust Belt needs an industrial rebirth, such as an infusion of capital to rebuild the industrial base and the machine tool capability. A Kennedy-style national mission, such as a crash program to rebuild our infrastructure, relaunch the Space Program, and other initiatives, are “just what the doctor ordered.” And, it must happen now, while we still have the skilled labor force to mobilize.

Jobs and Wages

The Ruins of Detroit, photographed by Yves Marchand and Romain Meffre

Betz declares that there is a demand for long-term labor jobs, and for education. “Just going from a high school degree to some college reduces your overdose rate by four and half times,” he says. “If you get a bachelor’s degree, it is 14 times less than those who only have a high school degree”.

“In 1980, the wage difference between a high school degree and college degree was only about 20 percent. Today, that gap is about 75 percent. Living standards since 1973, measured as median household income, has barely budged in the United States,” says Partridge. “White men have not seen an increase after adjusting for inflation since 1972.”

Expectations are destroyed. “I will have things like my parents, a certain reasonable standard of living, and then these aspirations get completely dashed, and it creates a lot of problems. Since 1972, instead of seeing what we have seen in the past with wages, (a four-fold increase in the post war years), wages were flat. You can see with Americans putting so much value of their lives in their jobs, one can easily identify that if they are not doing well in the labor market, then they feel they are a failure, and this leads inevitably to drug abuse. “

Yes, this is a national emergency, which will not be solved until the nation returns to its founding principles and defends the “general welfare for ourselves and our posterity.” What is urgently needed is a Roosevelt-style recovery, starting with Glass-Steagall, a gigantic national credit policy, such as a new National Bank for Infrastructure, and large-scale projects. Only such a mission will rebuild our dying nation, and give its citizens a purpose and a desire to create and achieve. That is a real detox program for the nation.

“My City Was Gone” (lyrics), by The Pretenders, 1984; This song, written about Akron, Ohio, captures the spirit, or lack thereof, of the country, which has led to the opioid crisis.

“I went back to Ohio,
But my city was gone.
There was no train station;
There was no downtown.
South Howard had disappeared,
All my favorite places.
My city had been pulled down,
Reduced to parking spaces.
A, o, way to go, Ohio.

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