Opioid epidemic brings carnage to Trump’s back yard in Florida
In the affluent southern Florida town of Delray Beach, a short drive along the coast from Donald Trump’s “Winter White House” at Mar-a-Lago, America’s opioid epidemic is exploding. Amid the fluttering palm trees, million dollar homes, and multi-million dollar yachts, people are overdosing in record numbers.
“A 17-year-old kid collapsed and died right in front of me outside my store,” said Sarah Epstein, who runs a boutique selling expensive handbags and paintings in the genteel high street. “My heart broke,” she said. “It was unbearable, oh my God. The medics came but they couldn’t save him. They’re finding them everywhere. All you hear now all day long is the ambulances, and every time you hear one that’s someone overdosing.”
This year at least 64,000 Americans will die after overdosing on opioids, whether it be prescription painkillers or illegal street drugs like heroin. That is more than die in car crashes or gun incidents, and more than the number of US soldiers that perished in the Vietnam War.
The scale of the crisis has reached epic proportions, now even invading Mr Trump’s Florida back yard, for two reasons. First, despite having only five per cent of the global population, the US consumes 80 per cent of all the world’s prescription painkillers. More Americans take them than smoke cigarettes. The legal opioid market is worth around $15billion (£11.4billion) a year and rising fast.
Second, the US has been hit by a tidal wave of powerful synthetic opioids smuggled from China and traded over the dark web. The biggest killer among them by far is fentanyl, a version of a drug originally intended for use by cancer patients. It is 50 times stronger than heroin, and is taken with heroin to increase the strength. More than half of American overdose victims now have fentanyl in their system. Its street names include “Poison” and “Drop Dead”.
In last year’s election campaign Mr Trump promised to tackle the growing crisis, and this week he announced a “public health emergency”, declaring it a “horrible plague”. He promised a massive Eighties-style “Just say no” advertising campaign, and improvements to “telemedicine” for rural areas. But he faced sharp criticism from Democrats and drug treatment advocates for not releasing any new funding for treatment.
In Palm Beach County, which includes both Mr Trump’s Mar-a-Lago weekend retreat, and Delray Beach, 589 people died from opioid overdoses last year. That was double last year, and triple the year before. At the county morgue the bodies are piling up. Dr Michael Bell, the chief medical examiner, said he was seeing “overdose after overdose” and a “crisis point” has been reached. He added: “What’s happening is people have moved beyond prescription opioid use. They’re done with that. For the most part they’re now using heroin. But it’s what they think is heroin. Most of it’s not heroin, it’s actually fentanyl.”
Having been hit by the fentanyl wave, Palm Beach is now in the grip of a second, even more frightening drug. It is called carfentanil, a synthetic Chinese-made version of an elephant tranquilliser, which is at least 5,000 times stronger than heroin.
“Prior to July last year I’d never seen carfentanil in my life,” said Dr Bell. “This year we’ll probably have 250 people with fatal doses of it.” Last year Dr Bell saw 299 people with fatal doses of fentanyl, 199 heroin, 118 carfentanil, and 51 the prescription painkiller OxyContin. “They were almost all white, mostly men, some in their 60s and 70s. These are not homeless people. It’s an older crowd.
“I’m not sure there’s anything Washington can do about it. Trump’s approach is ‘Just say no’. But Nancy Reagan did that. It didn’t work then, it won’t work now. Putting pressure on China would be a big help but it will be like whack-a-mole. You shut one drug manufacturer down there, another pops up.”
There is also another reason for Palm Beach County becoming a hotbed amid the national epidemic. It has long been a kind of “rehab riviera” for addicts, many of them wealthy, attracted by the prospect of recovering in the sun by the ocean.
But something has gone very wrong in southern Florida’s treatment industry in recent years. Unscrupulous businessmen began setting up “sober homes” and engaging in a scam they call the “Florida shuffle”. Addicts from around the country are lured by offers of free plane tickets, gym memberships, and “getting clean by the beach”. Then, in a process known as “body brokering”, the corrupt sober houses pass them on to outpatient treatment centres – for a fee.
Treatment centres, in on the scam, provide little care, but charge huge sums to the patients’ insurance companies. The patients become cash cows and are sometimes encouraged to keep using drugs. In Delray Beach well-heeled residents are used to seeing opioid addicts passed out in coffee shops, or stumbling zombie-like down the street. “The recovery system is broken. It’s become the Wild West,” said Cary Glickstein, the mayor of Delray Beach. “I could open a sober home tomorrow with no qualifications. It’s a fraudulent sham.”
Mr Glickstein, a Democrat, is sceptical about receiving a “single dollar” in help from Mr Trump.
Having despaired of help from its presidential neighbour, Delray Beach next month plans to launch a David vs Goliath legal case against some of America’s biggest drug companies, suing them for the millions of dollars the town has spent responding to emergency overdose calls.
The city will allege negligence, deceptive marketing practices, and consumer fraud in a case it hopes will burgeon into the kind of litigation faced by the tobacco industry.
‘Trump’s approach is just say no. But Nancy Reagan did that. It didn’t work then, it won’t work now’
Nearly a year on from the presidential election, many commentators still invoke “Trump voters” as an unexplainable phenomenon worthy of a David Attenborough documentary. This is due in large part to the fact that the vast majority of us called the election wrong, and it’s easier to pretend that what we now face was wholly unpredictable than to admit our mistake, born of carelessness and no small amount of snobbery.
Polling and economic data have shown for years that a large swathe of the electorate is financially stressed and downbeat both about their own future and the future of America as a whole. What we failed to predict was that these people would become politically engaged. The centre held as long as our system’s losers stayed far away from voting booths, allowing policymakers to continue propagating many of the policies which had created winners and losers in the first place.
There’s no use pretending that the elevation of Donald Trump to the office of the presidency has changed all of that. But his victory has expanded the realm of the possible for the rest of us: look what happens when the losers show up.
Polling data indicates that these electoral upheavals are not over yet. Pew’s annual Political Typology report came out this week, the 30th year of analysis that breaks the population down not by party, but by core values and concerns. Pew has correctly argued for decades that the labels “Republican” and “Democrat” are wholly insufficient to describe the full range of views to be found along the American political spectrum.
Its data show wealthy, welleducated, politically active and generally optimistic people on both the Right and Left, with less well-off, less-educated, less politically active and increasingly pessimistic people bunched in the middle. Trump found a way of activating those people in the middle who sit Right-of-centre, and it’s a question of when, not if, someone manages to do the same thing with disaffected voters on the Left.
Pew identifies two groups in the Democratic coalition that are underrepresented in terms of their political engagement, both of whom are formed of a majority of minorities: the “Disaffected Democrats” and the “Devout and Diverse”. The “Disaffected Democrats” are primarily over 50; they overwhelmingly disapprove of Trump’s conduct in office; and they are alone among Left-leaning groups in believing that government spending is almost always wasteful, while simultaneously supporting a bigger government that delivers more services. The “Devout and Diverse” are primarily under 50, the only group that straddles the two main parties (roughly three-quarters vote Democrat), and the most likely amongst Left-leaning groups to say that religious faith is a prerequisite to being a moral person.
Only a third of people in these two groups report that they would be able to live off their savings for three months; less than a quarter say that life is better for people like them than it was 50 years ago. They are the most likely to believe that the American dream is out of reach for their family and the least likely to be registered voters.
Someone is going to figure out how to wake these people up.
I’d bet that it isn’t going to be the Democratic Party in its current form, a tribe of tribes unable to agree on more than one or two messages. Instead Democrats have settled, for now, on pluralism, a strange breed of identity politics based on the notion that America’s problem is that its citizens are not sufficiently tolerant of lifestyles different to their own. This might be a problem, but it is not the problem, and suggesting such a tone-deaf and oversimplified solution is certain to provoke a backlash.
The Republican Party did the same thing. Rather than take the time to explain the breadth and depth of conservatism, they wrongly believed that the benefits of the free market were sufficiently obvious, and that they could focus on to the important business of governing, rather than make the case for capitalism. They were wrong.
Democrats’ pluralism isn’t going to get a 25-year-old into work (or out of her parents’ home), any more than Republican triumphalism was going to bring back her father’s factory job. At present, neither party has a comprehensive answer on whether and how government is going to hold up its end of the social contract and change your life for the better.
The Republicans waited too long to offer its voters anything more than a platitudinous bumper sticker, and sent up the least qualified president in the history of the republic as a result. It is not too late to prevent an equal and opposite calamity on the Left.
Many in the Left’s ‘Disaffected Democrats’ and ‘Devout and Diverse’ groups believe the American dream is out of reach for their family. Someone is going to figure out how to wake these people up