Trump & Hillbilly Heroin

Donald Trump’s presidency has had a rocky start, but at least, the narrative goes, he is delivering for his supporters. Matthew Continetti over at the Washington Free Beacon sure seems to think so. Mr. Continetti assures us that he’s making sure his supporters “win” either by canceling TPP, ramping up immigration crackdowns, or bringing back jobs, though he functionally admits that last one is basically going off gut feeling rather than any hard data.

While one can quibble over whether or not making trade more difficult or spiting Mexican laborers really helps his core supporters, a major issue that Continetti ignores is the fact that President Trump’s FDA nominee is morally complicit in the deaths of thousands of Americans, disproportionately the sort of folks who voted for Trump in the first place.

Dr. Scott Gottlieb is a physician who worked for the Food & Drug Administration during the second Bush administration. He also is a resident fellow at the conservative American Enterprise Institute. Unlike some other appointees, Dr. Gottlieb will almost certainly sail through his confirmation hearings in the U.S. Senate.

But the fact that Dr. Gottlieb has been nominated and will be confirmed is nothing short of a national scandal, and one that remains totally uncovered by the conservative media outlets, whether they are generally critical or supportive of the president. At the date of this writing, I could find nothing about this at National Review, The American Conservative, The Weekly Standard, The Daily Caller, Breitbart, or Mr. Continetti’s Washington Free Beacon. Typing in “Gottlieb opioids” either produces generic results about opioids or literally nothing at all. By contrast, if you search for “white working class” you get endless scrolling with hundreds of articles to choose from.

This lack of reporting is disgraceful because we are in the middle of a drug overdose crisis of epidemic proportions. Drug overdoses are now deadlier than car crashes and firearm homicides. As of 2015 they are now deadlier than HIV/AIDS was in the 1990s. Prescription opioids such as OxyContin, Percocet and the like, are responsible for 63% of these deaths.  Over 560,000 Americans have died of drug overdoses from 1999 to 2015, with another 50,000 in 2016 alone. To put this into context this is the roughly the number of Americans killed in action in both World Wars. The agony of Owens’ war poetry could be equally descriptive of either a young man dying in France or a middle-aged woman ebbing away with a handful of pills in Corbin, Kentucky.

How do Trump’s supporters figure into this disaster? The opioid crisis has not hit all sectors of America equally. It is most harshly felt in places like Kentucky, West Virginia and Ohio, and especially among white, working class Americans. Prescription opioid abuse is so common it’s been nicknamed “hillbilly heroin.” One former West Virginia addict, Sam Cox, remembers opioids as “…straight from the devil. The devil comes to steal your soul. That’s his job. The drug is [a] demon.”

And while this demon is sharpening his scythe for those addicted to it, hillbilly heroin fuels a wider spree of crime and violence across Appalachia and the Rust Belt. Car wrecks, petty theft, aggravated assault, domestic violence, murder and racketeering. In some Appalachian towns, sheriffs are now estimating that in some places as much as 80% of crimes are related in some way to opioids. The chain of events is simple. Pharmaceutical companies produce opioids en masse. The narcotics find their way onto the illegal market either through theft or by pumping fake prescriptions through pill mills. It’s gotten so brazen that criminals literally bus hillbilly heroin from Florida to West Virginia by the truckload. The “OxyContin Express” fuels Appalachian organized crime the same way liquor smuggling used to finance the Mafia.

The old folk song “O Death” asks, “What is this that I can’t see | with ice cold hands takin’ hold of me?” No worries, sir. That’s just a legal prescription The Weekly Standard assures me is “safe and effective” as well as a “home run.”

So how does Dr. Gottlieb fit into all this? A new investigation from the Intercept found that Gottlieb is deep in the pockets of the opioid industry. Mallinckrodt Pharmaceuticals paid Gottlieb over $22,000 for one speech alone in 2016. That’s more than double the average annual income in Jackson County, Kentucky. And Mallinckrodt is infamous for willfully ignoring obvious red flags and pumping over half a billion prescriptions from Florida in a four-year period. Pollyannaishly assuming each prescription was just 10 pills, that’s more than enough generic Oxy to kill every man, woman and child in Appalachia several times over.

Gottlieb has also done paid speaking gigs for the Healthcare Distributors Alliance, a trade conglomerate for companies like Cardinal Health. Cardinal Health made its bones in the Oxy game by pouring over 780 million opioid pills into West Virginia alone from its Florida warehouse (seeing a connection here?). They were so irresponsible they got on the DEA’s radar and lost their license to distribute. Gottlieb’s response? He condemned the move and said the DEA shouldn’t have the right to regulate the opioid market. “Cardinal isn’t a Colombian drug ring,” he whined. “Its CEO isn’t Pablo Escobar.”

That’s certainly an interesting comparison. While Gottlieb gets paid more than the average annual Appalachian income from public speaking alone, his friends over at Cardinal and Mallinckrodt flood Appalachia with hillbilly heroin. They rake in billions. Over 600,000 Americans have died. By contrast, fewer people have died in the Colombian civil war and the Mexican drug war combined. While he and his pals may not be Pablo Escobar, they are functional drug pushers who shouldn’t be allowed anywhere near the levers of American medical policy.

Conservatives should ask ourselves; Will Gottlieb’s tenure really promote order and tranquility? Can a defender of hillbilly heroin really promote the dignity of the person and the common good?

(Similarly, will Trump really deliver for his voters? I don’t know. Maybe. Those left alive, anyway.)

Featured image: “Empty Pill Bottles” by Flickr user Chris Yarzab (CC-BY-2.0)