It's not hard to discern a general pattern over the course of American history when it comes to drug use: Every decade or so, a new panic emerges. In the 1960s, the slogan was "speed kills," and the alarm was raised about LSD. The 70s saw the emergence of a bona fide heroin epidemic. The 80s, of course, were high on cocaine, culminating in the crack era. The 1990s embraced nostalgia: Heroin was chic again, even if it allegedly fried your brain like an egg. The 2000s saw the rise of methamphetamine, and so far, this decade has largely (if by no means exclusively) been a story of heroin and opioids.
So what does this panic calendar portend for the future of our currently en vogue opioid problem—and drug policy in America?
The failure of any given generation to recognize the dangers of drugs not currently in fashion is such a recurring theme that it's been given a name. The University of Michigan's Lloyd Johnston calls it "generational forgetting," and, during the four decades in which he's led the US government's large national survey of youth drug use, Monitoring the Future (MTF), it has been on consistent display.
"We use the term to refer to the general idea that younger generations often do not know about the dangers of a drug-use epidemic," says Richard Miech, another professor at the University of Michigan and a co-investigator for MTF. "While one generation may have learned the hard way about the dangers of a specific drug… the next generation may have to learn the same lesson all over again."
"I often mention in it my lectures," adds University of California professor emeritus Craig Reinarman, a sociologist. "It seems to me that it's the result of a policy choice because the amount of cultural learning that takes place gets erased," he continues, explaining that as users become familiar with particular drugs, they tend to develop ways to manage risks. Drug education that focuses primarily on "just say no" doesn't leave room to pass these harm-reduction measures down, he notes.
The problem is exacerbated by mass-media outlets, which, as I noted in my last column, have a nasty habit of using select quotes and anecdotes to refashion the currently hot drug into the most deadly and addictive scourge ever. This results in ironic contradictions for anyone who actually bothers to read the archives and misinformation that drives public policy. Since every new threat is described as unprecedented, the lessons of the past go unheeded.
I experienced this for the first time myself in the 1980s, when, if you listened to the media, crack use was going to escalate forever until every suburban teen was curled up in a den with her own pipe. In fact, by the time a drug epidemic becomes a matter of public concern, it is typically already on the wane: Reinarman's research documented this quite clearly in a seminal analysis of that period. He notes that cocaine use in the US overall had begun to decline before the 1980s panic over it even started: the percent of the population who said they'd ever tried cocaine peaked in 1982, around four years before the media hysteria about the problem really took off.
As for crack, the first time the government measured use by high school students resulted in the highest number ever seen: About 4.1 percent of high school seniors in 1986 reported having used it in the past year, though the vast majority of these had done so only once. That number was down by 25 percent within two years. Nonetheless, media coverage continued to report that a whole generation was at increasing risk because of the "deadly" drug. (In 1985, there were a total of eight crack-related deaths among youth in the entire US, and such deaths were never seen in more significant numbers, as reported in Reinarman's book Crack in America.)
Of course, violence related to the illicit sale of crack, crack addiction itself, and the mass incarceration policy that was pursued in the name of addressing the problem did do tremendous harm—particularly in the black community in cities. And in fact, a healthy generational response grew up indigenously: The younger siblings and children of the crack generation—far from becoming the crack-fueled "super-predators" politicians had predicted—mainly turned to a different, and far more benign drug.
While the media and politicians were obsessing about young white Americans, grunge and the "deplorable" fashion trend of heroin chic, in the 1990s, the black hip-hop generation was turning to marijuana, according to David Courtwright, a professor of history at the University of North Florida, who cites research by Andrew Golub and Bruce Johnson.
Courtright, who is a pioneer in the study of opiate use in American history, notes that in the 90s, some black teenagers "shunned the drugs that messed up their elders. They would see what they called a 'thirsty crackhead' and say, 'I'm not going to do that. I'll smoke reefer instead.'" And some of the adults who had themselves been hooked on crack began using marijuana, too—to wean themselves off of the harder stuff.
Check out our interview with Alexis Neiers about 'The Bling Ring' and her drug problems.
It's too early to tell yet how our current opioid epidemic will play out and whether there will be another turn toward less risky drugs like marijuana—or whether this generation will switch to a drug type that has harmed prior generations, but received little notice lately.
If recent history is any guide, next up should be a stimulant—perhaps Ritalin, Adderall, cocaine, or some new synthetic upper. Today's young people have been exposed to countless headlines and videos warning of opioid problems, and they've likely seen the struggles of family members or older friends. But far less attention is given to stimulant risks.
Still, what is clear is that the move away from opioids is already happening among younger people. According to MTF data, past-year use of prescription opioids by high school seniors peaked at 9.5 percent in 2004 and was just 5.4 percent by 2015; for heroin, past year use peaked at 1.5 percent in 2000 and is currently only .3 percent. Daily use of prescription opioids reached .4 percent in 2009, but is now just .1 percent. Says Miech, of the trend among youth, "Since 2009, use of these drugs fell by 40 percent."
That's the good news. The bad news is that people suffering from opioid addiction right now are not being adequately treated and will continue to be at risk for overdose, particularly given the rising supply of fentanyl. If we want to stop the constant cycling of generations from one drug to the next, we need to focus more on why people use—not on whatever drug is particularly fashionable.
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