“the opioid epidemic is the new AIDS”

For the last couple of years, when trying to explain the experience of the opioid crisis, I’ve often said, “I imagine it’s kinda like the AIDS epidemic in the late 1980s and early 1990s.” However, I always qualify the statement by emphasizing “kinda” and saying something like, “I’m not saying it’s that rough.”

Now, Andrew Sullivan, who survived the AIDS epidemic, says the following:

Those of us who lived through the AIDS epidemic retain one singular memory: The plague that ravaged our lives was largely invisible to others. The epidemic was so concentrated for a while in a gay male subculture — often itself veiled by various closet doors — that straight people without gay family members or friends couldn’t see it. There was blanket media coverage, of course. But in your everyday life, if you were straight, you could live quite easily in the 1990s without coming across someone with AIDS. While gay men were living in a medieval landscape of constant disease and death, many others carried on in safe, medical modernity, that elysian period in human history when most diseases can at least be treated, if not cured.

It occurred to me reading this reported essay by Christopher Caldwell that the opioid epidemic is the new AIDS in this respect. Its toll in one demographic — mostly white, working-class, and rural — vastly outweighs its impact among urbanites. For many of us in the elite, it’s quite possible to live our daily lives and have no connection to this devastation. And yet its ever-increasing scope, as you travel a few hours into rural America, is jaw-dropping: 52,000 people died of drug overdoses in 2015. That’s more deaths than the peak year for AIDS, which was 51,000 in 1995, before it fell in the next two years. The bulk of today’s human toll is related to opioid, heroin, and fentanyl abuse. And unlike AIDS in 1995, there’s no reason to think the worst is now over.

It’s a very powerful statement. However, I’d need more information about the emphasis on the single demographic of  “white, working-class, and rural.” Especially since Sullivan’s emphasis on this demographic ends up becoming a convenient vehicle for his pet arguments in support of Charles Murray.

Sullivan also notes an important contrast between the opioid crisis and the AIDS epidemic:

There are major differences between the two health crises, of course, but none of them are very encouraging. AIDS was eventually overcome by innovation by pharmaceutical companies. The heroin epidemic is, in many ways, the creation of those very same companies, thanks to their cynical marketing of opioid products in the 1990s.

He ends with these thoughts about policy and advocacy:

Worse: Funds for AIDS research kept rising and rising through the 1990s. Today, the Trump administration’s proposed cuts to Medicaid could drastically reduce treatment options in a spiraling crisis. Silence = Death, once again. But where, one wonders, is the ACT UP of the red states?