The Opioid Epidemic Is This Generation’s AIDS Crisis
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.
In Maryland, the first six months of 2015 saw 121 fentanyl deaths. In the first six months of 2016, the figure rose to 446. The population of addicts is like the population of deer. It is highest in rustic places with access to urban supplies. Missouri’s heroin problem is worst in the rural counties near St. Louis. New Hampshire’s is worst in the small cities and towns an hour or so away from the drug markets of Massachusetts: Lawrence, Lowell, and Boston.