Conclusion—Looking for Solutions

“Since September 2023, more than 105,000 Americans died from overdoses—almost double the number killed in combat in Vietnam, Afghanistan and Iraq. No matter how zealously the government patrols the border and how ferociously it pursues traffickers, the problem only seems to get worse.” Economist [124]  

In the 18th and 19th century, Britain and other European countries developed the opium trade in which they exported opium grown in India and sold it to China. In the mid-19th century, the British East India Company established a virtual monopoly on that trade when they developed a method of growing opium poppies cheaply and abundantly in the Indian province of Bengal, making it inexpensive and readily accessible to Chinese people. The company soon controlled nearly all of the world opium production— the British East India Company became “the world’s first drug cartel.”[125]   The amount of opium imported into China increased from 10,000 chests annually in the early 1830s to 40,000 chests annually starting in 1838.[126] The levels of opium addiction grew so high that it created serious social and economic disruption. Under the Qing dynasty, China’s enforcement efforts and the British response to those efforts, eventually resulted in two armed conflicts known as the Opium Wars, both of which China lost and which contributed to the decline of the Qing dynasty and ultimately its collapse in favor of republican China in the early 20th century.[127]

Like the Qing dynasty in the 19th century, the opioid crisis in America over the last two decades has created grave social and economic problems that threaten the country.  As examined in this article, it began with prescription opioids (first wave) in the 2000s, followed by heroin around 2015 (second wave), then fentanyl and super meth starting around 2020 (third wave), and now fentanyl-laced meth, heroin, and other opioids (fourth wave). Today, fentanyl and meth are inexpensive to produce, easy to make, hide, and smuggle, and so highly addictive they crease a captive market. Moreover, it seems that the war is being lost in spite of extensive efforts by law enforcement to apprehend cartels, producers, and dealers, the judicial system to convict, and social workers to rehabilitate. To quote The Economist:

Global Solutions

What is the solution? At a global level, some politicians have called for extreme measures such as declaring war on drugs with an invasion of Mexico to eradicate the gangs. Donald Trump is said to have contemplated missile strikes on traffickers’ hideouts when he was president.[129] A more balanced and moderate approach to eradicating the drug cartels and transnational gangs is a multinational solution. However, one of the problems with that is that the illegal drug industry is a vital economic part for many countries. Any multinational war on the illicit drug industry needs to be combined with economic incentives.   

In his keynote address on October 27, 2023 at the Smith Center Forum of the Fentanyl Crisis, Sam Quinones proposed a type of Marshall Plan to fighting the opioid crisis. Enacted in 1948, the Marshall Plan provided the equivalent of $173 billion in 2023 dollars in foreign aid to rebuild war-torn Europe. In addition to foreign aid, the Marshall Plan proposed the reduction of interstate barriers and the economic integration of the European Continent. The Marshall plan was in many ways the first step towards the creation of the European Union. Today, the EU is a fully-integrated trading block with not only the free flow of goods and services but also the free movement of labor and capital among member nations. European Union citizenship affords EU citizens with rights, freedoms, and legal protections available under EU law. EU citizens have freedom of movement, and the freedom of settlement and employment across the EU.[130] By encouraging multinational companies to set up production facilities within the EU and by increasing the mobility of labor, the creation of the EU became an engine for the economic growth of Western Europe.

The 2020 United States-Mexico-Canada Agreement (USMCA)—a substitute for the North America Free Trade Agreement (NAFTA)— is similar to the EU in that it allows for the free flow of goods, services, and capital between the U.S. Canada, and Mexico, but it differs in there is no free mobility of labor.  A possible long-run solution to promoting economic growth in the Americas and eradicating the illegal drug industry, as well as dealing with immigration and border crisis, is to expand USMCA by (1) increasing memberships to include cooperative Central American and South American countries, such as Columbia, Brazil, Chile, Ecuador, Peru, Argentina, and Uruguay; (2) creating an EU-form of integration that allows for the free mobility of labor and creates a new supply chain; and (3) creating strong trade barriers with non-member nations, especially those involved in the illegal drug trade. A prerequisite or corequisite to achieving this level of integration would be for member nations to declare a war on the drug cartels—by doing so, they would realize economic growth.

National Solutions

At a national level, the solution to the crisis may require changing the drug laws. At one extreme would be an effort to decriminalize less lethal drugs such as cocaine and instead focus on eradicating the fentanyl and super meth that are killing Americans. In focusing on fentanyl, it may be time to declare it a weapon of mass destruction and as a poison. When declared as a poison, drug dealers could be indicted for murder when their sale leads to an overdose death. In July 2023, a Placer County, California jury found a fentanyl dealer guilty of second-degree murder in a case involving the fatal overdose of a 15-year-old girl in Roseville, California. The case marked the first-ever drug-related murder conviction. As reported in a US New and World Report article, Steven Clark, a former Santa Clara County District Attorney, called this conviction a “watershed moment in the war on fentanyl. The fact that there was a conviction sends a message to the people dealing fentanyl you could pay for being in jail for the rest of your life, noting that the key to these cases is proving the dealer knew they were selling deadly fentanyl."[131] 

Also, at a national level, there is need to make overdose antidotes such as Narcan and fentanyl strips for fentanyl-laced testing more widely available, to increase public funding of treatment facilities and the availability of methadone, and to revamp the national drug education and public awareness programs.

Regional Solutions

At the regional and local level, the solution is the work of community initiatives. Community initiatives include the work of drug courts that provides a unique combination of intensive court supervision, treatment, additional interventions, and continuous care aimed at disrupting the addiction cycle. It is the work of first responders and faith and business community organizations fighting the opioid crisis in communities around the country. It is the work of scientists, such as those at Ohio State University and West Virginia University, searching for medical solutions to addictions.  It is community initiatives, like those in Portsmouth, Ohio and Hazard, Kentucky that invest in residential treatment services that include sober housing, child care, job training, and employment opportunities for recovering addicts. It is the youth community centers that provide an alternative to youth gangs. The work of community initiatives as a solution may in fact be the most impactful solution. To again quote Sam Quinones: “In a time when drug traffickers act like corporations and corporations like traffickers, our best defense, perhaps our only defense, lies in bolstering our community.”[132] 

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