Over the weekend came news that the Nebraska State Patrol arrested two men for transporting with intent to deliver enough Fentanyl to kill 26 million people. That is extraordinary. Obviously, we are grateful to the authorities for doing their job and glad that the officers who came into contact with this deadly drug were not themselves injured, which is a very real possibility in such cases.
I first became aware of Fentanyl a few years ago as part of an “end of life” question in hospital. There I was told that Fentanyl is a powerful, even dangerous drug and everything I have seen since supports that view. Police officers and other first responders now must carry NARCAN in their vehicles to treat other officers who may inadvertently come into contact with Fentanyl while searching a person or a vehicle. It is so powerful that there is concern that the gloves they ordinarily wear for such searches may not be sufficient to protect them.
My concern here, however, is not so much public safety and public policy as it is to ask what it means that Americans are apparently consuming such powerful drugs in such quantities. That shipment of Fentanyl was, in effect, a weapon of mass destruction. What on earth is happening?
A partial explanation is illustrated by a 1943 documentary I saw on Saturday. The Spring cold that has been circulating in our area finally tracked me down. So spent a beautiful Saturday in front of the television watching war films. One of them was particularly striking, December 7th a documentary shot by the great cinematographer Greg Toland and directed by John Ford about the Japanese sneak attack on Pearl Harbor. The film was apparently censored by the War Department and not released in full until 1991. I had never seen it before. The film is cast as a dialogue between Uncle Sam and Mr Conscience, who raises questions about the American response to the attack, including the war-time internment of Americans of Japanese descent.
One of the more striking features of the film is its patent assumption of and unashamed appeal to a shared Christian faith. It refers to Sunday as “the Sabbath” without explanation of what a Sabbath is and how the Christian Sabbath differs from the Jewish Sabbath. At one point the narrator says, without apology, “our faith teaches us…”. We may be sure that few blanched at such language in 1943. Indeed, such language was common during my childhood in the 1960s and early 70s. In post-Christian America, however, to hear such language used sincerely, without irony, is remarkable indeed. My point is not to justify such assumptions but only to note the difference between then and now.
Might people have taken Fentanyl in 1943 had they the opportunity? Who knows? Americans not only defied the the 18th amendment in great numbers, with great ingenuity, and industry but they repealed it at the first opportunity. Yet, beer and Fentanyl are hardly the same thing. The latter represents a quest for relief for temporary euphoria, even if it kills us. The CDC says, “The age-adjusted rate of drug overdose deaths involving synthetic opioids other than methadone (drugs such as fentanyl, fentanyl analogs, and tramadol) doubled between 2015 and 2016, from 3.1 to 6.2 per 100,000.” News accounts, including the latest, suggest that trend is not slowing.
Perhaps the fact that Americans are buying, and using Fentanyl tells us something about the American character? Perhaps it tells us something about how we now define the “happiness” of which we spoke in the Declaration? Perhaps, however, it is an indicator of the emptiness of late-modern life? No one could make a a general documentary today and speak the way that Ford did in 1943. It would not make sense. It would not be true (setting aside the question of the degree to which it was true then). Americans seem to have become existentialists or “Epicureans” as Luke calls the philosophy in Acts 17:18. It has been called materialism. Whatever we call it, this philosophy, this religion (for it is that too) says that this life is all there is. Paul summarizes it in 1 Corinthians 15:32, “If the dead are not raised, ‘Let us eat and drink, for tomorrow we die.'” Paul was quoting the 8th century BC prophet Isaiah (22:13), so there is nothing new about this view. It is just as empty today as it was in Isaiah’s day and in Paul’s.
Whether we call him an Epicurean, an existentialist, or a materialist he knows in his conscience that he is liable to judgment (Rom 1:18–22; 2:15–16). What is one to do when one’s conscience is testifying against what one’s mouth and keyboard confess? The materialist says that human existence ends at death, that life is random, meaningless. From that starting point people have tried to theorize about different ways that life can be meaningful even if this is all there is. Evidently the theories are failing. Why else do people turn to deadly narcotics such as Fentanyl to dull their psychic and emotional pain? What is the quest for euphoria but a witness that we know in our conscience that there is more to life than this life.
Then there is Jesus and his empty tomb. The Christian conviction, as Paul indicated, is that Christ was raised from the dead. The life after this one is not absorption into the One or nothingness but an accounting before Jesus. Either one has reckoned with Jesus of Nazareth, who was crucified, raised, ascended, and who rules now or one has not. Either one has acknowledged and repented of one’s sins and put one’s trust in Jesus for righteousness and eternal life or one has not. That empty tomb also stands as a witness against the materialist/Epicurean/existentialist.
It is not just poverty. Americans have been poor before. In the Great Depression people stood in bread lines. Before that some hardy Nebraskans ate bugs to survive famine. Today, even our homeless have $800 mobile phones. In some cities the authorities will pick up the willing homeless, feed them. clothe them, house them, and educate them for free. No, it is not poverty that drives people to Fentanyl. It is hopelessness. That people risk their life for another high, possibly their last, tells us how much humans desire something beyond this life—even if they have substituted blessed fellowship with the living God, in whose image they are made, for a narcotic high.
Fentanyl cannot save you but it might kill you. Jesus saves sinners who have given up hope in this world. The only way to enjoy this world, as it was meant to be enjoyed, to the degree it can be enjoyed, is to give it up. It is a paradox. Jesus: “Whoever loves his life in this world will lose it. He who hates it will keep it forever” (John 12:25). He also said, “come to me all your who are weary and burdened and I will give you rest” (Matt 11:28).
Tangentially related is this NYT piece about the role that the Pharmaceutical Industry has played in allowing the opioid crisis to get so out of hand. https://www.nytimes.com/2018/05/29/health/purdue-opioids-oxycontin.html
In parcelling out the blame, here’s more to consider: https://www.physiciansweekly.com/the-opioid-epidemic-what-was-the-joint-commissions-role/
If opioids are so bad, why did the FDA approve of them in the first place? Are you aware that it costs upwards to $900 million dollars to get a drug approved by the FDA in the U.S.? The process is terribly expensive and rigorous. Now we are going to ask the FDA how they screwed up so badly after $900 million dollars were spent in trials? Does anybody really believe that pharmaceutical companies strive to make drugs that hook people? Pfizer caught lightning in a bottle with Viagra (Lily followed with Cialis) but major firms are not lining up to introduce the latest opioid.
The last time I checked, a Rx was required for just about any kind of medicine. Those drugs on the street got there because a Doctor wrote a script, somebody filled it and then sold it. There are scores of controlled substances legally prescribed in the U.S. every day. The Doctor is supposed to be the gatekeeper.
If you read the link to the news article Dr Clark is referring to, you will find that the bust was for 118 POUNDS of the drug. No doctor script book involved here, the “drugs on the street” in this story came from illicit drug labs, which is a problem many orders of magnitude greater than crooked doctors writing bad scripts.
Fentanyl, along with other opioids, are great drugs when used in the proper setting, and for their intended purpose. Alcohol is a wonderful thing, when used for its intended purpose. Unfortunately, people have found ways to use these things outside their intended purpose. Is it the fault of pharmaceutical companies? I don’t believe so. It is rather the fault, as Dr. Clark pointed out, people seeking a purpose and meaning to life. Viagra was originally developed as a blood pressure medication, but had an unintended side effect. Depraved humans found a way to make a buck off it. People will find ways to abuse anything that brings a fleeting pleasure, even if death is an unintended consequence. Outside of Christ, life is meaningless and without purpose. Let us pray that those who are dead in spirit find their way to life in Christ. Let us be thankful that we have been blessed with drugs to ease our pain in horrible traumatic incidents. But use them in the intended manner, not as a feel good fix to a broken empty life.
Would Americans have taken Fentanyl in 1943 had they had the opportunity? YES.
Heroin: The Great Depression and World War ll. “With established smuggling pipelines and a comprehensive distribution system in place in American cities, dealers began doing a brisk heroin business in the early 1930s. They likely would have expanded their sales substantially throughout the decade of the Great Depression —a worldwide economic slump—hadn’t interrupted their plans. The economic hardship of the Depression postponed further spread of heroin use since money for the purchase of the drug was largely unattainable by any means.
Further, World War ll brought international drug traffic to a complete halt. Wartime border security measures an a shortage of ordinary commercial shipping made it nearly impossible for traffickers to smuggle heroin into the United States. As a result of all this, American addicts were forced to undergo involuntarily withdrawal, and by the end of World War ll the American addict population had dropped to less than 20,000. In fact, as the war drew to a close, there was every reason to believe that the scourge of heroin had finally been purged from the United States. By the time the war ended in 1945, consumer demand for the drug was the lowest it had been in fifty years. Supplies were nonexistent, and international criminal syndicates had fallen into disarray. Within several years, however, criminal syndicates had regrouped. The estimated 20,000 active addicts at the war’s close in 1945 nearly tripled by the decades end.”
100% of the precursor chemicals to make Fentanyl come from China into Mexico, and the major drug trafficking into the United States is from Mexico. Unless the stream of precursor chemicals is interrupted ( drug traffic was completely halted during WW2 by border security) Mexican cartels are capable of producing more than enough of the drug. In this way, Fentanyl mirrors meth. In both cases, halting the flow of the precursor is the key to halting the manufacture.
The root of the problem is the total depravity of human beings alienated from God, and without hope, following after Satan’s promise of happiness through self-gratification by disobeying God’s law. Eph. 2: 12 The junkie and the pusher will break any and all of the commandments of God for the money and the fix.