Is Media Coverage of the Opioid Crisis Making It Worse?

The long history of drug scare journalism sank to a new low recently with a photo from Ohio posted to social media. Chances are, you’ve seen it: a couple, both of whom have allegedly overdosed, lying comatose in the front seats of a car while a toddler strapped into a car seat can be seen in the back. The East Liverpool Police Department in Ohio explained their decision to share the shocking image in a Facebook post: “It is time that the non drug using public sees what we are now dealing with on a daily basis… This child can’t speak for himself but we are hopeful his story can convince another user to think twice about injecting this poison while having a child in their custody.” Predictably, the photo appeared in hundreds of news stories from across North America and around the world, and has been shared tens of thousands of times. And just a week ago, CNBC published an article with the catchy headline “An elephant sedative is causing a drug overdose epidemic,” explaining that this is “a sign of a shift from heroin to synthetic opioids, which can be far more potent and dangerous.”

The intention with these and many other stories about drugs is to protect people (and maybe get clicks). But headlines like these only serve to reinforce a narrative that’s been ingrained into our media culture: Drug crises are unpredictable, dangerous, and can only be dealt with with the firm hand of the criminal justice system. But by focusing on the latest pop-up drug crisis, they miss the bigger picture about why these crises are happening in the first place.

I am an addictions epidemiologist, which means that I research the impact of drug use across populations. So I am aware, probably more than most, that drug use is almost never entirely safe. And yes, there are lots of really potent drugs out there that seem to have come out of nowhere, like fentanyl—which is responsible for thousands of fatal overdoses in Canada and the United States in the past few years— and which people should be rightly cautious about using. The media has a responsibility to cover these stories and emphasize the dangers inherent in drug use. But our relentless focus on the immediate “drug crisis” of the day, be it fentanyl, bath salts, or crack, obscures the real reason why we as societies are continually being flooded with new, more dangerous drugs.

Drugs like bath salts or street fentanyl don’t just simply show up in a city one day. Instead, increases in production and trafficking of one drug are usually a response to pressures on another part of a drug market. Take fentanyl. After news reports came out in Canada that OxyContin, a pharmaceutical grade opioid, was being over-prescribed by doctors and leading to addiction and overdose, the Canadian government took action. In 2012, OxyContin was taken off the market and police worked to get it off the street. The result? A drug policy success: the use of OxyContin in Canada plummeted.

But then, just as the OxyContin crisis was waning, a new one emerged: fentanyl. Suddenly, the days of Oxy, when you had a decent sense of what was in that pill you were taking, looked pretty good. But why did we see fentanyl use emerge just as OxyContin was receding? With less access to OxyContin, people who were dependent on the drug switched to the next most available—but much more dangerous—option.

This phenomenon isn’t just a one-off. Under alcohol prohibition, for instance, when beer and wine production was strictly forbidden, people turned to more potent and deadly forms of alcohol like bathtub gin and industrial alcohol, resulting in thousands of deaths by poisoning. In 2001, a massive drop in the availability of heroin in Australia resulted in thousands of people switching from heroin to crystal meth use. More recently, the production of bath salts and synthetic cannabis products like Spice can be traced back to ongoing government efforts to schedule psychotropic substances as dangerous (and therefore illegal). If drug traffickers produce new drugs like bath salts, though, they can circumvent existing drug laws until policymakers catch up with new legislation. The catch is that this system constantly incentivizes the production of new and often more dangerous drugs.

All of this leads to an obvious question: Would we have been better off if the government hadn’t intervened in the first place? The answer, I think, is a resounding yes. But more importantly, we have to look at why there’s always so much support for cracking down on the next major drug crisis using the blunt hammer of prohibition, be it with grain alcohol, bath salts, or fentanyl. And a lot of the blame, in my mind, lies with how they are covered by the media. Sensationalistic stories about the danger of drugs and the lack of morality of people who are drug-dependent feed the myth that we need to crack down, either by stopping the supply of drugs or by punishing people who use them. Publishing an image of two opioid-dependent parents passed out in a car with a toddler in the backseat is the perfect example of this phenomenon: It elicits a gut reaction that makes us feel like we need justice and protection in equal measures. When we read headlines stating that drugs are more dangerous than they’ve ever been [Editor’s note: Which to be fair, VICE has done and stands by], we feel like we’re under siege. And when you’re in the midst of a battle, you can’t stop and think about why the war is happening in the first place.

Ending these pop-up drug crises means crafting policies that stabilize drug markets rather than incentivize the production and trafficking of new drugs. It means thinking about how, if people are going to use drugs (which they are), we can help them use less harmful ones in less dangerous ways. That story hasn’t, by and large, been told yet. But it’s a story that needs to get out there so that we can stop fighting drug war skirmishes and move on to a lasting peace.

Dan Werb, PhD, is an assistant professor in the Division of Global Public Health at the University of California San Diego, and Director of the International Centre for Science in Drug Policy.