Opioids, a Mass Killer We’re Meeting With a Shrug

About as many Americans are expected to die this year of drug overdoses as died in the Vietnam, Iraq and Afghanistan wars combined

Nicholas Kristof

Credit Dominick Reuter/Agence France-Presse — Getty Images

For more than 100 years, death rates have been dropping for Americans — but now, because of opioids, death rates are rising again. We as a nation are going backward, and drug overdoses are now the leading cause of death for Americans under 50.

“There’s no question that there’s an epidemic and that this is a national public health emergency,” Dr. Leana Wen, the health commissioner of Baltimore, told me. “The number of people overdosing is skyrocketing, and we have no indication that we’ve reached the peak.”

Yet our efforts to address this scourge are pathetic.

We responded to World War II with the storming of Normandy, and to Sputnik with our moon shot. Yet we answer this current national menace with … a Republican plan for health care that would deprive millions of insurance and lead to even more deaths!

More on President Trump’s fumbling of this problem in a moment. But it’s bizarre that Republicans should be complacent about opioids, because the toll is disproportionately in red states — and it affects everyone.

Mary Taylor, the Republican lieutenant governor of Ohio and now a candidate for governor, has acknowledged that both her sons, Joe and Michael, have struggled with opioid addiction, resulting in two overdoses at home, urgent calls for ambulances and failed drug rehab efforts. Good for her for speaking up.

It should be a national scandal that only 10 percent of Americans with opioid problems get treatment. This reflects our failed insistence on treating opioids as a criminal justice problem rather than as a public health crisis.

A Times investigation published this month estimated that more than 59,000 Americans died in 2016 of drug overdoses, in the largest annual jump in such deaths ever recorded in the U.S. One reason is the spread of fentanyl, a synthetic opioid that is cheap and potent, leading to overdoses.

Another bad omen: As a nation, we’re still hooked on prescription painkillers. Last year, there were more than 236 million prescriptions written for opioids in the United States — that’s about one bottle of opioids for every American adult.

Even with all that’s at stake, there are three reasons to doubt that Trump will confront the problem.

First, Trump and Republicans in Congress seem determined to repeal Obamacare, which provides for addiction treatment, and slash Medicaid. The Congressional Budget Office estimated that the G.O.P. House plan would result in an additional 23 million Americans being uninsured in a decade — and thus less able to get drug treatment. Other, more technical elements of the G.O.P. plan would also result in less treatment.

Second, Tom Price, the secretary of health and human services, last month seemed to belittle the medication treatments for opioid addiction that have the best record, and Attorney General Jeff Sessions still seems to think we can jail our way out of the problem.

Third, Trump’s main step has been to appoint Gov. Chris Christie of New Jersey to lead a task force to investigate opioid addiction. But we needn’t waste more time investigating, for we know what to do — and in any case Christie talks a good game but bungled the issue in his home state.

Among experts, there’s overwhelming evidence of what works best: medication in conjunction with counseling. This doesn’t succeed in every case, but it does reduce deaths and improve lives. It also saves public money, because a result is fewer emergency room visits and inpatient hospital stays. So the question isn’t whether we can afford treatment for all people fighting addiction, but whether we can afford not to provide it.

The bottom line is that we need a major national public health initiative to treat as many Americans abusing drugs as possible, with treatment based on science and evidence. We also need to understand that drug overdoses are symptoms of deeper malaise — “deaths of despair,” in the words of Anne Case and Angus Deaton of Princeton University, stemming from economic woes — and seek to address the underlying issues.

Above all, let’s show compassion. Addiction is a disease, like diabetes and high blood pressure. We would never tell diabetics to forget medication and watch their diets and exercise more — and we would be aghast if only 10 percent of diabetics were getting lifesaving treatment.

Innumerable people with addictions whom I’ve interviewed haunt me. One was a nurse who became dependent on prescription painkillers and was fired when she was caught stealing painkillers from a hospital. She became homeless and survived by providing sex to strangers in exchange for money or drugs.

She wept as she told me her story, for she was disgusted with what she had become — but we as a society should be disgusted by our own collective complacency, by our refusal to help hundreds of thousands of neighbors who are sick and desperate for help.

Syrian Patriarch: The West Abandoned Christians for Oil

The Patriarch of Antioch accused Western countries

of hypocrisy in their fight against Islamist extremism

by caring about oil more than refugees.

BY ELLIOT FRIEDLAND Sun,


An oil truck. (Photo: © Creative Commons/Brett Jordan)

A senior Syrian priest accused Western countries of abandoning their principles and allowing Islamist extremists to massacre Christians in the Middle East because they are blinded by their lust for oil, according to the Christian media outlet Crossmap.

Patriarch Ignatius Joseph III Younan of the Syriac Catholic Church of Antioch made the remarks to a meeting of the Knights of Columbus in Toronto.

"We have to understand that totalitarianism based on Islamic creed is the worst among all systems of government. Yes, my friends, the very survival of Christians in the cradle of Christianity is quite in danger," the patriarch said.

"Why shall we wonder at the rise of the Islamic State or its new 'Caliphate,' when these 'allied rich countries' - with among the most retrograde systems of government - continue to channel funding and weapons to terrorists spreading hatred and committing barbaric atrocities in the name of a religion?" he asked, referring to Saudi Arabia.

He directly attacked the West's funding of Syrian rebel militia groups saying, "We, the Church pastors, kept warning Westerners who pretended to have the right to interfere in Syria in the name of democracy, that fomenting violence would surely lead to terrible sectarian war because of the complex religious and ethnic diversity in Syria. We knew innocent people, primarily Christians and minorities, would suffer most."

He also blasted Western support of Saudi Arabia, quoting New York Times Columnist Nicholas Kristof, who said,"For decades, Saudi Arabia has recklessly financed and promoted a harsh and intolerant Wahhabi version of Islam around the world in a way that is, quite predictably, producing terrorists."

"You can't be allied with regimes that discriminate or do not accept the religious freedom of non-Muslims" he asserted. "It's not honest or sincere to be allied to such a regime, and [then] to say we have an annual report about religious freedom."

Saudi Arabia does not allow any non-Muslim to enter the Muslim holy city of Mecca. Churches are forbidden and leaving Islam is punishable by death. Women are not allowed to drive or perform a host of other basic tasks without the permission of their male guardian, their father, husband, brother or occasionally son.

Also, we should note that Saudi Arabia is funding the construction of many, many mosques all over the west.

The Patriarch is right to attack the West for supporting regimes that promote Islamist extremism while it attempts to cope with that very same problem. Without directly tackling the Saudi regime, which funds its totalitarian vision of Wahhabist Islam worldwide, measures to address radical Islam will be addressing the symptoms rather than the cause.

A Confession of Liberal Intolerance

Nicholas Kristof NYTimes


WE progressives believe in diversity, and we want women, blacks, Latinos, gays and Muslims at the table — er, so long as they aren’t conservatives.

Universities are the bedrock of progressive values, but the one kind of diversity that universities disregard is ideological and religious. We’re fine with people who don’t look like us, as long as they think like us.

O.K., that’s a little harsh. But consider George Yancey, a sociologist who is black and evangelical.

“Outside of academia I faced more problems as a black,” he told me. “But inside academia I face more problems as a Christian, and it is not even close.”

I’ve been thinking about this because on Facebook recently I wondered aloud whether universities stigmatize conservatives and undermine intellectual diversity. The scornful reaction from my fellow liberals proved the point.

“Much of the ‘conservative’ worldview consists of ideas that are known empirically to be false,” said Carmi.

“The truth has a liberal slant,” wrote Michelle.

“Why stop there?” asked Steven. “How about we make faculties more diverse by hiring idiots?”

To me, the conversation illuminated primarily liberal arrogance — the implication that conservatives don’t have anything significant to add to the discussion. My Facebook followers have incredible compassion for war victims in South Sudan, for kids who have been trafficked, even for abused chickens, but no obvious empathy for conservative scholars facing discrimination.

The stakes involve not just fairness to conservatives or evangelical Christians, not just whether progressives will be true to their own values, not just the benefits that come from diversity (and diversity of thought is arguably among the most important kinds), but also the quality of education itself. When perspectives are unrepresented in discussions, when some kinds of thinkers aren’t at the table, classrooms become echo chambers rather than sounding boards — and we all lose.

Four studies found that the proportion of professors in the humanities who are Republicans ranges between 6 and 11 percent, and in the social sciences between 7 and 9 percent.

Conservatives can be spotted in the sciences and in economics, but they are virtually an endangered species in fields like anthropology, sociology, history and literature. One study found that only 2 percent of English professors are Republicans (although a large share are independents).

In contrast, some 18 percent of social scientists say they are Marxist. So it’s easier to find a Marxist in some disciplines than a Republican.


George Yancey, a sociology professor, says he has faced many problems in life because he is black, “but inside academia I face more problems as a Christian, and it is not even close.” Credit Nancy Newberry for The New York Times

The scarcity of conservatives seems driven in part by discrimination. One peer-reviewed study found that one-third of social psychologists admitted that if choosing between two equally qualified job candidates, they would be inclined to discriminate against the more conservative candidate.

Yancey, the black sociologist, who now teaches at the University of North Texas, conducted a survey in which up to 30 percent of academics said that they would be less likely to support a job seeker if they knew that the person was a Republican.

The discrimination becomes worse if the applicant is an evangelical Christian. According to Yancey’s study, 59 percent of anthropologists and 53 percent of English professors would be less likely to hire someone they found out was an evangelical.

“Of course there are biases against evangelicals on campuses,” notes Jonathan L. Walton, the Plummer Professor of Christian Morals at Harvard. Walton, a black evangelical, adds that the condescension toward evangelicals echoes the patronizing attitude toward racial minorities: “The same arguments I hear people make about evangelicals sound so familiar to the ways people often describe folk of color, i.e. politically unsophisticated, lacking education, angry, bitter, emotional, poor.”

A study published in The American Journal of Political Science underscored how powerful political bias can be. In an experiment, Democrats and Republicans were asked to choose a scholarship winner from among (fictitious) finalists, with the experiment tweaked so that applicants sometimes included the president of the Democratic or Republican club, while varying the credentials and race of each. Four-fifths of Democrats and Republicans alike chose a student of their own party to win a scholarship, and discrimination against people of the other party was much greater than discrimination based on race.

“I am the equivalent of someone who was gay in Mississippi in 1950,” a conservative professor is quoted as saying in “Passing on the Right,” a new book about right-wing faculty members by Jon A. Shields and Joshua M. Dunn Sr. That’s a metaphor that conservative scholars often use, with talk of remaining in the closet early in one’s career and then “coming out” after receiving tenure.

This bias on campuses creates liberal privilege. A friend is studying for the Law School Admission Test, and the test preparation company she is using offers test-takers a tip: Reading comprehension questions will typically have a liberal slant and a liberal answer.

Some liberals think that right-wingers self-select away from academic paths in part because they are money-grubbers who prefer more lucrative professions. But that doesn’t explain why there are conservative math professors but not many right-wing anthropologists.

It’s also liberal poppycock that there aren’t smart conservatives or evangelicals. Richard Posner is a more-or-less conservative who is the most cited legal scholar of all time. With her experience and intellect, Condoleezza Rice would enhance any political science department. Francis Collins is an evangelical Christian and famed geneticist who has led the Human Genome Project and the National Institutes of Health. And if you’re saying that conservatives may be tolerable, but evangelical Christians aren’t — well, are you really saying you would have discriminated against the Rev. Martin Luther King Jr.?

Jonathan Haidt, a centrist social psychologist at New York University, cites data suggesting that the share of conservatives in academia has plunged, and he has started a website, Heterodox Academy, to champion ideological diversity on campuses.

“Universities are unlike other institutions in that they absolutely require that people challenge each other so that the truth can emerge from limited, biased, flawed individuals,” he says. “If they lose intellectual diversity, or if they develop norms of ‘safety’ that trump challenge, they die. And this is what has been happening since the 1990s.”

 Should universities offer affirmative action for conservatives and evangelicals? I don’t think so, partly because surveys find that conservative scholars themselves oppose the idea. But it’s important to have a frank discussion on campuses about ideological diversity. To me, this seems a liberal blind spot.

Universities should be a hubbub of the full range of political perspectives from A to Z, not just from V to Z. So maybe we progressives could take a brief break from attacking the other side and more broadly incorporate values that we supposedly cherish — like diversity — in our own dominions.