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My feature topic this week, technology’s role in America’s drug crisis, may be inappropriate for young or sensitive ears. Listener discretion is advised.

Whether you or a loved one are recovering from addiction or, in the worst-case scenario, grieving from the loss of someone you know, this elephant sits quietly in the corner of every American living room. Overdose deaths are the number one killer of Americans under the age of 50. The number of overdose deaths in the United States has grown from about 16,000 in 1999 to over 70,000 in 2017. That’s 12,000 more people dead in one year than all the American casualties during the entire Vietnam war. Over that 18-year period, more than 300,000 people were lost to drug overdoses. Drug Abuse | The Vietnam War

Illegal drug sales are a huge business and like any business it looks for ways to maximize profits and drive down costs. The internet has played a small role in increasing these disheartening numbers. Dark web marketplaces like the Silk Road, Silk Road 2, and Dream Market have all contributed to the ease with which addicts can get their drug of choice. But what happens when the supply runs low?

Drugs are mixed with easily made alternatives like Fentanyl. Fentanyl is a legal drug that was designed in 1959 for anesthetic use and over the next five decades became available in a wider variety of forms including pills and patches for chronic pain treatment. The common availability of the ingredients and the ease of making it makes fentanyl an ideal option for cutting other drugs, even drugs that don’t have a sedative effect like heroin. Vice | Rapid Response Industrial Group | News-Herald

Just this month, a popular seller on the dark web called sinmed, was taken down by a federal joint task force. Sinmed was in the top 3 percent of vendors on Dream Market. The trio behind the screenname were caught after shipping more than 1,000 packages to buyers in 43 states. Once the indictment was unsealed, it was revealed the group had laundered more than 2.3 million dollars in cryptocurrency and were sitting on an inventory of about half a million Xanax pills they’d cut, stamped, and bottled themselves. There was also a significant amount of fentanyl-laced heroin and other assorted drugs on the premises. Wired

But there’s more to this epidemic than just death statistics and drug dealers. Laws and social attitudes cause the issues that lead to illegal drug use. The US’s war on drugs has been a long fought and resounding failure. A modern prohibition that has worked as well as alcohol prohibition in the 1920’s. The drug war started with the criminalization of marijuana and heroin by President Nixon and his Chief Domestic Advisor John Ehrlichman who saw the anti-war left and pro-civil rights blacks as enemies of the White House. President Reagan further criminalized non-violent drug offenses with policies that saw the country’s incarceration rate skyrocket. These policies continued through George H.W. Bush and Bill Clinton’s presidency, despite Clinton’s advocacy of treatment over incarceration during his 1992 campaign. CNN | Drug Policy.org

When a nation has become so deeply entrenched in the vilification of drug dealers and users, how do you get out of it? Portugal’s answer, in 2001, was decriminalization. Portugal abolished all criminal penalties for personal possession of drugs. A 2009 study by the libertarian think-tank the Cato Institute concluded that the policies were a resounding success. Illegal drug use among teens was down, rates of new HIV and hepatitis infections dropped, and the number of people seeking treatment doubled. That last point is the real key: it means drug users were no longer shamed and driven underground. Time | The Guardian

The internet didn’t start this epidemic. Opioids have been used and abused for over two hundred years; morphine was invented in 1803 and marketed by the German pharmaceutical company Merck. The invention of the hypodermic needle in 1853 meant an easier, quicker delivery of pain relief. It’s been estimated that by the end of the 1860’s 400,000 male veterans of the US Civil War were addicted to opioids. Smart Drug Policy

That also means ineffective drug policies didn’t start the current health crisis. So, what did? A combination of ease of access, policies that shamed, compassionate but misguided doctors, and a public uneducated about the warning signs of addiction. Doctors did their best to ease the pain and suffering of millions of patients with opioids. Many patients took those opioids and found the associated relief of physical and mental anguish addictive. New York Times

So, how can we, as a nation, address the issue? It requires a complex, multi-faceted approach. President Trump took a positive step in August of 2017 by declaring the opioid epidemic a national emergency, but more needs to be done on the legislative side. Pre-emptive education to reduce the likelihood of addiction is a necessary goal. Addiction often results from trauma such as difficult family situations or childhood physical, sexual, or emotional abuse. Exposure to alcohol and drug abuse as a child and family histories of addiction can also increase the likelihood of becoming an addict as an adult. Educational campaigns on social media coupled with informational apps can be helpful on this front. Twin Lakes Recovery Center | Positive Choices

Treatment over incarceration would be a big step in reducing the stigma around finding and getting help. This point is critical to save those who are currently caught in the addictive cycle.

Finally, in the interim until these previous two suggestions can be implemented, additional resources both on and offline can be used to reduce the chances of overdose deaths. I reported back in January on an app developed by researchers at the University of Washington that can turn a smartphone into a breathing rate monitor to detect when an opioid user is on the precipice of an overdose. This sort of technology coupled with safe injection sites where users can go to be monitored while using can dramatically decrease the instances of overdose deaths. Engadget

Using data-driven, science-based approaches to solve problems is key, especially when the problem is as large as this national health crisis.

Alright, that was really heavy, let’s wrap up this episode with some good news.