The Opioid Epidemic in the United States: Missed Opportunities and Policy Failures by Kant B. Patel and by Mark E. Rushefsky

Abstract

The current opioid epidemic is a multifaceted phenomenon with no easy solutions in sight. With this text, Kant B. Patel and Mark E. Rushefsky provide a relatively comprehensive look at the development of the current crisis and the various efforts to combat it, with a keen eye towards the titular failures and oversights of government at all levels. The authors use a policy process frame throughout the book, making it appropriate for adoption in courses on drug policy or the policy process in general. Despite a few notable omissions, the book is thorough and appropriate for a variety of audiences. After setting out the policy process they use to frame the rest of the text, the authors begin in chapters 2 and 3 by reviewing the country’s first two opioid epidemics, the first in the late nineteenth century and the second beginning in the 1960s. In the first, blame lies primarily with little or no restrictions on opium imports and sales, allowing the expanded use of smoking opium and eventually allowing morphine and heroin to take root. Early efforts to combat these drugs included ineffective bans on imports, new regulations on the packaging and sale of narcotics, and new taxes such as the Harrison Act of 1914. Later during the second epidemic, efforts to curb a growing heroin epidemic centered on returning veterans from Vietnam as well as urban, poor, and Black neighborhoods. Ultimately, this second wave of efforts to combat opioid use led to the War on Drugs, which the authors rightly characterize as a policy failure in theory, as it was certainly effective in its enforcement, evident in skyrocketing incarceration rates and police budgets.