Whiteness, Scapegoating, and Scarcity: Medicalizing ‘the US Opioid Crisis’

Katherine Pettus

doi:10.31389/jied.62

Abstract

This paper characterizes the successful civil lawsuits brought by sub-national units of government in the US against multinational pharmaceutical companies to recover the costs of public expenditures (goods and services) incurred as they attempt to manage the ‘opioid crisis,’ as a scapegoating strategy whose function is to deflect attention from the governance failures that allow corporate colonization of the public sphere and rescue the moribund privileges of whiteness enjoyed by the ‘blue collar aristocracy’ until neoliberal globalization rendered them obsolete. Recent drops in white life expectancy, which are associated with chronic diseases and non-medical opioid use, map onto high unemployment and under-employment rates in formerly prosperous communities, now fodder for populist political campaigns. Criminalizing the pharmaceutical companies and executives for peddling prescription medicines to inadequately trained (in the treatment of pain) physicians — some of whom prescribed opioids inappropriately to (majority white) patients/consumers, some of whom developed addictions, and/or poisoning following non-medical use or consumption with alcohol or illicit substances —medicalizes the white opioid crisis and identifies consumers as victims. This distinguishes them from the Americans of color whose ‘drug use’ has been criminalized, who have been disproportionately arrested, and sentenced to long periods of incarceration that entail the loss of civil and political rights, including the right to vote. White elites staked out the ‘color line’ before the Founding, perpetuating it through various scapegoating and ‘shapeshifting’ strategies to the present day. The lawsuits are only the most recent iteration of a morally bankrupt carceral state.

Highlights

Prior to coronavirus lockdown restrictions, US civil courts were awarding millions of dollars in compensatory damages to state, local, and tribal governments that successfully sued global pharmaceutical companies for allegedly perpetrating the latest ‘opioid crisis’ on their constituencies (McCollum 2019)
This paper argues that the opioid crisis litigation strategy and associated narrative of pharmaceutical venality, scapegoats the pharmaceutical industry for the consequences of globalization-induced governance failures that breach the Racial Contract for all but the governing and corporate elites (Mills 2014)
Scapegoating industry for the harmful use of prescription medicines, rather than holding the state, whose job it is to regulate those industries and protect the health of populations, accountable for the current opioid crisis, will not remedy the longstanding structural inequalities in the American body politic originally configured by ethnic cleansing, racial slavery, and herrenvolk democracy (Van den Berghe 1978)

Summary

Introduction

Prior to coronavirus lockdown restrictions, US civil courts were awarding millions of dollars in compensatory damages to state, local, and tribal governments that successfully sued global pharmaceutical companies for allegedly perpetrating the latest ‘opioid crisis’ on their constituencies (McCollum 2019). Always framed as a scarce resource, which by definition excludes those who lack it, its beneficiaries maintained the hereditary privilege it conferred by scapegoating those denied it This strategy loses its viability when what was the white American working (‘under’) class finds itself on the same underprivileged side of the tracks as communities of color that have always been exploited and abandoned by governing elites. It is one thing for racially marginalized and criminalized populations in the US to suffer from lack of recognition of their essential human dignity and rights to the social and economic determinants of health, and quite another for the postindustrial white working class to experience the consequences of damaged status and a crisis of recognition (Fleming 2014). The paper concludes with speculation on how the paraclete (the advocate) might end the pathological cycle of US scapegoating once and for all, in the context of the current COVID-19 pandemic (which has exposed the lethal heat map of American health inequities) and the raging US movement for racial justice in the wake of the murder of George Floyd in Minneapolis

Scapegoating theory and practice

American Scapegoating and the New Poverty of Whiteness

Status Recognition and Damaged Identities