David Dodwell

Outside In | How the US opioid crisis and trade dispute with China have echoes in 19th-century history

David Dodwell says Donald Trump is justified in declaring war on the opioid crisis but he cannot expect quick results to a problem 150 years in the making

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OxyContin pills are among those being overprescribed by doctors in the US, leading to what has been dubbed the opioid crisis. Photo: LA Times

David Dodwell

Published: 3:00pm, 29 Jun 2018Updated: 10:30pm, 29 Jun 2018

I find it difficult to get my head around America’s opioid crisis. It is hard not to be alarmed by reports of more than 300,000 Americans dying since 2000 from abuse of prescription opioids – more than deaths in car accidents, or from gun violence.

After declaring a national emergency last October, with substantial new funding to tackle the crisis, President Donald Trump said at a rally in March: “Together, we will end the scourge of drug addiction in America once and for all. We will win. We will beat it. We’ll be kind. We’ll be loving. We’ll do whatever we have to do. But we’re going to win.”

Brave words, but scratch the surface, and the issue becomes murkier, with some fascinating serendipitous side stories that link frequently back to China. Awful though the story of opioid abuse is, it seems it is neither especially unusual, nor new.

Certain aspects of the crisis seem genuinely new. A large proportion of victims are men in predominantly white parts of middle America. Much of the problem comes not from underground criminal gangs, but from painkillers being prescribed by the country’s doctors. And the drug Fentanyl – mostly imported from China, 50 times stronger than morphine, and more typically useful in knocking out a rhinoceros with toothache than a person with back pain – is playing an alarming role.

But much of the problem has ancient roots – and many intriguing connections to China. While it was Britain that played the largest role in addling China’s population with opium up to and through the Opium Wars, American merchants like Russell & Company were plentiful in grabbing a share of the profits from the opium trade.