edited by Paulina Lucio Maymon
Over the past decade, Mexico and the United States have experienced a heroin epidemic that might not be easily solved. An estimated 914,000 people reported using heroin in the past year in the United States, causing the death of over 47,000. In almost ten years, the number of users of this drug increased at an alarming 145 percent. In the same period, Mexico’s cultivation of opium poppy―from which heroin is produced―has consistently grown, and Mexican cartels have become the main suppliers of heroin in the United States. How can the rapid increase of demand and supply of the drug be explained? Most importantly, how can it be solved?
According to international organizations and national authorities in Mexico and the United States, there are three different and unrelated policies in both sides of the border that catalyzed the new heroin trends and dynamics: First, the United States imposed stricter requirements to obtain prescriptions for opioid painkillers, causing an increase in the demand for heroin, which is a natural substitute for opioids given that it produces similar effects in the body. Second, due to the escalation of violence in Mexico’s cities, the National Army was diverted from the countryside to urban areas, allowing for the production of opium poppy to flourish. Third, the legalization of marijuana for recreational and medical purposes in some parts of the United States has pushed Mexican cartels to diversify their incomes through the trafficking of more profitable drugs.
Additionally, there is some preliminary evidence that people´s socioeconomic status, income, and education level may be related to opioid problems. For instance, patients with higher education levels are three times less likely to receive an opioid medication prescription than those with lower education levels. Furthermore, among white young adults—the group with the fastest increasing consumption of opioids in the United States―the overdose death rate rose faster for the less educated between 2009 and 2014. It rose by 23 percent for those without a high school education, compared with only 4 percent for those with a college degree or more. In other words, it is possible to infer that the lesser socieconomic opportunities that people have, the most likely it is for them to start using opioids.
Assuming that the three aforementioned policies and the lack of opportunities as a result of socioeconomic status are in fact the causes of the heroin epidemic, the solution would not be easy, neither impossible. Before suggesting any solution it is fundamental to explain the policies that have catalyzed an increase of demand and supply of heroin.
Stricter requirements to obtain prescriptions for opioid painkillers in the United States
The first policy that allegedly created an increase of demand of heroin in the United States was the creation and adoption of Prescription Drug Monitoring Programs (PDMPs) nationwide. PDMPs were developed by state governments to prevent drug abuse and diversion of prescription medications through electronic databases that collect dispensing and prescribing information on specified substances, including legal opioid painkillers such as Vicodin and OxyContin. PDMPs were adopted by almost every state in the country because “an estimated 1.9 million Americans now abuse or are dependent on legal opioids.” Nevertheless, despite the intention of the policy to prevent the abusive consumption of opioid painkillers, addicts shifted to heroin, which is now easier and cheaper to obtain than prescription drugs and has similar effects to those medications. According to the National Institute of Drug Abuse, nearly half of the people who inject heroin in the United States reported abusing prescription opioids prior to using heroin (See Figure 1).
Mexico’s decision to divert the National Army from the countryside to urban areas
On December 11, 2006, ten days after his Inauguration Day, Mexico’s former President, Felipe Calderón, ordered the deployment of more than 5,000 soldiers to the state of Michoacán, in whose main cities organized crime had gotten out of control. As some pundits have observed “one of the many unintended consequences of Mexico’s war on organized crime in urban hotspots was that the army was diverted from poppy eradication in the countryside.” Such diversion resulted in a diminished capacity of the State to monitor and eradicate illicit crops. In 2006, an estimated 5,000 hectares of opium poppy were cultivated in Mexico; by 2009, the cultivation area of opium poppy almost quadrupled, reaching 19,500 hectares. After 2009, there was a consistent three-year decrease, probably attributed to the inclement droughts which devastated crops of every kind during that period. Nevertheless, since 2013, the cultivation has continued to grow. Opium poppy cultivation reached the highest point in Mexico’s history with an estimated 24,800 hectares in 2015 (See Figure 2).
Legalization of marijuana for recreational and medical use in the United States
Alaska, Colorado, Oregon, Washington, the District Columbia, and most recently California, Nevada, and Massachusetts have voted in favor of legalizing the use of marijuana for recreational purposes. Additionally, cannabis can be legally acquired for medical reasons in many other states (See Figure 3). Such policies seem to have created an unexpected imbalance for the Mexican cartels, which are now trafficking less cannabis and more heroin into the United States. It is possible to infer from the decrease of marijuana seizures in the U.S.-Mexican border that the traffic of cannabis is no longer as profitable as it was some years ago. In part, this phenomenon is explained because American cannabis users can buy it now legally in the United States. As a matter of fact, the legalization of cannabis in the United States has created the unexpected consequence of having high-quality American marijuana being trafficked into Mexico.
Considering the aforementioned situation, Mexican cartels have been pushed to traffic more heroin into the United States to compensate from their losses on cannabis. American authorities have implied that the increase of heroin use in the United States “is being driven by the increasing availability of heroin in the U.S. market.” Meanwhile, the Mexican government claims that in every economic market, the supply always responds to the demand, not otherwise.
Further steps to stop the heroin epidemic
The heroin problem represents a common and shared responsibility for Mexico and the United States. It has caused severe impacts in the health and public security of both American and Mexican citizens. Therefore, it is a problem that must be addressed bilaterally through effective and increased cooperation. During the last meeting between President Obama and President Peña Nieto of Mexico, on July 22, 2016, both mandataries agreed to work jointly to improve the prevention of heroin use, to reduce the availability of poppy cultivation and heroin production, to secure the border, to strengthen law enforcement, and to strengthen the observance of human rights. However, even if these good intentions were carried out by the new administration in conjunction with the Mexican government, they would only mitigate a problem whose complexity requires to be addressed from its roots.
Drug traffickers in Mexico and heroin users in the United States statistically have something in common: they generally represent a group of people that lacks socioeconomic opportunities. This lack of opportunities, has created in Mexico the notion that drug trafficking is the only way out of poverty. Meanwhile, in the United States, heroin is perceived as a “mitigator” for the disenchanting situation in which thousands of Americans live. Therefore, the main solution to reduce both the increases in supply and demand of heroin, is to invest in the regeneration of social fabric and to foster social mobility.
The lack of socioeconomic opportunities of both suppliers and consumers in Mexico and the United States, respectively, was the spark that ignited an epidemic that might not be easily quenched. Unless both governments regenerate the social fabric of their countries by prioritizing the creation of dignifying jobs, granting access to quality education and health, developing inclusion programs for underprivileged communities, and allowing social mobility based on merits, any other drug policy would be doomed to failure. It is moment for the Mexican and American governments to divert a fraction of the millions of dollars that are invested every year in law enforcement activities, to the development of social, cultural and urban policies. The solution to the heroin epidemic is more likely to be found in the creation of opportunities rather than in drug law enforcement.
References:
Centers for Disease Control and Prevention (CDC); Increases in Drug and Opioid Overdose Deaths: United States, 2000–2014; December 18, 2015; available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm?s_cid=mm6450a3_w (Accesed on October 24, 2016)
United Nations Office on Drugs and Crime (UNODC); World Drug Report 2016; available at http://www.unodc.org/doc/wdr2016/WORLD_DRUG_REPORT_2016_web.pdf (Accesed on October 24, 2016)
Drug Enforcement Administration (DEA); National Drug Threat Assesment 2015; available at https://www.dea.gov/docs/2015%20NDTA%20Report.pdf (Accesed on October 21, 2016)
Joynt, M., Train, M.K., Robbins, B.W., Halterman, J.S., Caiola, E., & Fortuna, R.J. (2013). The impact of neighborhood socioeconomic status and race on the prescribing of opioids in emergency departments throughout the United States. Journal of General Internal Medicine, 28(12). 1604-1610. As cited by Lauren Brande; Available at http://drugabuse.com/library/prescription-opioid-addiction/ (Accesed on November 17, 2016)
Platts-Mills, T.F., Hunold, K.M., Bortsov, A.V., Soward, A.C., Peak, D.A., Jones, J.S., … McLean, S.A. (2012). More educated emergency department patients are less likely to receive opioids for acute pain. Pain, 153(5). 967-973. As cited by Lauren Brande; Available at http://drugabuse.com/library/prescription-opioid-addiction/ (Accesed on November 17, 2016)
Gina Kolata & Sarah Cohen; Drug Overdoses Propel Rise in Mortality Rates of Young Whites; The New York Times, Published on January 16, 2016; available at http://www.nytimes.com/2016/01/17/science/drug-overdoses-propel-rise-in-mortality-rates-of-young-whites.html?_r=0 (Accesed on November 22, 2016)
Diversion Control Division (DCD), State Prescription Drug Monitoring Program; available at https://www.deadiversion.usdoj.gov/faq/rx_monitor.htm (Last update was on June, 2016. Accesed on October 23, 2016)
Healthcare Distribution Alliance (HDA); State Prescription Drug Monitoring Programs; available at https://www.healthcaredistribution.org/~/media/pdfs/government-affairs/position-statements/state-prescription-drug-monitoring-programs.ashx (Accesed on October 23, 2016)
Substance Abuse and Medical Health Services Administration (SAMHSA); Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health; September 2015; available at http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf (Accesed on October 21, 2016)
National Institute on Drug Abuse (NIDA); Drug Facts: Heroin; available at https://www.drugabuse.gov/publications/drugfacts/heroin (Last update was on October, 2014. Accesed on October 21, 2016)
Presidencia de la República de México; Anuncio sobre la operación conjunta en Michoacán; December 11, 2016; available at http://calderon.presidencia.gob.mx/2006/12/anuncio-sobre-la-operacion-conjunta-michoacan/ (Accesed on October 23, 2016)
The Economist; The Great American Relapse; November 22, 2014; available at http://www.economist.com/news/united-states/21633819-old-sickness-has-returned-haunt-new-generation-great-american-relapse (Accesed on October 21, 2016)
Servicio Meteorológico Nacional (SMN); Monitor de Sequía en México; available at http://smn.cna.gob.mx/es/climatologia/monitor-de-sequia/monitor-de-sequia-en-mexico; (Accesed on November 16, 2016)
Governing; State Marijuana Laws Map; available at http://www.governing.com/gov-data/state-marijuana-laws-map-medical-recreational.html (Accesed on November 16, 2016)
Steve Nelson; DEA: Cartels Now Smuggle U.S. Pot Into Mexico; US News; December 2, 2014; available at http://www.usnews.com/news/articles/2014/12/02/dea-cartels-now-smuggle-us-pot-into-mexico (Accesed on November 15, 2016)
United States Border Patrol; Sector Profile – Fiscal Year 2015; available at https://www.cbp.gov/sites/default/files/documents/USBP%20Stats%20FY2015%20sector%20profile.pdf (Accesed on October 21, 2016)
Drug Enforcement Administration (DEA); National Drug Threat Assesment 2015; available at https://www.dea.gov/docs/2015%20NDTA%20Report.pdf (Accesed on October 21, 2016)
Presidencia de la República, Mensaje del Presidente Felipe Calderón, August 26, 2011; available at http://calderon.presidencia.gob.mx/2011/08/mensaje-del-presidente-felipe-calderon/ (Accesed on August 26, 2011)
The White House, Office of the Press Secretary; Remarks by President Obama and President Peña Nieto of Mexico in Joint Press Conference, July 22, 2016; available at https://www.whitehouse.gov/the-press-office/2016/07/22/remarks-president-obama-and-president-pena-nieto-mexico-joint-press (Accesed on October 25, 2016)
