This story mentiones suicide. If you or someone you know is having suicidal thoughts, call or text the Suicide and Crisis Lifeline at 988.

All good people agree, 
And all good people say, 
All nice people, like Us, are We 
And everyone else is They.” — Rudyard Kipling

Opinion

To date, more than 230 people have been killed by our armed forces in the Caribbean. They were presumed to be drug smugglers, but there has been no process whatsoever to assess their guilt. How do we account for this outrage? Even the criminals slaughtered for entertainment in Rome’s Colosseum had been adjudicated. 

Human use of mood-altering substances and psychotropic drugs goes back thousands of years. After the Civil War, unregulated opiates flooded the country to treat the war wounded, and addiction became epidemic. Our government attempted to rein in this problem by passing the Harrison Narcotic Act in 1914. This federal law sharply reduced the legal supply of narcotics. This had the effect of making most attempts to obtain narcotics illegal, and created the problem of “those” people and “those” drugs. 

The furor over “those” people and “those” drugs reached a peak in 2023 when over 70,000 people in the U.S. died from fentanyl overdose. This led to the chapter of the “narcoterrorist” in our War on Drugs. However, this number is dwarfed by 178,000 deaths from beverage alcohol and 480,000 deaths from tobacco in the United States that year. 

In Wyoming that year, 50 people died from fentanyl overdose; 178 people died as a direct consequence of drinking alcohol; and indirect deaths from alcohol totaled 48 from alcohol-related motor vehicle accidents and 57 from suicide. One-third of people who died by suicide test positive for alcohol. The day after heavy drinking there is a seven-fold increase in suicidal behavior. 

A fundamental truth is that legality does not protect from lethality. The separation of mood-altering substances into legal and illegal has created a “them and us” construct. There are many problems with this construct, and the War on Drugs is a big one. So far this war has cost us $1 trillion with 60% going to incarceration, 20% to interdiction and 20% to treatment. 

A commonality between legal and illegal drugs is that human beings have feelings — physical and emotional. Some people use chemicals to alter these feelings. Not infrequently, they have problems with the chemicals they use. 

What you see in life often depends on where you sit. I possessed the unique perspective of a board-certified dermatologist who was also trained and certified in addiction medicine. I saw that there was little difference between people who had been using the wrong substance to treat an itch and made their problems worse, and those who treated their physical or emotional issues with mood-altering substances and made their problems much much worse. 

The solutions for the former were much easier. I became a voluntary combatant in this drug war in 1989, and was involved with community, tribal and professional treatment programs. I witnessed over and over the astounding similarities in the nature of the problems of addiction. Whether the drug is illegal or legal, upper, downer, all-arounder, whether the person is rich or poor, educated or not, white, black, Native American, it’s all the same. What differs most is the availability of support and treatment. The 80% of drug war dollars currently being spent on interdiction and incarceration are largely wasted. 

Interdiction addresses the supply side of this war. We hear that X tons of drugs and XX dollars are seized. Although this gives the impression that our government is doing something, there is always an adequate supply. Even C.J. Box thinks they can make fentanyl in the Bighorn Mountains. 

Incarceration manifests the thinking that the problem is “those” people and “those” drugs. Some 43% of federal inmates and 20% of state inmates are there on drug charges, with minority populations disproportionately represented in prison populations — “those people.” 

Addiction to illegal or legal drugs is a giant health problem. Right now, the greatest health and social problems in the state of Wyoming are legal drugs: alcohol and tobacco. The slaughter in the Caribbean won’t fix these, but just turn our heads elsewhere. Politicians and the media feed on each other, focusing us on “those” people and “those” drugs. 

Humanity has an endemic addiction problem; we need humane solutions. A strong step in the right direction is to protect and expand Medicaid and protect and expand funding for mental health and substance abuse treatment. We need to keep an honest assessment of the drug and alcohol culture in Wyoming. The “Them and Us” delusion is not functional. Honesty is essential. Addiction is an endemic affliction of humanity. We should look for humane solutions. 

Resources:

Suicide and Crisis Lifeline: 988
Alcoholics Anonymous: 307-362-8421
Al-Anon: 888-425-2666
Narcotics Anonymous: 818.773.9999
Nar-Anon: 800-477-6291

Dr. Tom Hogarty is retired and lives in Big Horn. He practiced in Sheridan and Gillette for 30 years. He was the founding president of the Wyoming Professional Assistance Program and a Medical Review Officer...

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