Well, who helped to make that all possible, Mr. President? The way I remember the 1990s, there were at least six ways in which the Clinton Administration helped to facilitate the modern opioid overdose crisis.
Bill Clinton’s FDA Opened the Floodgates to Big Pharma’s Pill Pushing
“In the beginning, this despicable epidemic had a less violent delivery system. Our kids were delivered and a lot of our adults were delivered into a paralyzing addiction by doctors, pharmacists and drug manufacturers, not by armed gangs,” explained Mr. Clinton to the mayors.
In 1983, Big Pharma aired its first direct-to-consumer television advertisement for a prescription drug.
It’s difficult these days for Americans to understand how incredibly unethical it is to have such advertisements. The United States and New Zealand are the only countries that allow drug cartels – er, Big Pharma – to push their drugs directly to the user – sorry, I mean, the patient.
By 1985, the FDA had set stringent rules regarding the Big Pharma ads. Primarily, they couldn’t express that a specific drug could treat a specific claim. This mostly kept Big Pharma’s TV drug pushers at bay.
That all changed in 1996, in Bill Clinton’s first term. That’s when Big Pharma figured out the “ask your doctor” loophole. They made an ad for Claritin, a cheery spot that never actually explained what Claritin was or what it was for, thus obeying the FDA’s advertising mandates.
Instead, the ad implored the user to “ask your doctor if Claritin is right for you.” Experts credit the Claritin ad for opening the floodgates for Big Pharma’s TV ads.
In 1997, at the start of Bill Clinton’s second term, the FDA relaxed its rules to allow TV ads to refer to print ads for detailed information, to offer 800 numbers and websites, and to make the kind of specific-drug-for-specific-ailment claims that fill every other ad slot on the evening news these days.
In 1993, Big Pharma was spending $360 million on its advertising. By 1998, it was up to $1.3 billion in spending. In 2006, it reached $5 billion. Last year, it was still around $5.2 billion, with one-quarter of that spent on advertising just five drugs: Humira (arthritis), Lyrica (nerve pain), Eliquis (stroke), Cialis (erections), and Xeljanz (arthritis).
Bill Clinton’s FDA Does Nothing as OxyContin Sales Jump From $45 Million to Over $1 Billion
“We should all acknowledge that we should have seen more of this before,” Clinton told the Conference of Mayors. “But what we have to acknowledge now is we have a chance to deal with this in a comprehensive way, and we’re not close.”
What is it that the President of the United States in the 1990s could’ve seen more of?
That story starts in 1995, again in Clinton’s first term, when Purdue Pharmaceuticals came up with a new drug, an opioid painkiller they called OxyContin. The FDA approved it for sale in 1996 and the company made $45 million selling OxyContin.
From 1996 to 2000, Purdue doubles its pushers – whoops, sales force – dedicated to selling OxyContin, which they claimed had a “less than one percent” chance of causing dependence. By 2000, Purdue is selling $1.1 billion in OxyContin, and its sales reps are getting average bonuses of $70,000 a year, with some bonuses as high as a quarter million dollars for reps who pushed the most pills.
To be fair, it’s not as if Presidents Bush and Obama put a stop to the flood of Oxy. In 2007, a subsidiary of Purdue and three of its executives pleaded guilty to misbranding OxyContin as “less addictive and less subject to abuse and diversion than other opioids.” Nobody went to prison, of course; the company just had to pay $634 million in fines.
By 2010, Purdue is selling $3.1 billion worth of OxyContin, accounting for 30 percent of the entire US painkiller market. By 2015, the Sackler family, owners of Purdue, finally make it into Forbes’ List of Top Twenty Richest Families, at $14 billion.
Purdue also made sure to keep tabs on its dealers – sorry, doctors – by composing databases to track who was selling the most pills. The Los Angeles Times reported that the company had been tracking doctors since 2002 and knew about 150 of them were recklessly overprescribing OxyContin, one of whom was making $1.5 million a year just prescribing those pills to the addicted.
Bill Clinton’s DEA Opened the Floodgates to OxyContin Manufacturing
“As the government got better at dealing with opioids,” Clinton told the mayors, “more people moved into heroin.”
“Better at dealing with opioids” would be better expressed as “finally pumped the brakes on opioid manufacturing.”
OxyContin is a Schedule II drug. That means that its production is strictly monitored by the Drug Enforcement Administration, particularly within a bureau called the Office of Diversion Control. That office is in charge of setting the production quotas that pharmaceutical companies are allowed for Schedule II drugs.
In 1997, the first year after OxyContin was released, the DEA approved a quota of 8.3 tons. By 2011, the quota had risen to 105 tons, an increase of over 1,200 percent. Again, that’s not all on Bill Clinton’s DEA; George W. Bush’s DEA and Barack Obama’s DEA were also approving these quota increases.
The maddening part is why the DEA approved the increases. As former Office of Diversion Control head Gene Haislip told Salon, “The way I did it for 17 years, which was basically the way it had always been done even before the DEA was the DEA, is that when a significant diversion problem occurred, the quota increase requests would come under greater scrutiny. With Oxy, there has been a significant diversion problem since the late 1990s, so the requests should have come under greater scrutiny.”
They didn’t. The reason why, according to DEA, was because they had to allow Big Pharma to make enough OxyContin for illegal drug abusers so legal pain patients wouldn’t go without.
No, seriously. In that 2011 interview with Salon, DEA supervisory special agent Gary Boggs explained that DEA is required by statute to set quotas so there is “an uninterrupted supply for the legitimate medical and scientific research needs of the United States.”
Boggs then explained that illegal users threatened to interrupt that supply. “What you have to understand,” Boggs told Salon, “is that you do have legitimate patients and they’re fishing from the same pond that the illegitimate patients are fishing from, so you have to be cautious not to restrict the quota to the point that when the legitimate parties go to the pool, all the fish haven’t been taken out by the illegitimate parties.”
It’s funny how that reasoning doesn’t work for medical marijuana. Try explaining to the DEA that you needed to grow those 29,000 cannabis plants so that when the recreational marijuana smokers have “fished from the same pond” there is still enough marijuana left for the legitimate medical marijuana patients. With every other drug but OxyContin, the DEA seemed to believe that cutting off the supply of that drug will reduce abuse of it.
Bill Clinton’s NAFTA Opened Up the Floodgates to Mexican Drug Cartels
“Heroin is even cheaper now because it is now being grown in Mexico in the hidden parts of the Sierra Madre Mountains and being harvested by preteens,” Clinton said to the mayors.
In his book “Compromised: Clinton, Bush and the CIA,” former CIA asset Terry Reed tells the story of the then-governor of Arkansas, Bill Clinton, who in 1983 allowed CIA operatives to use the rural airport in Mena, Arkansas, to allow the CIA to bring in massive quantities of cocaine from Central America. In exchange, Reed alleges, the CIA would back the then-unknown governor in a bid for the presidency.
That cocaine would go on to be sold through the CIA on the streets of South Central Los Angeles with the help of “Freeway” Ricky Ross, as told by the late Gary Webb in his stunning investigative journalism, leading to the 1980s crack cocaine epidemic. The proceeds of those sales then illegally funded the Nicaraguan Contra rebels, fighting on behalf of the CIA in an insurgency against the communist government.
Clinton wins the election for president in 1992. By 1994, Clinton has successfully pushed Congress to pass the North American Free Trade Agreement, or NAFTA. The trilateral agreement between Canada, United States, and Mexico opens up the borders to increased trade. By 2013, about 350,000 loaded truck containers, 442,000 loaded rail containers, over 1.2 billion personal vehicle passengers, and more than 41 million pedestrians crossed the U.S.-Mexican border, according to the Bureau of Transportation Statistics.
That suddenly made the Mexican land routes far more attractive to drug traffickers than air and sea transport. NAFTA “has certainly attributed to increasing drug traffic over the border,” says a 2015 report from the Council on Hemispheric Relations.
That NAFTA would increase drug trafficking was no mystery, either. In his book “Border Games: Policing the US/Mexico Divide,” author Peter Andreas explained that “pushing NAFTA through Congress… required deflecting concerns that opening the border to legal trade might unintentionally open it to illegal drugs.”
Indeed, in the early 1990s, the US crime rate was at an all-time high and the crack epidemic had reached its apex. Had Congress been fully aware that NAFTA was guaranteed to increase drug trafficking, it’s likely it never would have passed. Bill Clinton’s administration purposefully kept quiet about knowing NAFTA’s dark Mexican drug secret.
Bill Clinton’s Crime Bill Created the Perfect Street Dealer Labor Force
“Now it’s becoming attractive to urban gangs,” Clinton warned the mayors. “It’s going to eat us all alive.”
As the crime wave of the early 1990s peaked, Bill Clinton became as much of a staunch drug warrior as any Republican president who preceded him. He promised to get tough on crime and signed the 1994 Crime Bill, which mandated “three strikes and you’re out” penalties and strict mandatory minimum sentences for drug trafficking. He also put 100,000 more police officers on the streets, now equipped with military gear and a directive to stamp out drug trafficking.
While the get-tough-on-drugs policies had already been started in 1986, pushed primarily by then-Democratic Senator Joe Biden, during the Clinton years the effects became more pronounced. Though designed to take down the so-called drug kingpins, the policies actually cracked down on mid- and low-level dealers, who spent increasingly longer times in prison.
More dealers in prison for longer times just opened up more drug dealing jobs for the people on the street. The revolving door from street to prison to street continued turning out people who, tarnished by the label “convicted drug dealer,” could only find work by returning to the drug trade.
Combined with NAFTA, the Crime Bill made it possible for the Mexican drug cartels to wage increasingly violent wars south of the border for control of the lucrative border crossing routes and to build increasingly sophisticated gang networks north of the border to distribute the product.
Bill Clinton’s Drug Czar Fought to Prevent Safer Alternatives to Opioid Painkillers
“Now, what has happened is this addiction has become more expensive and more hazardous because the government’s finally doing a better job of dealing with it. So it is morphing into a heroin epidemic in all kinds of small towns and rural areas all across America,” Clinton said at a fundraiser in 2015.
In the 1990s, as Big Pharma is imploring TV viewers to “ask your doctor” about their latest pills, a revolution is taking place on the West Coast as patients begin to ask their doctor about the medical benefits of marijuana.
In the 1996 election, Bill Clinton won his second term and California passed the Compassionate Use Act, the nation’s first medical marijuana law. Patients began to use cannabis for a myriad of purposes, but one of the primary uses turned out to be analgesic, as cannabis was found to be a superior pain reliever, specifically for the kind of neuropathic pain that is resistant to opioid treatments like OxyContin.
Today, we have the studies showing that states with access to medical cannabis show a great reduction in the harms from opioids, including fewer deaths from, overdoses from, addictions to, use of, and prescriptions for opioids. Back in the late 1990s, these were just anecdotes from patients being relayed to doctors.
But Bill Clinton’s Drug Czar not only tried to halt the expansion of medical marijuana in California and elsewhere, referring to it as “Cheech & Chong medicine,” he actually tried to punish doctors if they even mentioned medical marijuana as an option for their patients. The Clinton Administration convened a secret meeting of 40 government and private-sector drug warriors to strategize how to prevent medical marijuana initiatives from passing in other states, leading to a push for anti-drug messaging from the government inserted surreptitiously into television shows and magazine articles.
It took a lawsuit against the federal government to recognize the free speech rights of doctors to talk about – not prescribe – medical marijuana to their patients. That’s why all 29 states with working medical marijuana laws allow doctors to recommend medical marijuana, not prescribe it, which is barred by federal law.
It’s great that Bill Clinton is calling for smarter ways of dealing with our nation’s opioid overdose epidemic, but let’s not forget how much of it was created and enabled by his administration’s drug and crime policies.