You can draw a parallel between how imperialists forced opium on China and how the American state pushed a lot of working-class people to fentanyl first by getting them addicted to pharma opioids and then cutting their legal supply off.
Definitely, I think that's a great point. In both cases we have the initial proliferation of opioids and addiction in pursuit of profit. But in the case of the US, I believe the over prescription of opioids is already over and now we're just dealing with the remaining consequences. The pendulum swung away from pill mills and forcefully towards doctors and pharmacists treating every patient in pain like a criminal. Especially black patients.
Tons of people who legitimately needed opioid painkillers were kicked off their prescription and made to suffer in agony. At the same time, tons of people who didn't initially need their prescription were also cut off, but their resulting chemical dependency presented a legitimate medical need for opioids all the same. Buprenorphine and Methadone maintenance therapy success rates prove that a maintenance dose of an opioid is a valid and effective treatment for opioid use disorder. Some countries are taking this further by prescribing clean Heroin, Morphine, and Hydromorphone in the same capacity as a Methadone clinic, these programs are essentially always successful at reducing overdoses.
Unfortunately in the US, Methadone clinics have strict rules that I believe are designed to deter patients from actually receiving Methadone maintenance therapy. You need to show up every single day to take your dose, and you probably don't live near a clinic unless you live in a big city. Regardless of whether you were addicted to anything other than opioids, using marijuana will also disqualify you from the treatment even in legal states. There are so many hoops to jump through that Methadone is not a viable option for most addicts in the US. Buprenorphine is easier to get prescribed and much harder to abuse, it's how I got clean from full agonist opioids seven years ago, and I still take my maintenance dose to this day. But since it's a partial agonist, it has a dose ceiling at which point taking more of the drug does not have any effects. People who have a huge tolerance to fentanyl will have a much harder time keeping their withdrawals at bay using Buprenorphine than they would using Methadone.
So barring those two maintenance therapy options, people who were kicked off their prescription in the US had no other immediate recourse other than to illegally seek out street opioids. These days, heroin and pharmaceutical grade opioids are increasingly rare on the black market. In some areas Heroin has all but disappeared and been replaced with fentanyl analogues and tranquilizers. You can't get that dangerous shit off the street with more enforcement. Opium requires large tracts of arable land in an appropriate climate to grow whereas fentanyl and its analogues are fully synthetic drugs produced in labs. As I mentioned earlier, these drugs are insanely potent, so it is vastly easier to hide and smuggle them than an equivalent number of opium doses.
In this situation, the more you crackdown on dealers, the more you disproportionately remove safer opioids from the drug supply while fentanyl remains in increasing concentrations. And the more you crackdown, the more you empower the racist, capitalist serving policing institutions in this country.
I can see an argument that a more China-like drug policy could work in the US after a proletarian revolution, but it isn't in our best interest otherwise. So long as the legacy of slavery and Jim Crow lives on in the modern US policing and prison institutions, the only viable goal is for us to push for full legalization while banning all profiteering from the production and/or distribution of addictive drugs. I recommend you take a look at Canada's safe supply program to get an idea of what such a program looks like and how it has been successful in reducing overdoses.
I can relate to this so much. I have a severe needle phobia as a result of autism plus extreme childhood trauma, and doctors used to give me a single dose benzo prescription of Ativan when I needed to do bloodwork and get vaccines. That all stopped, forever, the moment my history of opioid addiction made it into my medical record. Makes sense, opioid+benzo is likely to equal dead, right? Well, come covid I was several years clean, and still got denied any sort of sedatives.
I made it as clear to the doctor as possible that without heavy sedation, I would not be able to get the covid vaccine because in a sober state of mind I cannot control myself at all when someone is about to puncture my flesh with a needle. I will try to exit the room as fast as possible, and I will get violent if someone tries to stop me. Doctor wouldn't budge, somehow they came to the conclusion that taking a single dose of a benzo is more of a danger to me than catching fucking covid unvaccinated.
In the end, I had to buy illegal Xanax off the DNM. I showed up for my covid vaccine obviously barred the fuck out. Since then I've realized how perfect of a microcosm this situation was for how the war on drugs has severely hurt patient outcomes in situations calling for controlled substances. Do doctors not realize that denying people prescriptions doesn't mean their patients just give up on trying to source them? That it's possible that we'll just get it ourselves at the cost of using unregulated drugs that are far more dangerous? I hope to god they start to notice and factor this into their decision making soon. Shit's fucked out there.