JD Vance on the opioid crisis: a medical, cultural, economic problem

JD Vance says he’s become all too accustomed to hearing a certain phrase when his family calls to update him on life in small-town Ohio: “They died of an overdose.”

The phrase, which Vance invoked Wednesday night at the Republican National Convention as he accepted his party’s nomination for vice president, is consistent with the political identity he has cultivated since the 2016 publication of his famed memoir, “Hillbilly Elegy.” .

Under the Biden presidency and Democratic power, “prices rose, dreams were shattered and China and the cartels sent fentanyl across the border, adding to the grief,” Vance told RNC attendees in Milwaukee on Wednesday evening.

“Thanks to these policies that Biden and other outrageous politicians in Washington gave us, our country was flooded with cheap Chinese goods, with cheap foreign labor and, in the decades to come, with deadly Chinese fentanyl,” he later said.

Over the past decade, Vance has built much of his public persona from his personal witness to the opioid crisis. He cites it as an example of what ails the U.S. not only medically, but economically and culturally. In his book and countless interviews over the years, Vance portrayed the overdose epidemic as a symptom of despair, economic instability and disintegrating family structures. While running for office, the Yale-educated lawyer wove his family story into a broader attack on Democratic border and immigration policies, a position he incorporated into several border control bills after the 2022 election.

Many of his comments on the fate of addiction itself are tempered and nuanced. Vance, now a Republican senator representing Ohio, has spoken or written extensively about his own mother’s struggle with drug use, culminating in an overdose and hospitalization. And he has portrayed drug use and overdoses as a problem rooted in trauma, family chaos and a lack of economic opportunity — an analysis similar to that of U.S. Surgeon General Vivek Murthy, a top health official in the Biden administration. During his 2022 Senate campaign, so did Vance a fundraiser canceled after discovering that the host was a doctor named in lawsuits involving Purdue Pharma, the manufacturer of OxyContin.

Yet his rhetoric has sometimes taken on a darker tone. In one 2022 interview Along with Gateway Pundit, a far-right media site known to spread conspiracy theories, Vance accused President Biden of allowing fentanyl to pass through the country’s southern border in an attempt to kill Trump voters.

Since formally entering politics, Vance has continued to speak out about the drug overdose crisis and signed a handful of legislative proposals aimed at combating the drug epidemic, including a bill that would impose sanctions on fentanyl traffickers. In a recent hearingVance expressed concern that the Senate has consistently been “a few years behind” on the opioid crisis, citing the rapid evolution of drug supply from prescription pills to heroin to highly potent synthetic opioids like fentanyl.

Yet he also took significant criticism after the addiction-focused nonprofit he founded, Our Ohio Renewal, failed to produce any published work or implement programs designed to prevent drug deaths, instead paying large fees to Vance’s top political adviser .

Below, STAT highlights Vance’s rhetoric and track record on the opioid crisis.

The Atlantic Ocean, July 2016: “Shortly before I graduated from law school, I learned that my own mother was in a coma in a hospital from an apparent heroin overdose. Yet heroin was just her latest drug of choice. Prescription opioids—”hillbilly heroin” some call it, to emphasize their special appeal among working-class whites like us—had already landed my mother in the hospital and cost our family a lot of money in the decade before they were first introduced. tasted real heroin.”

Vance’s magazine article highlights the personal toll the addiction crisis has taken on him. It was published in a story called “Opioid of the Masses” – ironic because it invokes Karl Marx’s famous critique of religion, and even more so because the “opioid” Vance was referring to was his future boss: Donald Trump. The subhead reads: “Trump is a cultural heroin. He makes some people feel better for a while. But he can’t fix what ails them, and one day they will realize it.”

NPR’s Fresh Air, August 2016: “In many ways, I was at the root of the opioid epidemic because I saw it happen to my mother before it really reached crisis proportions.”

Vance also underscored his Christian values, suggesting that religious preferences could keep people away from substance use because “kids who go to church are less likely to commit crimes and are less likely to use drugs.”

Philanthropy Roundtable, Summer 2017: “When you think about addiction, in some cases it’s a simple matter of medical treatment. But it is also linked to chaos and trauma in certain families. This, in turn, is related to economic opportunities and jobs becoming harder to come by. If we want to make any progress on these problems, we have to tackle them all at once.”

Once again, Vance presented a theory of chaos, trauma and economic stability – but above all a clear vision that addiction is a medical problem that is often solvable with medical treatment.

George Washington University, November 2017: “People turn to substance abuse because the prospects for their community seem hopeless… not just for today, but hopeless for the future.”

At a DC event in 2017, Vance reiterated what seems to be the cornerstone of his philosophy on addiction: that it is largely a response to circumstances of desperation.

Gateway Expert, April 2022: “If you want to kill a bunch of MAGA voters in the heart of the country, what better way to do it than attack them and their children with this deadly fentanyl? …It looks intentional. It’s as if Joe Biden wants to punish the people who didn’t vote for him and opening the floodgates to the border is one way to do that.”

The claim is both baseless and extraordinary: that the sitting president is allowing deadly drugs into the border in the hopes that they can kill Americans who do not support him politically. But apart from being the truth, it is also illogical. Drug overdoses are now killing Black people and Native Americans — among the demographic groups that most strongly support Democrats — at a higher rate than white people, the majority of whom vote Republican. And of the ten jurisdictions with the highest drug overdose rates (nine states, plus the District of Columbia), five went to Biden in the 2020 election and five went to Trump.

Meet the press, July 2023: “There’s a very direct line between the job losses in China, especially in the ’80s and ’90s, and the heroin and now the fentanyl problem today – a very, very direct line. So number 1, we need to rebuild the middle class in this country and make sure people don’t want to use drugs in the first place. The second is that we obviously want to prevent people from becoming addicted, but once they are addicted, treatment is an important source of redress.”

In this TV interview, Vance blames the addiction crisis on globalization and the loss of manufacturing jobs. But again, he is quick to emphasize the role of treatment for those already addicted.

Looking forward

Vance’s openness to treating addiction as a health condition may itself be a promising sign for addiction and recovery advocates. These advocates have expressed concern that a second Trump White House would turn its back on treatment, roll back the Biden administration’s efforts to expand access to addiction medications and implement a tough-on-crime approach that police would be at the forefront of the opioid epidemic. Trump has already promised not only to take a tougher stance against cartels, but also to impose the death penalty on convicted drug dealers.

Whether any of these policies will actually be implemented and who will oversee them remains an open question. During Trump’s first term as president, he largely delegated responsibility for addressing the opioid crisis to aides like Kellyanne Conway. Should Trump be reelected, Vice President Vance would have major influence over the next White House’s policy portfolio — perhaps especially when it comes to addiction.

STAT’s coverage of chronic health conditions is supported by a grant from Bloomberg Philanthropies. Us financial supporters are not involved in decisions about our journalism.