Did the opioid epidemic help Trump win?

New article in The Nation:

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New research shows that Trump made huge gains in counties with the highest rates of death from drugs, alcohol, and suicide.
By Zoë Carpenter

The Nation article draws on empirical work by Penn State prof Shannon Monnat, who argues that counties “heavily burdened by opioid overdoses and other ‘deaths of despair'” [eg suicide] were where Trump “overperformed” in terms of his voting outcomes compared to Mitt Romney.

There’s been a lot of debate recently about whether Clinton “lost” Democratic votes (ie suffered lowered turnout) or whether Trump found some appeal, beyond explanations deriving from a politics of fear or racism. Logically, both could be true at the same time of course, but for my money I am most persuaded by Monnat’s analysis. I see it fitting a tradition of writing about rural/rustbelt anxieties about being left behind in terms of the economic transition. In Kentucky for example, there’s plenty of angst around the coal industry (Appalachian Kentucky voted overwhelmingly for Trump…even as they massively preferred Bernie Sanders over Clinton in the primaries.)

Here’s a picture of a typical car license plate I took on the UKY campus, outside the computer science building, part of the “Friends of Coal” movement:

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You could respond with the observation that this is a rear-guard defense of the 6,254 (Q3 2016) people still in mining in Kentucky, and/or are long-standing trends (and were apparent during Romney’s and Obama’s election campaigns). Indeed, the shift from industrial to post-industrial “service” economies was taught in my undergraduate curriculum in the early 1980s by my former Liverpool university lecturer Peter Daniels, among others. [Sidenote: he’s emeritus now, wow].

The counter to that would then be something like, yes, but Trump mobilized sentiment in effective ways [how?]; just like Brexit, there’s something affectively going on at this particular time. Opioid use has certainly shot upward in the last few years alone. The recent Surgeon General report claimed that more people have a substance use disorder than who have cancer (20.8 million vs. 14 million). More precisely, 47,000 died from a drug overdose (30,000 from prescription drugs, largely opioids). This has led to headlines like the “Oxy electorate” and “opioid alley” referring to Kentucky, where 1,248 people died from drug overdoes in 2015. This has knock-on effects of high rates of hepatitis C. These do seem new developments at this scale.

Some of these eastern Kentucky counties are also the most heavily dependent on government benefits (well over 45% of county income in some cases). This means a full explanation will also have to account for stagnant/declining wages since the 1980s. And for that we need an account of neoliberalism…

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