A DEFINITE CRISIS

One of the suggestions this blog has offered is for civics teachers to use local civic problems to illustrate governmental action and to provide opportunities for students to engage in some sort of political engagement.  Unfortunately, one such problem is the opioids epidemic that has ravaged many communities across the US.  Starting with this posting, this blog will report, in real time, the development of a unit of study that looks at this epidemic.

          As way of background, this blog did a similar development with another issue area, foreign trade.  That issue was one that could be considered an international issue and was treated as such.  The opioids epidemic could either be treated as a national problem or a local one.  This treatment will treat it as a local concern.  As such, if the resulting unit were to be situated within a course of study, it is recommended that it be placed toward the beginning of the course.

          Picking up on the recommended approach this blog has described, there are three main elements upon which a course should be built. 

·        One, the course should highlight political problems or issues suitable for students to participate with politically relevant action. 

·        Two, the course, in a progressive way, should develop from discussion to formal debate.  As the course provides appropriate instruction, the students should be expected to participate in more sophisticated modes of discussion. 

·        Three, the course should tackle political conditions – usually one per unit – that offends federalist values. 

The regular readers of this blog know that it has dedicated significant space explaining each of these elements.

          The overall approach has been given the name, historical dialogue-to-action.  As a reminder, here is what the blog had to say about the “dialogue” aspect of this approach:

In terms of the total course, this development is to advance by students, at the beginning of the course, engaging in discussions.  This is followed by students participating in arguments or the development of arguments.  In the final phase, students compete in, to some degree, formal debates. 

This development is one that has students, during the arguing stage, choose between offered opinions, usually between two polar-opposite opinions that address a chosen topic.  The goal in this initial phase would be to have students identify and defend supportive data – factual information.

In the second phase, students argue a position that should be more specific than one in which they espouse by expressing a broader opinion.  This is of course, to a great degree, determined by the questions asked by the teacher.  The general aim should be to ask questions that get students to be more concrete and policy directed:  should the government do X or Y or, as the students become more sophisticated, Z or be able to choose from even more options.  In terms of foreign trade, an example would be:  should the US manipulate the value of its currency to help its balance of trade with other countries?

In the final phase, the one that would align with the final unit, students take on the responsibility to conceptualize the issue area into subtopics and policy considerations.  This is more complex, and a teacher should exercise judgement as to what his/her students are prepared to do as the course evolves over the term(s).  In all of this, the process is organized by what constitutes a logical argument.[1]

Since this unit is about a local problem, the unit would arise early in the course.  Therefore, dialogue would mostly zero-in on the first phase of this progression.

          With that bit of background, this development can begin.  The opioids crisis seems to many Americans as a sudden mushrooming problem that befell the nation all at once.  But there is a history to it and knowing and understanding that history seems essential to finding solutions that meet its challenges.  The detrimental use of prescription and non-prescription opioid drugs to notable numbers began in the late 1990s.  Since then, as the statistics below demonstrate, their use escalated.

          What are opioids?  They are a collection of painkillers and originally – and of late – are prescribed to relieve both short-term pain – as for example in post-surgery treatment – and chronic pain.  They include the following:  oxycodone, hydrocodone (Vicodin), and the synthesized drug, fentanyl.  In terms of killing pain, they work well and, therefore, despite their addictive qualities, they are sought after by patients in pain.

          As an addictive set of drugs, they are also popular for recreational purposes.  And overdosing has potentially fatal effects.  Here is part of the biology involved:  their sedative qualities are caused by the effect on that part of the brain – the respiratory center in medulla oblongata – that controls breathing.  If taken in high enough doses, they can function to depress respiratory processes, potentially resulting in respiratory failure and even death.[2]  That has been the fate for many who consume these drugs.

          How many?  The US Drug Enforcement Administration has described the levels of these deaths with this characterization:  “overdose deaths, particularly from prescription drugs and heroin [another related, illicit drug], have reached epidemic levels.”[3]  What adds to the tragedy of these deaths is that there is evidence of related abuses among the medical corps:  almost half of those deaths in 2016 resulted from consuming opioids attained through prescriptions.  This practice smacks of a scandal.

          Here are some initial statistics: 

Males account disproportionally for number of deaths lowering their overall life expectancy from 76.3 years to 76.1 years.[4]

In 2015 almost 53,000 died from overdoses, 38,300 people died in car accidents that year; in 2016, more than 64,000 died of overdoses, a 21% increase over the year before.  The death figure in 2010 was 16,000 and in 1999 it was 4,000.[5]

With those types of figures, one can readily understand why the term epidemic is being used to describe the problem.  It turns out that the numbers are concentrated in certain localities.  It is those communities that might find it useful for students to take a close look at what is happening and ask what should happen regarding this unfortunate state of affairs.  An appropriate look in their civics classrooms is judged as a legitimate place to do so – not because it is a “popular” issue, but because it offends federalist values.  Next posting will continue this effort.

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[1] See posting “A Progressing Process,” August 8, 2017.

[2] “Information Sheet on Opioid Overdose,” World Health Organization (UN), November 2014, accessed June 14, 2018, http://www.who.int/substance_abuse/information-sheet/en/.

[3] “2015 National Drug Threat Assessment Summary,” Drug Enforcement Administration, US Department of Justice, October 2015, accessed June 14, 2018, https://www.dea.gov/docs/2015%20NDTA%20Report.pdf.

[4] Lenny Bernstein and Christopher Ingraham, “Fueled by Drug Crisis, U.S. Life Expectancy Declines for a Second Straight Year,” Washington Post, December 12, 2017, accessed June 14, 2018, https://www.washingtonpost.com/national/health-science/fueled-by-drug-crisis-us-life-expectancy-declines-for-a-second-straight-year/2017/12/20/2e3f8dea-e596-11e7-ab50-621fe0588340_story.html?utm_term=.975df0e5e2cc .

[5] Josh Katz, “Drug Deaths in America Are Rising Faster Than Ever,” The New York Times, June 5, 2017, accessed June 15, 2018, https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html AND “Provisional Counts of Drug Deaths, As of 8/6/2017,” United States:  Centers for disease Control and Prevention Source – lists of US totals for 2015 and 2016 by states, accessed June 15, 2018, https://www.cdc.gov/nchs/data/health_policy/monthly-drug-overdose-death-estimates.pdf AND German Lopez, “In 2016, Drug Overdoses Likely Killed More Americans Than the Entire Wars in Vietnam and Iraq,” Vox Media, accessed June 15, 2018, https://www.vox.com/policy-and-politics/2017/7/7/15925488/opioid-epidemic-deaths-2016 AND Dan Nolan and Chris Amico, Frontline, February 23, 2016, accessed June 15, 2018, https://www.pbs.org/wgbh/frontline/article/how-bad-is-the-opioid-epidemic/ AND “America’s Addiction to Opioids:  Heroin and Prescription Drug Abuse,” National Institute on Drug Abuse (NIDA), May 14, 2014..