Zak Burns: Sorry, critics, Macklemore’s song ‘Drug Dealer’ is dead on

“My drug dealer is a docta, docta / Had the plug from Big Pharma, Pharma / He said that he would heal me, heal me
…
I think he trying to kill me, kill me / He tried to kill me for a dollar, dollar”

I typically find Macklemore’s social issue songs silly, maybe catchy or nice. I’m not a fan but his work doesn’t ever really bother me. But his most recent single (is that what we call them?) “Drug Dealer” is surprisingly meaningful to me in that he’s addressing something I can relate to in a mostly accurate way. It’s also affecting all walks of life – an inner city and rural problem — around the country.

Detective: Keep safe-injection sites away from Pierce County

That’s why a recent article from a drug blog really made me mad.

Carl Hart and Kristen Gwynne from The Influence, a blog that dissects drugs and addiction, attack Macklemore for the above lyrics that talk about the opioid epidemic. Macklemore’s point is, essentially, that doctors giving out opioids get people addicted and do so because of conglomerate pharmaceutical companies. Here’s what the writers had to say:

Macklemore attempts to render drug users as victims without any autonomy, while characterizing the physicians (the “dealers”) as unscrupulous predators. …

“Drug Dealer” does not remotely approach the real conversation about race and drugs that the US so badly needs. But it does provide a blueprint for racists to show their support for punitive drug policies, policies that disproportionately lock up black and brown bodies, without appearing to be explicitly racist.

Is Macklemore using inflammatory language? Yes. Calling a doctor a dealer is a bit extreme, but he does have a point.

I don’t think there is any doctor in the country prescribing their patients Vicodin with the hopes of getting them addicted — that every two months, or whenever the prescription runs out, the patient will need to return to the office and get another fix. I don’t think that’s the case. However, the opiate addiction explosion in this country undoubtedly comes from prescription pills like Vicodin, Percocet, and, more than any other pill dating back to 1995, OxyContin. That, without a doubt, doctors have been far, far too liberal in prescribing these pills without explaining the addictive nature of how these pills can, in a very short amount of time, ruin your life. Or at least change the path of your life.

A ‘Drug Dealer’ life

Here is your typical patient … Scratch that, I’ll just use a personal example. I come from an addiction background. I was severely addicted to opiates in my late teens and early 20s. The last time I was prescribed pain killers in any meaningful way was 2009. I’d sprained my wrist and the only reason I went to the emergency room was to make sure that it wasn’t broken. It wasn’t.

My doctor asked me how much it hurt. I said, ‘A lot.’ The response: 60 Vicodin. And that’s someone with a checkered past with opiates. Sixty Vicodin is enough to put you on the pathway to addiction. After 60 Vicodin, you could declare yourself addicted. You are going to feel the need to replenish your supply of opiates after taking that many pills.

Did the doctor want that to be the end result? Did he want me to be an addict? No. But he was the one who prescribed the pills so he was, technically, the dealer. That’s happening more and more as the FDA is allowing an increasing number of opiates to be prescribed in this country.

Back in 1995, before OxyContin lobbied to basically be the pill of choice for anyone who had any sort of pain, it was remarkably difficult to get an opiate prescription. Post-1995, after Pfizer lobbied for the FDA to expand the number of opiates in this country, the company went from $45 million in sales to $1.1 billion over five years’ time. So don’t tell me there isn’t some sort of profit motive for these doctors to prescribe these pills.

According to the National Institute on Drug Abuse, nearly half of young heroin injectors reported abusing prescription opioids before using the drug, which is also an opioid.

So, yeah, Macklemore’s point is fair. Truly, most opiate addictions start in a doctor’s office. Then, once the prescription runs out, and the patient is still addicted, they seek cheaper and easier options. That usually means heroin.

To me, there is no difference between someone who is abusing Vicodin and someone who is abusing heroin, except maybe they are getting the Vicodin, at least initially, legitimately, and the heroin later illegally. It’s not that Vicodin is a gateway drug — it’s the pill you start popping after you’ve already walked through the gate.

We invited Gwynne onto the show to better explain her position:

“We know that most people who die from opiates are not using them from a doctor’s prescription. In fact, we also know the vast majority of people who are prescribed opiates don’t ever develop a problem. So if you’re talking about your doctor being a drug dealer who is prescribing you some dangerous drug that you’ll become fatally addicted to, we’re talking about a very small percentage of people who this happens to.”

This spawned quite the debate. Listen below: