November 1st, 2016
Macklemore’s new song “Drug Dealer” is gaining a lot of media coverage and social media traction for its “powerful” and “emotionally raw and real” message about Big Pharma’s role in the increase of opioid-related deaths in the United States.
The song reiterates two popular, troubling narratives about the so-called opioid epidemic: Big Pharma and crooked doctors get people hooked just to pad their pockets, and heroin has made its way to the white suburbs, eliciting an unprecedented concern for white heroin users who were previously uninterested in the drug.
Macklemore’s credentials, as a white rapper who was formerly addicted to opioids, appear to cement his credibility—at least in the eyes of the media, still swooning over his statesmanship after he teamed up with President Obama to discuss this subject—as an expert on opioids.
The notion that he is any such thing is absurd. It’s like saying that Donald Trump, as a result of the many sexual assault allegations against him, is qualified to provide educational programming for preventing sexual assault. Are you kidding me?
But don’t take our word for it. Just listen to—but don’t purchase—the song “Drug Dealer.” It unequivocally demonstrates Macklemore’s cluelessness on the subject matter. Not only is the song corny in general terms, but it also sounds embarrassingly like a Reagan-era “just say no” PSA.
In it, Macklemore attempts to render drug users as victims without any autonomy, while characterizing the physicians (the “dealers”) as unscrupulous predators:
“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”
Really, Macklemore? Your physician is trying to kill you? How about you kill the hyperbole?
Setting aside the unlikelihood of this murderous intent to violate the Hippocratic Oath, let’s consider the reality of opioid-related deaths.
While it is possible to die from an overdose of an opioid alone, this is rare. Only about a quarter of the thousands of opioid-related deaths each year occur as a result of a single drug. Combining an opioid with another sedative, such as alcohol or a benzodiazepine, causes many more of these deaths.
So if rappers wish to help people avoid opioid-related deaths, their message should be clear and simple: Don’t combine opioids with other sedatives!
Yes, it’s true that some physicians engage in unethical practices, such as overprescribing opioids and other medications. But to be clear, this group represents a small minority, and medical boards and committees work diligently to weed them out. Further, the majority of people who use opioids chaotically or addictively do not obtain them from their doctor; the largest group obtain them instead from relatives or friends.
The misinformation and exaggerations expressed in Macklemore’s song do not address real concerns. They may, however, have a real-world effect by decreasing the willingness of physicians to prescribe opioid medications, thereby making it more difficult for patients to obtain opioids when medically indicated. The agony of people whose pain is under-medicated is an under-told part of this story.
What’s more, this suffering is not evenly distributed: It has been well documented that physicians are much less likely to prescribe opioids to black people than to whites—one area in which unethical conduct by doctors is widespread.
Suffering and inequality will certainly be exacerbated if otherwise-reasonable people start taking seriously the myths peddled by Macklemore’s song.
But what’s even worse is that Macklemore attempts to express concerns about the plight of sisters and brothers (plus a couple of honorary members in Amy Winehouse and Heath Ledger) as it relates to the dangers of drugs. At the same time, he lectures America for only being concerned when drug problems reach the white ‘burbs:
That’s Prince, Michael and Whitney / That’s Amy, Ledger and Pimp C / That’s Yams, that’s DJ A.M / God damn they’re making a killing /
Now it’s getting attention cause Sara, Katey and Billy / But this shit’s been going one from Seattle out to South Philly / It just moved out about the city / And spread out to the ‘burbs Now it’s everybody’s problem, got a nation on the verge /
Take Activis off the market / Jack the price up on the syrup / But Purdue Pharma’s ’bout to move that work.
The vast majority of the people named in the song died from drug combinations. In other words, they died from ignorance.
Macklemore’s over-simplistic and inaccurate characterization of the opioid situation reinforces the misguided victim-predator rhetoric of the War on Drugs era. Over the past three decades, this rhetoric has functioned to further subjugate the very people he claims to want to liberate: black people and his black friends.
“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.
Sure, no one will shed a tear when Big Pharma and those rich doctors are painted as the villains. But if you encourage the scapegoating of one “dealer,” it follows that it’s ok to scapegoat another—and that’s a toxic message in a country that needs little encouragement to do so in the most vicious ways.
You can see this happening, for example, in Maine, where Governor Paul LePage said of dealers:
“The traffickers, this aren’t people who take drugs, these are guys with the name D-Money, Smoothie, Shifty. These type of guys that come from Connecticut and New York. They sell their heroin, then they go back home. Incidentally, half the time they impregnate a young white girl before they leave.”
LePage later said:
“[I] made that comment that black people are trafficking in our state. Now ever since I said that comment, I’ve been collecting every single drug dealer who has been arrested in our state. I don’t ask them to come to Maine and sell their poison, but they come, and I will tell you that 90-plus percent of those pictures in my book—and it’s a three-ringed binder—are black and Hispanic people from Waterbury, Connecticut, the Bronx and Brooklyn.”
With friends like Macklemore and Governor LePage, black people don’t need enemies.
Macklemore’s ignorance is further highlighted by the fact that he perpetuates the debunked “gateway theory” of drug use and lambasts one of the few effective addiction treatments:
They said it wasn’t a gateway drug / My homie was takin’ subs and he ain’t wake up
The gateway theory, in essence, states that drug use progresses from “softer” to “harder” drugs in an orderly fashion. For example, marijuana use will eventually lead to heroin use. The problem is that the overwhelming majority of users of marijuana never progress to heroin use—or any other illicit drug use.
And Suboxone (“subs”) is arguably the most effective treatment for opioid addiction—more effective at reducing mortality than other treatments. Would Macklemore have the thousands of people being treated with Suboxone discontinue their medication?
If Macklemore really cared about his fans, people with addiction issues or his black friends, he’d accept that drug use is a reality and try educating himself before he wrote an unsolicited anthem for drug users.
Macklemore, who after all, is ignorant rather than malicious, has a history of using music (or trying to) for the greater good. It’s time he put in a bit more effort.
Carl L. Hart is a columnist for The Influence. He is a professor (in psychiatry) at Columbia University. He is also the author of the book High Price: A neuroscientist’s journey of self-discovery that challenges everything you know about drugs and society. His previous pieces for The Influence have included “High on Irrationality: At the UN Drugs Summit, It’s Time to Climb Down” and “Meth Is Virtually Identical to Adderall—This Is How I Found Out.” You can follow him on Twitter: @.
Kristen Gwynne is a reporter with a focus on criminal justice and drug policy. Her work has appeared in Rolling Stone,Vice and the Guardian, among other publications. She is a former drugs editor at Alternet and a former associate editor of The Influence. Her last piece for The Influence was “The Naked Self-Interest of Insys, the Pharma Company Funding Opposition to Weed Legalization in Arizona.” You can follow her on Twitter: @KristenGwynne.