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Chasing Heroin | Watch S34 E6 | FRONTLINE | PBS | Official Site

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Chasing Heroin | Watch S34 E6 | FRONTLINE | PBS | Official Site

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Watch full-length episodes of PBS documentary series FRONTLINE for free. Chasing Heroin - A searing, two-hour investigation of America's heroin crisis.

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Crime and despair in Baltimore - An exceptionally murderous city

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Crime and despair in Baltimore - An exceptionally murderous city

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Gives good background information for the crack epidemic in Baltimore, can be used in the introduction.

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BACK in the 1980s and early 1990s, when Dante Barksdale was playing the game in Baltimore-dealing drugs, toting guns, making some money-there was a process to killing people. "You couldn't shoot someone without asking permission from a certain somebody," muses the former gangster, on a tour of the abandoned row-houses and broken roads of West Baltimore, the most dangerous streets in America. "It's become like, "I'm going to kill whoever's got a fucking problem with it."

Mr Barksdale, who spent almost a decade in prison for selling drugs, speaks with authority. His uncle, Nathan "Bodie" Barksdale, was a big shot in the more hierarchical Baltimore gangland he recalls. Avon Barksdale, a fictional villain in "The Wire", a TV crime drama set in Baltimore, was partly inspired by him. The younger Mr Barksdale was himself fleetingly portrayed in it. ("'The Wire' was a bunch of bullshit," he sniffs. "I got shot in the fourth episode and I didn't get paid.") Now employed by the Baltimore health department, in a team of gangsters-turned-social workers known as Safe Streets, he uses his street smarts to try to pre-empt murders by mediating among the local hoodlums. This also gives him a rare vantage onto the city's latest upwelling of violence, which is concentrated in poor, overwhelmingly black West Baltimore-and is horrific.
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Hours after Mr Barksdale conducted his tour of some of Baltimore's most troubled streets on June 12th, they witnessed another six murders. That raised the number of killings in the city to 159, the highest recorded so early in the year at least since 1990, even though the city's population was much bigger then than it is now. If weighted to reflect the fact that the murder rate always climbs in the hot, fractious summer months, this suggests Baltimore may see more than 400 murders this year. That would smash the existing record of 344 killings, which was set in 2015, fuelled by violent rioting over the death in police custody of a drug peddler called Freddie Gray.

This is catastrophic. A 50-minute drive from Washington, DC, black men aged 15 to 29 are as likely to die violently as American soldiers were in Iraq at the height of its Baathist insurgency. Yet there is no sign of Maryland or the federal government taking the sort of emergency action such a disaster would seem to justify. Instead of bolstering law enforcement in Baltimore and a few other violent cities, including chiefly Chicago, but also St Louis and Milwaukee, Jeff Sessions, the attorney-general, has tried unsuccessfully to row back a modest federal-government intervention devised by his Democratic predecessor. Meanwhile he has used the violence in those places to misrepresent the much more pacific state of America at large.

"The murder rate is up over 10%-the largest increase since 1968," Mr Sessions said last month in testimony to the Senate intelligence committee. He neglected to clarify that, notwithstanding that rise, the murder rate is at close to its lowest level in a quarter of a century. In most places, Americans have never been less likely to be murdered; the homicide rate in New York is below the national average. More than 55% of the increase last year was accounted for by Chicago, where 781 people were murdered-more than the total for New York and Los Angeles combined.

America is not experiencing a crime wave, in short, but rather historic progress marred by a few exceptionally bleak places. That does not justify Mr Sessions's campaign for harsher custodial sentences across the board, which would not cut violent crime much or at all in Baltimore or anywhere. The attorney-general would do better to fathom what is causing the bleak spots, starting with a few stark truths.

As American as cherry pie

Most murder victims in America are black people shot dead by other black people. Blacks represent 13% of America's population, yet in 2015 they represented 52% of the slain. The toll on black families and communities is appalling; between 1980 and 2013, 262,000 black men were murdered in America, more than four times America's total number of casualties in Vietnam. If black Americans were murdered at no more than the national rate, America would still be an unusually violent developed country; its murder rate would fall from the current level of 4.9 per 100,000 people, which is similar to that of some African countries, to 2.4 per 100,000. That would make America merely three times as dangerous as Germany.

Criminologists have for decades argued about what makes young black men so much likelier to commit murder than young men of other ethnicities. The answer lies in some combination of poverty, family instability, epidemics of drug use in the wretched inner-city districts into which many blacks were corralled by racist housing policies, and bad, or non-existent, policing. The last of these, which may be the most important, extends far beyond occasional instances of police brutality. In America's overtly racist past, the killers of black Americans were less likely to be caught than the killers of whites because black lives were valued less. These days, inadequate resources, recruitment and training of inner-city police officers are bigger problems. Yet the outcome is the same. In the 1930s, Mississippi solved 30% of black murders; in the early 1990s, Los Angeles County, then in the grip of a violent crack-cocaine epidemic, solved 36%; in 2015 the police in Baltimore solved 30.5% of murders, most of which involved blacks.

Where murderers operate with a sense of impunity, they are likely to commit more murders. "I probably know ten dudes right now who have shot people and never been arrested," says Mr Barksdale. Another grim indicator of impunity is that, while the number of fatal shootings has soared this year, the number of non-fatal ones has hardly increased. "Instead of taking a shot and running away, the gunmen are walking up and taking multiple shots to leave no witnesses alive," says Cassandra Crifasi, a researcher into gun violence at Baltimore's Johns Hopkins Bloomberg School of Health. In the absence of effective policing, friends and relatives of murder victims are also more likely to take the law into their own hands-and so the virus spreads.

The same pattern has been noted in other poorly policed societies, especially those experiencing upheaval or trauma. The homicide rate among black Americans, notes Jill Leovy, a writer on murder in America, is similar to that among Arabs in some parts of Israel's occupied territories and American frontiersmen in the 18th century. "Like the schoolyard bully," she writes in "Ghettoside", "our criminal-justice system harasses people on small pretexts but is exposed as a coward before murder. It hauls masses of black men through its machinery but fails to protect them from bodily injury and death."

Better policing contributed to the drop in violent crime seen in most American cities from the mid-1990s. The size of its contribution is unclear, however: the complexity of local circumstances and the patchiness of America's crime data makes accounting for changes in crime rates hard. Even with decades of data to mull over, and a list of likely factors including better policing, strong income growth, demographic changes and reduced alcohol consumption, researchers at the Brennan Centre for Justice, at New York University, could account for only half of the national reduction in violent crime. Accounting for the recent surge in killing in Baltimore and Chicago is even harder. Yet it is striking that both places have recently suffered a dramatic collapse in public trust in the police, sparked by acts of brutality.

Loathed but needed

Just as the killing of Freddie Gray, who suffered a fatal spine injury in the back of a police van, lit up Baltimore, so the killing of Laquan McDonald, another young black man, who was shot dead in possession of a pocket-knife, led to protests in Chicago. In both cases the police, undermanned and unsure how to comport themselves in a world of mobile-phone cameras in every pocket, retreated. Between November 2015 and January 2016, the number of suspects briefly detained in Chicago dropped by 80%. In Baltimore, arrest numbers have fallen in the past three years, even as the murder rate soared.

Baltimore's police department was thrown into additional disarray last year by a damning report from the Department of Justice, which concluded that many of its officers were poorly trained, racist and incompetent, especially in their bungled efforts to police poor black neighbourhoods. This finding led the feds to demand the overwatch role that Mr Sessions has tried unsuccessfully to give up. Another scandal, in March, has made matters worse; seven members of an elite Baltimore police unit were charged with robbing drug dealers and law-abiding Baltimoreans, among other crimes. "I sell drugs," one allegedly boasted.

Baltimore's police bridle at the suggestion that they are to blame for the city's violence. They are at least trying harder. The case-closure rate for murders is currently around 50%. In response to the six murders on the day of your correspondent's visit to West Baltimore, the city's police commissioner, Kevin Davis, also announced what amounted to a weeklong state of emergency. He dispatched most of the city's 2,850 police officers-including many previously dedicated to office-work-on 12-hour patrols. If such efforts could be sustained, they would probably be popular, even though the police are not. "No one trusts the police, no one wants to tell them anything," said Yolanda Stewart, a resident of the troubled Sandtown-Winchester neighbourhood, whose 21-year-old nephew was recently shot and maimed outside her house. "But we need strong police around here to protect us."

A tour of Baltimore's trouble spots also evinces some sympathy for the cops. Better policing alone cannot curb a major crime wave; though New York's crime-fighting success is often attributed to an imaginative crackdown on petty crime in the 1990s, the city's long economic boom probably played a bigger part. By contrast, the state of Baltimore's poorest neighbourhoods, huddled on either side of the Patapsco river, is unrelentingly dire.

Whole streets have been boarded up against the junkies who hunker miserably on the weedy verges. Where an occasional inhabited house interrupts the monotony of abandonment, a glimpse of curtains or a pot-plant appears both valiant and acutely pathetic. ("The people in these communities are doing the best they can," says Ericka Alston, a former addict who runs a much-praised after-school club in West Baltimore.) The city has an estimated 16,000 abandoned houses, some of which have lain empty since its previous big riot, in 1968, following the death of Martin Luther King. Most of the damage is more recent, however. A former steel and manufacturing hub, the city has lost 75,000 factory jobs since 1990; as a result, around a quarter of Baltimoreans are stuck in poverty, with few obvious exits. A 25-year-long study of 790 children in Baltimore by the sociologist Karl Alexander and colleagues, from 1982 to 2007, found only 4% of poor children made it through college. In Sandtown-Winchester, shortly before the riots, 52% of adults were unemployed, 49% of teenagers were "chronically absent" from school and a third of houses were empty or abandoned. Whatever caused the drop in crime that Baltimore experienced with the rest of America, such indicators suggest it was fragile progress.

That is especially true given the attendant horrors of Baltimore's other big scourge, drug addiction, which also has a long history in the city. "If you think dope is for kicks and for thrills, you're out of your mind," said Billie Holiday, a jazz singer and heroin addict, who grew up in Sandtown-Winchester in the 1920s. Mr Barksdale and many of his ex-gangster colleagues cut their teeth during the crack-cocaine binge of the late 1980s and 1990s. Many, including Mr Barksdale, are the sons of addicts. Underpinning the latest crime surge is a third epidemic, of opioid prescription drugs, which is in some ways the deadliest yet.

According to an estimate by the health department, around 50,000 Baltimoreans are addicted to opioids. Some consider that an exaggeration; a visit to the streets around Baltimore's Lexington Market suggests it might not be. "See him on the bike! He's so high he can't ride straight," says Mr Barksdale, from behind the wheel, picking out the stoners with an expert eye. There appear to be dozens of them; two dealers are plainly visible, dishing out the content of orange pillboxes. It is probably Percocet, an opioid pain-reliever, with a street value of $30 for a 30mg hit. One of the dealers is operating within a few feet of a police van-perhaps, Mr Barksdale speculates, because he too is stoned. "Everyone's high!" he exclaims. "You used to be ostracised if you was on drugs. Now it's so common it's accepted."

In the view of Mr Barksdale and his co-workers, these and other changes in Baltimore's illegal drugs market help drive the killing. The more hierarchical gangs, and regulated murders, depicted in "The Wire" were based on the relative scarcity of heroin and cocaine; a gangster with a good supply of the drugs occupied a commanding position. By contrast, the easier availability of prescription drugs-especially in the aftermath of the riots, during which many pharmacies were looted-has led to a profusion of petty dealers, many of whom are also addicts. The result is constant turf battles which, unchecked by sobriety, are especially liable to turn bloody.

Barksdale, gangster-turned-helper

In turn, the bloodshed has led to a general downgrading of the value of a life. "The normal has changed, violence and retaliation and pain are expected," says Ms Alston, who estimates that 98% of the 50-100 children who attend her after-school club have heard or seen someone being shot. "This is about six-year-olds walking in and saying, 'Did you hear so and so got shot?'" That suggests a third way in which violence, which public-health experts increasingly view as analogous to infectious disease, spreads. The community starts taking it for granted.

Safe Streets is one of the more imaginative efforts to stop the contagion. It was launched in Baltimore a decade ago after a model pioneered in Chicago by an epidemiologist, Gary Slutkin. His idea was to erect barriers around the violence in the form of interventions by community leaders and streetwise locals. Of 31 such "violence-interrupters" employed by Safe Streets, all but two have done prison time. "We all did shit, got shot, got hit the fuck up, that's why we're credible messengers," explains Mr Barksdale. "Ain't none of us were snitches." Patrolling their areas in orange T-shirts, the violence-interrupters soak up news of the latest disagreements with obvious relish. ("So there are these two marching bands got this beef going on," recounts one with delight, through an open window of Mr Barksdale's car, "and they got knives and pit-bulls...")

Uncertainty about where the violence-interrupters stand in relation to the law has made them controversial. Because they are devoted to forestalling violence, they tend to take no view on the drugs deals they observe. A few have also sought to augment their meagre salaries unwisely. Mr Barksdale concedes that one of the problems is keeping people engaged without dipping back into their old lifestyles. His gangster uncle, who briefly worked for Safe Streets, was one who succumbed to temptation. Nathan Barksdale died in prison in North Carolina in February, aged 54, having been jailed for four years for trafficking heroin. Such controversies have left Safe Streets short of friends in high places; it almost lost its annual funding, of $1.6m, last year. Yet the ex-crims appear to be effective. A study by researchers at Johns Hopkins University published in 2012 found a statistically significant reduction in non-fatal violence in the four neighbourhoods they patrol, and a significant reduction in killings in two of them. Given the high cost of violence, financially and otherwise, that suggests Safe Streets is good value. It is estimated that $80m has been spent on treating gunshot wounds in Baltimore over the past five years.

It will take more than a few more ex-gangsters to pacify Baltimore, however. A straw-poll of Safe Streets workers suggests the city's troubled parts need four things above all. They need better schools, to mitigate the damaging effects on teenagers of their chaotic families, and to equip them for the jobs being created in Baltimore's plusher areas. They need fewer prescription drugs. And they need more and better policing. For the last of these, there is at least some hope in the form of the promised reforms and federal oversight. Of better schools and fewer drugs in Baltimore's violent districts there is no sign and, in the absence of serious attention to this calamity, little prospect.

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BACK in the 1980s and early 1990s, when Dante Barksdale was playing the game in Baltimore-dealing drugs, toting guns, making some money-there was a process to killing people. "You couldn't shoot someone without asking permission from a certain somebody," muses the former gangster, on a tour of the abandoned row-houses and broken roads of West Baltimore, the most dangerous streets in America.

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When was it published?
A dot net anyone can create.

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A great embed I could use, to enhance the blog post. WSJ is a very credible and known source.

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The
Syndicate
By Peter S. Green
How Cocaine Traffickers from Medellín Transformed the Multibillion Dollar Global Drug Trade

The Medellín Cartel was an empire of stunning sweep and unimaginable violence. At its height, it earned as much as $4 billion a year-most of it cash-for its members and controlled 80 percent of the cocaine supply in the United States, leaving tens of thousands of corpses in its wake.

Pablo Escobar and his partners called their business a cartel, but instead of controlling price and supply, it behaved far more like a criminal syndicate that pumped an endless supply of cocaine into the market and let the market set the price. It was not only a lethal purveyor of stimulants and mayhem, it was also a brilliant business, no different in many ways from a Fortune 500 corporation, but built to operate wholly outside the law.

"What the Medellín cartel did is exactly what any global pharmaceutical firm has to do," says Philip Heymann, a Harvard Law School professor who fought the drug cartels as a deputy U.S. attorney general in the mid-1990s. "You start with an ordinary manufacturing and sales business, and then you overlay it with three other things to make up for the fact that you are working outside the legal system."

That first element was fierce, almost irrational, loyalty to the syndicate's leaders, especially Escobar. The loyalty, often laced with violence, replaced the courts that a legal corporation would use to enforce contracts. Escobar was a master at wielding loyalty to get what he wanted. "Escobar was the CEO, very charismatic, very powerful, very demanding," says former U.S. Drug Enforcement Agency officer Javier Peña. He tracked Escobar from 1988 until the trafficker's death in 1993. "He was considered a Robin Hood in Colombia."

Escobar rallied support among Colombia's poorest citizens by stepping in where the government couldn't or wouldn't. He built an apartment complex in a neighborhood of Medellín that still bears his name, where even today people praise him for what he did for their families and community. "There were tugurios [slums], what we call houses of cardboard and wood," remembers Iván Hernández, a community leader in the Barrio Pablo Escobar. Escobar paid to build hundreds of homes in the impoverished area that had previously been a vast garbage dump. "While he was alive, everyone respected him, everybody managed themselves well in the neighborhoods and comunas."

If loyalty didn't work, then the syndicate turned to brutal violence.

Violence was a masterful substitution for the merger and acquisition tactics of legitimate businesses. Anyone who crossed Escobar, even fellow cartel members, was killed by his legion of sicarios, hired guns as young as 14, plucked straight from the hellish ghettos of Medellín. He paid them $100 to $3,000 to kill Colombian cops-a huge amount of money in a city where kids from the slums had few options.

Peña remembers sicarios telling him, "Our life expectancy is 22. If we have some money to give to our mama, some money for sneakers and drinking, what else do we want?"

Cartel member José Gonzalo Rodríguez Gacha built the cartel's military arm, hiring British and Israeli mercenaries to train his men, and uniting with right-wing death squads and paramilitary groups battling Colombia's leftist guerillas.

Plata o Plomo

Escobar's challenge was simple: "Plata o plomo" ("Take my silver or take my lead").

Finally, the Medellín organization used vast amounts of money to bribe law enforcement and government officials. The bribes were the criminal equivalent of legitimate businesses hiring lobbyists and paying regulatory fines. Although it meant handing over "a very sizeable share of their income" in bribes, Heymann says, it was simply a line item on the cartel's profit and loss statement. Of course, the bribes came with a not-so-subtle threat of violence. Escobar's challenge, oft repeated, was simple: "Plata o plomo" (literally, "silver or lead," as in, "take a bribe or take a bullet to the head").

Loyalty, violence, bribery: For two decades, that lethal mix gave the Medellín syndicate a stranglehold on nearly every aspect of the global cocaine trade, from coca farms in Colombia to street dealers in Chicago. The deft use of those tactics made the Medellín syndicate the world's most ruthless, violent and financially successful criminal organization before it withdrew into the shadows following Escobar's death in 1993. In Colombia, a limited version of the business model lived on for another couple of decades through the Oficina de Envigado, whose members included surviving Medellín traffickers and some of Escobar's former associates, and the Urabeños, the largest surviving criminal organization in Colombia. Pressured by Colombia's police and U.S. law enforcement, today's Medellín traffickers form smaller, looser organizations with less control of their markets and no visible kingpins, while keeping a lower profile as they move cocaine around the world and develop a thriving market in Brazil and Argentina. The business model has thrived where the state is weak and police corrupt, most notably with Mexico's Sinaloa Cartel, led by Joaquín "El Chapo" Guzmán.

The
Ever-Changing
Logistics of
Drug Smuggling

By Peter S. Green

If Escobar was the syndicate's charismatic CEO, his cousin Gustavo Gaviria Rivero was its chief operating officer and the "brains of the cartel," Peña says. Gaviria Rivero developed and controlled the cartel's key smuggling routes-what would be called logistics in the legitimate world of moving goods around the world.

Until the late 1970s, cocaine entered the United States mainly in small quantities stuffed into suitcase linings on commercial flights or smuggled via small boats and fishing trawlers. But as cocaine became the disco era's drug of choice and Wall Street's drug of power in the 1980s, ever-larger quantities were required to meet a seemingly insatiable demand.

Drug Routes Through the Decades

Escobar, who started out as a car thief, then small-time trafficker and kidnapper, first saw opportunity in feeding America's cocaine habit by smuggling coca paste into Colombia, refining it and paying "mules" to smuggle it into the U.S. in their luggage or by swallowing condoms stuffed with cocaine.

Escobar shipped much of the cartel's cocaine through the Caribbean, working with Carlos Lehder and George Jung, who were organizing flights into South Florida through the Bahamas. Lehder then broke with Jung and took control of the tiny Bahamian island of Norman's Cay in 1979, using it as a base where planes would land in broad daylight on the 3,300-foot-long airstrip with loads of cocaine from Colombia. The cocaine was transferred to small planes that could fly below U.S. radar and land on dirt roads and berms in Florida's Everglades.

Such out-in-the-open smuggling wasn't going to last long. In 1982, the Bahamian government forced the traffickers off Norman's Cay. The South Florida Drug Task Force, a combination of agents from the DEA, Customs, FBI and other government agencies along with the military, brought a screeching halt to the Colombia-Bahama-Florida route.

But Gaviria Rivero simply shifted the Medellín supply chain. He tapped legitimate cargo shipments, replacing the insulation in refrigerators and insides of TV sets from Panama with cocaine. They also mixed the highly soluble drug into Guatemalan fruit pulp, Ecuadorian cocoa, Chilean wine and Peruvian dried fish-even soaked it into blue jeans-which was removed by chemists upon arrival in the United States.

From Plant To Powder

The Medellín syndicate was involved in every part of the drug trade, from coca farms in Colombia to street dealers in the United States.

In the 1980s, a kilo of cocaine might cost $1,000 to refine, but Escobar's agents could sell it for up to $70,000 in the U.S.

He began moving cocaine through poverty-stricken Haiti instead of the tourist enclaves of the Bahamas. Profits were so big, pilots made one-way trips to the Florida coast, dropping sacks of cocaine, ditching their planes in the sea and then swimming to waiting ships.

The cartel also began moving cocaine through Panama. From there Mexican couriers would take it overland through Mexico and across the border into the U.S. That meant befriending Mexican smugglers, which helped launch the Sinaloa, Juárez and Tampico cartels that have since turned Mexico into a virtual narco-state.

Throughout it all, the Medellín syndicate remained a decidedly wholesale organization. Escobar and his partners used a collection of distributors and retailers, from U.S. organized crime groups to small-town drug barons and Colombian émigrés, to control the majority of the cocaine moving through Southern Florida and over the Mexican border to the streets of America.

The distributors effectively became "franchisees" of the Colombians, says Paul Gootenberg, a historian and SUNY distinguished professor at Stony Brook University in New York. Violence, bribes and loyalty helped the Medellín syndicate control them. In fact, just the promise of violent retribution from Escobar's enforcers if they didn't pay for deliveries made it possible for the syndicate to control the retail side of the drug trade thousands of miles from home.

Even if they had to share the final profits, the riches were vast. A kilo of cocaine might cost $1,000 to refine and up to $4,000 to smuggle to Miami, where Escobar's agents could sell it for $50,000 to $70,000 in the mid-1980s. At its peak, the Medellín syndicate had five to seven flights a day into the U.S., Mexico or the Caribbean, each carrying some 500 kilos of dope, say Peña and his DEA partner at the time, Steve Murphy. Tons of cocaine became billions in profits.

Drug Routes Through the Decades

Wanted:
Dead or Alive

By Peter S. Green

As cocaine use morphed into an epidemic in the early 1980s, and cheap, toxic crack cocaine ravaged America's inner cities, the U.S. stepped up its war on drugs. When seizures of tons of cocaine in the U.S. failed to dent the supply, the U.S. increased pressure on Colombia to capture the drug kingpins and extradite them for trial in the U.S. Escobar made a bold, and in the end foolhardy, effort to fight the U.S. extradition.

"I would rather have
a grave in Colombia
than a jail cell in the U.S."

- Pablo Escobar

Still known locally as a successful and generous businessman, Escobar co-opted the venerable Liberal Party, and won a seat in parliament in 1982 as an alternate representative, where he pressured legislators to renounce a 1979 extradition treaty with the U.S. and funded a campaign to build opposition to extradition. A year later, crusading Justice Minister Rodrigo Lara Bonilla exposed Escobar as a drug baron, forcing him out of parliament and vowing to bring the Medellín Cartel to justice.

Lara Bonilla would pay for his heroic act with his life. On April 30, 1984, gunmen on a motorcycle ambushed the minister's government limousine, killing him. Escobar was blamed for the assassination, but wasn't convicted. President Belisario Betancur declared war on the drug traffickers, and for the next decade, Colombia was consumed with violence as Escobar, the government, and leftist militias and right-wing death squads fought each other-the country's decades-long civil war stretching beyond politics to control of the increasingly lucrative drug trade.

Facing extradition to the U.S. on drug charges, Escobar vowed never to surrender, telling a meeting of traffickers: "I would rather have a grave in Colombia than a jail cell in the U.S."

The cartel took on Colombia, killing Attorney General Carlos Mauro Hoyos Jiménez in a kidnapping attempt near Medellín in January 1988. A few months later, the DEA sent Peña to Colombia to help capture Escobar and extradite him to the U.S. The traffickers struck again and again, blowing up a Colombian airliner in November 1989 and the headquarters of Colombia's intelligence agency, the DAS, a month later. A special police team, the Bloque de Búsqueda (the Search Bloc), was formed to bring in Escobar.

Pressured by police, rival traffickers and a potent militia called the PEPES (People Persecuted by Pablo Escobar), Escobar negotiated his own surrender in 1991 to a luxury prison he designed and built near his home in Medellín. But a year later, Escobar escaped from the prison as authorities arrived to move him to a secure jail near Bogota.

Within days, Peña and Murphy had a $300,000 price on their heads.

Death Rate Rising

Violence spread across Colombia in the early 1990s, with the murder toll topping 28,000 deaths in a single year.

The Search Bloc was reactivated, and Peña and Murphy were sent to Medellín to join the hunt for Escobar. Within days, they had a $300,000 price on their heads. "We were aware of that, but we didn't think about that; it simply doesn't interfere with the way you're going to do business," Murphy says almost without emotion more than 20 years later. The murder toll in Colombia surged, peaking that year at over 28,000 across the country, with 7,081 in Medellín alone (almost 10 times the number in 1980).

The bounty on Peña and Murphy was the stuff of dreams for the ghetto-born hitmen who were paid a fraction of that sum to kill Colombian cops. To keep out of the sicarios' gunsights, Murphy and Peña were not allowed out on their own in Medellín. They lived with the police unit hunting Escobar in a converted school surrounded by barbed wire fences and patrolled by perimeter guards. If they left the base, an elite corps of bodyguards surrounded them. To get to Medellín from the airport, they were often flown by Colombian police in Huey helicopter gunships.

But just as legal corporations find the roots of their failure in their very success, the violence that Escobar wielded eventually led to his downfall and death. Escobar's obsession with killing his enemies-and increasingly, innocent people-would be his downfall. The murder of two allies turned fellow traffickers against him. The Search Bloc and the PEPES were gradually arresting or killing his trusted aides, and the government pressured Escobar's family. With a bounty of more than $5 million on Escobar's head, tips poured into a police hotline in Medellín.

"What killed the Medellín cartel was clearly the strong violence," says Thomas Pietschmann, a researcher at the United Nations Office on Drugs and Crime in Vienna. "Violence was never good for business, and Pablo Escobar clearly overdid it. He no longer took the precautionary measures you would do as a drug trafficker."

A day after his 44 th birthday, he lingered too long talking to his son on a mobile phone, allowing a Colombian police lieutenant, Hugo Martinez, whose father led the Search Bloc, to trace him to a three-story house in Medellín. He was cornered by several hundred police and shot dead as he leapt to a rooftop on December 2, 1993. In the minutes after his death, Colombian commandos posed like big game hunters over Escobar's corpse. "Viva Colombia! We have just killed Pablo Escobar!" a Colombian policeman shouted over his radio as he broke the news.

The Global Impact of the Cocaine Trade

By Mack Gelber

Wars between two rival drug cartels have nearly destroyed Juárez, a Mexican border city of about 1.5 million people across the Rio Grande from El Paso, Texas. Until recently, violence was a fact of life for most of its citizens, for whom public shootouts and piles of mutilated corpses (messages of retribution from one cartel to another) were part of everyday life.

In fact, even a decline in the murder rate is being attributed to the fluctuations of the drug economy, for which Juárez remains a critical gateway to the world's biggest drug market-the United States.

In 2010, 3,000 people were killed in Juárez (an average of 8.5 people per day), but in 2014 that number dropped sharply to just 434. But the decline isn't being attributed to better police work or the escalation of army troops by former Mexican president Felipe Calderón. Instead, even U.S. authorities see it as a side effect of how Juárez remains in thrall to the drug trade. The Sinaloa Cartel, run by Joaquín "El Chapo" Guzmán, appears to have won the city's drug trade away from the rival Juárez cartel. The decline in deaths comes from one simple fact: The Sinaloa Cartel won the war.

With the decline in deaths, the tourism board has launched a campaign featuring the slogan "Juárez Is Waiting for You"-words that, just a few years ago, would have carried a sinister undercurrent. But whether tourists will be lured to Juárez remains to be seen. It's a haunted place with gravestones and crosses lining the city streets and piles of rusty bullets easily discovered from old shoot-outs.

More than 1,500 miles north, Chicago is a major distribution point for the Sinaloa cartel-affiliated drug rings that move as much as 2,000 kilos of cocaine a month to meet U.S. demand. The organization controls an estimated 70 to 80 percent of the narcotics dealt in the area.

The Mexican cartels use the city's location to their benefit. Chicago is within a day's drive of 70 percent of the U.S. population. A total of six interstates crisscross the metropolitan area, and then there are the city's ports on Lake Michigan and the rail lines that link it to both coasts.

The city's ethnic makeup may also be making it easy for the Mexican and South American cartels to operate under the radar. Cartel operatives can be found in neighborhoods such as Pilsen and Little Village, according to county law enforcement, which are more than 80 percent Hispanic. Both also are close to two of the city's main interstates.

While it's hard to separate out the full impact of the cartels from the other violence that comes from gang activity and drug use, law enforcement in the Chicago areas say the drug trade likely has contributed to the violence in Little Village, which has been named one of the 25 most dangerous neighborhoods in the country by Neighborhood Scout.

But the death and destruction the cocaine trade brings is very localized with few outside of the Little Village neighborhood understanding what it is like to live in an area that is home not only to drug cartels, according to law enforcement, but also violent gangs. If Juárez is haunted by its recent past, Little Village is haunted by the present. Residents impose their own curfews and lock down businesses on what should be busy Friday nights to guard against the violence that comes from being at the epicenter of gangs and drugs.

Across the globe, Sierra Leone has become a major player in the European cocaine trade. That became apparent on Sunday, July 13, 2008, when around 3:30 a.m., a small plane touched down at Lungi International Airport near the country's capital, Freetown. According to news reports, a fake Red Cross insignia was painted on the tail, along with the Venezuelan flag. Inside were five AK-47 rifles, 34 containers of aviation fuel and over 700 kilograms of cocaine, valued at nearly $100 million.

Even though thousands of miles of ocean separate Latin America from the West African coast, the country's foreign minister has said in media reports that cartel operations are thriving as drug traffickers take advantage of Sierra Leone's geographical position on the west coast of Africa to supply Europe's growing cocaine market, often through the port city of Naples. They also capitalize on the country's unstable government institutions, say drug enforcement officials.

The country's geography and political instability have helped make the country popular for Mexican and South American drug cartels and has given rise to a cocaine abuse problem that the country had never faced before. Sierra Leone doesn't produce cocaine locally, but local drug handlers are sometimes paid in product-a fact that may have contributed to the rise of cocaine use in West Africa. According to some estimates, up to 30 percent of trafficked drugs are consumed locally, and the 2012 United Nations Office on Drugs and Crime World Drug Report draws a connection between the cocaine trade in South America to the growing abuse of the drug in Sierra Leone and other West African countries.

When Le Vele, the Le Corbusier-inspired housing project in Naples' Scampìa neighborhood, was completed in 1975, its design was intended to suggest a billowing set of sails. That's what the name means- Le Vele di Scampìa (The Sails of Scampìa)-and it spoke to idealism and optimism that has little to do with the place Le Vele has become.

Now reportedly a major hub for the Camorra, a loose-knit collective of crime syndicates operating in Naples, Le Vele's high-rises are more a series of battlements keeping police activity at bay than sails of promise. The people who do live here (some legally, but most as squatters) share space with the local cocaine and heroin business that brings in more than $11 million a month to meet the demand for coke in Western Europe. The European drug trade, rooted in Latin America and shipped through West Africa, has turned these apartments into trenches, residents into co-conspirators and children into soldiers. Meanwhile, Camorra operatives in Latin America and Mexico broker deals with the region's cartels, ensuring that the circuitous route between South America and Naples remains open.

The place's devastation, both social and physical, can be read as a metaphor for the larger devastation of the cocaine trade on Naples. One feud over control of the Scampìa drug market left an estimated 140 dead in 2004. Hundreds of innocent bystanders have been killed by mistake by Camorra assassins since 1980 as well. A crackdown followed, but like the rot eating at the walls and floors of Le Vele, purging the project of cocaine won't be easy.

Wars between two rival drug cartels have nearly destroyed Juárez, a Mexican border city of about 1.5 million people across the Rio Grande from El Paso, Texas. Until recently, violence was a fact of life for most of its citizens, for whom public shootouts and piles of mutilated corpses (messages of retribution from one cartel to another) were part of everyday life.

In fact, even a decline in the murder rate is being attributed to the fluctuations of the drug economy, for which Juárez remains a critical gateway to the world's biggest drug market-the United States.

In 2010, 3,000 people were killed in Juárez (an average of 8.5 people per day), but in 2014 that number dropped sharply to just 434. But the decline isn't being attributed to better police work or the escalation of army troops by former Mexican president Felipe Calderón. Instead, even U.S. authorities see it as a side effect of how Juárez remains in thrall to the drug trade. The Sinaloa Cartel, run by Joaquín "El Chapo" Guzmán, appears to have won the city's drug trade away from the rival Juárez cartel. The decline in deaths comes from one simple fact: The Sinaloa Cartel won the war.

With the decline in deaths, the tourism board has launched a campaign featuring the slogan "Juárez Is Waiting for You"-words that, just a few years ago, would have carried a sinister undercurrent. But whether tourists will be lured to Juárez remains to be seen. It's a haunted place with gravestones and crosses lining the city streets and piles of rusty bullets easily discovered from old shoot-outs.

More than 1,500 miles north, Chicago is a major distribution point for the Sinaloa cartel-affiliated drug rings that move as much as 2,000 kilos of cocaine a month to meet U.S. demand. The organization controls an estimated 70 to 80 percent of the narcotics dealt in the area.

The Mexican cartels use the city's location to their benefit. Chicago is within a day's drive of 70 percent of the U.S. population. A total of six interstates crisscross the metropolitan area, and then there are the city's ports on Lake Michigan and the rail lines that link it to both coasts.

The city's ethnic makeup may also be making it easy for the Mexican and South American cartels to operate under the radar. Cartel operatives can be found in neighborhoods such as Pilsen and Little Village, according to county law enforcement, which are more than 80 percent Hispanic. Both also are close to two of the city's main interstates.

While it's hard to separate out the full impact of the cartels from the other violence that comes from gang activity and drug use, law enforcement in the Chicago areas say the drug trade likely has contributed to the violence in Little Village, which has been named one of the 25 most dangerous neighborhoods in the country by Neighborhood Scout.

But the death and destruction the cocaine trade brings is very localized with few outside of the Little Village neighborhood understanding what it is like to live in an area that is home not only to drug cartels, according to law enforcement, but also violent gangs. If Juárez is haunted by its recent past, Little Village is haunted by the present. Residents impose their own curfews and lock down businesses on what should be busy Friday nights to guard against the violence that comes from being at the epicenter of gangs and drugs.

Across the globe, Sierra Leone has become a major player in the European cocaine trade. That became apparent on Sunday, July 13, 2008, when around 3:30 a.m., a small plane touched down at Lungi International Airport near the country's capital, Freetown. According to news reports, a fake Red Cross insignia was painted on the tail, along with the Venezuelan flag. Inside were five AK-47 rifles, 34 containers of aviation fuel and over 700 kilograms of cocaine, valued at nearly $100 million.

Even though thousands of miles of ocean separate Latin America from the West African coast, the country's foreign minister has said in media reports that cartel operations are thriving as drug traffickers take advantage of Sierra Leone's geographical position on the west coast of Africa to supply Europe's growing cocaine market, often through the port city of Naples. They also capitalize on the country's unstable government institutions, say drug enforcement officials.

The country's geography and political instability have helped make the country popular for Mexican and South American drug cartels and has given rise to a cocaine abuse problem that the country had never faced before. Sierra Leone doesn't produce cocaine locally, but local drug handlers are sometimes paid in product-a fact that may have contributed to the rise of cocaine use in West Africa. According to some estimates, up to 30 percent of trafficked drugs are consumed locally, and the 2012 United Nations Office on Drugs and Crime World Drug Report draws a connection between the cocaine trade in South America to the growing abuse of the drug in Sierra Leone and other West African countries.

When Le Vele, the Le Corbusier-inspired housing project in Naples' Scampìa neighborhood, was completed in 1975, its design was intended to suggest a billowing set of sails. That's what the name means- Le Vele di Scampìa (The Sails of Scampìa)-and it spoke to idealism and optimism that has little to do with the place Le Vele has become.

Now reportedly a major hub for the Camorra, a loose-knit collective of crime syndicates operating in Naples, Le Vele's high-rises are more a series of battlements keeping police activity at bay than sails of promise. The people who do live here (some legally, but most as squatters) share space with the local cocaine and heroin business that brings in more than $11 million a month to meet the demand for coke in Western Europe. The European drug trade, rooted in Latin America and shipped through West Africa, has turned these apartments into trenches, residents into co-conspirators and children into soldiers. Meanwhile, Camorra operatives in Latin America and Mexico broker deals with the region's cartels, ensuring that the circuitous route between South America and Naples remains open.

The place's devastation, both social and physical, can be read as a metaphor for the larger devastation of the cocaine trade on Naples. One feud over control of the Scampìa drug market left an estimated 140 dead in 2004. Hundreds of innocent bystanders have been killed by mistake by Camorra assassins since 1980 as well. A crackdown followed, but like the rot eating at the walls and floors of Le Vele, purging the project of cocaine won't be easy.

The Global Impact of the Cartels

By Mack Gelber

Cocaine still flows through the Medellín Cartel's distribution networks. The routes feed demand for the drug and are paved with death, decay and destruction.

Who Else Profits From The Drug War?

By Mack Gelber

Who Else Profits from the Drug War?

By Mack Gelber

From private prisons to plastic surgery, legitimate industries have benefited from the fight against drug traffickers.

The Global Impact of the Cocaine Trade

By Mack Gelber

Wars between two rival drug cartels have nearly destroyed Juárez, a Mexican border city of about 1.5 million people across the Rio Grande from El Paso, Texas. Until recently, violence was a fact of life for most of its citizens, for whom public shootouts and piles of mutilated corpses (messages of retribution from one cartel to another) were part of everyday life.

In fact, even a decline in the murder rate is being attributed to the fluctuations of the drug economy, for which Juárez remains a critical gateway to the world's biggest drug market-the United States.

In 2010, 3,000 people were killed in Juárez (an average of 8.5 people per day), but in 2014 that number dropped sharply to just 434. But the decline isn't being attributed to better police work or the escalation of army troops by former Mexican president Felipe Calderón. Instead, even U.S. authorities see it as a side effect of how Juárez remains in thrall to the drug trade. The Sinaloa Cartel, run by Joaquín "El Chapo" Guzmán, appears to have won the city's drug trade away from the rival Juárez cartel. The decline in deaths comes from one simple fact: The Sinaloa Cartel won the war.

With the decline in deaths, the tourism board has launched a campaign featuring the slogan "Juárez Is Waiting for You"-words that, just a few years ago, would have carried a sinister undercurrent. But whether tourists will be lured to Juárez remains to be seen. It's a haunted place with gravestones and crosses lining the city streets and piles of rusty bullets easily discovered from old shoot-outs.

More than 1,500 miles north, Chicago is a major distribution point for the Sinaloa cartel-affiliated drug rings that move as much as 2,000 kilos of cocaine a month to meet U.S. demand. The organization controls an estimated 70 to 80 percent of the narcotics dealt in the area.

The Mexican cartels use the city's location to their benefit. Chicago is within a day's drive of 70 percent of the U.S. population. A total of six interstates crisscross the metropolitan area, and then there are the city's ports on Lake Michigan and the rail lines that link it to both coasts.

The city's ethnic makeup may also be making it easy for the Mexican and South American cartels to operate under the radar. Cartel operatives can be found in neighborhoods such as Pilsen and Little Village, according to county law enforcement, which are more than 80 percent Hispanic. Both also are close to two of the city's main interstates.

While it's hard to separate out the full impact of the cartels from the other violence that comes from gang activity and drug use, law enforcement in the Chicago areas say the drug trade likely has contributed to the violence in Little Village, which has been named one of the 25 most dangerous neighborhoods in the country by Neighborhood Scout.

But the death and destruction the cocaine trade brings is very localized with few outside of the Little Village neighborhood understanding what it is like to live in an area that is home not only to drug cartels, according to law enforcement, but also violent gangs. If Juárez is haunted by its recent past, Little Village is haunted by the present. Residents impose their own curfews and lock down businesses on what should be busy Friday nights to guard against the violence that comes from being at the epicenter of gangs and drugs.

Across the globe, Sierra Leone has become a major player in the European cocaine trade. That became apparent on Sunday, July 13, 2008, when around 3:30 a.m., a small plane touched down at Lungi International Airport near the country's capital, Freetown. According to news reports, a fake Red Cross insignia was painted on the tail, along with the Venezuelan flag. Inside were five AK-47 rifles, 34 containers of aviation fuel and over 700 kilograms of cocaine, valued at nearly $100 million.

Even though thousands of miles of ocean separate Latin America from the West African coast, the country's foreign minister has said in media reports that cartel operations are thriving as drug traffickers take advantage of Sierra Leone's geographical position on the west coast of Africa to supply Europe's growing cocaine market, often through the port city of Naples. They also capitalize on the country's unstable government institutions, say drug enforcement officials.

The country's geography and political instability have helped make the country popular for Mexican and South American drug cartels and has given rise to a cocaine abuse problem that the country had never faced before. Sierra Leone doesn't produce cocaine locally, but local drug handlers are sometimes paid in product-a fact that may have contributed to the rise of cocaine use in West Africa. According to some estimates, up to 30 percent of trafficked drugs are consumed locally, and the 2012 United Nations Office on Drugs and Crime World Drug Report draws a connection between the cocaine trade in South America to the growing abuse of the drug in Sierra Leone and other West African countries.

When Le Vele, the Le Corbusier-inspired housing project in Naples' Scampìa neighborhood, was completed in 1975, its design was intended to suggest a billowing set of sails. That's what the name means- Le Vele di Scampìa (The Sails of Scampìa)-and it spoke to idealism and optimism that has little to do with the place Le Vele has become.

Now reportedly a major hub for the Camorra, a loose-knit collective of crime syndicates operating in Naples, Le Vele's high-rises are more a series of battlements keeping police activity at bay than sails of promise. The people who do live here (some legally, but most as squatters) share space with the local cocaine and heroin business that brings in more than $11 million a month to meet the demand for coke in Western Europe. The European drug trade, rooted in Latin America and shipped through West Africa, has turned these apartments into trenches, residents into co-conspirators and children into soldiers. Meanwhile, Camorra operatives in Latin America and Mexico broker deals with the region's cartels, ensuring that the circuitous route between South America and Naples remains open.

The place's devastation, both social and physical, can be read as a metaphor for the larger devastation of the cocaine trade on Naples. One feud over control of the Scampìa drug market left an estimated 140 dead in 2004. Hundreds of innocent bystanders have been killed by mistake by Camorra assassins since 1980 as well. A crackdown followed, but like the rot eating at the walls and floors of Le Vele, purging the project of cocaine won't be easy.

Wars between two rival drug cartels have nearly destroyed Juárez, a Mexican border city of about 1.5 million people across the Rio Grande from El Paso, Texas. Until recently, violence was a fact of life for most of its citizens, for whom public shootouts and piles of mutilated corpses (messages of retribution from one cartel to another) were part of everyday life.

In fact, even a decline in the murder rate is being attributed to the fluctuations of the drug economy, for which Juárez remains a critical gateway to the world's biggest drug market-the United States.

In 2010, 3,000 people were killed in Juárez (an average of 8.5 people per day), but in 2014 that number dropped sharply to just 434. But the decline isn't being attributed to better police work or the escalation of army troops by former Mexican president Felipe Calderón. Instead, even U.S. authorities see it as a side effect of how Juárez remains in thrall to the drug trade. The Sinaloa Cartel, run by Joaquín "El Chapo" Guzmán, appears to have won the city's drug trade away from the rival Juárez cartel. The decline in deaths comes from one simple fact: The Sinaloa Cartel won the war.

With the decline in deaths, the tourism board has launched a campaign featuring the slogan "Juárez Is Waiting for You"-words that, just a few years ago, would have carried a sinister undercurrent. But whether tourists will be lured to Juárez remains to be seen. It's a haunted place with gravestones and crosses lining the city streets and piles of rusty bullets easily discovered from old shoot-outs.

More than 1,500 miles north, Chicago is a major distribution point for the Sinaloa cartel-affiliated drug rings that move as much as 2,000 kilos of cocaine a month to meet U.S. demand. The organization controls an estimated 70 to 80 percent of the narcotics dealt in the area.

The Mexican cartels use the city's location to their benefit. Chicago is within a day's drive of 70 percent of the U.S. population. A total of six interstates crisscross the metropolitan area, and then there are the city's ports on Lake Michigan and the rail lines that link it to both coasts.

The city's ethnic makeup may also be making it easy for the Mexican and South American cartels to operate under the radar. Cartel operatives can be found in neighborhoods such as Pilsen and Little Village, according to county law enforcement, which are more than 80 percent Hispanic. Both also are close to two of the city's main interstates.

While it's hard to separate out the full impact of the cartels from the other violence that comes from gang activity and drug use, law enforcement in the Chicago areas say the drug trade likely has contributed to the violence in Little Village, which has been named one of the 25 most dangerous neighborhoods in the country by Neighborhood Scout.

But the death and destruction the cocaine trade brings is very localized with few outside of the Little Village neighborhood understanding what it is like to live in an area that is home not only to drug cartels, according to law enforcement, but also violent gangs. If Juárez is haunted by its recent past, Little Village is haunted by the present. Residents impose their own curfews and lock down businesses on what should be busy Friday nights to guard against the violence that comes from being at the epicenter of gangs and drugs.

Across the globe, Sierra Leone has become a major player in the European cocaine trade. That became apparent on Sunday, July 13, 2008, when around 3:30 a.m., a small plane touched down at Lungi International Airport near the country's capital, Freetown. According to news reports, a fake Red Cross insignia was painted on the tail, along with the Venezuelan flag. Inside were five AK-47 rifles, 34 containers of aviation fuel and over 700 kilograms of cocaine, valued at nearly $100 million.

Even though thousands of miles of ocean separate Latin America from the West African coast, the country's foreign minister has said in media reports that cartel operations are thriving as drug traffickers take advantage of Sierra Leone's geographical position on the west coast of Africa to supply Europe's growing cocaine market, often through the port city of Naples. They also capitalize on the country's unstable government institutions, say drug enforcement officials.

The country's geography and political instability have helped make the country popular for Mexican and South American drug cartels and has given rise to a cocaine abuse problem that the country had never faced before. Sierra Leone doesn't produce cocaine locally, but local drug handlers are sometimes paid in product-a fact that may have contributed to the rise of cocaine use in West Africa. According to some estimates, up to 30 percent of trafficked drugs are consumed locally, and the 2012 United Nations Office on Drugs and Crime World Drug Report draws a connection between the cocaine trade in South America to the growing abuse of the drug in Sierra Leone and other West African countries.

When Le Vele, the Le Corbusier-inspired housing project in Naples' Scampìa neighborhood, was completed in 1975, its design was intended to suggest a billowing set of sails. That's what the name means- Le Vele di Scampìa (The Sails of Scampìa)-and it spoke to idealism and optimism that has little to do with the place Le Vele has become.

Now reportedly a major hub for the Camorra, a loose-knit collective of crime syndicates operating in Naples, Le Vele's high-rises are more a series of battlements keeping police activity at bay than sails of promise. The people who do live here (some legally, but most as squatters) share space with the local cocaine and heroin business that brings in more than $11 million a month to meet the demand for coke in Western Europe. The European drug trade, rooted in Latin America and shipped through West Africa, has turned these apartments into trenches, residents into co-conspirators and children into soldiers. Meanwhile, Camorra operatives in Latin America and Mexico broker deals with the region's cartels, ensuring that the circuitous route between South America and Naples remains open.

The place's devastation, both social and physical, can be read as a metaphor for the larger devastation of the cocaine trade on Naples. One feud over control of the Scampìa drug market left an estimated 140 dead in 2004. Hundreds of innocent bystanders have been killed by mistake by Camorra assassins since 1980 as well. A crackdown followed, but like the rot eating at the walls and floors of Le Vele, purging the project of cocaine won't be easy.

The Global Impact of the Cartels

By Mack Gelber

Cocaine still flows through the Medellín Cartel's distribution networks. The routes feed demand for the drug and are paved with death, decay and destruction.

Who Else Profits From The Drug War?

By Mack Gelber

Who Else Profits from the Drug War?

By Mack Gelber

From private prisons to plastic surgery, legitimate industries have benefited from the fight against drug traffickers.

Medellín:
A Post-Pablo
Economy By Fara Warner and Christine Sanders
By Fara Warner and Christine Sanders

Medellín is a study in contrasts. Visit the El Poblado comuna (or neighborhood), and the city feels worthy of the "miracle" moniker that's been applied to its comeback economy.

High-rise apartments punctuate the sky. Open-air restaurants are filled with people-an unimaginable scene when gunfights between Pablo Escobar's sicarios and government forces meant sitting outside was a potential death sentence. The Museo de Antioquia rivals any in the world and features more than 188 works by one of Medellín's other famous citizens-sculptor and painter Fernando Botero.

The Miracle of Medellín

After decades of violence, Medellín has become one of South America's most dynamic cities.

Go beyond the upscale El Poblado and the other Medellín-the noise, pollution and chaos of the more notorious comunas -begins to reveal itself.

Poverty, crime and income inequality-systemic problems in the city before cocaine was added to the mix-are still prevalent. Neighborhoods such as Comuna 13 and Comuna 9 are made up of ramshackle houses with tin roofs and stucco-covered brick perched on the steep hills. Here, Medellín's economic comeback feels more elusive. The divide between rich and poor is higher here than the rest of Colombia as defined by the Gini coefficient, which represents income distribution. The lower the Gini number, the more economically equal a society is considered to be. Medellín's Gini number has dropped from .54 to .50 from 2008 to 2012. Colombia's average is .49. By comparison, the United States' Gini number was .41 in 2013.

But stop. Listen closely. You'll hear the distinctive sounds of Spanish-laced hip-hop emanating from Casa Kolacho in Comuna 13. Turn a corner and you'll be met with the riotous beauty of graffiti that has become the community's defiant symbol of rebirth. You begin to see why Medellín is a model for other cities trying to put their violent pasts behind them. It's one of the very few cities torn apart by narco-terrorism to make a comeback.

The local government has begun to contribute to revitalizing neighborhoods where once the illegal economy of drugs and crime were the only ways out of the slums-or at least the only way to make money. An escalator has been built to connect the people at the top of the steep hill with those at the bottom, in an effort to bridge the city's topography.

"I don't want a segregated city that is not one city but 15 different cities," says Medellín's mayor Aníbal Gaviria Correa. "Communities and neighborhoods where the quality of life and security are much worse than others."

He admits that while Medellín has come a long way from the violent, decimated city it was in the 1990s, "there is so much left to do, despite today having historically lower levels of both extreme poverty and violence." The city's murder rate has dropped from 381 per 100,000 in 1991 (almost 40 times higher than the U.N.'s marker for an epidemic of violence), to less than 27 per 100,000 in 2014. That is lower than U.S. cities such as Baltimore, Maryland.

But the deep economic divide that the Medellín Cartel capitalized on still exists. For the city's poorest residents, the illegal economy-the economy of drugs in particular-was and still is a way to rise up and out of extreme poverty.

The intensity of the crisis and the sheer number of people killed in the violence has shaken Medellín to its core. And while no one would want any city to go through what Medellín did, the horrific crisis here has forced the government and social institutions to be more creative in their efforts to bring the city back.

The local government has invested in traditional ways, with money for the escalators, schools, roads and other public works. But it may be the government's willingness to accept that acts of seeming defiance like graffiti and hip-hop are in fact acts of economic power that will move the city forward.

"The movement to make art a part of culture and creating spaces for dance, to sing, to do graffiti and more has given rise to youth engaging in such activities," says Chota, a graffiti artist who goes by a single name. But unlike graffiti artists elsewhere who learned their craft under threat of arrest for defacing property, Chota was actually schooled in the art of graffiti. "When I was in 11th grade, the opportunity to participate in art programs was provided. Because I liked drawing, I became involved with graffiti and fine-tuned my techniques," he says.

One of his murals, called America and representative of South America as opposed to North America, features a face where the neck is made of leaves, the hair is painted to represent weeds and a lotus flower defines the crown of the head.

"Art has become something that has helped communities resist violence," he says. "But it is also a way for the city itself to gain a different reputation away from being a dangerous and violent place to a place where young people can have a prosperous outlook of the future."

In Comuna 13, hip-hop can provide a path to that future and may protect young people from getting involved in gangs. The irony is that the community has embraced a musical form that is defiant, anti-establishment and born out of despair-and often comes from the very place, the United States, that provided the market for cocaine. Here it is the music of hope. "We work with kids who have never been involved in gang violence," says Jeihhco, a hip-hop artist who helped start Casa Kolacho. "These are kids who are living surrounded by violence, but have been fortunate enough not to be living it. We have become an option here in Medellín. Violence is still rampant. Gangs still exist, stronger than ever. Fortunately, we're also stronger than ever."

Pablo Escobar was a complicated character-a ruthless criminal but also a cunning business entrepreneur. His ability to outthink his competition and deflect attempts to bring him to justice set him apart. Could you have stayed one step ahead like Escobar?

Narcos Now

The power of the global drug trade continues to make headlines around the world.

Previously published Wall Street Journal articles selected by Netflix.

Bolivia Cuts Coca Production for Fourth Consecutive Year, U.N. Says

Study: 'Fair Sentencing' Law Leads to Decrease in Crack Prosecutions

Colombian Coca Crop Increases in 2014, Raising Concern About Cocaine Trafficking

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By Peter S. Green How Cocaine Traffickers from Medellín Transformed the Multibillion Dollar Global Drug Trade The Medellín Cartel was an empire of stunning sweep and unimaginable violence. At its height, it earned as much as $4 billion a year-most of it cash-for its members and controlled 80 percent of the cocaine supply in the United States, leaving tens of thousands of corpses in its wake.

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N.H. Has Third Highest Drug Overdose Death Rate in the U.S. | New Hampshire Public Radio

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N.H. Has Third Highest Drug Overdose Death Rate in the U.S. | New Hampshire Public Radio

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Source gives statistics, and background information on the opioid addiction.

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A new report from the Centers for Disease Control shows that New Hampshire had one of the highest drug overdose death rates in the country last year.

The state saw an overdose death rate of 39 people per 100,000 in 2016. That's up from 34 people per 100,000 the previous year.

New Hampshire had the third-highest rate among the states, behind West Virginia and Ohio.

The national average is 20 deaths per 100,000. Since 1999, overdose deaths have risen threefold.

New Hampshire is expected to close out this year with 466 overdose deaths - about 20 fewer than in 2016.

As the rate of drug deaths remains high, New Hampshire's congressional members have sought more money to combat the crisis.

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N.H. Has Third Highest Drug Overdose Death Rate in the U.S.

# data[].attributes.attachment_link.description
A new report from the Centers for Disease Control shows that New Hampshire had one of the highest drug overdose death rates in the country last year. The state saw an overdose death rate of 39 people per 100,000 in 2016. That's up from 34 people per 100,000 the previous year.

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Opioid Crisis: NIH Launches New Push to Fight Epidemic - NBC News

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Opioid Crisis: NIH Launches New Push to Fight Epidemic - NBC News

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NBC is a reliable source. Shows a way in which the epidemic is being fought.

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The National Institutes of Health announced a new push Wednesday to fight the opioid crisis, with fresh efforts to develop better drugs to fight addiction, to treat pain, and to stop overdoses.

The giant agency - the world's biggest funder of medical research - is meeting with drugmakers to figure out the best and fastest ways to come up with a better solution to treating pain than the current addictive opioid class of drugs.

"Every day, more than 90 Americans die from opioid overdoses," NIH director Dr. Francis Collins and Dr. Nora Volkow, head of the NIH's National Institute for Drug Abuse, wrote in a special report for the New England Journal of Medicine.

Collins said the NIH will be meeting with "a dozen or more" drug companies over the coming weeks to develop better overdose drugs; better drugs to treat opioid addiction; and pain drugs that not only work better, but that are not addictive.

"Some may be reformulations of drugs that we already know can be used for treatment of overdoses," Collins told reporters. "Some of them will be totally new ideas about pathways that have been recently discovered."

One example: Narcan nasal spray, a quick-acting formulation of naloxone (Adapt Pharma Inc's Narcan) that was approved by the Food and Drug Administration in 2015. The opioid antagonist blocks the effects of the opioid drugs, which slow breathing, sometimes fatally. NIH and the drug's maker collaborated to develop it and get it approved.

Related: Trump Admin to Pay Cash Promised by Obama to Fight Opioid Crisis

"The NIH will now work with private partners to develop stronger, longer-acting formulations of antagonists, including naloxone, to counteract the very-high-potency synthetic opioids that are now claiming thousands of lives each year," Collins and Volkow wrote.

"Industry is very interested and committed," Collin added in the phone briefing.

"The holy grail was to develop an opioid that was not addictive ... but it's failed completely."

Getting there may not be easy. "Reformulating opioids to deter abuse doesn't improve their efficacy, and opioids haven't been shown to relieve pain or improve functioning any better than nonopioid medications or nonpharmacologic treatments - which is the primary reason the CDC recommended those alternatives for managing chronic noncancer pain," Dr. William Becker and Dr. David Fiellin, both of Yale University, wrote in a separate commentary in the New England Journal of Medicine.

Related: Ohio Sues 5 Pharma Companies over Opioid Abuse Crisis

President Donald Trump has suggested slashing the NIH budget, but leaders in Congress have said there's no way they'll do that and Trump himself has also said fighting the opioid addiction crisis is a priority.

"This will be something we put very high on the list of things we just have to do," Collins said.

Drug companies and science alike have failed to keep moving, in part because it took a while to realize that new formulations of synthetic opioids, such as fentanyl, were even more deadly and addictive than heroin and morphine.

"It was partly because we believed as recently as 20 years ago that we had this problem solved," Collins said.

"The holy grail was to develop an opioid that was not addictive ... but it's failed completely," Volkow added. One big mistake was believing that if people were taking opioids to treat pain, they would not become addicted, Volkow said.

Related: Opioid Abuse Epidemic Worse Than Ever, Surgeon General Says

However, advances in science might make it easier to design better drugs. Molecular level imaging of the nerve receptors involved in pain may allow for the precise design of drugs that can block pain without having side effects.

Collins also pointed to an extremely rare condition making people insensitive to pain. It's caused by a mutation in a gene called SCN9A.

"It's pretty obvious that if we are going to have new drugs, people need access."

A drug that blocked that pathway, Collins said, might be able to block pain effectively without the side-effects of opioids. "It's still early days to know how that might work," he admitted.

Without taking on the politics of fighting drug abuse, Volkow and Collins also noted that it's important to ensure that people get the treatments they need. "It's pretty obvious that if we are going to have new drugs, people need access," Collins said.

And Volkow pointed to Canadian research showing that providing people with safe sites to inject drugs not only helps prevent the transmission of diseases, but gets people into treatment for their addiction. "The extent to which this can be applied to the U.S. has not been studied," she said.

Separately, the Health and Human Services Department said it was releasing $70 million authorized by Congress last year as part of the Comprehensive Addiction and Recovery Act.

Governments and groups must apply for the money, which is available for three broad areas:

Medication-assisted treatment for addiction

Training and resources for first responders

Better access to overdose treatment

"We are committed to bringing everything the federal government has to bear on this health crisis," HHS Secretary Tom Price said in a statement.

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The NIH is taking a fresh approach to opioid abuse

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The National Institutes of Health announced a new push Wednesday to fight the opioid crisis, with fresh efforts to develop better drugs to fight addiction, to treat pain, and to stop overdoses.

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Opioid crisis weighs on New Hampshire’s chief medical examiner - The Boston Globe

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Opioid crisis weighs on New Hampshire’s chief medical examiner - The Boston Globe

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Boston Globe is credible, and the chief medical examiner is an amazing source of information.

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CONCORD, N.H. - On some days, Dr. Jennie Duval calls as many as six families after fatal overdoses - some of the families stunned and heartbroken, some of them resigned to a death they saw coming.

This, Duval said, is the most difficult part of her job as the only full-time medical examiner in New Hampshire, which leads the nation in per-capita deaths caused by fentanyl and other synthetic opioids.

"It's not like I can rush the call," said Duval, the state's chief medical examiner, as she described a heart-wrenching notification. "It takes a lot of time. But sometimes I feel like a broken record."

The crush of fatal overdoses has forced the office to abandon its practice of conducting an autopsy on each suspected overdose victim. Still, Duval has no alternative but to work a grueling schedule of 10- to 12-hour days that drains her physically and emotionally.

"If this epidemic is cresting, I'm not feeling it," Duval said in a conference room at Concord Hospital, the strain of another long day visible on her face. "There are many more autopsies that I'm not doing."

A Chelsea physician writes of the importance - and rewards - of treating opioid addiction in primary care.

Duval's only assistance comes from two contractors who each work five days a month. Among them, they conducted 548 autopsies last year - about one-third for overdoses in a state where 476 people are confirmed or suspected to have died from drugs in 2017. Duval conducted nearly 300 autopsies, far above the profession's suggested limit of 250.

The state Legislature has approved funding for two physicians to join the office. But in the ultra-competitive field of forensic pathology - a limited pool of doctors to fill many openings in the country, coupled with the challenge of recruiting in a rural state with long winters - Duval is crossing her fingers that help arrives soon.

"It takes a certain kind of person to do this job," she said. "It's not pleasant. You're dealing with death every day."

The state's former chief medical examiner, Dr. Thomas Andrew, said the opioid epidemic was part of the reason he retired last year to pursue a calling for the ministry.

The office's overall caseload has more than doubled since 1997, the year Andrew became chief medical examiner, and reached 1,820 in 2017. Twenty years ago, opioids were linked to less than 10 percent of deaths referred to the office, Andrew estimated.

"It was simply a slowly unfolding catastrophe that, even in seeing it coming, we didn't have the surge capacity to account for it," Andrew said. "The casework was getting done, don't get me wrong, but the numbers became so overwhelming."

The medical examiner's office investigates fewer than 20 percent of the approximately 12,000 people who die in New Hampshire each year. They include victims of suicide, accidents, and sudden, unexpected deaths of people under 60.

The number of cases that include an autopsy makes up about one-third of all referrals, although they are mandatory for some cases, such as homicides.

Choosing which overdose victims to autopsy "is a gamble," Duval said.

Some cases seem obvious - a syringe in the arm, opioids near the body, and a documented history of drug abuse, she said. But even cases that appear straightforward can involve factors that are discovered only through an autopsy, Duval said. Perhaps a pulmonary embolism will be found. Perhaps other damage might have caused or contributed to the death.

And as the opioid crisis continues, autopsies can yield valuable information about the effects of synthetic drugs such as fentanyl.

"It's the right thing to do," Duval said. "You want to have every piece of the puzzle."

New Hampshire is not alone in its staffing struggles.

Dr. Kim Collins, a South Carolina physician who is president of the National Association of Medical Examiners, said the profession is finding it hard to fill vacancies as fewer students choose the field and more forensic pathologists are retiring.

Each year, only about 30 to 40 young doctors in the United States become certified in forensic pathology, Collins said. Medical schools are devoting less attention to the subject - "some medical students will never even see an autopsy,'' Collins said - and the field pays far less than many other specialities.

Massachusetts, for example, is working to add three or four more doctors to a staff that already has hired two others since the beginning of the fiscal year, said Daniel Bennett, the state secretary of public safety, who oversees the medical examiner's office.

The state's nine full-time medical examiners average more than 300 autopsies a year, Bennett said. Massachusetts also has three part-time forensic pathologists, nine contracted examiners, and three young physicians who work for the office on a fellowship program.

Still, Massachusetts must improve to be fully accredited by the national association that Collins leads. Bennett said the opioid epidemic, mirroring its impact elsewhere, has created a backlog in completed autopsy reports that the office hopes to shrink to industry guidelines this year.

The national association requires that 90 percent of autopsy reports be completed in 90 days. In Massachusetts, 58.3 percent of autopsy reports met that standard between October 2015 and September 2017.

To help address the lag, Governor Charlie Baker wants to boost funding for the office by $1.7 million in fiscal 2019, to a total of $11.9 million.

In Maine, two full-time forensic pathologists handle nearly all the autopsies. Two others work on a per-diem basis and handle about 10 percent of the cases.

"We did have trouble with turnover in this office, and it was difficult. Once you get an employee trained, they leave, usually for more money," said Mark Belserene, administrator of the state's medical examiner's office.

"We were successful in reclassifying positions to better reflect the actual tasks and also to bring the salaries up to a more competitive level," Belserene said.

Despite the physical and mental stress, Duval plans to stay put as New Hampshire's chief medical examiner.

"I'm not going anywhere," she said with a small smile.

Although the caseload continues to climb, the addition of two doctors should make the work more manageable. Still, Duval said she does not expect the yearly number of autopsies to fall below 250 for any examiner.

The opioid crisis should ensure that.

Brian MacQuarrie can be reached at brian.macquarrie@globe.com.

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Opioid crisis weighs on New Hampshire's chief medical examiner - The Boston Globe

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CONCORD, N.H. - On some days, Dr. Jennie Duval calls as many as six families after fatal overdoses - some of the families stunned and heartbroken, some of them resigned to a death they saw coming.

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New Hampshire Hoping Boost in Opioid Funds in Federal Spending Deal Hits Home | New Hampshire Public Radio

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New Hampshire Hoping Boost in Opioid Funds in Federal Spending Deal Hits Home | New Hampshire Public Radio

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Funding increased to help the NH citizens deal with the epidemic. NPR is very credible and reliable.

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New Hampshire's congressional delegation is cheering a significant increase in federal funds for fighting the opioid epidemic included in the federal spending deal released Wednesday. The draft bill contains an additional $3 billion over 2017 funding levels to fight opioid and mental health crises nationally.

"These federal dollars will deliver the material assistance that is desperately needed for prevention, treatment, recovery, law enforcement and first responders," said Senator Jeanne Shaheen in a statement Thursday.

The deal reflects an agreement reached by a group of bipartisan senators, including Shaheen and Senator Maggie Hassan, in February, securing the additional opioid funds.

It remains unclear, though, exactly how much New Hampshire stands to gain from the boost.

Shaheen and Hassan had advocated for a change in the formula used to allocate major federal substance abuse grants to states. They argued the existing formula unfairly favored high population states over smaller states that have a high level of drug abuse per capita. Of the approximately $500 million distributed nationally last year, New Hampshire received only $3 million.

The spending bill does not include a change to that formula, but does specifically set aside about $142 million for states like New Hampshire with high overdose rates. How that $142 million will be distributed, and among how many states, is yet to be determined.

"I will work with Senator Shaheen and the entire delegation to ensure that the Trump Administration provides New Hampshire with a fair share of the funds for states that have been hardest-hit by the opioid crisis," said Hassan in a statement.

The agreement also includes funding increases for research on opioid addiction, prescription drug monitoring programs, substance abuse and mental health efforts in the Department of Veterans Affairs, and local law enforcement programs to fight the crisis.

"This is an important step," said Congresswoman Annie Kuster in a statement. "I'll continue to push for long term funding to ensure the treatment community, healthcare providers, and law enforcement have the certainty they need."

Her tone was echoed by Congresswoman Carol Shea-Porter. "The $142 million set-aside for the hardest-hit states will help New Hampshire," she said. "But we will still need the Trump administration to direct more resources to our state."

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New Hampshire Hoping Boost in Opioid Funds in Federal Spending Deal Hits Home

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New Hampshire's congressional delegation is cheering a significant increase in federal funds for fighting the opioid epidemic included in the federal spending deal released Wednesday. The draft bill contains an additional $3 billion over 2017 funding levels to fight opioid and mental health crises nationally.

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The deadliness of the opioid epidemic has roots in America’s failed response to crack - Vox

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The deadliness of the opioid epidemic has roots in America’s failed response to crack - Vox

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Histo

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The death toll from the opioid epidemic ravaging the US has been climbing by the thousands for years:In 2015, opioid overdose deaths killed more people in the US - 52,000 - than guns, car crashes, and even HIV/AIDS at its peak, and overdoses since the epidemic began in the late '90s had killed more people than the entire population of Atlanta.Based on preliminary data, 2016 will be worse. And 2017 could be even worse than that, as the deadly synthetic opioid fentanyl continues to spread across the US.

Public health officials at every level of government have been unable to reverse or even stabilize the rising death toll from the crisis, which was sparked by the widespread misuse of highly addictive prescription painkillers. This stark inability to manage the crisis shows just how unprepared America is to deal with such a massive epidemic of addiction.

But that's not because America has never dealt with a drug crisis in the past. Since the 1980s, for instance, devastating and prolonged crack cocaine and methamphetamine epidemics have destroyed and destabilized communities across the country. Rather, the opioid crisis has gotten so far out of control because of the spiraling effects of America's flawed response to those previous crises. And that has a lot to do with who the victims of those crises were, and how that informed the way Americans viewed their struggle.

Consider a hypothetical scenario, raised to me by Atlantic writer Ta-Nehisi Coates: Back in the 1980s and early '90s, America was ravaged by the crack cocaine epidemic, with thousands of overdoses a year and thousands more murders associated with the drug trade at the time. If the US had responded to this crisis by investing in drug addiction treatment, there would be an infrastructure for dealing with such a crisis that could have endured to this day. This may have prevented one of the biggest challenges in the current opioid crisis - that only about 10 percent of people with a drug use disorder get specialty treatment, according to a 2016 report from the surgeon general.

But crack largely afflicted black communities, and the response at the time was not public health-oriented. Instead, it focused almost entirely on criminalizing addiction, passing laws to lock up people who use drugs and drug dealers through exorbitant prison sentences, such as mandatory minimums - an approach that many policymakers, including some Republicans, now consider a mistake and are looking to undo. As a result, the US never got the treatment system it needs to deal with these crises.

Today, white Americans are the ones disproportionately suffering in the opioid crisis. The largely empathetic rhetorical response to their addiction, compared with the way black people addicted to crack were treated decades ago, has been noted many times over. But you can draw a direct line between the fact that the people suffering in this crisis can't get the help that they need and society's failure, 30 years ago, to view black people as worthy of the same help.

"There weren't signs on the billboards and the subways that said save people at all costs," Heather McGhee, president of the left-leaning public policy group Demos, told me. "White Republican politicians weren't saying that this is a national crisis, and 'there but for the grace of God go I,' as Chris Christie has said. There is a difference. There absolutely is a difference." She added, "Racial bias distorts our response and ... made it so we did not create the infrastructure and the policy understanding during the earlier drug epidemics."

This is just one of the many ways that systemic racism ultimately hurts not just those who are the targets of bigotry, but society as a whole. Time and time again, politicians have deployed explicit racism and dog whistles to justify policies to white constituents who harbor racial resentment. But these policies can lead to outcomes that ultimately hurt the white constituents who are activated by racial calls. The opioid epidemic, as the country's deadliest drug overdose crisis in history, is a concrete example of this trend.

"In our interconnected society, racism - both interpersonal and institutional - is the flaw in the machine that often stymies our democracy and our economy," McGhee, who's working on a book on this topic, said. "Racism and bias against full portions of the population color the policy responses of elected officials."

The US was totally unprepared to handle the opioid epidemic

The opioid epidemic is not America's first drug overdose crisis, although it is so far the deadliest. In 2016, preliminary data suggests that 59,000 to 65,000 people died of drug overdoses - the highest death toll from overdoses ever recorded in the US. In the next 10 years, as many as 650,000 people could die from opioid overdoses alone - a death toll that totals more than the entire population of Baltimore.

Policymakers and the public are widely in agreement that people addicted to opioids need treatment. But there is little existing addiction treatment infrastructure in the US, and systems like that cannot be built overnight.

It's common to hear stories across the US, particularly in places hit especially hard by the crisis (such as West Virginia and New Hampshire), about weeks- or months-long waiting periods to get into treatment - if patients can get into care at all.

Take Dean Lemire of New Hampshire: In 2012, as reported by NPR, Lemire was finally fed up with his heroin addiction. He tried to sign up for a state-funded treatment center but was put on a waiting list. He called multiple times a day for three weeks, but after repeated denials, he gave up. He drank some whiskey, got into his car to find heroin, and got into three car crashes before waking up in a jail cell. Only then could the treatment center let him in, apparently deeming his case serious enough.

And Lemire is one of the lucky ones - he survived and ultimately got into care.

States that want to treat a growing wave of newly addicted people just don't have the resources in place to act quickly. That's because they're largely starting from scratch. And starting from scratch is expensive - New Hampshire, which is second in overdose deaths after West Virginia, still doesn't have treatment centers in swaths of the state, especially in rural areas.

Drug policy experts have told me that the US as a whole will likely need to spend tens of billions a year to seriously boost addiction treatment. That may lead to financial savings in the long term, given that studies show addiction treatment prevents all sorts of negative, costly outcomes. But it's a big upfront investment, and it will take years to implement and build on.

Meanwhile, people will continue to die - and so states may be tempted to use their existing criminal justice systems to deal with their overdose crises. Some states have, for example, begun asking prosecutors to bring more drug-induced homicide charges against people who supply opioids to someone who overdoses and dies.

Criminal justice experts widely agree this is not only costly but ineffective. A 2014 review of the research by Peter Reuter at the University of Maryland and Harold Pollack at the University of Chicago, for example, found that while simply prohibiting drugs to some extent does raise their prices, there's no good evidence that tougher punishments or harsher supply-elimination efforts do a better job of driving down access to drugs and substance misuse than lighter penalties. So increasing the severity of the punishment doesn't do much, if anything, to slow the flow of drugs.

As ineffective as that may be, states already have the means to carry out this kind of response. They have enough prisons to make the US the world's leader in incarceration. They have old laws in place that allow prosecutors to pursue stiffer penalties. And they have an incentive to use these systems, because it makes them look like they're doing something about an epidemic that kills tens of thousands of people a year.

America "built up this massive incarceral state, which is a hungry critter," Keith Humphreys, a Stanford drug policy expert, told me.

Put another way, the table is set so that America responds in the same way it has before to drug crises: not much on the public health side, but a lot more on the criminal justice side. And people will suffer and die as a result.

It didn't have to be this way. In the 1980s, America had a chance to implement the sort of public health infrastructure for addiction that states are scrambling to put in place today. Under pressure from the public to do something about the crack epidemic, policymakers could have invested in a serious drug addiction treatment system that could have been scaled or retooled for other drugs, from meth to opioid painkillers and heroin.

Humphreys gave a concrete example of how this could have worked: "Something we could have done then, which is what we've done now, is we could have mainstreamed addiction treatment benefits into the Medicaid system." That, he said, would have let patients more easily afford treatment today - and since health care providers would know those customers are around and now able to pay, they would have been more likely to scale up treatment to match demand even before the opioid epidemic got so bad.

Of course, that didn't happen in the '80s and '90s.

The differences between the response of today and that of the 1980s and '90s

In the 1980s, crack cocaine came to America. Taken up disproportionately by black and poor neighborhoods (while the original powdered version of cocaine remained popular in wealthier, whiter areas), crack quickly became the center of the illicit drug trade - contributing to thousands of overdose deaths as well as a spike in murders and violent crime in the '80s and '90s. As crack addiction strangled black communities in particular, policymakers didn't reach to more treatment to deal with the problem; instead, the response to the crack epidemic was built almost entirely around the criminal justice system.

The media reflected this. There was not a day that the nightly news didn't tell a new, horrifying story of a gang shooting related to crack. The New York Times ran headlines like "New Violence Seen in Users of Cocaine." Stories of "crack babies" dominated much of the news, warning that crack use by single black mothers in particular would lead to a new wave of addicted, stunted, violent youth later called "superpredators" - warnings that later research found to be severely exaggerated.

"The media portrayals during the crack epidemic were exceedingly hostile," Rachel Godsil, co-founder and director of research at the Perception Institute, previously told me. "When they talked about mothers who were crack-addicted, there wasn't, 'What kind of treatment can we provide for them?' but, 'What kind of criminalization can we impose upon them?'"

The prejudiced ties between race and drug use had a long history in America. In 1914, for example, the New York Times ran an article headlined "Negro cocaine 'fiends' are a new southern menace," in which an actual physician claimed that cocaine made black men uniquely violent and even impervious to bullets. Many Americans can now look back at this kind of claim with scorn at its obvious absurdity, but it shows the sort of attitudes that have dominated American views on drugs for decades.

Policymakers responded in kind. Across the country, states passed tougher prison sentences for drugs. The federal government enacted with its own "tough on crime" laws, such as the Anti-Drug Abuse Acts of 1986 and 1988. Republicans backed these measures, but Democrats played a big role too - with former Vice President Joe Biden even helping write some of the "tough on crime" laws of the '80s and '90s while he was a senator. It was a time when it was bipartisan to treat drugs as a moral failure and a criminal justice issue.

Take former President George H.W. Bush, who used his first televised national address in the Oval Office to warn of what he called "the greatest domestic threat facing our nation today": drugs. He held up a bag of crack cocaine - purportedly bought near the White House, though later the story was found to be a bit more complicated - and vowed to escalate the war on drugs.

"Drugs are sapping our strength as a nation," Bush said. "Who's responsible? Let me tell you straight out: everyone who uses drugs, everyone who sells drugs, and everyone who looks the other way." He was as brutal in describing the consequences, arguing that crack is "turning our cities into battle zones" and "murdering our children."

There were also some treatment-focused programs in response to crack, such as the creation of drug courts. But the great majority of the response was punitive.

The opioid epidemic has inspired a different response. Media coverage of the epidemic is much more sympathetic of people struggling with drug addiction, with the New York Times now running headlines such as "In Heroin Crisis, White Families Seek Gentler War on Drugs."

In a rarity in today's politics, the compassion is even bipartisan. Michael Botticelli, President Barack Obama's former drug czar, repeatedly stated that "we can't arrest and incarcerate addiction out of people." New Jersey Gov. Chris Christie, who's leading President Donald Trump's opioid commission, in 2015 gave a passionate speech urging Americans to treat addiction as a medical issue, drawing from a friend's story to argue that "we need to start treating people in this country, not jailing them. We need to give them the tools they need to recover, because every life is precious."

And the one major piece of legislation that Congress has passed related to the opioid epidemic, the 21st Century Cures Act, put $1 billion toward addiction treatment over two years - far from what experts say is necessary, but remarkable in that it approached the crisis exclusively as a public health problem.

Some states have passed laws toughening prison sentences related to opioids, and more have encouraged police and prosecutors to use old "tough on crime" laws to crack down on drug addiction. But these kinds of actions have not reached the all-consuming fervor, at least yet and at least not rhetorically, that engulfed the nation during the crack epidemic in the 1980s and '90s.

Of course, a change in the public perception of addiction - a disease we still don't fully understand but understood even less in the 1980s - has something to do with this disparity. But racism does too.

A key explanation in all of this is race

Consider this chart, which shows that until the early 2000s, black Americans tended to suffer more drug overdose deaths when controlling for population - and now white Americans have taken the lead by far, due to the opioid epidemic:

The trend is central to understanding why America's drug addiction treatment system remains woefully inadequate - to the point that as many as 90 percent of people with drug use disorders won't access it.

Drug addiction was widely seen in the past as a problem that afflicted mostly racial minorities, especially black Americans. So a lot of Americans felt more comfortable treating it not as a medical problem but more as a criminal justice issue, with surveys of the era showing greater support for arresting drug dealers and, to a lesser degree, people who use drugs than later surveys have found.

As an example of how this can work, consider a 2007 study that examined the aftermath of Hurricane Katrina in 2005. In that study, researchers found that people tended to believe that victims in racial groups they don't belong to suffered fewer "uniquely human" emotions like anguish, mourning, and remorse than victims in racial groups they did belong to. And in the aftermath of a natural disaster, that perception of fewer "uniquely human" emotions led participants to be less willing to help victims of a different race.

A 2009 study similarly found that when participants looked at images of people in pain, the parts of their brains that respond to pain tended to show more activity if the person in the image was of the same race as the participant. Those researchers concluded that their findings "support the view that shared common membership enhances a perceiver's empathic concerns for others." Other studies reached similar conclusions.

Really, it seems like common sense: Once someone can relate to the person who's suffering, it becomes much easier to empathize. And when it comes to federal and state legislators - the majority of whom are white - empathy can then translate to more sympathetic policy preferences and outcomes.

So it's not hard to understand why America didn't have much in the way of serious discussions about scaling up drug addiction treatment in the 1980s and '90s but is suddenly discussing the value of treatment in response to the opioid epidemic.

Ithaca, New York, Mayor Svante Myrick, who's black, previously told me the disparity in how crack was approached in previous decades and how opioids are now viewed has led to resentment in much of the black community in his predominantly white town.

"It's very real," he acknowledged. The typical response from his black constituents, he said, goes something like this: "Oh, when it was happening in my neighborhood it was, 'Lock 'em up.' Now that it's happening in the [largely white, wealthy] Heights, the answer is to use my tax dollars to fund treatment centers. Well, my son could have used a treatment center in 1989, and he didn't get one."

Still, Myrick added, "I'm as angry about this as anybody. But just because these are now white kids dying doesn't mean we shouldn't care, because these are still kids dying."

Now, race isn't the only reason these systems turned out as they are today. For one, the crack epidemic was associated with more street violence - there were more shootings and murders during the crack epidemic, as the homicide statistics show, than there have been during the opioid epidemic. To some degree, that justified a criminal justice response at the time. (Although the greater levels of violence in minority communities can also be blamed on institutional racism.)

Class likely plays a role too. The recent meth epidemic was predominantly linked to white Americans, yet it also invited a punitive "tough on crime" response. That may be because it was also linked to poor white Americans, while the opioid crisis is associated more with middle-class white Americans.

And society's understanding of addiction was simply much worse in the 1980s. As Humphreys has noted, activists in the addiction treatment and recovery fields have done a lot to boost the view of addiction as a medical problem in recent years. This kind of awareness simply wasn't around in the '80s, especially as racism colored how Americans viewed addiction.

The result, however, is that America is better suited to deal with drug addiction as a criminal justice, not public health, problem as it faces an extremely deadly overdose crisis.

Racism affects policy outcomes for everyone in all sorts of ways

The response to drug epidemics exemplifies just one way in which race can shape so much of American politics and policy.

A prominent example is President Donald Trump. Several studies suggest that racial resentment was a big predictor of support for his candidacy, which was launched with an infamous speech explicitly attacking Mexican immigrants. Yet his legislative policy agenda so far has focused on efforts to repeal Obamacare, a budget that slashes social services to the poor, and a tax reform package that will mainly benefit the wealthy. As Dylan Matthews explained for Vox, the cuts hit programs that help millions of white Americans and keep millions out of poverty - yet through racial resentment, Trump managed to get people to support this agenda.

"People's level of racial resentment ... was the single best indicator of whether they were against the ACA, or Obamacare, in the outset," Godsil told me. "It is clear that the right used racial resentment and racism and this idea of who's benefiting from certain kinds of government programs to undermine support for [Obamacare]."

There's a lot of social science research behind this idea. As researchers Sean McElwee and Jason McDaniel explained for Vox, racial attitudes are a very strong predictor for beliefs about government spending. "For decades, social scientists have found that attitudes about race, particularly toward African Americans, persistently impact political attitudes and opinions toward government services, spending, and welfare," they wrote.

McElwee and McDaniel measured racial resentment, economic peril, and support for more government spending. They found that higher measured racial resentment correlated with a preference for decreased government spending and services, while more economic insecurity appeared to correlate - but not at a statistically significant level - with more support for increased government spending.

A recent study is particularly illustrative in this regard. In a survey, white respondents were asked about their beliefs on housing assistance. (The researchers only used data from white respondents because support among minority groups for Trump was too low to be statistically reliable.) With the question, survey takers were primed with a subtle image of either a black or white man.

The results were striking: Greater favorability toward Trump highly correlated with more opposition to a federal mortgage aid program, higher levels of anger that some people receive government assistance, and a greater likelihood to say that individuals who receive assistance are to blame for their situation. In contrast, favorability toward Hillary Clinton, Trump's 2016 opponent, did not have a statistically significant effect.

The researchers concluded, "These findings indicate that responses to the racial cue varied as a function of feelings about Donald Trump - but not feelings about Hillary Clinton - during the 2016 presidential election." Trump was clearly attracting people with high levels of racial resentment.

Much of this is driven by the perception of who gets these benefits. If critics can paint a policy as benefiting black people, that makes white people more likely to oppose it. This is why coded rhetoric about "welfare queens" and other recipients of government benefits can be so effective: It suggests the government is taking money from white taxpayers and redistributing that money to people of color who are, McGhee argued, seen as "lazy at best and criminal at worst." Never mind that, as just one example, the plurality of food stamp recipients are white.

This has been a trend for decades, going back to Richard Nixon's "Southern strategy," Ronald Reagan's original use of the term "welfare queen," and now Trump's own coded rhetoric. It's what some experts call the identity politics of the right, and perhaps the big reason, McGhee argued, that a majority of white voters have rejected Democrats in presidential elections after 1964, when the Civil Rights Act passed.

We see this consistently throughout American politics: Race plays a tremendous role in how people respond to certain policy issues and how people vote. That lets politicians like Trump leverage race to get white voters in particular to go along with an agenda that could actually hurt them - whether the issue is housing, welfare, Obamacare, or drug addiction treatment.

"It scapegoats and vilifies people of color," McGhee explained. "It sets up a response among many white people that sees policies that benefit people of color as suspect, regardless of the fact that those policies would also benefit similarly situated white people."

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The deadliness of the opioid epidemic has roots in America's failed response to crack

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The death toll from the opioid epidemic ravaging the US has been climbing by the thousands for years:In 2015, opioid overdose deaths killed more people in the US - 52,000 - than guns, car crashes, and even HIV/AIDS at its peak, and overdoses since the epidemic began in the late '90s had killed more people than the entire population of Atlanta.Based on preliminary data, 2016 will be worse.