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Hip Hop and the American Opioid Epidemic

Find out more about the Hip Hop Drug epidemic.

3rd Mar 2018

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Following the recent deaths of prominent Hip Hop stars Fredo Santana and Lil Peep, members of the Hip Hop community are taking note of the impact lean and Xanax are having on rappers and their fans.

Right now, in America, there is a public health emergency. The death toll by runs well into the tens of thousands per year as opioid addiction decimates states like West Virginia, Ohio, and New Hampshire. At this moment, it’s estimated that over 2 million Americans are abusers of opiates, 72,000 of which will die from an overdose this year alone. A slim proportion of this will be from abusing street drugs such as heroin, but the overwhelming majority will be from prescription painkillers such as OxyContin, Percocet, or Tramadol. Of those who do use heroin, it’s estimated by the National Institute on Drug Abuse that 3 out of 4 turned to the drug after abusing similar prescription drugs. The seriousness of the American opioid epidemic is indisputable, and has drawn comparisons to the AIDs epidemic of the 80s and 90s.

The magnitude of the issue is inescapable, pervading beyond the lives of the individuals afflicted by opiate addiction, and into much of modern art and culture as a whole. The recent opioid-related deaths of rappers Lil Peep and Fredo Santana have once again brought the epidemic to the forefront. In particular, they force us to question the dangers of modern hip-hop’s love affair with prescription drug abuse, of both opioids and of “benzos” like Xanax. From Lil Wayne, 21 Savage to Drake himself, it seems almost every major figure in hip-hop raps about prescription drug abuse. Whilst drug abuse in hip-hop lyrics is nothing new, the recent high-profile overdoses and the continually unfurling prescription drug epidemic make this an interesting discussion.

Why Now?

The reasons for the prevalence of prescription drugs in hip-hop are many. First and foremost is the same reason for the prevalence of prescription drug abuse anywhere in the US; the targeted lobbying of pharmaceuticals companies. In particular, Purdue Pharma, the manufacturers of OxyContin, were responsible for an aggressive marketing campaign in 1995 to promote the opiate as a safe, effective painkiller for chronic pains like arthritis, using testimonials from genuine OxyContin users.

In supporting this campaign, they shared non-fact-checked false statistics, such as claiming that fewer than 1% of patients suffer addiction due to opioid medication. Previously, opiates had only been used to treat acute pain in cancer patients, due to its relative danger and seriousness. Purdue pushed for doctors to readily prescribe OxyContin, and encouraged them with assorted free seminars and offered them paid speaking engagements. The campaign was a huge success, and by 2000, over 6 million prescriptions of the drug had been sold, expanding the supply of opioids in public hands immensely.

Around this time, reports of opioid abuse became widespread, and the number of heroin users in the US also began rise proportionately. By 2007, the federal government sued Purdue for misleading physicians and customer, gaining $635mn. OxyContin abuse had already become widespread at this point, with two of the initial poster children used to market the drug now dead and a third desperately fighting an addiction. Eleven years later, over-prescription of the drug is still a huge problem, and abuse of it is more prevalent than ever.

In hip-hop, abuse of the drug is most noticeably referred to in the lyrics of “SoundCloud Rap”, a genre characterised by lo-fi production, mumbling vocals, and regular references to depression. The genre as a whole is filled with pained lyrics describing self medication of a number of sorts - not just prescription drugs, but alcohol, and sex are regularly referred to as empty passionless pursuits to distract from a pained existence. Perhaps the most famous SoundCloup rap is Lil Uzi Vert’s ‘XO Tour Llif3’, featuring the lines “Xanny, help the pain, yeah/ Xanny make it go away/ I’m committed not addicted, but it keep control of me”. The message is blunt unflinching, and representative of much of the nihilistic output of many of the most prominent rappers in the scene. Indeed, much of Lil Peep’s work was unabashedly tortured, to the extent that most his whole artistic identity was constructed around his depression and drug use. Clearly there is a correlation between issues of depression and prescription drug abuse within the industry - and it is likely to get worse as time goes by. The growing success of SoundCloud Rappers and their emotionally honest raps is pushing this sort of content into the musical mainstream, to be emulated and imitated by countless others.

While this may lead to interesting musical variety, it risks encouraging the glamorization and commodification of mental illness and depression. In a genre wherein issues of masculinity, bravado, and sexuality already serve to affect the self-perception of artists, twisting mental health into a commodity in this way could be extremely dangerous.

In observing modern music then, it seems prescription drug abuse is likely rooted in two channels. The first of these is the overwhelming abundance of easily acquirable opioid pushed by profit driven pharmaceutical companies. The second is the crisis of mental health issues within hip-hop. With the pressures of modern culture and fame, twinned with the classic toxic masculinity and competitiveness that is characteristic of hip-hop, mental health issues become a more pressing matter than ever for modern rappers, and so in turn does the trend of self-medication through drugs.

The solution for the drug problem is far from simple, yet it seems clear that at least two things must be done: First, regulations on pharmaceutical companies and prescribing doctors should be tightened to minimise over - prescription of opioids. Second, mental health support should be more readily available to those who need it, regardless of which industry they are in. The target for improvement is hence the American health sector, and to truly improve things, the US government must make drastic changes.

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