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OxyContext: “Hillbilly Heroin” and the Kentucky Crime Scare of the Late 1990s

Updated: Aug 30, 2023

As we continue in our quest to get to the bottom of the current moment’s hysteria about “pill mills,” Points is delighted to have as a guest blogger Kenneth D. Tunnell, talking about the ways in which OxyContin abuse was portrayed in the media the first time people got all worked up over it.   Professor of Criminology at Eastern Kentucky University, Tunnell is the author of Choosing Crime, Political Crime in Contemporary America, Living Off Crime, and Pissing on Demand: Workplace Drug Testing and the Rise of the Detox Industry.  His forthcoming photography book, Once Upon a Place, details the vast changes occurring across rural agricultural communities in Kentucky.

Pre-Oxy Press Coverage of Eastern Kentucy

During the late 1990s Kentucky experienced a new drug abuse epidemic.  OxyContin, a powerful analgesic for terminal disease-related pain, was over-prescribed and diverted into informal black markets.  Media reports linked OxyContin use to increases in crime and overdose deaths.  The OxyContin problem in Eastern Kentucky was graphically featured in a Newsweek cover story.  Media rhetoric oftentimes was bigoted toward rural, mountain people (hence, “hillbilly heroin”).  Media coverage of the OxyContin-crime connection was momentary (the early 2000s) as symbolic crusades about other drugs (methamphetamine and mephedrone) emerged.

OxyContin became the stuff of frequent front-page news stories that consistently increased in number.  Similar to previous drug panics, the OxyContin problem was described using hyperbolic imagery and rhetoric.  Its construction often relied on unverified claims.  Much public discourse focused on OxyContin’s relationship to Kentucky’s increasing crime problem.  Claims of increases in crime and due to one variable — OxyContin — were widely reported as fact.  Although crime data are public, they were ignored by media and public officials who made sensational claims.  Data simply do not support linking any crime increases (or decreases)  to OxyContin’s introduction.

The realities of the crime problem are nothing like the rhetoric. Crime rates in Kentucky are declining and have been for years.  The violent crime rate in 1990 was 390 per 100,000 dropping to 258 during 2001 (the year of most media attention) and increasing since then to 284 per 100,000.  Property crime rates (the crime type usually associated with drug abuse) steadily decreased from 2909 per 100,000 in 1990 to 2638 in 2001 and further to 2470.

Beyond Kentucky, newspapers reported that OxyContin was fueling a national crime wave.

The Mainstream Media: Presenting the Public with Nuanced Accounts of Drug Use and Abuse

The fact is no such crime wave exists.  For years now, crime rates in the US have steadily decreased.  Property crime decreased from 5,073  per 100,000 population in 1990 to 3,658 in 2001 (the year of most media reporting) to 3,036 per 100,000 in 2009.  In fact, property and violent crime has declined by 40 percent since 1990.

After a drug bust netting 201 people, a US Attorney General, justifying the arrests, claimed that  OxyContin had caused 59 deaths in one year in Kentucky.  Although dismissed as “inflammatory,” his claims, with no factual basis, were widely published.  The actual number of OxyContin-related overdose deaths likely will never be known due to poly-drug use, most commonly OxyContin mixed with alcohol and other depressants.  Data do not distinguish accidental deaths from suicides.  Emergency room reports reveal that oxycodone (OxyContin’s drug category) is mentioned by fewer than one percent of patients.  Oxycodone products evidently remain far less widely used than rhetoric suggests.  Nonetheless, estimates — and alarming ones — have been uncritically published by the media and officials.

Like other social problems, OxyContin abuse requires social explanations.  Kentucky’s history includes: OxyContin’s sales and marketing strategies, Congress’s declaration of the “decade of pain” and doctor’s treating pain differently, the DEA granting consistent increases in opiate manufacturing, and a history of pharmaceutical use. Yet Kentucky’s OxyContin-crime relationship is socially constructed.  Granted, crime rates in some Kentucky counties are increasing but mainly due to decreases in population.  These rate increases likely would not occur with positive population gains.  But, this news further reinforces OxyContin- crime panic.

Whenever drug scares emerge, the role of the media–its focus and how the public comes to accept its stories–must be examined.  During a few short years, OxyContin news stories increased, from none in 1998 to 404 stories in 2001(and then declining).  In 2003, the Lexington Herald-Leader, serving nearly half the state, ran a 12-part series detailing OxyContin and its connection to crime.  Such media attention contributes to the acceptance of the news as factual.

Although some may question the harm in hysteria, scare campaigns are ineffective at reducing abuse; they assign blame to individuals when explaining social problems. Drug scares have helped propagate the behaviors they aim to contain and fail at disseminating accurate information.  Drug scares result in extreme reactions to perceived problems that may not correspond to reality.   Drug scares, as moral panics, are symbolic crusades involving interest groups or agencies that lead the way in labeling drug as dangerous, oftentimes benefitting from such.  Public officials, often aided by media outlets, embellish reports for greater crime fighting resources and social control initiatives.  The OxyContin-crime panic is only the latest in the history of moral panics.


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