Drugs, Violence, and Capitalism: The Expansion of Opioid Use in the Americas

• Published date: 01 January 2021
• Date: 01 January 2021
• Author: Paulo José dos Reis Pereira
• DOI: 10.1177/0094582X20975007
• Subject Matter: Articles

https://doi.org/10.1177/0094582X20975007

LATIN AMERICAN PERSPECTIVES, Issue 236, Vol. 48 No. 1, January 2021, 184–201

DOI: 10.1177/0094582X20975007

© 2020 Latin American Perspectives

184

Drugs, Violence, and Capitalism

The Expansion of Opioid Use in the Americas

by

Paulo José dos Reis Pereira

Translated by

Sean Purdy

In the past two decades, the United States has experienced a rapid rise in the use of

opioids by its population, a context that has come to be assessed by the U.S. government as

a threat to national and international security that requires emergency measures. The strat-

egies of the U.S. government and transnational pharmaceutical corporations for resolving

the insecurity generated by capitalist accumulation constitute what a certain literature

calls “pacification.” In addition, these corporations export to the “foreign” the contradic-

tions inherent in the opioid control policy that underlies the capitalist logic of drugs. Thus

Latin American populations have been instrumentalized in the “solution” of this crisis

either as a focus of violence by the state or as a focus of consumption by the market.

Nas últimas duas décadas, os Estados Unidos vivenciaram uma rápida ascensão do uso

de opioides pela sua população, contexto que passou a ser avaliado pelo governo estadun-

idense como uma ameaça à segurança nacional e internacional que demanda medidas

emergenciais. As estratégias do Estado estadunidense e das corporações farmacêuticas

transnacionais para solucionar a insegurança gerada pela acumulação capitalista configu-

ram o que certa literatura chama “pacificação” Ademais, elas exportam para o “estrangeiro”

as contradições próprias da política de controle de opioides que fundamenta a lógica capi-

talista das drogas. Assim, populações latino-americanas têm sido instrumentalizadas para

a “solução” dessa crise, seja como foco da violência pelo Estado, seja como foco do consumo

pelo mercado.

Keywords: Latin America, Opioids, Pacification, Drug Control, United States

In the past two decades, the United States has experienced a rapid and enor-

mous expansion of the use of opioids by its population both from the legal

market, via pharmaceutical corporations, and from the illicit market, via crim-

inal groups. As a result, the country annually sees thousands of fatal overdoses

related to these substances. In 2017, it is estimated that there were 49,000 deaths,

Paulo Pereira is a professor of international relations and coordinator of the Transnational Security

Studies Center at the Pontifical Catholic University of São Paulo (PUC-SP). He thanks the journal

editors and the anonymous reviewers for their thoughtful comments toward improving this man-

uscript. The research was partly funded by the National Council for Scientific and Technological

Development (CNPq) and by the PUC-SP’s Research Incentive Plan (PIPEq). Sean Purdy is profes-

sor of the history of the Americas at the Universidade de São Paulo.

975007LAPXXX10.1177/0094582X20975007Latin American PerspectivesPereira / Drugs, Violence, and Capitalism

research-article2020

Pereira / DRUGS, VIOLENCE, AND CAPITALISM 185

more than four times the number in 1999 (CDC, 2019). This situation has

recently been assessed by the government as a national health crisis and a

threat to national security that requires emergency measures (CCDA, 2017;

United States, 2017b).

The literature that analyzes the international dimensions of the drug-secu-

rity nexus in the Americas has grown since the 1980s. It studies the so-called

war on drugs, focusing on the ways in which states combat criminal groups

linked to the illicit market of drugs (see Bagley, 1988; Labate, Cavnar, and

Rodrigues, 2016). In this article I analyze the drug-security nexus in the context

of the use of opioids in the United States in a different way, emphasizing what

Paley (2015) calls “drug war capitalism.” I share her interest in considering

“other factors and motivations for the war on drugs, specifically the expansion

of the capitalist system into new or previously inaccessible territories and social

spaces” (Paley, 2015:51). To this end, I examine the current context of opioid use

in the United States and its evolution toward Latin American countries— com-

plementary processes that have been driving forces in state violence and in the

interest of transnational pharmaceutical corporations. These actions configure

what a certain literature has called “pacification” (McMichael, 2017; Neocleous,

2011; 2014), which is equivalent to the Foucauldian notion of “peace as coded

war” and involves the construction/reproduction of a liberal social order

(Neocleous, 2014: 34). Accordingly, the main question of this work is how opi-

oids, capitalist interests, and state violence interact. The article is structured in

four parts and a conclusion. In the first part, I briefly explain the methodology

used in the research. In the second, I clarify the connections between drugs,

pacification, and capitalism from an international perspective. In the third, I

explain the relationship between legal and illicit markets for opioids in the

United States and their characterization as a national and international threat.

In the fourth, I look at the way Latin American populations have served as a

“solution” of the opioid threat in the United States. I conclude by establishing

the relationship between pacification and the expansion of opioid use in the

Americas.

Method and Materials

The research, developed during a stay as a visiting researcher at the

University of Ottawa in 2017–2018, analyzes the sociopolitical evolution of the

expansion of opioid use in the United States and its consequences for Latin

American populations within and outside that country. Process tracing was the

chosen qualitative method. Its use, which has a long history among social sci-

entists (e.g., Charles Tilly and Barrington Moore), provides parameters for

investigating one or more cases. The analysis seeks to build causal inferences

that critically dialogue with the literature (Bennett, 2010: 207). The objective is

to identify the connections among the various factors relevant to the observed

results and determine whether the actions and positions of the actors in the

causal process are consistent with the implicit world image predicted by the

theory (Hall, 2003: 394–395). In addition, the use of a single historical case, as

in the study presented here, “not only can develop new theoretical ideas, but

can also put them to the test and use the results in the explanation of outcomes”