Elected on a law and order platform, Richard Nixon launched the War on Drugs with a June 1971 press conference in which he declared drug abuse on the streets of American cities to be “public enemy number one.” Or so the conventional narrative goes. But drug historian Emily Dufton says that the true story is much more complicated – and interesting.

In fact, Dufton writes in her fascinating new book, Addiction Inc.: Medication-Assisted Treatment and America’s Forgotten War on Drugs, between 1971 and 1973 the Nixon administration presided over a massive expansion of publicly-funded methadone clinics and other treatment services that began to deliver real results in addressing the country’s burgeoning heroin addiction crisis, before largely abandoning the effort in the face of political backlash and public misunderstanding. And that was just the first of many systemic failures in a maddening, decades-long history of missed opportunities and failed approaches to dealing with the opioid addiction problem that plagues blue cities, which Dufton lays out in her book.

So we invited Emily to join us to talk about the history of what has gone wrong with our efforts to treat opioid addiction. That initial, promising early ‘70s effort to build an expansive treatment system of methadone clinics was fully defunded once Ronald Reagan took office in 1981. After that, she tells us, the clinic system was largely privatized, and efforts to effectively and comprehensively help the addicted became secondary to the profit motives of drug manufacturers and clinic operators. This was, she says, the rise of what she terms "Addiction Inc.," and she points out that today only about one in five American addicts receives Medically-Assisted Treatment (via one of the three approved drugs: methadone, buprenorphine, or naltrexone), which is the gold standard for treating opioid addiction.

As the conversation continues, it turns personal, as Sandeep explains both his deep initial reluctance to treat his own spiraling addiction in the ‘90s with methadone, but how once he overcame the stigma “methadone saved my life.” And Dufton tells the story of Dana, a close high school firend whose debilitating opioid addiction led to his suicide shortly after his 30th birthday, a tragedy that inspired her to spend eight years researching and writing the book.

As the episode concludes, we come to the disheartening conclusion that the American debate on addiction is trapped between two poles: either punishment without treatment, or, as is too often the case in blue cities, tolerance without intervention. Emily then points to the counter example of Switzerland, which in the 1980s faced an addiction crisis similar to that in the US, but which subsequently developed an effective multi-pronged approach that combines law enforcement with robust treatment interventions to greatly reduce the suffering and social harm addiction creates.

“Other countries don’t have the same issues with Medically-Assisted treatment that the United States does, and of course their overdose deaths are significantly lower,” Dufton says. “We should be almost embarrassed in the United States about how poorly we treat this issue. But I think we’re just too angry at drug users and simply too ready to transform their forms of treatment into additional forms of punishment to actually change our way of thinking.”

OUTSIDE SOURCES:

Emily Dufton, Addiction Inc.: Medication-Assisted Treatment and America’s Forgotten War on Drugs, University of Chicago Press (2026).

Please send your feedback, guest and show ideas to bluecitypodcast@gmail.com

For nearly two decades, Chris Cillizza was a star political commentator for legacy media. In 2005 Chris founded The Fix, the seminal, must read Washington Post political blog, before moving on to CNN in 2017, where he was based until 2022. Then, abruptly, he was laid off, and for a few dark months he thought his career in journalism was over. Instead, he started over in the brave new world of independent online journalism, moving his political coverage to his now hugely popular So What page on Substack and to its companion YouTube channel.

All of which is to say that Chris has had a front row seat to observe – and to directly experience – the 21st century upheavals of the media business. That’s why it caught our attention when Chris wrote a provocative piece in late July titled, “Donald Trump Was Right about the Media. And It Should Terrify Journalists,” where he argued that Trump was on target when he told the assembled media at the White House Correspondents Dinner that “you people have no idea how lucky you are. When I’m gone, you’re all going to be broke. Your business model is going to be finished.”

So we asked Chris to join us on BCB to explain his take on the plight of the legacy media, which he explains was on a sharp glide path towards collapse before Trump famously came down that escalator in 2015. “Donald Trump almost single-handedly saved legacy media from total and complete collapse,” Chris tells us. He juiced the attention economy, massively boosting public interest in his norm-breaking provocations, which in turn drove big circulation and ratings gains for legacy media outlets. But Chris also argues that the boost was temporary, a sugar high, and that the media’s increasing dependence on cataloging Trump's near daily outrages and shenanigans quickly turned parasitic, masking the industry’s ongoing structural problems.

We then turn to discussing Chris’ own searing experience of getting blindsided by his own firing from CNN, and the existential identity crisis it precipitated. But after some dark days, he says, he realized there was an opportunity to go his own way, and build his own brand online. The new world of media he joined was one built around the “disaggregation” of the old multi-faceted journalistic product offered by old media battleships like the Washington Post. Though he intriguingly predicts that the future of the online independent media may be in a process of “reaggregation.”

In the second half of the conversation we turn to politics, dissecting the rise of democratic socialism within the Democratic Party and how it has been upending primary races around the country, including Angie Nixon’s surprise win in the Florida Senate primary. We then discuss the implications of AOC’s “Woke 1 was crazy!” comment, the politically toxic legacy of Democrats’ flirtations with “defund the police” rhetoric, the prospects for Democrat Mary Peltola in the Alaska Senate race, and why Chris thinks, if the Senate is divided 50-50 after November, Lisa Murkowski might defect from the Republican Party to give Dems the majority.

And we close by connecting the two parts of our conversation, suggesting that both the legacy media and the Democrats have become too dependent on Donald Trump as the organizing principle for their respective business models. As we close the discussion, Cillizza offers some advice for Democrats: “Don't get blinded by Donald Trump, and that to me is, I think, what Democrats should focus on. They're not yet. We'll see if they do after the election.”

OUTSIDE SOURCES:

Chris Cillizza, “Donald trump Was right about the Media. And It Should Terrify Journalists,” So What, July 27, 2026.

Chris Cillizza, “Happy anniversary (of being laid off),” So What, Nov. 28, 2023.

Please send your feedback, guest and show ideas to bluecitypodcast@gmail.com