JD Vance says he’s grown all too accustomed to hearing a certain phrase when his family calls to catch him up on life in small-town Ohio: “They died of an overdose.”
The phrase, which Vance invoked Wednesday night at the Republican National Convention as he accepted his party’s nomination for vice president, is in keeping with the political identity he has cultivated since the 2016 publication of his famous memoir, “Hillbilly Elegy.”
Under the Biden presidency and Democratic power, “prices soared, dreams were shattered, and China and the cartels sent fentanyl across the border adding addiction to the heartache,” Vance told RNC attendees in Milwaukee on Wednesday night.
“Thanks to these policies that Biden and other out-of-touch politicians in Washington gave us, our country was flooded with cheap Chinese goods, with cheap foreign labor, and in the decades to come, deadly Chinese fentanyl,” he said later.
For the last decade, Vance has built a huge part of his public persona on his personal witness of the opioid crisis. He cites it as an example of what ails the U.S. not just medically, but economically and culturally, too. In his book and numerous interviews over the years, Vance painted the overdose epidemic as a symptom of despair, economic instability and disintegrating family structures. As he ran for office, the Yale-educated lawyer wove his family story into a broader attack on Democratic border and immigration policy, a stance he parlayed into several bills on border control after the 2022 election.
Many of his remarks on the plight of addiction itself are tempered and nuanced. Vance, now a Republican senator representing Ohio, has spoken or written at length about his own mother’s struggles with drug use, culminating in an overdose and hospitalization. And he has cast drug use and overdose as a problem rooted in trauma, family chaos, and a lack of economic opportunity — an analysis similar to that of U.S. Surgeon General Vivek Murthy, a top Biden administration health official. During his 2022 Senate campaign, Vance also canceled a fundraiser after discovering that the host was a doctor named in lawsuits relating to Purdue Pharma, the manufacturer of OxyContin.
Yet at times, his rhetoric has taken on a darker tone. In one 2022 interview with Gateway Pundit, a far-right media site known to traffic in conspiracy theories, Vance effectively accused President Biden of allowing fentanyl through the country’s southern border in an attempt to kill Trump voters.
Since formally entering politics, Vance has continued to speak about the drug overdose crisis and has signed onto a handful of legislative proposals meant to combat the drug epidemic, including one bill that would impose sanctions on fentanyl traffickers. In a recent hearing, Vance expressed concern that the Senate is consistently “a few years behind” on the opioid crisis, citing the drug supply’s fast evolution from prescription pills to heroin to highly potent synthetic opioids like fentanyl.
Yet he has also taken significant criticism after the addiction-focused nonprofit he founded, Our Ohio Renewal, failed to produce any published work or implement any programs meant to prevent drug deaths, instead paying hefty fees to Vance’s top political consultant.
Below, STAT highlights Vance’s rhetoric and record on the opioid crisis.
The Atlantic, July 2016: “Shortly before I graduated from law school, I learned that my own mother lay comatose in a hospital, the consequence of an apparent heroin overdose. Yet heroin was only her latest drug of choice. Prescription opioids — ‘hillbilly heroin’ some call it, to highlight its special appeal among white working-class folks like us — had already landed Mom in the hospital and cost our family dearly in the decade before her first taste of actual heroin.”
Vance’s magazine article highlights the personal toll that the addiction crisis has taken on him. It was published in a story titled “Opioid of the Masses” — ironic in its invocation of Karl Marx’s famous criticism of religion, and even more so in that the “opioid” Vance was referring to was his future boss: Donald Trump. The sub-headline reads: “Trump is a cultural heroin. He makes some feel better for a bit. But he cannot fix what ails them, and one day they’ll realize it.”
NPR’s Fresh Air, August 2016: “In a lot of ways, I was at the ground floor of the opioid epidemic because I saw it happening with my mom before it had really reached crisis proportions.”
Vance also underscored his Christian values and suggested that religious affiliations could keep people away from substance use because “children who go to church, they are less likely to commit crimes, less likely to do drugs.”
Philanthropy Roundtable, summer 2017: “If you think about addiction, in some cases it’s a straightforward question of medical treatment. But it’s also related to chaos and trauma in certain families. That’s in turn related to the fact that economic opportunities and jobs are harder to come by. If we’re going to make any headway on these problems, we have to tackle each simultaneously.”
Again, Vance presented a theory of chaos, trauma, and economic stability — but, notably, a clear view that addiction is a medical problem that is often solvable with medical treatment.
George Washington University, November 2017: “People turn to substance abuse because the outlook for their communities seems hopeless…not just for today, but hopeless for the future as well.”
At a D.C. event in 2017, Vance reiterates what appears to be the cornerstone of his philosophy on addiction: That it is largely a response to conditions of despair.
Gateway Pundit, April 2022: “If you wanted to kill a bunch of MAGA voters in the middle of the heartland, how better than to target them and their kids with this deadly fentanyl? … It does look intentional. It’s like Joe Biden wants to punish the people who didn’t vote for him and opening up the floodgates to the border is one way to do it.”
The claim is both baseless and extraordinary: That the sitting president is allowing deadly drugs through the border in the hope that they might kill Americans who don’t support him politically. But truthfulness aside, it is also illogical. Drug overdoses now kill Black people and Native Americans — among the demographic groups that most strongly support Democrats — at a higher rate than white people, a majority of whom vote Republican. And of the 10 jurisdictions with the highest drug overdose rates (nine states, plus the District of Columbia), five went to Biden in the 2020 election and five went to Trump.
Meet the Press, July 2023: “There is a very direct line between job losses to China, especially in the ’80s and ’90s, and the heroin and now the fentanyl problem today — a very, very direct line. So, No. 1: we have to rebuild the middle class in this country and ensure that people don’t want to do drugs in the first place. The second thing here is that of course we want to prevent people from getting addicted, but once they are addicted treatment is a major source of the story here.”
In this TV interview, Vance blames the addiction crisis on globalization and the loss of manufacturing jobs. But yet again, he is quick to highlight the role of treatment for those already experiencing addiction.
Looking ahead
Vance’s openness to treating addiction as a health condition may itself be a promising sign for addiction and recovery advocates. These advocates have expressed concern that a second Trump White House would turn its back on treatment, roll back the Biden administration’s efforts to increase access to addiction medications, and implement a tough-on-crime, police-first approach to the opioid epidemic. Already, Trump has pledged not only to take a tougher line on cartels but also to impose the death penalty for convicted drug dealers.
Whether any of those policies will actually be implemented, and who would oversee them, remain an open question. During Trump’s first term as president, he largely delegated responsibility for addressing the opioid crisis to aides like Kellyanne Conway. Should Trump be reelected, Vice President Vance would wield major influence over the next White House’s policy portfolio — perhaps especially so when it comes to addiction.
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.