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    Dear Elites (of Both Parties), the People Will Take It From Here, Thanks

    I first learned about the opioid crisis three presidential elections ago, in the fall of 2011. I was the domestic policy director for Mitt Romney’s campaign and questions began trickling in from the New Hampshire team: What’s our plan?By then, opioids had been fueling the deadliest drug epidemic in American history for years. I am ashamed to say I did not know what they were. Opioids, as in opium? I looked it up online. Pills of some kind. Tell them it’s a priority, and President Obama isn’t working. That year saw nearly 23,000 deaths from opioid overdoses nationwide.I was no outlier. America’s political class was in the final stages of self-righteous detachment from the economic and social conditions of the nation it ruled. The infamous bitter clinger and “47 percent” comments by Mr. Obama and Mr. Romney captured the atmosphere well: delivered at private fund-raisers in San Francisco in 2008 and Boca Raton in 2012, evincing disdain for the voters who lived in between. The opioid crisis gained more attention in the years after the election, particularly in 2015, with Anne Case and Angus Deaton’s research on deaths of despair.Of course, 2015’s most notable political development was Donald Trump’s presidential campaign launch and subsequent steamrolling of 16 Republican primary opponents committed to party orthodoxy. In the 2016 general election he narrowly defeated the former first lady, senator and secretary of state Hillary Clinton, who didn’t need her own views of Americans leaked: In public remarks, she gleefully classified half of the voters who supported Mr. Trump as “deplorables,” as her audience laughed and applauded. That year saw more than 42,000 deaths from opioid overdoses.In a democratic republic such as the United States, where the people elect leaders to govern on their behalf, the ballot box is the primary check on an unresponsive, incompetent or corrupt ruling class — or, as Democrats may be learning, a ruling class that insists on a candidate who voters no longer believe can lead. If those in power come to believe they are the only logical options, the people can always prove them wrong. For a frustrated populace, an anti-establishment outsider’s ability to wreak havoc is a feature rather than a bug. The elevation of such a candidate to high office should provoke immediate soul-searching and radical reform among the highly credentialed leaders across government, law, media, business, academia and so on — collectively, the elites.The response to Mr. Trump’s success, unfortunately, has been the opposite. Seeing him elected once, faced with the reality that he may well win again, most elites have doubled down. We have not failed, the thinking goes; we have been failed, by the American people. In some tellings, grievance-filled Americans simply do not appreciate their prosperity. In others they are incapable of informed judgments, leaving them susceptible to demagoguery and foreign manipulation. Or perhaps they are just too racist to care — never mind that polling consistently suggests that most of Mr. Trump’s supporters are women and minorities, or that polling shows he is attracting far greater Black and Hispanic support than prior Republican leaders.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Canada Re-Criminalizes Public Drug Use in British Columbia

    A province that was a global pioneer in harm reduction took a step back after a political backlash.The government of Canada on Tuesday walked back part of a program allowing people in British Columbia to possess small amounts of drugs, including heroin and cocaine, without fear of criminal charges. At the request of the province and after a public backlash, people in British Columbia are no longer permitted to use drugs in public places.Under the changes, which went into effect immediately, adults will still be allowed to possess small amounts of drugs. But they will now have to use them in legal residences, at safe injection sites and at other harm-reduction centers established by the health authorities.The re-criminalization of public drug use in British Columbia underscores the difficulties that governments face as they grapple with the opioid crisis. Even in a province that has been a global pioneer of the harm reduction movement, an approach that seeks to reduce risky behavior rather than to punish drug users, there are no easy answers.The province’s coroner estimated that there were a record 2,511 toxic drug deaths last year. Drug overdoses from toxic substances kill more people ages 10 to 59 than homicides, suicides, accidents and natural diseases combined in British Columbia, according to the provincial coroner’s office.The goals of decriminalizing possession were to enable police officers to focus their time on large drug distributors rather than users and encourage users to be open to treatment. But concerns about public drug use have quickly surfaced and raised repeatedly in the provincial legislature by members of opposition parties.Eugenia Oviedo-Joekes, a professor in the medical school at the University of British Columbia who studies addiction and public health policy, said the decision amounted to “three steps back” in dealing with the opioid crisis.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    McKinsey Is Under Criminal Investigation for Its Opioid Work

    Federal prosecutors are examining the consulting company’s role in helping “turbocharge” the sale of painkillers like OxyContin.The Justice Department is investigating McKinsey & Company, the international consulting giant, for its role in helping drug companies maximize their sale of opioids.The investigation is led by the U.S. attorneys’ offices in Massachusetts and the Western District of Virginia in coordination with the department’s civil division in Washington, according to two officials familiar with the case who spoke on condition of anonymity.Since 2021, McKinsey has agreed to pay about $1 billion to settle investigations and lawsuits across the United States related to the firm’s work with opioid makers, principally Purdue Pharma, the maker of OxyContin. McKinsey recommended that Purdue “turbocharge” its sales of the drug in the midst of the opioid crisis, which has killed hundreds of thousands of Americans. McKinsey has not admitted any wrongdoing.News of the criminal investigation was first reported by The Wall Street Journal on Wednesday.The investigation has been underway for several years. Endo, a pharmaceutical company that hired McKinsey to advise on the sale of the opioid Opana, said in a regulatory filing that it received a subpoena in December 2020 from the Western District of Virginia seeking information about McKinsey. The New York Times reported on the existence of that subpoena in 2022. Last year another opioid maker, Mallinckrodt, said it received a grand jury subpoena from the same U.S. attorney’s office but did not mention any connection to McKinsey.Federal prosecutors are also looking into whether McKinsey obstructed justice in its handling of records, according to The Journal.By 2018, senior McKinsey consultants were growing increasingly worried that they might be held to account for their opioid work. On July 4 of that year, Martin Elling, a leader in the firm’s pharmaceutical practice, made a decision he would later regret. He sent an email to Arnab Ghatak, a senior partner, asking whether they should eliminate documents and emails connected to opioids.Mr. Ghatak replied: “Thanks for the heads up. Will do.”Both men were fired after The Times reported in 2020 about the existence of the emails.It isn’t unusual for criminal investigations like this to go on for many years, especially ones involving two U.S. attorneys’ offices, the Justice Department and possibly state agencies as well, Rick Mountcastle, a former federal prosecutor, said.He led a criminal investigation into Purdue Pharma that resulted in the company’s guilty plea in 2007 to having misled regulators, doctors and patients about the dangers of OxyContin. “It is a huge monster bureaucracy that moves at a very slow pace,” said Mr. Mountcastle, who was not a source confirming the existence of the investigation.McKinsey made about $86 million over many years advising Purdue Pharma. The bulk of that work took place after Purdue’s guilty plea. In 2019, McKinsey said it would no longer advise clients on opioid-related business.Ramiro Prudencio, a spokesman for McKinsey, declined to comment. A spokesman for the Justice Department had no comment on the case. More

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    National Academy Asks Court to Strip Sackler Name From Endowment

    Millions in Sackler donations sat dormant, rising in value as the opioid epidemic raged and as other institutions distanced themselves from the makers of a notorious painkiller.The National Academy of Sciences is asking a court to allow it to repurpose about $30 million in donations from the wealthy Sackler family, who controlled the company at the center of the opioid epidemic, and to remove the family name from the endowment funds.The petition filed by the Academy in Superior Court in Washington, D.C., Thursday aims to modify the terms of the donations so the institution can use them for scientific studies, projects and educational activities.The move follows a report in The New York Times last year that examined donations from several Sackler members, including an executive of Purdue Pharma, which produced the painkiller OxyContin that has long been blamed for fueling the opioid crisis that has claimed thousands of lives.“The notoriety of the Sackler name has made it impossible for the Academy to carry out the purposes for which it originally accepted the funds,” Marcia McNutt, president of the National Academy of Sciences, said in a statement released on Thursday.Daniel S. Connolly, a spokesman for the Raymond Sackler family, said it supported the National Academies in “using the funds as they see fit” and would have supported the change.“We would have said yes if we’d been asked, just as we will still say yes despite this unnecessary court filing and false assertions about us,” Mr. Connolly said in a statement.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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    Republicans’ Promises to Combat Fentanyl Fall Flat With Some Voters

    The official toxicology report states that Andrea Cahill’s son died at 19 years old from an accidental fentanyl overdose. But more than three years after Tyler Cahill’s death in his childhood bedroom, she doesn’t believe that. It was a poisoning, she says, and there is no question about whom to blame: “the cartels.”Ms. Cahill believes the governments of Mexico and China should be punished for the drug’s flow into the United States. A political independent who nearly always votes for Republicans, she wants a president with relentless focus on the issue.“It does feel like maybe nobody cares,” she said.These days, Republican presidential candidates are working to convince people like Ms. Cahill that they share her urgency.Ron DeSantis talks about fentanyl in every stump speech, vowing to send the military into Mexico to target cartels. Nikki Haley has promised to send special operations forces across the border. Chris Christie has called for better access to treatment. Former President Donald J. Trump has offered few specific solutions but has tapped into victims’ families’ hunger to be seen: He likens deaths from the drug to wartime casualties.At Wednesday night’s debate, the candidates linked the crisis to immigration and foreign policy, and hammered home the toll.“We have had more fentanyl that have killed Americans than the Iraq, Vietnam and Afghanistan wars combined,” Ms. Haley noted.The promises are required of any politician wanting to appear in touch with New Hampshire, a state that can make or break presidential campaigns. As fentanyl has become one of the most urgent health crises in the country — it is now a leading cause of death for people under 45 — it has ravaged the small state. Last year, opioid overdose deaths hit a four-year high, though down slightly from their peak in 2017, according to state data. Most were from fentanyl.But truly connecting with voters — persuading them that help could be on the way — is proving difficult. In dozens of interviews with people on the front lines of the fight against fentanyl, a sense of abandonment is pervasive. Many said they believed the federal government did too little to stop the epidemic from happening and that it continues to do too little to try to bring it under control.The candidates’ talk of blockades and military intervention is met with cynicism and a deep distrust that their government can find solutions.“I don’t see it getting better if it’s Trump or Biden or whoever is going to step in,” said Shayne Bernier, 30, who fought opioid addiction years ago and is now helping to open a sober-living home in downtown Manchester, N.H. For more than a year, Mr. Bernier has patrolled parks and streets routinely, giving information about a city-funded detox program.Shayne Bernier fought opioid addiction years ago and now patrols the streets and parks of Manchester, N.H. He thinks politicians’ attention to the issue will be fleeting: “They’ll talk about it for an election, and then we’ll never hear from them again.”Mr. Bernier grew up in the city and has “Live Free or Die,” the official state motto, tattooed on his left bicep. He considers himself a conservative. He neither loves nor loathes Mr. Trump, though he understands how the former president appeals to the anger and frustration that courses through his friends.“They’ll talk about it for an election, and then we’ll never hear from them again,” he said of politicians’ promises to address the crisis.Five years ago, Mr. Trump traveled to New Hampshire and remarked how “unbelievable” it was that the state had a death rate from drugs double the national average. When he promised to secure the border “to keep the damn drugs out” the audience responded by chanting: “Build that wall!”The drugs never stopped coming in. The supply only increased, with heroin entirely eclipsed by fentanyl, its cheaper and deadlier synthetic cousin. The state is less of an outlier than it once was: In one recent public opinion poll, more than a quarter of American adults ranked opioids and fentanyl as the greatest threat to public health.To some extent, Mr. DeSantis has picked up where Mr. Trump left off. He promises to shoot drug traffickers “stone cold dead,” a vow consistently met with applause. He largely casts the problem as a symptom of a porous border, giving conservatives another reason to rail against illegal immigration.Tough talk about the Southern border brings some comfort to parents like Ms. Cahill. It’s unclear how her son got the drug that killed him. A video Tyler recorded and shared with a friend that night suggests he took what he believed to be Percocet to relieve pain from a recent tattoo, she says. His father found him dead the next morning.“I had no idea how deadly it could be, how immediate — you can’t call for help,” she said. She keeps fliers in her car that warn “there is no safe experience” using street drugs.But placing the blame on illegal border crossings is misleading. A vast majority of fentanyl in the United States enters through legal ports of entry, according to the Drug Enforcement Administration. Typically, U.S. citizens driving across the border smuggle in the drugs, stuffing them into trailers, trunks or vehicle linings. Keith Howard, who runs Hope for New Hampshire Recovery, a peer-support community group in Manchester, grimaces when he hears candidates talk about a border crackdown as a viable solution. Mental health support, well-paying jobs and long-term treatment programs are even more important, he said.“There is a need to escape from life for a lot of people right now,” Mr. Howard said. “The sense of alienation people have is much, much deeper than it was 10 or even five years ago.”Nikki Haley has promised to do more to target China’s funneling of chemicals used to create fentanyl.Chris Christie says politicians haven’t been honest with voters about solutions.When Mr. Christie, a former governor of New Jersey, visited Hope for New Hampshire Recovery earlier this year, he notably did not mention the border. He served as the chair for Mr. Trump’s special commission to combat the opioid crisis, but many of the recommendations in the 138-page report that the commission issued in 2017 went nowhere. Mr. Christie blamed the pandemic, but he also said the Trump administration did not focus enough on crafting specific policies and programs.Since then, he said, the crisis has worsened, and politicians haven’t been straight with voters about solutions.“It’s dishonest to lead people to believe that you can enforce your way out of this problem,” he said in an interview, adding that he would support sending National Guard troops to legal ports of entry to help Border Patrol agents intercept drugs. At the same time, he added: “I don’t want to fool the American people into thinking that if I send National Guard to the Southern border, that will solve the problem.” President Biden has focused on both expanding enforcement and improving treatment. In March, the Food and Drug Administration approved over-the-counter sales of Narcan, a nasal spray that reverses opioid overdoses. Mr. Biden has called for closer inspection of cargo and stronger penalties for those caught trafficking drugs. Recently, he criticized the Republican-controlled Congress for risking a federal shutdown, which would prevent billions allocated to the D.E.A., Department of Homeland Security and Border Patrol to address the crisis.Victoria Sullivan considers Mr. Biden’s approach a failure. A former Republican state lawmaker in New Hampshire and political talk show host, Ms. Sullivan this year helped open a sober-living home for men in recovery.Ms. Sullivan calls her role “government cleanup,” as she tries to fill gaps left by local agencies. She is convinced the city’s drug policies are too permissive and drawing people from around the region to Manchester’s streets. (Roughly a quarter of people who are homeless in Manchester report that they are from the city.)Some advocates argue that Manchester’s permissive policies have drawn people from around the region to the city’s streets.Ms. Sullivan says the problem requires more aggressive interventions, accessible medical treatment, strong families and religious institutions. Her solutions hit at a contradiction in many Republicans’ views about the drug crisis: She is unabashed about her conservative, small government views, but she argues that agencies need to spend more money on rehabilitation programs.“The government has just failed at every level,” Ms. Sullivan said. “They encourage dependence but don’t do anything near enough to get anyone on their feet on their own.”Ms. Sullivan has voted for Mr. Trump in the past and still supports him. But she also been impressed by Ms. Haley, a former ambassador to the United Nations, who earlier this year hosted a discussion at Freedom House, the sober-living home Ms. Sullivan helped create. There, Ms. Haley promised to do more to target China’s funneling of chemicals used to create fentanyl brought into the United States.Victoria Sullivan, a former Republican state lawmaker in New Hampshire and political talk show host, said she wanted the government to spend more money on rehabilitation programs.Patrick Burns, 35, grew up in rural Maine, where he began pilfering his mother prescription opioids as a teenager. At 17, he enlisted in the Army and served for several years in Afghanistan.When he returned in 2013, nearly everyone he grew up with was battling an addiction of some kind. He moved to Manchester partly to be closer to a larger Veterans Affairs Medical Center, thinking he could get more help there. Instead, he ran into one bureaucratic hurdle after another and said he found fentanyl all around him.“We’re just a bunch of people who have been discarded,” said Patrick Burns, an Army veteran who struggled to get help with his addiction.Mr. Burns voted for Mr. Trump once before and could imagine doing so again. What he finds harder to imagine, he said, is that the government that sent him to war can find a way out of the morass he sees in Manchester.“People just don’t have a clue — it’s become such a problem,” Mr. Burns said. “Now rather than address it, they just kind of ignore it. They try to mitigate the effects, but there are not pre-emptive strikes at all. We’re just a bunch of people who have been discarded.”Ms. Cahill has tried to ensure that Tyler is remembered. She allowed his photograph to be displayed in the Washington headquarters of the Drug Enforcement Administration, and attended a rally at the state capitol earlier this year to raise awareness.That day, she stood with another mother in Concord, N.H., to pass out Narcan to anyone who walked by. When she offered it to two teenage boys, their father stepped in to intervene. “No thanks; they’re good kids,” she remembered him telling her, before shuffling them away.Ms. Cahill was taken aback.“That’s not the point,” she said, recalling the incident. “Tyler was a good kid. This stuff is out there whether we want to acknowledge it or not.”Nicholas Nehamas More

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    Democrats and Republicans Are Living in Different Worlds

    Competing partisan views on how we see men and masculinity are emerging as key factors in the run-up to the 2024 election.Two books published last year, very different in tone — Senator Josh Hawley’s “Manhood: The Masculine Virtues America Needs” and Richard Reeves’s “Of Boys and Men” — have focused public attention on this debate.Hawley approached the subject from a decidedly conservative point of view.“No menace to this nation is greater than the collapse of American manhood,” he declared, placing full blame “on the American left. In fact they have helped drive it. In power centers they control, places like the press, the academy and politics, they blame masculinity for America’s woes.”Hawley added:More and more young men are living at home with their parents, apparently incapable of coping with life on their own. As for jobs, fewer and fewer young men have them. In 2015, nearly a quarter of men between the ages of 21 and 30, historically a cohort strongly attached to work and the labor force, had no work to speak of. These men had not engaged in labor during the previous 12 months. At all.Reeves painted a similarly downbeat picture of the state of men but contended that the solutions lie in an expansion of the liberal agenda. “Men account for two out of three ‘deaths of despair’ either from a suicide or overdose,” Reeves wrote, andyoung men are five times more likely to commit suicide than young women. The wages of the typical man are lower today than in 1979. Boys and men of color, and those from poorer families, are suffering most. In part, this reflects a dramatic reversal of the gender gap in education. In fact, the gender gap in college degrees awarded is wider today than it was in the early 1970s, just in the opposite direction. But there is also a big gap in what might be called personal agency: Men are now only about half as likely as women to study abroad or sign up for the Peace Corps, much less likely to buy their own home as a single adult and half as likely to initiate a divorce. In advanced economies today, women are propelling themselves through life. Men are drifting.Reeves and Hawley had quite dissimilar causal explanations for this phenomenon — as do so many Republicans and Democrats. Let’s take a look at a July survey, conducted by Ipsos for Politico, “The Best Way to Find Out if Someone Is a Trump Voter? Ask Them What They Think About Manhood.”“It turns out ideas about gender and masculinity can be reliable indicators of how people vote by party and by candidate,” Katelyn Fossett, an associate editor at Politico Magazine, wrote in an article describing the poll.In blunt terms, the poll asked, “Do you agree or disagree with the statement ‘The Democratic Party is hostile to masculine values’?” Republicans agreed, 68 to 8 percent; Democrats disagreed, 62 to 6 percent.One of the core differences between Republicans and Democrats lies in their views on family structure. Ipsos asked respondents whether they agreed or disagreed with the statement “Traditional family structure with a wage-earning father and a homemaking mother best equips children to succeed.”Republicans agreed 52 to 24 percent; Democrats disagreed 59 to 16 percent — once again almost mirror images of each other.A similar level of partisan disagreement emerged in responses to the statement “The MeToo movement has made it harder for men to feel they can speak freely at work.” Republicans agreed 65 to 10 percent; Democrats disagreed 43 to 21 percent.These differences were then reflected in key policy issues. For example, “Do you support or oppose increased military spending?” Republicans supported it, 81 to 11 percent; Democrats modestly opposed it, 47 to 40 percent. “Laws that limit access to firearms”? Republicans opposed them, 67 to 28 percent; Democrats supported them, 87 to 10 percent.The substantial 22-point gender gap found in the 2022 election pales in comparison with the policy and attitudinal differences found in the current Ipsos/Politico survey.Other polls provide further illumination.In its 2022 American Values Survey, the Public Religion Research Institute asked a related question: “Has American society as a whole become too soft and feminine?” Among those surveyed, 42 percent agreed, and 53 percent disagreed.There was, however, P.R.R.I. noted, a “partisan divide on this question of nearly 50 percentage points: Approximately two-thirds of Republicans (68 percent) say society has become too soft and feminine, compared with 44 percent of independents and less than one in five Democrats (19 percent).”What’s not clear in the data from the Ipsos/Politico poll is how these partisan differences on gender-linked issues will play out in November 2024.There are a number of additional emerging trends that have clear partisan implications, including generational schisms.In a July 10 Washington Post essay, “2024 Won’t Be a Trump-Biden Replay. You Can Thank Gen Z for That,” Celinda Lake, a Democratic pollster, and Mac Heller, a producer of political documentaries, described the growing strength of young Democratic-leaning voters. “Every year,” they wrote,About four million Americans turn 18 and gain the right to vote. In the eight years between the 2016 and 2024 elections, that’s 32 million new eligible voters. Also every year, two and a half million older Americans die. So in the same eight years, that’s as many as 20 million fewer older voters.Which means that between Trump’s election in 2016 and the 2024 election, the number of Gen Z (born in the late 1990s and early 2010s) voters will have advanced by a net 52 million against older people. That’s about 20 percent of the total 2020 eligible electorate of 258 million Americans.Why is that significant? These Gen Z voters are turning out in higher percentages than similar-age voters in the past, and their commitment to a liberal or even progressive agenda has “led young people in recent years to vote more frequently for Democrats and progressive policies than prior generations did when of similar age — as recent elections in Kansas, Michigan and Wisconsin have shown,” Lake and Heller wrote.Ideologically and demographically, these voters tilt sharply left.The Lake-Heller essay continued:About 48 percent of Gen Z voters identify as a person of color, while the boomers they’re replacing in the electorate are 72 percent white. Gen Z voters are on track to be the most educated group in our history, and the majority of college graduates are now female. Because voting participation correlates positively with education, expect women to speak with a bigger voice in our coming elections. Gen Z voters are much more likely to cite gender fluidity as a value, and they list racism among their greatest concerns. Further, they are the least religious generation in our history.A February 2023 Brookings report, “How Younger Voters Will Impact Elections: Younger Voters Are Poised to Upend American Politics,” noted, “Younger voters should be a source of electoral strength for Democrats for some years to come.”The authors, Morley Winograd, a senior fellow at the U.S.C. Center on Communication Leadership and Policy; Michael Hais, a consultant; and Doug Ross, a former Michigan state senator, argued that “younger Americans are tilting the electoral playing field strongly toward the Democrats” and “their influence enabled the Democrats to win almost every battleground state contest” in 2022.The authors cited 2022 exit poll data for Georgia, Arizona, Nevada, New Hampshire and Pennsylvania showing a consistent pattern: Voters 45 and older cast majorities for Republicans, while those 18 to 44 backed Democrats by larger margins.There are, conversely, developments suggesting gains for the Republican Party.On June 8, Gallup reported a steady increase in the percentage of Americans who described themselves as “social conservatives” — from 30 percent in 2021 to 33 percent in 2022 to 38 percent this year. The percentage describing themselves as very liberal on social issues fell from 34 to 29 percent.Among Republicans, the percentage describing themselves as social issue conservatives rose from 60 in 2021 to 74 in 2023. More important politically, social issue conservatism among independents, who are most likely to be swing voters, grew from 24 to 29 percent from 2021 to 2023. The share of social issue conservative Democrats remained unchanged at 10 percent.In another signal of possible troubles for Democrats, Gallup reported this month that the percentage of Americans describing immigration as “a good thing for the county” had fallen to 68 percent this year from 77 percent in 2020. The percentage describing immigration as a “bad thing for the country” rose from 19 to 27 percent over the same period.On a different and perhaps more revealing question, Gallup asked whether immigration should be increased, kept the same or decreased. From 2020 to 2023, the percentage saying “decreased” grew sharply to 41 percent from 28 percent. The share supporting an increase fell to 26 percent from 34 percent.Gallup created a measure it called “net support for increased immigration” by subtracting the percentage of those calling for a decrease in immigration from the percentage of those calling for an increase.From 2020 to 2023, net support among Democrats fell from plus 38 to plus 22 percent. For Republicans, net support fell from minus 34 to minus 63 percent. Among the crucial block of self-identified independents, support fell from plus 6 to minus 12 percent.Exit polls from 2022 showed that voters who took conservative stands on social issues and those who were opposed to immigration voted by decisive margins for Republican candidates.There are other forces pushing voters to the right. One unanticipated consequence of the opioid epidemic, for example, has been an increase in Republican support in the areas that suffered the most.In a paper published this month, “Democracy and the Opioid Epidemic,” Carolina Arteaga and Victoria Barone, economists at the University of Toronto and Notre Dame, found that an analysis of House elections from 1982 to 2020 revealed that “greater exposure to the opioid epidemic continuously increased the Republican vote share in the House starting in 2006. This higher vote share translated into additional seats won by Republicans from 2014 and until 2020.”Not only did exposure to increased opioid usage correlate with higher Republican margins; it “was accompanied by an increase in conservative views on immigration, abortion and gun control and in conservative ideology in general,” Arteaga and Barone wrote.The two economists used an ingenious, if depressing, method quantifying opioid use by measuring different geographic levels of cancer deaths: “The opioid epidemic began with the introduction of OxyContin to the market in 1996,” they wrote. One of the key marketing strategies to increase sales of OxyContin was to concentrate on doctors treating cancer patients:We start by showing the evolution of prescription opioids per capita by cancer mortality in 1996. Commuting zones in the top quartile of cancer mortality in 1996 saw an increase of 2,900 percent in oxycodone grams per capita, while areas in the lowest quartile experienced growth that was one-third of that magnitude.There is, Arteaga and Barone wrote, “a positive and statistically significant relationship between mid-1990s cancer mortality and shipments of prescription opioids per capita. The connection between cancer mortality and opioid shipments tracks opioid-related mortality.”This linkage allowed Arteaga and Barone to use cancer mortality rates as a proxy for opioid use, so that they could show that “a rise of one standard deviation in the 1996 cancer mortality rate corresponds to an increase in the Republican vote share of 13.8 percentage points in the 2020 congressional elections.”There are other, less disturbing but significant developments emerging from growing partisan hostility.As Democrats and Republicans have become increasingly polarized, three political scientists have found that partisan schadenfreude has gained strength among both Democrats and Republicans.In another paper from July, “Partisan Schadenfreude and Candidate Cruelty,” Steven W. Webster, Adam N. Glynn and Matthew P. Motta of Indiana, Emory and Oklahoma State Universities wrote:Partisan schadenfreude is a powerful predictor of voting intentions in the United States. Moving from below the median to above the median on our schadenfreude measure predicts an increase of approximately 13 points.American voters “are not averse to supporting cruel candidates,” according to Webster, Glynn and Motta. “A significant portion — over one-third — of the mass public is willing to vote for a candidate of unknown ideological leanings who promises to pass policies that ‘disproportionately harm’ supporters of the opposing political party.”Among those high in schadenfreude, they continued, “cruel candidates are not merely passively accepted. On the contrary, for this subset of Americans, candidate cruelty is sought out.”I asked Webster whether schadenfreude was stronger in either party, and he replied by email:It is hard to say whether Democrats or Republicans are more prone to partisan schadenfreude. This is because we measured schadenfreude in slightly different ways according to one’s partisan identification. Democratic schadenfreude was measured after subjects saw a vignette of a Democrat losing government-provided health insurance following a vote for a Republican; Republican schadenfreude was measured after seeing a vignette about voting for a Democrat and losing take-home pay in the wake of tax increases.There was, Webster continued, “a clear pattern: Both Democrats and Republicans express partisan schadenfreude, and this attitude is most pronounced among those who are ideologically extreme (i.e., liberal Democrats and conservative Republicans).”I also asked whether a candidate signaling willingness to punish opponents would see a net gain or loss of votes. Webster replied:We find that most Americans do not register an intention to vote for candidates who promise legislative cruelty. It is only among those individuals who exhibit the greatest amount of schadenfreude that we see an acceptance of these candidates (as measured by a willingness to vote for them). So there is certainly a trade-off here. If political consultants and candidates think that their constituency is prone to exhibiting high amounts of schadenfreude, then campaigning on promises of legislative cruelty could be a successful tactic. As in most cases, the composition of the electorate matters a great deal.While partisan schadenfreude is present among voters on both sides, among politicians the two most prominent champions of its use are Republicans — Donald Trump and Ron DeSantis — and they share the honor of being most willing to adopt policies to hurt Democratic constituencies to win support.Given the assumption that turnout will be critical in 2024, the 2022 elections sent some warning signals to Democrats. In an analysis published this month, “Voting Patterns in the 2022 Elections,” Pew Research found:The G.O.P. improved its performance in 2022 across most voting subgroups relative to 2018 — due almost entirely to differential partisan turnout. Voters who were more favorable to Republican candidates turned out at higher rates compared with those who typically support Democrats.These trends were visible in Hispanic voting patterns:A higher share of Hispanic voters supported G.O.P. candidates in the 2022 election compared with in 2018. In November 2022, 60 percent of Hispanic voters cast ballots for Democrats compared with 39 percent who supported Republicans. This 21-point margin is smaller than in 2018, when 72 percent of Hispanic voters favored Democrats and 25 percent supported Republicans.Crucially, Hannah Hartig, Andrew Daniller, Scott Keeter and Ted Van Green, the authors of the report, wrote:among Hispanic voters who cast ballots in the 2018 election, 37 percent did not vote in the 2022 midterms. Those who did not vote had tilted heavily Democratic in 2018 — reflecting asymmetric changes in voter turnout among Hispanic adults.If Joe Biden and the Democratic Party allow the turnout patterns of 2022 to define turnout in 2024, Biden will lose, and Republicans will be odds-on favorites to control the House and Senate.Trump is a master of turnout. In large part because of Trump, voter turnout in 2020 — measured as a percentage of the voting-eligible population — was the highest in 120 years, at 66.7 percent.Trump is the Democrats’ best hope. In the past three elections — 2018, 2020 and 2022 — when he was on the ballot either literally or through candidate surrogates, he brought out Democratic voters by the millions, reminding a majority of Americans just what it is that they do not want.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. More