When the Senate’s health-care bill died this week, it was worth noting the few who led the revolt.
Most were senators from states hardest hit by our epidemic of opiate addiction:
Maine (Susan Collins), West Virginia (Shelly Moore Capito), Utah (Mike Lee), Ohio (Rob Portman).
“I didn’t come to Washington to hurt people,” Shelly Moore Capito said.
Let’s leave aside how the bill would have done away with basic health care for millions of working folks and provided a tax cut for wealthy people.
One of the biggest problems with it, I think, was that it would have reversed Medicaid expansion and that meant taking away coverage for drug rehabilitation from hundreds of thousands of people, maybe millions of them.
I could not understand how that was a good idea.
It was also interesting to see how, as the debate progressed through the spring to now, a lot of people began to realize what they were losing.
In so many areas where Donald Trump did best in November’s election, areas he promised to make great again, there is a documented need for massive investment in more drug rehabilitation capacity, not less. That is not an opinion. What exists is saturated. Getting into rehab takes weeks, months. Many addicts have no resources of their own with which to seek treatment.
I wrote in another post that opiate addiction was the crucial element in Trump’s victories in several states that were in turn essential to his capturing the presidency.
Eight months later, the Senate’s health-care carnival emphasized my belief that this issue is one of the most potent political forces of our time.
In the spring of 2015, shortly after Dreamland was released, I received a call from Hillary Clinton’s campaign advisor for health issues. Hillary was feeling the ferocity of parents in Iowa and New Hampshire from all walks of life, horrified at their children’s addiction and not knowing where to turn. This surprised the candidate, her advisor told me.
I spoke with her for about ninety minutes. I told her that I thought this was the great silent issue in America today and whoever truly owned it, embraced it, treated it as a thing of the heart, would have a good chance of getting votes from unexpected places, but that this probably would not be felt in opinion polls ahead of time. Mrs. Clinton did some of that, but never enough, and in the end she wrote a position paper and that amounted to most of her campaign’s attention to opiate addiction. I might be wrong, but she didn’t seem to understand the latent power of the issue. Least she didn’t act on it. That was a huge mistake.
Politicians would do well to better understand the deep well of pain and anxiety surrounding, and thus the political power within, this issue. It’s not something expressed easily in polls. People aren’t likely to admit to a pollster on a phone that a loved one is an addict.
But it’s there and dims the view of the future of so many people, the prospects of so many towns and counties, the economies of so many regions, and thus is of paramount importance to them. Right up there with jobs – connected inextricably with jobs, in fact. In so many depressed areas, huge numbers of folks can’t pass an employer’s drug test.
Nor does it take many addicts for that foreboding to spread. A few cases in a small town, I think, are all that’s needed. People see it hit almost anyone and seemingly at random – like a plague – including families who before had no connection to the drug world or the criminal justice system. Soon everyone’s view of the future turns negative.
On top of that, today we have the increasing nationwide notoriety of the issue as compared with just two years ago. An awakening has taken place in those short years – a reckoning and a truth-telling when before there was subterfuge and fabrication.
Overall, this is healthy – for the families now telling the truth and for the country, I think.
But one effect is that the knowledge, and thus dread, has spread to even families untouched by addiction.
In that room where 13 of them put that bill together, Senate Republicans didn’t seem to understand that.
That was a huge mistake.
Because in the small towns or suburbs where folks live, they now know the high school’s quarterback has landed in jail again, and that their pastor’s daughter died from an overdose and that it wasn’t a heart attack after all.
Today a startup in the small town of Portsmouth, Ohio comes out with a line of t-shirts called DREAMLAND LIFEGUARD.
The shirts, designed by a company called 3rd and Court, also feature the words “Time to Turn So You Don’t Burn,” which was a jingle a local radio station broadcast every half hour, knowing that most of its listeners were at the legendary pool.
I’m proud that the designers say they were inspired by my book about our national opiate epidemic, which as many of you know has a lot to say about Portsmouth, and which took its title from the town’s Dreamland pool, which was razed in 1993.
But more than that, I’m impressed with the entrepreneurial DIY energy and imagination that 3rd and Court represents in a town that for years wallowed in a plague of narcotic negativity.
When the fog of dope lifts, creativity and passion have room to blossom. Something like that feels like it’s happening in Portsmouth. A lot of abandoned buildings are under renovation. Downtown has a lot of artists staking their claim.
I spoke with Connor Sherman, 23, who designed the shirts. Connor was partly raised in the Portsmouth area, then went to Shawnee State in town, and graduated with a degree in visual design.
“I see a lot of people, their mindset has changed to entrepreneurship and moving forward,” he said. “Not that I’m going to get out of school and somebody’s going to hand me something, like a job 9-to-5. It’s more about creating something out of nothing.”
The building at 3rd and Court streets in downtown Portsmouth has become a hive for small startups. Years ago, it was an auto shop. Then like so much of Portsmouth it stood vacant for a good while. Finally, it was renovated and PSKC Crossfit occupied the space. (This is part of Portsmouth’s recovery from opiates. Several workout gyms have opened in town. “A lot of people take pride in restoring themselves and restoring others,” Connor told me.)
The crossfit was a place for people to commune.
They began to share ideas and, in time, to discuss business possibilities. That had been lacking for many years in Portsmouth. Really ever since the pool closed in 1993. For years, with the town in decline, buildings abandoned, and half the population leaving, the only place people really saw each other was Walmart.
The new incarnation of the building at 3rd and Court emerged as part of some new alternatives to that isolation.
Soon, Doc Spartan, a maker of natural lotions and hand creams for workout aficionados, started in the building. They advertise their “Combat Ready Ointment” as made from coconut oil, beeswax, eucalyptus oil, vitamin E and more, and good for “cuts scrapes knicks rips rashes razor burn blistered feet rope burn diaper rash chapped skin and calluses.” (Check them out here.)
That was followed by 3rd and Court apparel, making “small town” summer clothes. “Apparel dedicated to the lovely Portsmouth, Ohio and other small towns like ours,” – reads their website.
“My desire to do design instead of something else that someone tells me to do all day is what made me want to start looking for opportunity,” Connor told me.
So the town where for years noxious pill mills were the only locally owned businesses to open is displaying capitalist effervescence of a more wholesome kind.
I get asked by people all over the country what the solution is to this nationwide pill-and-heroin epidemic. Honestly, I don’t always know what to say. But I do believe in harnessing the creativity of folks who are in recovery, or, like Connor, never did dope to begin with.
So here it is:
3rd and Court is offering DREAMLAND LIFEGUARD t-shirts in men’s and women’s sizes, plus a unisex tank top – each for $24.99.
My 40th high school reunion is this Saturday. I’m going.
I’ve been to all my high school reunions. They’re fun. Kind of weird, awkward at times, but fun. I like to think of them as great social experiments. Seeing where people landed who started more or less in the same spot. Not quite like those 7 Up movies from Britain, but something like that.
I grew up in Claremont, a small college town 35 miles east of Los Angeles. It was a great place to grow up, if you overlooked the milk-chocolate smog covering the huge mountains nearby.
As years passed, I noted that I kept in far greater touch with friends from high school than folks whom I met later in life had kept in touch with theirs. John Kennedy, David Fissel, Scott Edwards, Sara Kaviar, Norman Gee, Paul Rohrer, Arthur Cain, Alison Cain, and a few others. I’ll see a few of these folks, though probably not all. They’re all doing well, scattered about.
With John, I went to my first rock concert: Mountain and Canned Heat at the Long Beach Civic Auditorium. 1974. That was a loud show, and Leslie West and the guys from Canned Heat sure were fat. Canned Heat’s singer wore big blue overalls with the word “Boogie” in rhinestones across the chest.
Around that time I was forming fierce, highly convincing arguments that Leslie West was the world’s greatest guitar player. I had a lot of those kinds of arguments back then. I also argued that Kiss would be a “where are they now” story by the time we graduated.
Years later, I spent a lot of time traveling around Europe playing guitar in the streets and plazas for money with Arthur Cain. That was a lot of fun. Good thing to do.
A few of my high school chums have died. Steve Arena and Phil Cornell passed not long after high school. I wish I could see them again.
One guy I haven’t seen almost since before graduation is Robert O’Conner. We were Buddhists together in a group called Nichirenshoshu Sokagakkai of America (NSA), where we chanted Nam Myoho Renge Kyo.
It’s from Japan but was pretty big in the states back in the 1970s when a lot of California suburban kids assumed that any eastern religion was cool and worth checking out. Herbie Hancock and Tina Turner were members.
I started when I had pretty long hair.
For NSA, I cut my hair. For a while I even tried to learn the bagpipes. I was also in a couple pageants – on the outfield of Angel Stadium and once at Dodger Stadium – that looked something like Up With People.
As a Buddhist organization, NSA was wary of appearing too eastern and mystical and weird, so it went the other way, wanting to assimilate into the squarest of American culture. Hence these pageants – dancing to show tunes on the Dodger outfield. For NSA during the USA Bicentennial, I literally marched in a nighttime parade up 6th Avenue in New York City dressed as a Minuteman with a three-corner hat and a suit lined with lights that were battery-powered and lit up in 4/4 time. No lie.
I was a Buddhist from end of my freshman year at CHS to my sophomore year in college, then I quit. I was happy to be in it when I was – helped me weather adolescence — and happy to leave it when I did.
Through Facebook, Robert tells me he’s got a nice husband and career as an artist in Hawaii, all of which makes me feel good. Looks like he’ll be at the reunion, so that’ll be nice.
I played basketball in high school, though not well. I didn’t improve the way I should have. Senior year was a tough one. Had a falling out with the coach, who never could pronounce my last name, but that wasn’t why we had a falling out. He resigned a year or two later, though not because of me. He went on to coach a college team that holds the distinction of being the only team to lose to the Cal Tech basketball team in the last 30 years or so.
Oh well. I still love the smell of wood-floor gyms. I still play basketball and I’m teaching my daughter, who’s 10.
Unlike most folks at the reunion, whom I suspect are close to grandparenthood, I’m just getting started in the fatherhood game. I’m liking it, though.
When I was young, Claremont was a guitar mecca. This was due to the influence of the 1960s/1970s, the five colleges in town, and a local music store: Claremont Folk Music Center, where I took my first guitar lessons (folk music, “Michael Row the Boat Ashore”) from Dorothy Chase, who owned it with her husband, Charles. Ben Harper is their grandson.
(Claremont also had one of the first In-N-Outs, which taught us all what good fast food is.)
Claremont had(s) David Lindley and one of Emmylou Harris’s lead guitar players, whose brother was my guitar teacher later, after I learned to bend notes, which changed my life entirely. After I was taught that bending guitar notes was possible (Jimmy Reed, “Bright Lights Big City”), it seemed to suggest all kinds of things might be bent as well.
It wasn’t long before I was listening to Black Sabbath’s Master of Reality on our family’s old record player over and over. And from there, many years later, to George Jones and Sun Ra. Guitar-note bending will do that.
I think I probably knew 20 people who played guitar. I kept playing, though not well. Three chords, maybe a minor 6th. Enough to play Rolling Stones songs. (Never a major seventh, though. I can’t stand that chord. Ever heard “Color My World” by Chicago? That starts with a major seventh.)
Anyway, the best guitar player in my class was a guy named Pebber Brown. Maybe I’ll see Pebber this reunion. When I want to, I can watch him teaching and shredding away on Youtube.
Another guy, Martin Maudal, played some wicked drums in a band with Pebber, but now he makes guitars: Maudal Musical Machines. I think I’ll see Martin. Also, a guy from my class named Robert Elhai is a composer and writes soundtracks, last I heard anyway. Jim Earl and Barry Lank once had a pretty hip comedy duo. They were in my class – that’s Claremont High School, 1977.
Sid Robinson is a city councilman in Upland. We’re about that age now where some of us are city councilmen, or supervisors, or principals, or something in charge.
All in all, not a bad production for one high school class – and I’m leaving out a lot of folks.
I’ll be interested to see whether any of the girls I had crushes on show up. I remember, though, that that was a tormentingly large group, so probably some of them won’t. Not sure if my old girlfriend will or won’t.
Actually, I don’t know who’ll show up. Of course no one wants to go to a high school reunion on parole or something. A guy from the CHS year before mine aimed high and ripped off a Brinks Armored Car of $1 million. Very successful at his chosen trade, he was never seen again. So reunions tend to be kind of self-selecting. But then the really successful folks often have moved far away, so there’s that balancing it all out. Karen Huffman, our homecoming queen, ended up, last I saw her many years ago, as a curator at the Getty Museum. How many schools’ homecoming queens that you know ended up curating exhibits at major museums?
My grandfather, an illegitimate kid abandoned by his mother and thus an outcast in his Spanish village, always wanted to go home to show all the folks who’d treated him poorly that he’d made it in America, all by himself.
But the Depression, World War II, and the distance from Pennsylvania to Spain kept him from doing it. He (on the right in the photo) died in the 1950s, never having gone back.
I know that family reunions are huge business in Appalachia. That’s because so many have left the region, gone in search of work, yet don’t lose the connections to back home. Many go home every year, sometimes for months. West Virginia’s family-reunion business is massive, I was reading someplace. Same with Kentucky’s. Literally people do not lose touch with the place they left 50-60 years before.
So I have something in common with them.
Same with Mexican immigrants.
Years after high school, I lived in Mexico for a long time where I learned that they have their own version of these reunions – realizing yearly what my grandfather wanted to do just once but never could. They would return to their home villages for the annual fiesta, and throw huge parties, come dressed in fancy clothes. Usually it was the migrants who could afford to spend a lot of money who would go home. You didn’t want to go home poor-mouthing it. I remember they didn’t tell too many people back home about how hard they had to work to earn that money. (Mexican cops got used to shaking these folks down as they drove home. Highway 15 along Mexico’s Pacific Coast was a treasure-trove for cops.)
All that makes me think that the urge to go home and see everyone you grew up with is pretty universal – particularly if life’s been good.
ONE FINAL NOTE: That urge is a big reason why poor guys in Mexico get into drug trafficking. The kind of money you can make and the rep you develop are great ways of showing others back at the local fiesta how really well you’ve done, and of having other guys envy you, and of getting all the girls to want to talk to you. Especially if you’re buying beer for everyone in the plaza.
So maybe a high school reunion is really just like some get-together of local Mexican drug traffickers or an Appalachian family reunion.
The rule of law is something to be treasured. It is precious beyond value. It has been achieved in relatively few countries and times through history. Yet little good comes without it. No real economic development, no great technological innovation, no slow march of prosperity, no public safety, no civic life.
After living in Mexico, it seems to me the rule of law is achieved through culture and a host of attitudes that give rise to prolonged (taxpayer funded) investment in infrastructure and government.
The rule of law is accomplished through facts on the ground, through small things working well. These include courts, prisons, police, civil service, decent public-employee salaries and training, but also parks, street lamps, storm drains, clear title to property, and much more — above all at the local level.
Most of this is what Mexico lacks or has neglected.
Superimposed on that civic weakness, and growing from it, has been the venomous presence of drug traffickers who have lost any discretion they once displayed and now behave with medieval cruelty. But what allowed them to go from hillbillies to national security threats in the span of a few decades is the lack of rule of law and all that I mention above. The result is the difference between 3000 murders in Juarez a few years back while El Paso tallied only 20 or so. On one side are strong civic institutions and well-motivated law enforcement of various stripes working together; on the other, infrastructure has gone begging due to lack of budget, corruption, lack of accountability, and a general belief that local government isn’t worth the time.
All that is what got Javier Valdez killed a month ago today.
Valdez, you may have read by now, was an esteemed, brave journalist who chronicled the drug world of Sinaloa in books and his newspaper Riodoce.
He was gunned down by masked men who accosted him as he was getting into his car not far from his newspaper. To make it seem as if robbery was the motive, they took his car, ditching it not far away. The computer and cell phone he was carrying have not been found, according to his newspaper.
I met Javier in 2014. I saw him again in February. We had breakfast to talk about things in Sinaloa. In the meantime, I had provided a promotional quote to the English-language version of his book Los Levantados (The Taken) because, despite knowing him only casually, I admired the work he and his newspaper, Riodoce, did consistently.
The Taken (University of Oklahoma Press), by the way, offers an amazing view of worlds few of us will enter. You should read it. The first story is about a Mayan Indian from Chiapas who fathered six pairs of twin girls and, to support them, was recruited to do some kind of work in Sinaloa, only to find that the work he was hired to do was not in agriculture, but in something connected to drug trafficking, though he never figured out what that was because a battle between cartels consumed the region where he was sent. Just stunning stories.
In the month since Javier’s death, we’ve heard the calls for the government to do more to protect journalists, end the impunity with which the underworld rules many parts of the country. I echo those calls.
But what ails Mexico isn’t only lack of political will. It is certainly that, but it is also a systematic neglect of local government that goes far back in the country’s long history. So even with the political will to find the killers of Javier Valdez, investigators would be hampered by the lack of tools that their counterparts in other countries take for granted.
There is no way to make good on calls of better investigations without a mighty strengthening of the local and regional public institutions that go into such investigations.
As we examine all the reasons why brave people like Javier Valdez have fallen, Mexico needs to look to its local government and build up its institutions, its capacity, its ability to protect its citizens and the ability to find justice for them when it cannot.
Like all politics, justice, at its root, is local.
Ensuring that would be the greatest tribute to a brave man.
Alfredo del Mazo, of the Institutional Revolutionary Party (PRI), appears to have been elected Sunday as governor of the massive state of Mexico.
The state of Mexico surrounds Mexico City like a horseshoe. It is economically bustling and contains most of what is Metro Mexico City, with several suburbs with populations of more than 1 million people. It is the most populous state in the country (pop. 16 million).
For decades, it has been run by the PRI – which also ran the country as a one-party state.
(NB: For a good analysis, in Spanish, of why Del Mazo won and the effect this might have on the country’s presidential election next year, read this by Federico Berrueto, which ran after I published this blogpost.)
More than that, though, the state has often been run by a group of Priistas from one small town: Atlacomulco, a town (pop. 77,000) that has produced governors like Xalisco, Nayarit has produced heroin traffickers.
Del Mazo is not technically from this town, but his father was, and so was his grandfather. Both men were governors of the state of Mexico. Both men were PRI leaders. Del Mazo himself is a distant cousin to current Mexican president, Enrique Peña Nieto, who also hails from Atlacomulco and was once the governor of the state of Mexico.
Moreover, no group more exquisitely represents the worst of Mexican corruption than the governors from the town of Atlacomulco.
What’s popularly known as the Atlacomulco Group formed around an ideologue named Isidro Fabela in the 1940s and 1950s. The group shaped a governing philosophy that combined unregulated/crony capitalism with authoritarian, corrupt politics. Since World War II, of the 16 governors to run the state, seven have hailed from Atlacomulco. Others have taken their cues in how to govern from those from Atlacomulco.
(Each Mexican governor serves a six-year term, though during the PRI monopoly they often left office earlier to serve in the federal government or they finished the term of a governor who left early. This was particularly true of the state of Mexico, which has been a crucible for the formation of PRI leaders and high functionaries in the Mexican government during the years of the party’s political monopoly.)
Carlos Hank Gonzalez, also from this town and also once a governor of the state and a protégé of Fabela’s, encapsulated this philosophy with a now-famous statement, which as decades passed was adopted by many PRI politicians:
“Un politico pobre,” Hank said, “es un pobre politico.” Translation: A poor (not wealthy) politician is a poor (bad) politician.
Atlacomulco governors ran the state like little chieftains, accumulating power and wealth and leaving behind dozens of public assets named for them. (In the map guidebook to metro Mexico City, the listings of streets, avenues, boulevards, parks, neighborhoods, etc etc named for Hank Gonzalez take up three pages.)
This kind of governor is now a standard in Mexico, as the PRI lost its national political monopoly in 2000 and the president lost his undisputed power. It is now in the governors’ offices where power is exercised, at least on a regional level. Instead of one king, there are 31. The results have been disastrous for respect for the rule of law in Mexico.
In 2012, Peña Nieto hailed a “new generation” of governors, ready to do the country’s business in a modern way. At the time, he listed four governors as examples – of which three are now facing criminal charges and are on the run. One of them, Roberto Borge, former governor of the state of Quintana Roo, was detained this week in Panama, on the run fleeing charges of money laundering.
A lot of that can be traced, I believe, to attitudes on governance forged in the state of Mexico by the Atlacomulco Group, and their power within the PRI over the last many decades.
I remember covering the town of Nezahualcoyotl – a slum town in the state of Mexico on the eastern edge of Mexico City (pop. 1-3 million people, depending on who you ask) after residents elected their first non-PRI mayor. The new guy found a city hall teeming with corruption and incompetence. Outside, I remember, were at least 12 newspapers that circulated only within three blocks of city hall. Each was only four or eight pages. They had no interest in reporting news. They were instead intended as organs of promotion for the career of one politician or another and used to attack rivals – all within the broad umbrella of the PRI. That had become a real job in Nezahualcoyotl and other cities in the state of Mexico: start a newspaper, find a politician to fund it and become his promotional vehicle. I still have a bunch of these newspapers somewhere in my files.
This is the legacy of the PRI in the state of Mexico and why I find the election of yet another member of the Atlacomulco Group, no matter how distant, to be reason for discouragement.
The New England Journal of Medicine startled everyone this week by a posting a one-sentence warning over the so-called Porter & Jick letter to the editor that the journal published in January of 1980.
The warning note reads: “For reasons of public health, readers should be aware that this letter has been `heavily and uncritically cited’ as evidence that addiction is rare with opioid therapy.”
I find it remarkable that the NEJM did this, particularly so long after the letter itself was published in the journal. Apparently this kind of note is very rare.
But I think it confirms what I wrote in Dreamland – in which I interviewed the main author of the letter, Dr. Herschel Jick.
I think it’s important to reiterate the impact, as well as the intent, of the letter.
As written, it is entirely correct. That a data base of hospital patient records, that Dr. Jick ran, and still runs, found the following: of 11,800 patients given narcotic painkillers while in hospital, only four developed an addiction to those drugs.
Remember this was data taken from the 1960s and 1970s, a time when narcotic painkillers were rigorously controlled, and never given to patients to take home with them. So it stands to reason that patients, under such strict controls and administered the drugs only in hospital, would rarely develop addictions – as the letter’s headline in the journal read when it was published: Addiction Rare in Patients Treated With Narcotics.
They simply didn’t have access to large supplies of narcotics, and especially drugs to take home with them, as patients routinely do today. Hence they didn’t run much risk of addiction. (The whole thing, btw, helped change my mind about what ignites a scourge of addiction, which I now believe is not demand, but supply. Supply first sparks demand.)
The problem came not with how the letter was written, but how it was interpreted, then used, by others. Through the late 1980s and 1990s, it was widely cited, quoted, footnoted – as my research in Dreamland made clear and as a recent letter to the NEJM from the Canadian doctors confirmed. It was deemed to be proof that somehow science now knew that addiction was rare when opiates were used to treat pain. Through the years, it became known, through a process similar to a game of telephone, as some kind of “landmark study” that presumably refuted much about what we know about narcotic painkillers and addiction.
The Porter & Jick letter – 101 words – neither did, nor intended, anything of the kind.
It was also used, of course, by pharmaceutical companies – especially Purdue Pharma, manufacturer of OxyContin – as proof that their drugs no longer caused addiction when they were used to treat pain. The company used the statistic that “less than 1 percent” of all patients administered opiate painkillers drugs – especially OxyContin – grew addicted to it. This was not true nor supported by any science. It was not supported by Porter & Jick, which was making an entirely different observation. Yet the letter was used to convince a generation of doctors that science now knew new things about narcotic painkillers and one was that they were “virtually nonaddictive” when used to treat pain. A claim that, again, has no basis in science or the letter.
All this I wrote in Dreamland, which came out two years ago. I found the whole story to be an unsettling episode in how scientific thinking changes based on no evidence at all, but due instead to deft and relentless marketing.
I’ll add one more thing. The NEJM’s warning note was prompted, as I said, by a review of the letter and its influence in scholarly studies that was published by some Canadian doctors in the journal this week.
I read the letter these doctors wrote and I don’t see Dreamland credited or footnoted.
I’m trying to take it all in with equanimity. Yet I’ll admit to some frustration to have done so much research and storytelling that brought this to light as part of Dreamland’s larger story of how this opiate-addiction epidemic spread, and which others have read and learned from, and then not have it reflected in the work those people do. On the contrary, the Canadian doctors’ letter is presented as some new revelation, which it is not.
So I’ll just say that it would have been nice to see my work credited in the recent NEJM report by those Canadian doctors, as well as media coverage of that letter. I’ll leave it at that.
One important thing my mother told me when I was growing up was that first I should find the work I loved to do in life. That if I did, or didn’t, it would affect all the other aspects of life: sleep, romance, family.
I’m lucky. I love what I do. I’ve been a journalist for 30 years and when I’m on my deathbed I’m quite sure I’ll be making deals with God, saying, I’m happy to go but just let finish this one story first. Nothing I’ve done in the last 30 years has been drudgery, tedium. It has been exciting, mentally stimulating — and it paid the bills.
That didn’t happen by chance. I worked at it very hard for many years. I was helped by several great editors who pushed me to learn the craft and forge a writing style – sometimes not so politely.
I was helped above all by my parents who did not give us what we wanted growing up. They gave us what we needed. They gave us education and experience, above all. They gave us far less stuff than other friends I grew up with were getting from their parents. Later in life, I was very happy that was true.
I bring this up because I believe it is relevant to the opiate-addiction epidemic we face as a nation and a culture.
Recovery from addiction, I believe, means finding fulfillment in some project, endeavor or work. Finding something you love to do, something that means more than dope, that stimulates your mind more.
One way we, as a culture, have failed our kids is that too often we believe the stuff they get (and have demanded) without working for it, and that we give them, is somehow going to help them be happy. We as a culture have avoided pain, run from it. And we want our kids to be spared any pain at all – even hard work. But no one find’s his calling in life without hard work, sometimes demeaning work.
I hated all the years I spent washing dishes in cafeterias and restaurants while I was in high school, but I’m plenty happy I did it for it taught me to do things I didn’t want to do, taught me how important education is, and that fulfillment comes from finding the work you love and spending your life trying to get good at it.
So many kids I see have been given far too much without working for it. Too many haven’t learned that through hard work, pushing yourself to seek that calling, you actually learn and achieve and feel good about what you’ve done.
On the other hand, heroin, seems to me, is simply the final “stuff” for a culture that believes that more stuff leads to happiness. (Writing about heroin these days is really another way of writing about America, who we are and what we’ve become, I’ve grown to believe.)
My mom was right. It’s through hard work in something you love that you achieve fulfillment.
“To find out what one is fitted to do and to secure an opportunity to do it is the key to happiness. Nothing is more tragic than failure to discover one’s true business in life, or to find that one has drifted or been forced by circumstance into an uncongenial calling.”
“The opposite of a career is neither leisure nor culture, but aimlessness, capriciousness, the absence of cumulative achievement in experience, on the personal side, and idle display, parasitic dependence upon the others, on the social side.”
Interesting stuff, and relevant more than ever to today’s America.
The passing of grunge rocker Chris Cornell this week means that of the five major bands to emerge from the early 1990s’ grunge scene, Soundgarden, Alice in Chains, Stone Temple Pilots and Nirvana all have lost lead singers to early deaths.
Only Pearl Jam has not.
Mostly, these were singers whose lives were mangled by heroin/opiates, whether they died from it or not.
As I read the news, it occurred to me how deeply the grunge scene of the late 1980s and early 1990s swallowed the greatest drug scam ever sold, which is that heroin use is somehow a sign that the user is a rebel, an outsider, an artist finding his own tormented path on the margin of a claustrophobically conformist society.
The reality is that the drug, more than any other, is about commerce – about cold, hard business — and about enslavement to consumption. All of which, needless to say, is about as low-brow conformist as it comes.
Heroin should have been forgotten not long after it was invented for it has few medicinal benefits that other opiates don’t provide with far less addictive risk. It survived because it was a great drug for traffickers. It was easy to conceal, easy to cut, and it created customers that had to buy the product several times a day. A businessman’s dream.
The drug got its underground cachet beginning with Charlie Parker, the legendary saxophonist in the 1940s, who died in 1955 at the age of 34, having wasted much of his prodigious creativity in the pursuit of smack, while bringing an entire generation of younger musicians to dope. (Trumpeter Clifford Brown was staking out another path for jazz musicians – one of great devotion to art and improvisation combined with a sober lifestyle – when he was killed in a car accident at age 25.)
Beat writer William Burroughs helped solidify the drug’s reputation as an outsider’s substance.
Heroin got a bigger cultural boost from the Velvet Underground’s first album in 1967 and Lou Reed’s “Heroin,” followed as the years passed by notably addicted rockers like Johnny Thunders, Sid Vicious and, of course, Keith Richards. So that by the late 1980s, heroin was fully established as the go-to drug for anyone – often a pasty-faced white kid with a rocknroll heart — wanting a personal image as a non-conformist.
To the extent of few others before it, the grunge scene bought this fiction with gusto. Heroin, moreover, seemed the perfect drug for grunge’s nihilistic, dirge-like sound. So an entire scene was created that seemed to emerge from the swamp of the Velvet Underground’s first album. Many others died from it. Grunge did, too.
My music was punk rock and the grunge thing happened later. My focus in life was by then on writing and storytelling and not so much on the latest wrinkle in rocknroll. Grunge was too slow, too hopeless and depressing. Also, I lived in Seattle during this time, and didn’t like the city and left as soon as I could and moved to Mexico. So all in all, grunge didn’t do much for me. (Stone Temple Pilots were a bit different, and appealed to me more, in that the music was less grungy and they weren’t from Seattle, though their singer’s story is the same.)
There was, nevertheless, a do-it-yourself ethos to the scene that I found attractive. Bands were especially afraid of “selling out,” thus many of them first signed with the local Sub Pop label.
It’s a sad epitaph to the scene that the folks who created it fought mightily to avoid the taint of commercialism in their music and conformity in the way they lived — and ran, as they did, to the embrace of a drug that embodied everything they were fleeing.
Lately I’ve been looking for some inspiration that only human achievement can provide, given the news of the last few days.
So I was thrilled when my old friend from Claremont High School, Scott Edwards, sent me youtube clips of his son, Andrew, playing piano.
The problem with the way we use the word “awesome” is that when you use it to describe the color of your new car or a new iPhone it doesn’t leave you with much to describe something that is truly awe inspiring. Such as when you see your old high school friend’s son playing piano like this.
I first met Andrew Edwards when he was an infant. Now look at him. He’s entering college at USC next fall Scott tells me. (Bears mentioning that Andrew’s mother, Alison Edwards, is a piano professor and concert pianist of astounding talent.)
So many kids seem to expect something for nothing, or can’t see the deep benefit that comes with prolonged pursuit of talent or knowledge.
In our culture, we spend so much time thinking about how to be “happy.” We’re bombarded with easy paths to what marketers want to tell us is “happiness” – which is usually something more akin to amusement or distraction or titillation.
Seems to me that the kind of dedication displayed in these youtube clips brings a fulfillment and satisfaction that is real happiness. Amazing to see what kind of achievement true hard work, focus, and devotion brings….
Two weeks ago I had a heart attack at a high-rise hotel in Atlanta on the morning I was supposed to deliver a speech at a large conference on prescription-painkiller and heroin abuse.
Turned out one of my major arteries was completely blocked. I’ve written elsewhere about what happened that day and you can read it here.
I rebounded quickly because I was near help, and also because of an outpouring of prayers and good wishes sent from many you, which I greatly appreciated.
My wife and I were teary-eyed for days reading your posts and comments.
I went to visit my new cardiologist when I got home. I had never thought of what was happening during a heart attack.
“What you were feeling is the pain of the heart dying,” she told me.
This hit me much harder than anything else I’d heard from a doctor. I began to understand more deeply the enormous good fortune I’d had in being where I was when this happened. Another two or three hours without help, “and you’d have been in serious trouble,” she said.
I’ve spoken a lot about personal accountability in my talks about Dreamland. I believe it’s one of the lessons we ought to learn from our opiate-addiction epidemic: that as a culture, we almost demanded doctors cure our pain quickly and completely and we weren’t going to do much to help them do that – like eat better, exercise more, avoid processed foods. Opiate painkillers were quick, cheap and those were the tools doctors turned to.
So midway through writing the book, I stopped drinking sugary drinks; lots of junk food I’d already eliminated from my diet. I don’t buy food that’s advertised on TV. I’ve always walked a lot, but I added swimming. I had no clue that I had a blocked artery, or ought to believe I had one, because I thought I was doing a lot right. (My cardio rehab nurse said she thought the swimming had saved me, because through it my blood had found new ways of circulating around the blocked artery and used those when the attack came.)
Still, I’ve come to believe that our heroin/pill epidemic has a lot to say about who we are as Americans, how we do live and how we should live. I think I felt that a bit more deeply following my heart attack.
As part of that, I came across a discussion of the work of Viktor Frankl, a great philosopher and Holocaust survivor. It reads in part that what gave him the ability to survive Nazi concentration camps (four of them) was the search for meaning. That life is more than the pursuit of happiness; it’s the pursuit of meaning and with that comes fulfillment.
“We all said to each other in camp,” he writes, “that there could be no earthly happiness which could compensate for all we had suffered.” But it was not the hope of happiness that “gave us courage,” he writes. It was the “will to meaning” that looked to the future, not to the past. In Frankl’s existentialist view, we ourselves create that meaning, for ourselves, and not for others. … We must acknowledge the need to make sense of our lives and fill what Frankl called the “existential vacuum.” And we alone are responsible for writing better stories for ourselves.
That last sentence is the most important one.
Frankl’s work, I think, is hugely relevant amid this opiate-addiction epidemic.
I’m just beginning this new life – renewed approach to exercise, avoiding stress, and thinking of food differently than even I had. Feeling very fortunate to be alive and be around people who care – like many of you.
Hoping to continue writing a better story for myself, and wishing the same for you.
Veytia is the Attorney General for the state of Nayarit, and a figure bigger in the public mind than the state’s governor – which is rare in Mexico.
He was charged under an indictment out of New York alleging that he conspired to smuggle heroin, cocaine and methamphetamine into the United States.
Those who’ve read Dreamland know the importance of Nayarit in our heroin supply. Many have alleged that Veytia protected the heroin trade, in an alliance with a large and new cartel known as Jalisco New Generation, who has taken control of the region over the last six years.
Proceso, the Mexican new weekly, recently published this article calling him the “dark Prosecutor,” and repeating allegations that he had protected the drug trade.
Veytia began his career simply enough, as an attorney handling the taxi concessions for the city of Tepic. But in time, he was place in charge of the state’s anti-kidnapping squad and from there elevated to Attorney General.
(Stay tuned for a blog post later today about my own (brief) encounter with Edgar Veytia.)
In Nayarit, he has promoted an image of himself as a tireless, almost God-like, fighter against crime, subduing the violence that racked the state during 2010 and 2011. The governor of Nayarit named him government official of the year.
“Nayarit was a war zone, body mounted and the state needed a miracle sent from the Lord above.
Edgar Veytia is the name of this miracle, who returned peace to the land, risking his life
He’s been able to let people feel better, in a peaceful state and for that I thank God.”
In February, the Mexican Marines shot it out with – and killed – a wanted leader of the Beltran Leyva Cartel — Juan Francisco Patron Sanchez, aka H2 – who lived a few doors down from Edgar Veytia in the city of Tepic, Nayarit’s capital.
A businessman in Los Angeles who is from Nayarit, in an interview in 2014, told me Veytia had him kidnapped. (More on that interview later.)
So far, it’s unclear how Veytia was at the border and able to be arrested. I suppose we’ll hear more on that as the case unfolds.
Leaving aside the charges against Veytia, the Mexican drug trade since its origins in the 1970s has depended on political protection, collusion and corruption.
Her obituary doesn’t provide a lot of detail, but it does provide some. It sounded as if she spent a lot of time in rehab, then relapsed each time. Finally, when she looked to be putting the worst behind her, she relapsed again and overdosed and died.
It’s an extraordinarily sad story – and it must have been very difficult for her parents to write the obituary.
It made me think of what her death can tell us. First, all addiction seems to involve relapse. I quit smoking (and started again) nine times before I finally quit for good – at 37.
But I lived through my cigarette relapses. With opiates, particularly given the amount of supply of dope on the street, getting out of treatment is like Russian Roulette. People go in, detox, get clean. Their tolerance to narcotics drops. They leave rehab and do well, then they relapse. With these drugs, and their prevalence and potency on the street, relapse too often means death.
It feels good to say, `We can’t arrest our way out of this.’ I agree. We do need expanded treatment. But, frankly, that also feels too easy.
My feeling is, when it comes to opiates, we have to arrest our way out of this before we can treat our way out of it. That’s a bit discombobulated, I know. What I mean is that we need to address supply on the street. That comes only with arrests. It seems to me dangerous to assume that in modern America people can get out of rehab and go home to areas awash in dope and be expected to stay alive, given the likelihood of relapse and the potency and controlling nature of opiates. It’s not cigarettes people are relapsing on. It’s pain pills and, especially now, heroin and fentanyl.
This is a supply story and has been from the beginning. Huge amounts of very potent opiates were unleashed on the country – first in the form of prescription opiate painkillers. When millions of people grew addicted to these pills, a lot of them looked for cheaper alternatives. Heroin traffickers, mostly from Mexico, slowly realized that these folks were a growing market and expanded their offering.
But it all has to do with supply. No treatment has much chance against a cheap and plentiful supply of potent dope.
It’s why doctors and the medical establishment need to continue reassessing how they prescribe opiate painkillers.
It’s also why we need to make Mexico a sustained priority. I’ve written elsewhere that I don’t think building a wall — or rather, more walls — at the U.S.-Mexico border is likely to do much to slow heroin trafficking. That doesn’t mean we shouldn’t seriously address Mexico’s continued production and exporting of this drug. Ninety percent of our heroin comes from Mexico, according to the U.S. State Department. It’s unconscionable that one country should export so much of this junk. China fought a war with England in the 1800s, twice, over this issue. We don’t need wars with Mexico, but it does seem to me that we need to make this the priority it deserves to be – and walls are a distraction from the real work that needs doing.
This young woman’s death also shows why we probably need to make much greater use of what’s known as medically assisted treatment – the use of drugs as replacements, as shields. These include methadone, Vivitrol and Suboxone – they either take away the craving for heroin or block overdoses.
It’s unreasonable, I think, to assume that addicts can go back to these same neighborhoods, where opiate supply is plentiful, without some sort of protection, some kind of shield.
The last couple years have shown how dangerous that is.
It’s real world. It’s working the program. Accepting blame and accountability, breaking with fantasy. It’s hanging out with people who don’t think like you. It’s reminding yourself that life is full of constraints and you can’t just do whatever occurs to you. It’s realizing that you are not perfect and there are others whose opinions matter in this world.
That said, the recent health-care fiasco displayed House Republicans behaving like heroin addicts.
It’s easy to go on Fox News for years, blame someone else for everything when you don’t have to be accountable for finding solutions. It’s easy to rant about the endless failures of those people who do. Ranting is a narcotic; so is outrage; so is complaining and destroying. It gives us a big blast of dopamine to the brain. As does spending a lot of time insisting on all the nifty ways you’d do things better when you are king of the world. Feels so luxurious. Feels a lot like heroin, I suspect.
Being an opposition party means never having to put an idea to a constituent smell test. You get used to it – your tolerance for fantasy rises like an addict’s tolerance for a narcotic. Like addicts, you hang out with folks who think like you, talk like you, and never force you to face anything resembling reality, or the necessity of compromise.
Living without compromise is a nice idea in theory, but it’s possible only when you’re high on, and surrounded by, ideology — or dope.
A heroin addict brooks no compromise. He wants a world his way only. No messy complications, no one telling him no. Ask any parent of an addict.
What I think we saw was people addicted to a warm, euphoric ideological fantasy world in which they’ve lived for the last several years. Addicted to the idea that they could do it alone, didn’t need anybody, didn’t need to compromise. This Freedom Caucus seemed dead-set on depriving anyone but the wealthiest of what most would deem civilized health care: maternity care, ER visits, not to mention addiction-treatment coverage.
It was bizarre to watch them line up to take away benefits needed by so many who had just elected them and their president, and give them to our aristocracy.
How do you come to the conclusion that thinking like the upper classes of pre-revolution France is okay?
Well, perhaps because House Republicans lived in a bubble for seven years, voting to repeatedly repeal Obamacare knowing it would be vetoed. Then the fantasy ended and they finally had the power to do it. They had nothing to replace it with. (John Boehner is, I’m sure, happy to be away from all that.) What they came up with would have savaged the very people who put them in office.
The word `compromise’ gets a bad rap these days, but it’s actually another way of saying something else. It’s saying, we’re behaving like adults. We’re not going to act like petulant children who want a world run according to their whims alone, which is, in turn, another way of describing how a heroin addict thinks.
Something like this, I suspect, is what Ryan was referring to when he spoke of House Republican “growing pains.” Getting off the dope of viewing compromise as a dirty word.
A big part of addiction recovery is relating to others again, accepting that your views are not the only ones that matter, that you have to modify your behavior, answer to others who may not think like you.
It’s like governing.
It’s messy and ragged; it’s hard and far from perfect. It’s adult, in other words, and it’s the opposite of dope.
I was living in South Shore when Dr. David Proctor arrived in 1978. I had just come back from college and was working at the local brickyard. For a few years I was still apart of the local drug crowd but slowly moved away from it because I found it scary and upsetting. I did not like buying from biker dudes I did not know and I did not like the small dealers that sold drugs to kids.
In small rural towns there are the “saints” and “sinners” and the doctors in any town normally are in the “saint” category. One of my local small dealer friends went to Proctor while he was still apart of Dr. Riddle’s office. Proctor told him he would write him a script for any drug he wanted. When my friend told me this I will never forget the stunned and serious look on his face, even though he got a prescription for Black Beauties. My friend knew in the back of his sinner brain that something was very wrong.
Once my extended Pentecostal rumspringa was over, I returned to church. I got married and left the area. However, my husband was an abusive man and I returned to my mother’s home in South Shore with a small child. It did not take me long even in my state of mind to see that Dr. Proctor along with another doctor had done major damage to my small town. Even in my mother’s church there were five people that I knew about that were addicted to prescription drugs.
Your book focused on the opiates but there was a doctor who ran a “diet” clinic who was free with the amphetamines. I would walk around the corner to see his lot filled with cars from Hamilton, Franklin, Pike and other counties in Ohio plus cars from counties in Kentucky and West Virginia. The people I saw were lean not obese. So South Shore was a one-stop on the small time dealer network for both opiates and amphetamines.
There is one thing I would like to say about kids raised in fundamentalist churches. This is about the saint and sinner perspective. They will be zealously saint or zealously a sinner and there seems to be no middle ground. This especially applies to rural areas. If you are trained to live your life a religious zealot then when you turn away from your religious upbringing you live your worldly life just as fervently and passionately in the negative. However, when these same people turn back to their religious roots from the addictive life they are not ashamed to help others to do the same.
I left South Shore in the middle nineties with my middle school aged daughter. I went back to Morehead State and cleaned up my mess from the 70’s and graduated with honors just in time for my daughter to start college. My daughter went on to get her masters at UK. After reading your book I am glad we left the area for I can see decades of destruction manifest in South Shore when I go back to visit.
A positive note: I loved your description of Chillicothe Street especially during the holidays. I was not part of the middle class but was raise by a single mom with three children and no welfare. We would take a taxi to Portsmouth to shop on Christmas Eve. I can remember the Salvation Army Santa ringing his bell in front of Kresges’ and my mom singing “Silver Bells.” We would go to Kresges, Greens Five and Dime, Kobacher’s and to Martings to see their window display and buy hot peanuts from their candy area and play on the escalators.
All of this is etched into my childhood mind as well as all the great times swimming at Dreamland with my brothers and the neighbor kids who took us with them. I thought all city pools were like Dreamland.
While speaking on the topic of heroin in America, I’m often asked how much of our supply comes from Afghanistan, as we’ve been in a war over there for many years.
My answer, from interviews with traffickers, cops and DEA agents, is that most of our heroin comes from Mexico.
That view was confirmed this morning by William Brownfield, the U.S. State Department’s assistant secretary for International Narcotics and Law Enforcement Affairs.
In a conference call with reporters, Brownfield estimated that 90 to 94 percent of the heroin consumed in the United States originates in Mexico, with another 2 percent or so coming from Colombia and the remainder from other countries around the globe.
That represents a massive shift in our heroin supply since roughly 1980, when a lot of our heroin came from the Far East, and had for decades.
Interestingly, Brownfield said, a lot of Afghan heroin does make it to Canada, but not to the United States, where Mexican trafficking organizations, too close by, enjoy a more advanced and efficient distribution network, and offer therefore cheaper prices.
Brownfield was talking about the just-issued International Narcotics Control Strategy Report (INCSR), which talks a lot about the heroin/opioid problem in America. Brownfield’s message was a positive one about cooperation between Mexico and the United states on issues of drug enforcement.
A wall of law enforcement cooperation is in place, without constructing an actual wall, he said. Serious problems existed, he said, “but we have a far better architecture to address them today than we did in years past.”
Nevertheless, his answer on heroin’s origin stunned even me. I would not have guessed the estimate would be that high.
I’ve written elsewhere about my belief that it’s unlikely that more border walls between the two countries will do much to staunch the flow of heroin into the United States. What’s really necessary is even deeper cooperation, frank discussion with Mexico that a wall and the emotion it provokes would do much to corrode.
Yet Brownfield’s response highlights two things worth mentioning.
One is that Mexico must truly step up to this challenge. Its unconscionable that such a high percentage of illegal highly addictive dope come from one country to another. China had a similar issue in the 1800s, when the British forced opium into that country, resulting in the massive addiction of Chinese people for decades after.
If border walls are insulting to Mexico, it must understand that they are proposed because of Mexico’s own failings – both with regard to law enforcement and criminal justice, and in channeling the desires of its most hardworking citizens, who then feel the need to migrate illegally to the United States.
Second is that U.S. demand for heroin grows organically out of doctors’ massive prescribing over the last 20 years of pharmaceutical narcotic painkillers – the subject of my book DREAMLAND — something that no border wall will stop, of course. Also, if we get into discussions with Mexico about this topic, soon that discussion will also turn to our very accessible market for guns, many of which then go south through a variety of channels and end up being weapons in that country’s bloody drugs wars. So if we ask a neighbor to behave with maturity, we better be willing to do the same.
We have almost 700 miles of walls along the border that separate the two countries. Drugs aren’t much trafficked through those areas that have no walls, most of which are in forbidding terrain. Our drugs, instead, are trafficked through ports of entry where walls already exist. They are trafficked in cars, trucks, and by pedestrians. With heroin, the problem is exacerbated, as I’ve written elsewhere, by the fact that is the most condensable drug, thus the most easily and profitably trafficked,and one that we now have a huge demand for.
All in all, the issue begs a binational, cooperative solution, seems to me.