It now appears that within the NIH push is what is described to me as “a lot” of money (though how much is as yet unknown) to establish three research centers around the country. Here are the guidelines for applying for that money.
Sounds like it might be a good moment for folks in the tri-state Ohio River Valley, so badly hit by the epidemic and deindustrialization, to marshal some forces and look to the future of what such a center can mean for research, dollars, and attracting PhDs to the area — and what all that might mean, in turn, for regional economic development.
They might also consider, as I wrote two years ago, what such a center could mean for all those recovering addicts now studying to be drug counselors and social workers, who might be hired to help in the studies such a center would fund.
After so many years of negative behavior, many I’ve met are now eager to be part of something positive and something bigger than themselves. Harnessing them could mean a massive infusion of new energy to a region that’s lost a lot of it.
Portsmouth, a small town I wrote about in Dreamland, has been slowly rebounding from years of economic decline and drug addiction.
That’s a remarkable thing. For it was Portsmouth – on the Ohio River — that led the way into our national opiate-addiction epidemic. The town was where the Pill Mill – sleazy pain clinics prescribing massive amounts of pills to almost anyone for cash – was born.
With the town blasted by this huge supply, and the sense of community shredded by job loss and more, widespread pain-pill addiction was a fact of life in Portsmouth by the end of the 1990s.
But a lot has happened since then. The town, each time I return, seems slightly more energetic, more invigorated, more about positivity and less about dope’s inertia and fatalism. A recovery culture has taken hold there that’s exciting to watch.
Not that all the problems are behind Portsmouth, Ohio. But there’s another story now competing with the “let’s get high” culture that gripped the town for so long. I wrote about the beginnings of this at the end of my book – the small clues of rebirth: new gyms, a coffee shop, lofts, refurbished buildings and more.
Along that line, the folks of Portsmouth – 500+ volunteers – get together this Saturday to wash, repaint, redo their downtown in something they’re calling Plant Portsmouth.
They’ll be painting light poles, scraping and painting all the curbs, replacing 120 streetlights, and more. “None of this has been done in 20 years,” said Jeremy Burnside, an attorney in town who got the idea started.
They’ll also be planting plants as a way of signaling the town’s rebirth.
Burnside’s hoping to set a Guinness World Record for the most people planting plants simultaneously.
(Folks — please send me photos from the day and I’ll post them here and on social media. #plantportsmouth)
Organizers have raised $75,000 from local businesses to pay for supplies. That itself is a sign of how locally owned businesses are now growing in Portsmouth. None of that money came from the chain stores and corporate fast-food restaurants that have dominated the town’s economy since things began to go bad in the early 1980s and the shops on its main street closed. (Btw, I bought a couple t-shirts, inspired by Dreamland and the community pool that was the source of my book’s title, from a company called 3rdand Court that began in downtown Portsmouth. Check them out.)
The antidote to opiates is not naloxone. It is community. I say this often in my speeches when I’m traveling around the country. We Americans have isolated and fragmented ourselves in a million ways – this in poor areas and in wealthy areas. That left us vulnerable; it left us dangerously separate and disconnected from each other – strange to say in this time of technological hyper-connectivity.
The final expression of all that is our national epidemic of addiction to opiates – the most isolating class of drugs we know.
Rebuilding community (in a million different ways) is crucial to fighting it, I believe.
I’m glad to see Portsmouth leading the way on that, too.
From 2006 to 2015, Dr. Michael Rhodes was one of the top prescribers of OxyContin in the state of Tennessee.
His practice had many of the signs of what had come to be called a “pill mill.” Lines of people outside. A knife fight in front of his office. Investigators found he often prescribed without proper physical examinations or knowing the medical histories of his patients. Over those years, Rhodes, of Springfield TN, prescribed 319,000 OxyContin tablets. In May, 2013 had his license placed on restrictive probation by the Tennessee Board of Medical Examiners.
Still, representatives from drug-maker Purdue Pharma continued to call on him urging him to prescribe more OxyContin, their signature drug, according to a lawsuit filed by Tennessee Attorney General Herbert Slatery.
“In spite of this disciplinary action by the board (of medical examiners) and direct knowledge of his patient’s death from OxyContin, Purdue continued to call on Dr. Rhodes,” the Tennessee complaint states. They continued to “pressure Dr. Rhodes to prescribe more and more opioids, even when he expressed concerns regarding his own ability to competently do so.”
According to the lawsuit, Purdue reps called on Dr. Rhodes 126 times, include 31 times after his license was restricted.
They did so during the years after the company signed an agreement in 2007 with the federal government to be vigilant for abuse and diversion of the pills and look out for doctors prescribing in unscrupulous ways.
Part of the Tennessee complaint against Purdue catalogues alleged attempts by the company to get high-prescribing doctors and nurses to prescribe even more of their product, despite signs that those medical professionals were behaving in unethical ways and that their prescribing habits were out of control. Cultivating high-volume prescribers, the complaint alleges, was seen as crucial to the company’s business. The complaint alleges the company called on several such nurse practitioners, three now-shuttered pain clinics, and 13 doctors, who’ve retired or had their licenses revoked or placed on probation.
Among them was Dr. James Pogue, of Brentwood, TN, who prescribed 562,000 OxyContin 80mg pills between 2006 and 2013, making him one of the largest prescribers in Tennessee even three years after he stopped practicing medicine. He generated $655,000 in revenue for the company during one six-month period in 2009, according to the complaint.
Company sales reps called on him 53 times between 2005 and 2012, “more than half of those occasion coming after his license was reprimanded in 2009.”
The Breakthrough Pain Therapy Center, in Maryville TN, was known to have none of the typical diagnostic tools associated with pain clinics: examination tables, gloves, urine screens “or providers who performed independent pain diagnoses.” It also included “scant” office records and pre-written prescriptions often dispensed “without a physician present.”
While placing some staff on no-call lists, the complaint claims Purdue continued to call on other staff members at Breakthrough Pain Therapy, whose owners were federally indicted in December 2010. This included Buffy Kirkland, a nurse practitioner who worked there for several years. Between 1998 and 2017 as a nurse practioner in Tennessee, she prescribed 68,000 OxyContin tablets, of which two-thirds were of 40mg or stronger, according to the complaint.
The Tennessee complaint is one of numerous lawsuits filed in the last year or so against Purdue and several other drug companies that make opioid painkillers. The plaintiffs include Native-American tribes, small towns like Everett, WA and large cities like Los Angeles and Chicago. Most state attorneys general have filed lawsuits, as have at least 300 counties in a suit that alleges a “public nuisance” by these companies. That suit is consolidated in a federal court in Cleveland.
When I was writing Dreamland in 2013-14, I remember only three such lawsuits against makers of opioid painkillers. This was a time when the issue was largely hidden, those affected largely silent. Families were ashamed and wanted to obscure the truth of the addiction and manner of death of their loved ones. Thus the media paid scant attention and elected officials, outside those in a few states, paid less.
But the awareness has expanded in the last three years. One result is that many more lawyers across the country have turned to examining legal theories that might prosper in court.
Public agencies have been hammered by the cost of the epidemic. Indeed the epidemic’s costs have largely been borne by the public — by coroners and public health offices, police and sheriffs departments, jails, county hospitals, foster children agencies and more. Meanwhile profits have largely accrued to the private sector, mostly to pharmaceutical companies.
Thus, today, most state and county officials have to be seen by their constituencies as doing something dramatic about this epidemic, and a lawsuit has become an option to recoup some of those costs. None of the new lawsuits has yet gone to court.
To understand Ojeda’s importance, it’s important also to understand that the Mexican Mafia is neither Mexican nor was it, for many years, a mafia, strictly speaking. It is a prison gang, controlling Latino gang members in the state prison system. It took its name as a way of inspiring fear in others. Ojeda was part of that formation early on, as well as the spread of the Mafia’s influence across the state prison system.
The Mexican Mafia had no connection (until recent years) to the underworld in Mexico. Its members were, to begin with and for many years, like Ojeda’s, Mexican-American, who spoke only halting Spanish, if any at all, and whose families had been in the United States for generations.
For many years, in fact, the Mexican Mafia only ran prison yards and its influence was barely felt outside those walls.
But in the early 1990s, all that changed. The man who ushered in that change was Peter “Sana” Ojeda, a long-time member of the Mexican Mafia who had grown up in Orange County.
Ojeda, who was then on the streets, organized a meeting of O.C. street gangs at El Salvador Park in Santa Ana, filmed by law enforcement, during which he stood on bleachers dressed in a black-and-white long-sleeve shirt and told them all to stop with the gang killings and the drive-by shootings. He urged them to tax drug dealers in their neighborhoods as a way of funding neighborhood defense.
This stunned many in the Mexican Mafia, and they began to follow his lead, often using emissaries to organize meetings from San Bernardino and Pomona out to Elysian Park in Los Angeles, where one of the biggest meetings was held.
The Peace Treaty, as all this came to be known, sounded great. Gang leaders doing what law enforcement could not. But it evolved into something sinister and lasting: A system whereby gang members would indeed tax drug dealers in their area and funnel the proceeds to Mafia members, many of whom were in prison for life.
This taxation system far outlasted the Peace Treaty and is still in place today across Southern California, described in dozens of federal RICO indictments and in interviews I’ve done with dozens of gang members.
It amounts to the only regional organized crime syndicate that Southern California has ever known.
Taxation transformed Latino street gangs from scruffy neighborhood territorial entities into money-making ventures, though these were often fairly rag-tag. It gave career criminals, doing life terms in prison, access to a labor force — youths on the street who would do their bidding and admired them the way little leaguers look up to major league ball players. The Big Homies, as they were known on the street, could change life in a barrio with only a few words smuggled from prison in microprint on small pieces of paper.
It’s worth noting that their organizations on the streets, too, were often inept, bumbling, hampered by limited communications, by greed, envy, betrayal, rumor and gossip and drug use, as well as the constant return to prison of anointed emissaries of incarcerated Mafia members. One trial I sat in on involved a mafia member trying to organize three gang members to kill a rival, a man who rarely drove but was often walking in his Pomona neighborhood. Dozens and dozens of cellphone calls on how to do this and it still didn’t happen.
But Mafia taxation changed a lot about Southern California street life.
For a decade, Latino street gangs became the leading race-hate criminals in Southern California, a culture that grew from orders by many members of the Mexican Mafia that gangs should now rid their areas of black street gang/drug sales competition. As they were interpreted on the street, far from direct Mafia control, those orders often became directed at any black person, and thus in some neighborhoods campaigns were waged to get all black families to leave, which included murder, firebombings, assaults, racist graffiti and more.
Taxation made Mexican Mafia members equal in many communities to the town mayor or city council, at least with when it came to their ability to affect life in those areas. Now with the obedience of thousands of gang members on the street, many of whom were too young to have ever laid eyes on the incarcerated men they were obeying, Mafia members could, and did, ignite crime waves from maximum-security cells merely through letters smuggled from prison or via liaisons who transmitted their orders to the street. They drained city budgets, mangled lives, and forced young gang members to commit crimes that landed them in prison for life. I’ve interviewed several young men in such situations.
Ojeda was a contemporary of the pioneers of the Mexican Mafia (he’s far lower left in this photo). Among them was Joe Morgan (standing above him in the photo), whose story is also fascinating. Morgan was a Serbian-American who grew up in Boyle Heights/East LA and became culturally Mexican-American, and helped found the Mexican Mafia. Morgan died many years ago.
Ojeda was the last surviving member of that generation of the Mexican Mafia, made a member in 1972 in Tehachapi. Here’s a photo of him from those years (top right).
Throughout his life, but especially following the Salvador Park meeting, he would remain a household name in the Southern California Latino street-gang world. Meanwhile, he was in and out of prison.
In 2016, he was convicted a final time of conspiracy, largely on the basis of testimony from a former protégé, and sent to prison for 15 years, which most people figured was a life sentence.
But his control over Santa Ana and much of Orange County Latino street gang life seemed to me mostly unquestioned. So, too, his reputation as the Godfather of Orange County.
Los Angeles has seen gang violence plummet in the last decade.
Some of the reasons why were on display in two federal criminal conspiracy cases announced this afternoon at a press conference at the L.A. office of the U.S. Attorney.
The cases involved the Mexican Mafia prison gang controlling drug taxation and trafficking in two places: The LA County Jail, largest jail in America, and in the city of Pomona.
The Mexican Mafia is a prison gang that runs the Latino gang members in the state’s prison system. About 25 years ago, it extended that power to the streets, ordering those gang members to tax neighborhood drug dealers and funnel the proceeds to MM members. Drug taxation thrives and amounts to the first regional organized crime system in the history of Southern California.
One case involved a Mafia member who controlled drug trafficking in the entire jail, according to the indictment: Jose Landa-Rodriguez, who grew up in East LA, a member of the South Los gang. He’s apparently been in county jail for many years, during the reign of the now deceased Lalo Martinez, a controversial MM member. Through those years, and after Martinez died, Landa-Rodriguez allegedly grew to control the drugs entering and for sale across the jail system.
Inmates not with the Mexican Mafia had to get his permission to sell. Only way to do that was by funneling a third of their product to the gang — hence the name of the case, Operation Dirty Thirds — then waiting while Mexican Mafia associates sold the stuff. That’s one way of controlling your competition. Violators were often beaten. That’s another.
They were helped, prosecutors allege, by Gabriel Zendejas-Chavez, a local attorney whom investigators say helped facilitate the trade, passed notes back and forth between Mexican Mafia associates, and that kind of thing. They were also helped by a slew of go-betweens who would get arrested with drugs in their bodies.
The other indictment involved a Mexican Mafia member named Mike Lerma, who has controlled Pomona for many years from his cell in solitary confinement at Pelican BayState Prison maximum lockdown. Crews of members from 12thStreet, Cherryville and Pomona Sur street gangs were working together under Lerma’s command, the indictment alleges. The indictment alleges Lerma’s crews did kidnappings, robberies, identity theft. These are Pomona gangs that have harbored animosity against each other for years, but have repressed the urge to go after one another due to orders from Lerma, according to officers I spoke with.
(Btw, I briefly met Mike Lerma one time, in his cell in Pelican Bay State Prison. We were separated by Plexiglass and he was cooking a cup of cocoa on his hotplate in his pale-yellow concrete cell where he spent 23 hours of every day. He was small, a wan and bent fellow, wearied by years on solitary confinement. From behind the glass, he waved, said how you doing? I said fine.)
The mafia’s system has forced gangs to abandon what made them local neighborhood scourges because it leads to unwanted police attention.
“Years ago, they were about turf,” said one. “Now they’re about protecting their business.”
For decades, they waged wars over turf. They defended street corners, parks, markets, apartment buildings like they actually belonged to them. They were very much street gangs, and their activity — graffiti, shootings, car jackings, simple hanging out through which they did their recruiting — blighted working-class neighborhoods across Southern California.
These days, though, they are absent. They have retreated into the shadows. Doesn’t mean they’re gone for good. Just that they’ve disappeared from the streets, no longer are out in public, damaging neighborhoods that can least afford it, spraying up mom-and-pop markets. Homicides are way down because gangs don’t have easy rival targets to shoot at. That’s one reason anyway. In Pomona, the once-notorious Sharkey Park – from which Pomona 12thStreet earned its name the Sharks (members often had shark tattoos) — hasn’t had a shooting in who knows how many years. Some Pomona cops at the press conference couldn’t remember the last one. As if to exorcise the past, the park has been renamed Tony Cerda Park, in honor of a Native-American activist and tribal leader; pow-wows are held at the park.
Gangs are just not evidence in Southern California. It’s a remarkable, profound change in culture and crime, and one that benefits cities, neighborhoods, and working-class residents most of all. Parks are once again places for kids to play. This is part due to dictates in the underworld, from organizations like the Mexican Mafia, who want their business protected.
But it’s also due to an unprecedented amount of collaboration among law enforcement. In the 1980s and 1990s, this didn’t exist. Agencies fought each other for credit, turf, budget, as the gangs grew fierce and brazen. But the last decade or more has seen a remarkable change and that too you could see at the press conference.
At the press conference, cops of all stripes assembled to thank each other for working together. The feds thanked the locals. The locals thanked each other and the feds.
“I want to give special thanks to our law enforcement partners,” said Pomona Police Chief Mike Olivieri.
(For the record, apart from Pomona PD, that includes the FBI’s San Gabriel Safe Streets Task Force, the LA County Sheriff’s Department, ATF, the DEA, Ontario Police Department, the IRS Criminal Division, the U.S. Immigration and Customs Enforcement’s Homeland Security Division.)
“Today’s action is not an isolated event. Southern California law enforcement is united in its fight against violent criminals and street gangs,” said U.S. Attorney Nick Hanna, continuing the theme.
I’ve been to a dozen of these gang-conspiracy press conferences and I always like it when they thank each other. Because it wasn’t always that way.
Speaking with a prosecutor outside the press conference, we marveled at the change and wondered how the trauma of the 1980s and 1990s might have been avoided had this kind of collaboration been more common
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.
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.
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.
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.
On Facebook, I read the simple account – I’ve broken it out into four lines – from a mother from Kentucky. I’ve posted her story, and then the comments that followed:
I lost my son in August,
and my Daughter day after thanksgiving
the only two children I had
oh it’s so hard.
I have no words. I’m sorry just doesn’t seem to be enough. May
you find the strength you need to carry you through.
I’m so sorry, I lost 2 sons in three years.if i can help you add me as a friend.hugs
may God give you the strength to survive the loss of both of your children. Hugs and prayers to you mom
So very sorry for your loss prayers and hugs to sister momma I have lost two sons and no words to heal your pain
We lost my oldest nephew Joe on 7/5/16, it is terrible and sad and I’m so glad for this group. You are not alone sister 💙💙💙💙 sending hugs
Why why do we have to suffer so
God be with you.
There are no words…how can i comfort you…may God give you strength…i a truly hurt for you…my daughter continues to fight the beast…
I am so sorry. Much love to you and those who grieve with you. Praying.
This is incomprehensible and insane to think that “god doesn’t give us more than we can handle” – it’s cruel and unmerciful. I share your pain and fear that I may also lose my only other child, having lost my youngest 10 years ago. Sending hugs and more hugs – and strength for when you need it most.
I lost my son I could never imagine the thought of losing another. Hugs and prayers your way
I am so sorry and feel how you feel I lost my son one month ago yesterday my heart has been torn out I don’t know how we’re supposed to go on like this
I lost my only child in 2013, I couldn’t imagine losing 2, and so close together! God bless
My” heart” hurts for you….Don’t know what to say….I lost my son 6-15-16 and the pain is unbearable with one… let along two.I have a daughter on heroin really bad also . I ‘m afraid I’m gonna lose her.
I was in the town of Logan, Ohio last week, at the tail end of my speaking tour through Ohio, West Virginia, Kentucky and Indiana.
Logan, pop. 7,000, is an Appalachian coal town in the county of Hocking, about 40 miles southeast of Columbus in the farmland off of state Highway 33.
The morning after my talk, I spent an hour in the town’s drug court, which is now dedicated entirely to people with opiate addictions trying to expunge criminal records and keep their recovery going.
The court is run by Judge Fred Moses, who in this court looks and sounds more like a social worker. He asks each client about his or her recovery, job prospects, children – confers with prosecutors and probation and social workers. The idea behind drug court is that clients must get into addiction recovery, begin to repair their lives, before any record expunging takes place.
What struck me was, first, that there were such a court at all in a town like Logan. And then that all the 10 or so clients I met that day were addicted to opiates, heroin mostly.
All but one started into addiction on pain pills. A few began using them after they were prescribed the pills for some medical reason. Others began using them recreationally. But all of them got into their addiction because of the pervasive, massive supply of these pills that were, and are, available.
In Logan, according to a recovering addict I spoke with (whose interview I’ll post later), pain pills and benzodiazapines, and the insistence with which clients demand them, have made docs unimaginative it seems. At least, pills appear to be many physicians’ immediate go-to response.
Judge Moses has most of his clients on Vivitrol, the opiate blocker, paid for by Medicaid, which, in Ohio, has been available to anyone since 2014. This is due to a Republican governor, John Kasich, who expanded coverage to all Ohioans, largely, from what I understand, to give people without insurance access to addiction treatment – so big was the state’s problem.
Without that, Vivitrol would be too expensive for Hocking County. Sitting there that day, I wondered if at some point every heroin addict in America will have to be on Vivitrol.
Judge Moses’ drug court is a standing testament to how opiate addiction is changing minds in rural areas. I suppose there was a time when the idea of giving a drug to combat drug addiction was viewed askance in Hocking County. But this addiction is different and requires different response. Hence Vivitrol.
What also struck me, though, was that this scourge spread across the country largely due to the private sector – pharmaceutical companies and doctors, urging the aggressive prescribing of narcotic painkillers.
There’s a role we all have, as American health consumers, in what’s taken place, and it’s an important one. But it’s striking to me how this began due to the private sector – not underground drug traffickers – and how the profits have accrued to the private sector.
Yet dealing with the collateral damage has been charged almost entirely to the public sector: ERs, public health departments, cops, prosecutors, jails … and drug court, like the one run by Judge Fred Moses in the small town of Logan, Ohio.
I wish his clients well, as I do the town of Logan itself, where I met a lot of nice people (and received this Proclamation), and which now must battle this kind of persistent, costly addiction along with all the other issues facing small-town, rural America.
As I try to keep a gauge on the opiate-addiction epidemic in America, one place I go is to The Addicts Mom Facebook page, with 22,000 members, one of whom is me.
The posts are from mothers as they attempt to deal with the lacerating addictions of their children. Here are a few posts, with names removed, that I saw at random this morning. Those who listed a location are from Georgia, Wisconsin, upstate New York, Pennsylvania, and Alabama.
At times, it gets to almost an aching kind of poetry.
Note: AS means addicted son; RAS recovering addicted son
Well my almost 21 year old AS will be spending another birthday in jail I am sure! Please pray for his healing and mine!
I always knew it was going to be my child one day. On the Fourth of July I found my addicted daughter unresponsive and blue. I breathed for her until paramedics came. They saved her life this time. She spent three days in Icu and was released with no help at all. I live in Florida and I was wondering if this is enough for a marchman act? Doc is Xanax and snorting oxicodone. Any advise is appreciated. God bless all of us Mothers. I just can’t take much more.
I love having a place where people actually listen when I talk bout my addict children. Most people in my town don’t want to hear that there are children addicted in their town people need to wake up sad for the addicts who are outcast. Having trouble getting police to put narcan in there cars also
UPDATE: His PO is coming to see him tomorrow– I will let y’all know how it goes.
My Birthday overall was a good day. Thanks for the wishes and prayers. Blessings to you all.
Dilemma- my 18 almost 19 AS was released from jail last Friday to serve out his probation-14 months (it’s a joke; very seldom face to face visits with his PO). On Sunday he apparently used LSD; when I confronted him he said ‘no worries Mom; it won’t show up on a UI.’ He had no where else to go but our house and the court said our house is not an option for him to stay (we have a younger child at home). He was told the rules- no drugs or drug use. A small issue he flat out refuses to pick up his clothes (drives me crazy) states he’s just defiant; like I’m supposed to be ok with that answer.
Suggestions??? Oh yeah; today is my Birthday- I feel like hiding in a hole not celebrating life
Last night my phone rang at 11:30 my heart automatically started racing. Then I seen the caller I.D it was my RAS instantly worry washed over me, I picked up the phone and the first words out of my mouth was ” what’s wrong? Are you okay?” His reply was ‘Yes ma’am I was just on my way to work and I seen a shooting star and it was the brightest most beautiful one I’ve every seen, and just wanted to call and share with you”.
Four years clean, still suffer from shell shock but feeling blessed.
So another week and another dirty urine at probation. Told me he wants suboxone, I suggested vivitrol. Someone on the MAT (medically assisted treatment) site posted a link for a slide show on all the meds used. I sent it to him privately. He wants to do vivitrol now and I sent him the local dr name and address. He swears he wants to be sober. I asked him, you know how awful detox is, why isn’t that enough to not pick up? He CANNOT deal with stress. No coping techniques. We all have stress but you have to learn to cope. I get the whole disease thing I truly do, but I also struggle with the you know it’s not good for you, you know what you are running away from is gonna still be there and you are making more problems to deal with when you sober up. I know my mind doesn’t function as an addicts but they are all smart kids or adults. Dang fight for your sobriety hard the way you chase that freaking drug. He looks terrible. Lost weight again. And all he keeps saying is everyone is judging me and that makes me want to use. No that gives you a lame excuse to use. We aren’t judging we love you and are worried. I know my dealer he wouldn’t do that yadda yadda yadda. Won’t be long and he is gonna end up in jail, then maybe I can sleep:( I am ANGRY this time.
My soul is tired, my heart hurts, I just can’t do no more today😥
In Chillicothe, Ohio, the way I understand it, school janitors are heroes.
Many kids are growing up in families of addicts and have no place to go, their home studded with neglect and jagged edges; so they hang around after school. There, janitors have befriended them, bringing them food, giving them a sober adult to talk to and a calm place to hang out.
My family and I spent Thursday in Chillicothe, a southern Ohio town (pop. 21,000) bedeviled, as so many are, by the opiate-addiction epidemic.
I spoke all day long – a radio interview at 6:30 am, meetings with three groups through the day, and a 7 pm public talk at the Majestic Theater, the oldest (1853), continuously operated theater in America. Yet by the end I wasn’t exhausted; I was instead exhilarated by the electric, intense response of people I met.
That’s how it’s been everywhere lately.
Writing Dreamland wasn’t arduous; it was engrossing. But it was also about a tough topic in which the worst of human behavior was on display. So I’m thrilled to see towns like Chillicothe using the book to come together, form alliances, leverage talent, talk about this problem in a way that hasn’t happened before, and do something hopeful.
Heroin seems to be having the opposite effect in Chillicothe that it has on users. If heroin isolates addicts into self-absorption and hyper-consumption, the drug also seems to be bringing people together to fight against it. I see this elsewhere as well and that’s encouraging. I know the problem is big. A new sporting-goods store delayed its opening in Chillicothe for months, I’m told, because it couldn’t find enough workers that could pass a drug test.
I wish I had a better answer to those who asked what to do about families where drug addiction is now generational, where the grandparents on down are using, where great-grandparents are raising their grandchildren’s kids. Kentucky Gov. Matt Bevin, the day before in Louisville, told me that his state is on the verge of losing an entire generation, swallowed up in a morass of dependence, unemployment and now opiates. Kentucky has more able-bodied, working-age people who aren’t working than those who are, he said. That feels scary.
Heroin, it seems, is the final nausea to afflict small towns and rural communities already crushed by the farm crisis, downsizing, outsourcing, the loss of local retail, depopulation, and more. It seems that heroin has pushed many places to a life-or-death moment.
Knowing that, though, I also can’t help but recognize the energy I’ve been encountering in the people I meet.
In manufacturing, as I understand it, innovation happens through immersion in the work, people knowing the production process so well that together they find new, small, better ways to improve on how to make something.
Fighting heroin, I believe, is the same. When people come together, work together, knowing their community and its problems, when they leverage their talents and energies, the solutions specific to that place will emerge. I believe that.
And just as manufacturing processes improve incrementally, in small steps, so this problem has no sexy silver bullet, I suspect, but will be best fought with a combination of tiny efforts, many partial solutions, none of which is perfect, but together amount to something powerful. That’s good. Haven’t we had enough, after all, of the one sexy solution to solve all our problems: Didn’t `one pill for all people and every kind of pain’ do enough damage?
While I was writing Dreamland, people seemed to work in isolation, cut off from each other. Parents of addicts seemed hidden, silent. That’s the biggest change I’ve seen. People have now started talking about this issue, forming new alliances, comparing notes.
In Chillicothe, we stayed in the Carlisle, a beautiful brick building, restored after many years empty due to a fire. A hospital group decided to move into downtown and refurbish the building, believing apparently that it served the community best by being part of the revival of its core. The Majestic Theater will soon get a renovation. Luckily, the town never tore down its old beautiful brick buildings, which are being repurposed. New retail businesses are opening downtown. A t-shirt shop sells shirts of companies that have left town. My daughter now has a shirt proclaiming “Chillicothe, Ohio.” So the town seems to be rebounding, even as it battles this debilitating scourge. Maybe that’s the story – complicated, and not easily or neatly told.
I want to thank the people of Chillicothe for so hospitably welcoming my family and me. Thanks to Hudson Ward, at the Carlisle.
Thanks especially to Nick Tepe, the county’s head librarian, for organizing folks to bring us to town. Librarians ought to be playing exactly this kind of role in communities, and Ross County, Ohio seems to be blessed with a talented one.
Next, I’m heading to Knoxville, for the International Tuba and Euphonium Conference. And from there to Springfield, IL to speak to a conference of that state’s rural hospitals.
Meanwhile, Chillicothe had an annual street fair going while we were there, known as The Feast:
Opiate addiction appears to be emerging as an issue in the presidential campaign, as well it should.
I’ve read a lot that does seem to be too nuanced on either side of this topic.
Here are a few of my thoughts:
Virtually all our heroin comes from Mexico, or comes from Colombia through Mexico.
Originating now in our hemisphere, heroin now changes hands less and travels far shorter distances than it did when so much of it came from Turkey or Burma (1970s).
All that means that it’s cheaper here than ever, it’s more prevalent, and it’s far more potent. And all that, in turn, has a lot to do with why people begin using it in the first place (cost), and then stay addicted (prevalence), or relapse after rehab, and then why they die more frequently (potency).
Used to be that people (addicts from the 1970s) lived for many years on heroin – when it was more expensive and less potent and more arduous to find. A lot of heroin addicts who started in those years did die, but they died during the AIDS epidemic from sharing needles, not so much from overdoses.
Now heroin addicts aren’t living long; They’re dying young and quickly. I believe that’s because so much of the drug comes from Mexico, making it cheaper, more potent and more prevalent than ever.
When uncut or less cut, heroin is easy to conceal because it’s so concentrated – again because now it comes from Mexico, which is so close.
So you don’t need trucks to get a lot of heroin across – though trucks have been used. A lot of people walk it across at the border crossings hidden in a purse, or a backpack, or on their person.
There’s a market for heroin because there is a demand for it.
That said, I believe that supply is fundamental to this issue – supply created this demand, just as it did during the cocaine days. We didn’t have a huge demand for cocaine before Colombians began smuggling tons of it up through Florida. Likewise, we didn’t have huge numbers of heroin addicts before doctors began prescribing enormous quantities of opioid painkillers such as Vicodin and OxyContin, etc. and a lot of people got addicted, then switched to heroin, which is now, as I said, cheaper than ever.
Heroin traffickers, as I hope I made clear in Dreamland, came late to this party. They followed the demand for opiates that had been created by massive overprescribing by doctors of these painkillers.
Just as we cannot arrest our way out of this problem, we likely cannot treat our way out of it, either. Particularly with treatment costing so much and taking so long. Typical treatment that has any chance of success, from what addiction specialists tell me, is a minimum of nine months. One doc I know insists a year is the minimum.
Curtailing supply is thus essential to giving each attempt at rehab and recovery a greater chance of success. So that every recovering addict isn’t bombarded with dope at every turn, as they are in so many parts of the country today.
That said, among the steps I think we need to take – some of which are articulated by the CDC recently – is retraining doctors to question why they prescribe these drugs and, if they’re necessary, in what quantities. For example, for wisdom tooth extraction, 60 Vicodin is common. That seems crazy to me.
Seems like 6-12 pills would be reasonable, and that the patient should return if he needs more. Doctors prescribe so many of these pills out the gate because they don’t want to see patients a second time, and they know that insurance companies often won’t reimburse for those follow-up visits, no matter how few.
So this problem will require that insurance companies change their practices, and reimburse doctors for follow-up visits for the (again) few patients who might need more of those pills after routine surgery.
Walls have had a healthy effect on the border. Tijuana (two walls, as I said) is an excellent example of that. When it was the main crossing point – 1960s until mid-1990s – rapes, robberies, assaults and murders were common, particularly in the 1980s and early 1990s. Then the first wall went up, then the second. Now it’s calm on that border line. May be a weird symbol for a globalized world, but murders and rapes are rare now.
Despite those walls, heroin will seep in, through the cracks, in ways that seem to me impossible, or extraordinarily expensive, to stop. And that’s not the supply that caused this problem.
A new L.A. taco restaurant has a narco theme to it.
Tacos Los Desvelados in Maywood, California named its food for notorious Mexican and Colombian drug traffickers. Chapo Guzman gets a taco, Pablo Escobar gets a burrito, and so on.
That’s pretty funny, and possible only because of Maywood’s safe remove (it’s a small town southeast of Los Angeles) from the real and sinister violence that these guys have created.
Here’s something else that’s not so cute:
Mexico’s Attorney General’s office reports finding 662 bodies in 201 clandestine graves in 16 Mexican states from 2005 to the present. Of those, 380 have been so decomposed that investigators can’t tell if the bodies are of men or women.
In Iguala, Guerrero alone, 63 graves with 133 bodies have been found.