This summer, a sculptor built a steel, 11-foot, 800-pound bent heroin spoon. With the help of an gallery owner, he put it on a trailer and drove it to the headquarters of Purdue Pharma, the manufacturer of OxyContin.
The bent-spoon protest of the country’s opiate epidemic by Massachusetts sculptor Domenic Esposito and Fernando Alvarez, owner of a Connecticut art gallery, stayed in front of the company’s Stamford, CT offices for only two hours before police impounded the sculpture, but it gained worldwide attention.
Alvarez was arrested and eventually convicted of a misdemeanor charge of blocking free passage.
I was in Boston recently and had a chance to meet and talk with Esposito about the episode and what brought it on.
Our conversation ended up including his brother’s addiction, drug marketing, Americans’ pain, and #thespoon movement they hope to ignite.
Great story. Take a listen. Share it if you like it:
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.
In Louisville the other day, I wanted to see how jail was changing in America.
This epidemic of opiate addictions calling on us to reexamine a lot about how we live, our values, culture, ideas and institutions we’ve taken for granted.
One of them is jail. Jail has always been a crippling liability in our fight against drug abuse. Jails are usually places where humans vegetate, sit around, argue, learn better criminal techniques, then get out weary and stressed and, if they’re addicted to drugs, they head straight to the dealer’s house.
This epidemic is forcing new ideas. One of them is jail turned into an asset, a place of nurturing, of communion as addicts learn to help each other.
That’s a bizarre concept. I never thought I’d write “nurturing” and “jail” in the same sentence, but it’s happening.
The state of Kentucky seems furthest along in all this. I wrote an Op-Ed column for the NY Times about a visit I paid to the jail in Kenton County, Kentucky. Yet what’s being tried in Kenton County – and a couple dozen other county jails in Kentucky — began in Louisville – in Metro Jail.
Well, if “we can’t arrest our way out of this,” as is so often said, then we need more drug-addiction treatment. Yet this epidemic has swamped our treatment-center infrastructure. New centers are costly to build, politically difficult to site, and entering them is beyond the means of most uninsured street addicts, anyway.
I know that jailing addicts is anathema to treatment advocates. But opiates are mind-controlling beasts. Waiting for an addict to reach rock bottom and make a rational choice to seek treatment sounds nice in theory. But it ignores the nature of the drugs in question, while also assuming a private treatment bed is miraculously available at the moment the street addict is willing to occupy it. With opiates rock bottom is often death.
Jail can be a necessary, maybe the only, lever with which to encourage or force an addict to seek treatment before it’s too late. In jail, addicts first interface with the criminal-justice system, long before they commit crimes that warrant a prison sentence. Once detoxed of the dope that has controlled their decisions, jail is where addicts more clearly behold the wreckage of their lives. The problem has been that it’s at this very moment of contrition when they have been plunged into a jail world of extortion, violence, and tedium. It’s a horrible waste of an opportunity, and almost guarantees recidivism.
With this epidemic, though, we’re seeing new approaches – jail as a place of rehabilitation, a place where recovery can begin.
Several years ago, as heroin began to grip the area, the Louisville jail saw inmates dying from overdoses.
Mark Bolton, the jail’s director, said the spate of deaths forced new ideas.
“We modeled a pod on outside treatment (centers),” he said. “It became a matter of taking the resources we had and repurposing them. We sent people [to drug rehabilitation centers on the outside] and found out how they run their peer detox program. We learned from them.”
Louisville Metro began with female inmates. Those who were just off the street and detoxing, and who normally were spread across the jail, were placed together in one pod, christened Enough is Enough. This allowed more focus on their needs, and got them away from other inmates who were angered by their withdrawal symptoms, which included vomiting, diarrhea, screaming, insomnia and more.
Jail officials began allowing people in recovery into the detox pod as well. These recovering addicts mentored the new arrivals – washing and soothing them. Officers preferred it, as they no longer had to clean up vomit and diarrhea.
In addition to bathing and caring for those in withdrawal, inmates take classes in relapse prevention, understanding criminal thinking, accountability, parenting, and more; they run their own 12-step groups.
As the Enough is Enough pod began to function, there were fewer fights, less contraband. “Inmates into their recovery and into their sobriety are self-policing. The wear and tear is less,” Bolton said. “After we worked out the bugs, we began to see some of these people show progress. The inmates into their treatment appreciated the fact that they were caring for a human being that was at a place where they had been once.”
When they leave jail, they’re given a Vivitrol shot, which blocks opiates, and they were connected with housing and follow-up Vivitrol shots.
The jail now has the one women’s pod and three pods for men: 56 detox beds and 64 recovery beds, total.
I visited the pod – with about 30 women, four of whom were detoxing. The walls were covered with art work.
(Click here to hear the end of the pod’s afternoon meeting that day.)
It seemed, finally, a nurturing place in jail – far more about recovery than its connecting pod, where fights and loud noise were common until the early morning.
I spoke at length with a woman named Kara, whose addiction was more than 20 years old. This was her 17th time in jail. She had come from washing the vomit off another woman who had just arrived in the pod.
Here’s our interview:
The Louisville jail experiment isn’t a cure-all – no one thing is for this opiate-addiction epidemic. And the jail has difficulty tracking inmates who leave, so it’s unclear how well they do on the outside. What’s more, inmates by this time face a daunting uphill trudge to sobriety, hampered by family dysfunction on the outside, shredded personal relationships, a private sector wary of hiring them, and on and on.
And of course, there isn’t nearly enough in available treatment options.
“I would love to shut some of these programs down,” Bolton said. “This shouldn’t be the jail’s responsibility. [Addiction] is a public health issue. Our job is detention, protection of the public, to get people to court. When we have to become the quasi mental health facility for people who are poor and don’t have access to services, or for people who are drug addicts and who’ve created these chaotic lifestyles for themselves and can’t get treatment in the community — then we become this de facto fallback place for everybody. That’s not what jails are designed to do, nor should they be.”
Yet until a massive investment in community drug rehab and medically assisted treatment takes place, it’s likely that pods like Enough is Enough will be necessary.
It also occurs to me that with jail rethought and remade — a nurturing place — we have the chance that it will be an asset in the next drug scourge that comes along.
Either way, as with Kenton County, it seems like a better bet of public money than the way jail has been done up to now.
A couple weeks ago I was in the Midwest, speaking about Dreamland.
I decided to add a couple days to the trip to spend more time in places where I was visiting than I’ve done in the past.
First stop was Whitehall, a town of about 18,000, next to the airport in Columbus, Ohio.
I got there a little early because I wanted to see a new idea the town had instituted.
Whitehall Fire Department has established its firehouse as a Safe Station – meaning that addicts can come by, no questions asked, and will be shuttled to treatment. This has been tried by police departments elsewhere, but in Whitehall they decided on the fire department, believing that most folks would be more at ease there than showing up to talk to police.
The idea had been in place about six weeks and 54 people had made use of it. Whitehall being part of the Columbus metro area, the vast majority of Safe Station drop-ins are not from the town.
One fellow who dropped by was Matt, who grew up in a fairly difficult family but in a middle-class town nearby. He played football, baseball, basketball in high school. In his town, sports were it, he said. Young men got their identity from their participation, or stardom, in sports.
Readers of Dreamland may feel where this is going.
Our national opiate-addiction epidemic is different from other American drug scourges for many reasons.
It’s the deadliest and the most widespread. It didn’t begin with drug mafias, but through the promotion of narcotic painkillers by pharmaceutical companies to doctors, who were pressured by we Americans, demanding an easy solution
to our pain.
But the epidemic is also remarkable for whom it has forced to its frontlines.
Librarians make up one such group.
I’m in Ohio this week, speaking at four regional conferences of librarians around the state. Today was Gallipolis — pop. 3500, in rural Gallia County, along the quiet, majestic Ohio River.
I stayed after my talk to listen to a panel made up of a university librarian, an elementary school librarian, and a public librarian talking about their experiences with this epidemic.
We heard about needles in the bushes, about how a child who lives in a drug house smells, about calling 911 because a customer had overdosed in a bathroom, about the look of some people who come into the library high. The epidemic has made danger zones of innocuous public places.
One school librarian, I was told, suspects two girls at her school are being abused. They come to school smelling badly. She takes their clothes home and washes them.
I was also struck by the stories many in the audience (80 people or so) had to tell about addiction in their families. Several librarians were raising their addicted relatives’ children.
Librarians are also perfectly poised, though, to be great catalysts for change – community organizers in the fight against this plague. That’s what I believe. They have the spaces, the local trust and credibility, and often small towns need folks like librarians to bring them together — and this is happening.
As I said to the group I spoke to, who better than purveyors of the book to be the leaders in this fight.
Plus, librarians are looking for new roles to play – rebranding libraries as community centers, places where people can come together. This catastrophe is offering libraries and librarians that moment to reinvent themselves towns and counties.
In the afternoon, I drove through the pristine southern Ohio farmland – white houses, white churches, silver siloes, blue sky, and acres of green corn.
I stopped at the Dairy Queen in Washington Court House, another small town with a bunch of opiate addiction problems.
Tomorrow Dayton – then Findlay and, finally, Twinsburg.
Next week I speak in Weber County, Utah, and after that Brunswick County, North Carolina.
All frontlines in America’s epidemic of opiate addiction.
Couple weeks ago, I spent a morning in federal court in Los Angeles to learn a little more about drug underworld ingenuity.
Federal agents had busted an enterprise known as Manny’s Delivery Service, an organization that they alleged distributed heroin across the San Fernando Valley to customers who’d call in and place their orders.
Manny was the street name of the lead defendant, Sigifrido Gurrola Barrientos (see photo).
These guys reportedly used Uber to transport the proceeds – $129,000 in one instance, according to the indictment. (Read the press release here.)
They seemed to replicate the system that was perfected and taken nationwide by the folks from Xalisco, Nayarit, which I wrote about in my book, Dreamland.
As it turns out, according to defense attorneys, Manny’s was allegedly run by fellows from the Mexican states of Puebla and Guanajuato, which are not states I’ve associated with drug trafficking. Not sure where Mr. Gurrola Barrientos is from. But it’s not surprising the business model would be used by others. There’s no trademark or copyright in the underworld.
I was intrigued by the case as well because I’m fascinated by all the ingenuity displayed in that vast, profit-motivated culture of drug trafficking, particularly from Mexico.
In the 1990s, American medicine began to claim that opiate painkillers could be prescribed virtually indiscriminately, with little risk of addiction to patients. The result over the next two decades was a huge increase in our national supply of painkillers.
That happened without anyone realizing that our heroin market had also shifted during those years. Most of our heroin now came not from the Far East (Turkey, Burma, Afghanistan) but from Latin America – Colombia and, today especially, from Mexico. It got here cheaper and more potent than the Far East stuff.
Truth is, though, most Mexican traffickers for years cared little for heroin, which they viewed as decidedly scuzzy and back-alley and with a relatively small market of tapped-out users in the United States. So they focused more on cocaine and meth, and pot, of course.
Then we began creating scads of new opiate addicts with this expansion of indiscriminate prescribing of narcotic painkillers.
That, in turn, awoke an underworld version of Fedex, and unleashed the powerful and ingeniously creative forces of the Mexican drug-trafficking culture, then largely dormant when it came to heroin. By the way, that’s not to say, necessarily, cartels. Just a widespread culture of drug trafficking, particularly in certain regions of Mexico.
There’s a reason why heroin exists. It’s not because it has much medicinal use. Or, better put, the painkilling benefits it does possess can be provided by other drugs at far less risk of addiction. Heroin exists because it’s a great drug if you’re a trafficker. It’s easy to make and is very condensed. It’s easy to cut – making it profitable to traffic even in small quantities. So small-scale heroin trafficking is a big part of the story of how it gets here from Mexico.
Also, heroin is one of the few drugs that makes sense to sell retail – as it creates customers who must buy your product every day, Christmas included, and usually several times a day.
Thus applying basic business-school principles to heroin vending – principles of marketing, customer service, etc – just naturally occurs to folks.
Hence Manny’s Delivery Service. And a bunch more like them.
I meet a lot of great folks as I talk about Dreamland across America – and hear amazing stories, too.
In Richmond, Virginia recently, where Virginia Commonwealth University had chosen Dreamland as the Common Read for their incoming freshmen, I happened to meet Sheriff Karl Leonard, of nearby Chesterfield County.
We got to talking about a recovery pod – which he calls the Heroin Addiction Recovery Program (HARP) – he instituted in his jail. HARP allows inmates to begin their recovery from addiction, with a nurturing, inmate-led environment. This replaces the stress and tedium of traditionally run jail.
Traditional jail has always been a prod to crime and drug addiction. But sheriffs like Karl Leonard are rethinking how it’s done. I find this transformation of jail, which is growing as a response to our opiate-addiction epidemic, to be one of the most radical and positive ideas happening in America today.
Later, Sheriff Leonard sent me an email with the following story. Please read:
I work very hard with our Heroin Addiction Recovery program (HARP) to educate the public and to break down the stigma that is attached to not only being an addict but a criminal as well. I take recovered addicts from our program out into the community all the time so they can put a face with this disease. And once I do that I have personalized this crisis with them and they can no longer look away. I have these addicts tell their stories which are always compelling and gut wrenching. But just when I think I have heard it all, I get educated myself.
Just a few weeks ago after one such public engagement in the community with two of the HARP members, one male and one female, I decided to take them to lunch at a local Burger King as a reward, which I do often. (They are placed in civilian clothes when we take them out of the jail).
When we pulled into the Burger King parking lot, the male asked me what this was. I was dumfounded by the question and told him it was Burger King. I then asked him if he’d ever been in a Burger King before, thinking he was messing with me. But he said no. I then asked him if he was ever in a McDonald’s before; he again said no.
I shrugged it off and took him inside. He spent several minutes looking at the menu above his head like a child on Christmas morning. He turned to me and asked me if he could get whatever he wanted. I said yes. He then asked me if he could get the biggest thing on the menu and I again said yes, knowing that jail food probably didn’t satisfy this 6’4”, strapping 26-year-old. He then ordered the mushroom Swiss triple burger and a large Coke and fries.
I watched him devour his meal. I asked him if he liked it and he replied he did very much, especially the Coke. I asked him if he had Coke before and he told me he had not. This kid who never had a Burger King or McDonald’s hamburger or a Coke is a heroin addict.
He told me he grew up in a very rural county in Virginia and his father was very strict with him about eating junk food, sugars, sodas, etc. His father made sure they only ate good fresh food without sugars. It is also why he led a life that was drug free – not even marijuana.
His father also helped him with his athletic skills, which helped him become a very good football player in high school. So good he was given a scholarship to play football at a prominent four-year university in our state. I was intrigued by how this seemingly innocent guy became a heroin addict.
Then the common thread to almost all of our heroin addicts revealed itself.
While at the university, he said, he was involved in a bad car crash and suffered a broken femur, shoulder, and other bones. Eventually his doctor gave him Oxycontin and Dilantin pills. He was directed to take four Oxycontin pills a day for 30 days in addition to the Dilantin.
Once the prescriptions ran out he said he started to become very sick but he didn’t know why. He spoke to a friend who told him he was in withdrawal from the painkillers, which was causing his sickness. So he went back to his doctor, who refused to prescribe him any more. He was very sick and tried to get pills on the street but they were hard to get and expensive so he turned to heroin. And that was all it took.
He eventually had bad drug screens at school and was kicked out of the university and lost his full scholarship. When his father found out he was using drugs he disowned him. So now, without a dorm room or family to take him in, he turned to criminal activity to sustain his life.
These stories go on and on. They are all heartbreaking but also examples of how these are not bad people trying to be good but sick people trying to get well. And we are making a difference here with our very unconventional approach to recovery.
Thank you for enlightening a Nation with your book!
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.
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.
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.
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.