Tag Archives: recovery

Dreamland Turns Four

Four years ago today, April 15, Dreamland was released after a lot of work, interviews, travel, and endless revisions.

At the time, my family and I thought the book would fail and fade quickly because throughout my research I found people – families mostly – very reluctant to talk. This issue remained largely hidden, though I judged it to be the country’s worst drug scourge.

But those families were ashamed, mortified that loved ones were addicted, and thus they kept silent.

In the four years since Dreamland came out, I’ve been thrilled to watch awareness of the problem spread, and the response to the book grow every year more intense.

Media outlets now devote large pieces to it.

Families now speak publicly about it, instead of staying in the shadows. Their obituaries are more likely nowadays to tell the truth. That’s healthy for those families, and for the country.

Politicians have expanded budgets and enacted new policies to fight this problem.

Opiate addiction is now recognized as one of the top issues facing the country, which is where it should always have been.

When I was writing Dreamland, there were three lawsuits against drug companies. Today, there are some two thousand plaintiffs: counties, towns, Native tribes, Attorneys General, and more.

So I wanted to take a moment to thank all of you who have read Dreamland, who’ve passed it around, read it for book groups or in classes, gave it as gifts, pestered co-workers to read it, and talked about it endlessly.

Thanks, too, to elected officials who have used it to shape policy, doctors who’ve used the book to inform their practices, families who’ve gone public, and podcasters for sharing it.

As I’ve spoken all over this country — more than 200 times since the book came out — I’ve realized how important word-of-mouth has been.

I have cherished the chance to speak to so many kinds of groups: public health nurses, judges, drug counselors, coroners, librarians, doctors, legislators. And more.

I’ve especially loved the chance to visit small towns where I assume authors don’t often show up: Tiffin, Bluffton, Leadville, Hendersonville, Whitewater, Whitehall, Marion, Peoria, Van Wert, Springfield, Newark, York, Worchester, Jeffersonville, Chico, Morehead, Mishiwaka, Spartanburg, Simi Valley, Greensboro, Scottsburg, Chillicothe, Grosse Pointe, Ashtabula, Marysville, and others.

I want to thank all the folks who helped me with the book when they didn’t have a clue who I was. Especially the good people of Portsmouth, Ohio, where I kept on showing up to listen to stories of pill mills, of a beloved swimming pool, and finally, of recovery.

There’s still a long way to go in all this.

The numbers of deaths remain staggeringly high. Each one reflects crushed families and friends. I think a lot about them as I’m on the road. I meet them everywhere, though I often don’t know what to say, or whether what I say is of any help. So I tend to do a lot of hugging.

One crucial issue is convincing insurance companies to reimburse for pain treatment that does not involve opioid painkillers. This would allow doctors to fashion a more holistic array of treatment for chronic-pain patients, instead of just cutting them off from the pills and forcing them, cruelly, into the black market.

A Young Adult version of Dreamland will come out this summer, which I hope will allow high school teachers to guide students in understanding, discussing, and, who knows, taking action in their communities.

I’m working now on a follow up to Dreamland, which will chart the epidemic and all that’s happened surrounding it in the last several years.

All that is to come.

For now, I’m shaking my head at the long amazing trip that Dreamland has been so far, and my family and I thank all of you who read it for allowing the book to play a role in our national story and yours.

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Tattoo Removal Ink in NK

Jo Martin is a retiree from the corporate world who now removes tattoos from the skin of people for whom the inked hieroglyphics mark lives of addiction and crime they are trying to escape.

I met Martin when I was recently in Northern Kentucky.

A few years ago, with her children grown, Martin was tutoring jail inmates, most of whom were repeat offenders and long-time drug addicts. A friend told her about a priest in Los Angeles working with gang members.

Father Greg Boyle had begun Homeboy Industries, which offered paths out of gang membership, the friend said. Boyle was speaking at a university in Ohio, so Martin went to see him.

She was especially taken by Homeboy’s tattoo removal service, she told him. Every jail inmate she tutored had them, and the stains were impediments not just to them getting work and renting apartments, but in fully leaving behind a damaging way of life.

Some part of why people remained in addiction seemed to have to do with their tattoos, she said. The markings served to keep them mired in crime and drugs, pulling them back even when their intentions were good. Removing the ink, on the other hand, seemed to imply a commitment from which there was no turning back.

She emailed Boyle later to find out more. “Come to California,” he wrote back. She went, toured Homeboy Industries and saw the organization’s tattoo removal operation. 

She returned to Northern Kentucky and formed a tattoo-removal nonprofit, Tattoo Removal Ink. Using the life insurance her late husband had left her, she spent $55,000 on a laser machine – an Astanza Duality – that removes tattoos of black and red ink.

Astanza sent people to train Martin in using the machine. “Never in my life had I touched a laser,” Martin told me. “None of us knew how, but it’s very doable. To practice, we did a whole bunch of people who weren’t incarcerated, charging them nothing.”

In 2016, from a small office, Martin and two nurses began removing tattoos of those leaving the jail where she used to tutor – with particular emphasis on those on the face, neck and hands, as well as the markings of gang membership, and the tattoos pimps apply to brand their prostitutes.

Soon she began to see the bizarre – the man with a Hannibal Lecter mask tattooed across his lower face. Another with a dotted line tattooed down the middle of his face, with one side of his face clean, then other mightily tattooed.

“We take a lot of swastikas off,” she said. “And teardrops.”

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Coming Soon: Money For Three Addiction Research Centers

The National Institute of Health yesterday announced what sounds like a major new push to attack the opiate epidemic at the community level.

A big part of what it’s calling its HEALing Communities initiative will be to try to integrate prevention and treatment efforts for addicts while strengthening communities.

There’s more than that, though.

Two years ago, I wrote about the potential for economic development to the Ohio River Valley region that I thought could come from the region positioning itself as a center for addiction research. Northern Kentucky University, and their provost, Sue Ott Rowlands, picked up on that idea, I’m honored to say, and the Ohio River Valley Research Consortium was formed.

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.

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Louisville: Jail Among The Solutions

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.

Why 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.

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Planting Portsmouth, Ohio

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.

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THE HEROIN HEARTLAND: Dino’s story — an addict comes clean

I first talked to Dean Williams when he was in prison for his part in a network of heroin traffickers out of Nayarit, Mexico who work many cities, including Indianapolis, where he met them.

This was in 2009 or so. He was cleaned up by then.

Dean had been using since the late 1960s, when some older guys from his neighborhood returned hooked from the Vietnam War.

I finally met him earlier this year, and then again just a few days ago. A sweet guy with a good story.IMG_9264

I made this video (7 minutes) — among my very first and the first to go up on my Youtube channel — which is, you guessed it, TrueTalesVideo.

So let me know where it can be improved.

For my book, I’m hoping to make more of these to include on my website. I’ve got four already, which I’ll put up in due time.

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