Here’s a link to a Christopher Caldwell essay in First Things that will grab you by the lapels and shake you hard. It’s about the opioid addiction in America. Excerpts:
Drug addiction used to be a ghetto thing. Now Oxycodone has joined shuttered factories and Donald Trump as a symbol of white working-class desperation and fecklessness. The reaction has been unsympathetic. Writes Nadja Popovich in The Guardian: “Some point to this change in racial and economic demographics as one reason many politicians have re-evaluated the tough ‘war on drugs’ rhetoric of the past 30 years.”
The implicit accusation is that only now that whites are involved have racist authorities been roused to act. This is false in two ways. First, authorities have not been roused to act. Second, when they do, they will have epidemiological, and not just tribal, grounds for doing so. A plague afflicting an entire country, across ethnic groups, is by definition more devastating than a plague afflicting only part of it. A heroin scourge in America’s housing projects coincided with a wave of heroin-addicted soldiers brought back from Vietnam, with a cost peaking between 1973 and 1975 at 1.5 overdose deaths per 100,000. The Nixon White House panicked. Curtis Mayfield wrote his soul ballad “Freddie’s Dead.” The crack epidemic of the mid- to late 1980s was worse, with a death rate reaching almost two per 100,000. George H. W. Bush declared war on drugs. The present opioid epidemic is killing 10.3 people per 100,000, and that is without the fentanyl-impacted statistics from 2016. In some states it is far worse: over thirty per 100,000 in New Hampshire and over forty in West Virginia.
Can you believe those numbers? In terms of death, the opioid epidemic is five times worse than the crack epidemic. Remember how (rightly) freaked out we were as a nation by the crack epidemic?
Caldwell says that our response to the crisis has been to cast aside the language and concepts of moral condemnation, and to focus exclusively on the therapeutic. For example, there’s a whole new set of politically correct rules that you are supposed to use when you talk about drug addicts, so they don’t feel so bad about themselves. Caldwell adds:
Calling addiction a disease usefully describes certain measurable aspects of the problem—particularly tolerance and withdrawal. It fails to capture what is special and dangerous about the way drugs bind with people’s minds. Almost every known disease is something people wish to be rid of. Addiction is different. Addicts resist known cures—even to the point of death. If you do not reckon with why addicts go to such lengths to continue suffering, you are unlikely to figure out how to treat them. This turns out to be an intensely personal matter.
Medical treatment plays an obvious role in addressing the heroin epidemic, especially in the efforts to save those who have overdosed or helping addicts manage their addictions. But as an overall approach, it partakes of some of the same fallacies as its supposed opposite, “heartless” incarceration. Both leave out the addict and his drama. Medicalizing the heroin crisis may not stigmatize him, but it belittles him. Moral condemnation is an incomplete response to the addict. But it has its place, because it does the addict the compliment of assuming he has a conscience, a set of thought processes. Those thought processes are what led him into his artificial hell. They are his best shot at finding a way out.
In 1993, Francis F. Seeburger, a professor of philosophy at the University of Denver, wrote a profound book on the thought processes of addicts called Addiction and Responsibility. We tend to focus on the damage addiction does. A cliché among empathetic therapists, eager to describe addiction as a standard-issue disease, is that “no one ever decides to become an addict.” But that is not exactly true, Seeburger shows. “Something like an addiction to addiction plays a role in all addiction,” he writes. “Addiction itself . . . is tempting; it has many attractive features.” In an empty world, people have a need to need. Addiction supplies it. “Addiction involves the addict. It does not present itself as some externally imposed condition. Instead, it comes toward the addict as the addict’s very self.” Addiction plays on our strengths, not just our failings. It simplifies things. It relieves us of certain responsibilities. It gives life a meaning. It is a “perversely clever copy of that transcendent peace of God.”
That is profound. It brought to mind a guy I knew in college in the 1980s. He was not an addict, though he was a heavy drinker, like many of us. He was also a really smart kid, but lost as he could be. Felt his life had no purpose. It’s normal for college students to go through this, “What is my life all about?” phase, and it’s even healthy. But there was something especially intense about him. He was really into the Existentialism class we took together, and now that I look back on it, I can see that he was in it because he was craving a reason to live. He said something to me once in jest, but in light of what I know about him, and Caldwell’s article, I think it was a deep truth: “My life would be easier in one way if I had a heroin addiction. At least then I would know what to do with myself.”
As far as I know, there was no heroin in Baton Rouge back then, or if there was, it was not easy for middle-class white college boys to find. That’s why I didn’t take him seriously. But I wonder what that guy would have done had heroin been around, and easy to obtain. Would what he said as a joke (apparently) have given him the idea to try it? Understand what I’m saying here: this guy was in spiritual pain. He was really anxious, and searching for some grounding in life, something to give his life meaning, purpose and direction.
Thinking of him this morning in light of Caldwell’s article, I can see so clearly that he was looking for that “transcendent peace of God.”
I was too, in my own way, though in a much less dramatic form. I drank like a fish back then on the weekends, not because it was pleasurable, but so that I could forget my own anxiety, self-loathing, and self-consciousness long enough to talk to girls. That was it: to drown my inhibitions. To experience, however crudely and fleetingly, deliverance from myself. No wonder I liked that heroin guy. His inner drama was existential; mine was about talking to girls. But we both wanted peace and deliverance. When Caldwell writes that addiction plays on our strengths as well as our weaknesses, I think about that classmate, who was not a bad guy at all, but to the contrary, the kind of person looking for a mission in life, something greater than himself to serve. If that passion could have been focused and channeled to the good, he could have become somebody great. If not, not. But it had to go somewhere. It was tearing him up inside.
I wonder what happened to him.
This was an intelligent middle-class white kid who had social capital and economic resources, and, this being the 1980s, didn’t have serious temptations greater than booze and pot. Now, think about this same kid in 2017, working class version. Raised by his mother, who had a series of live-in boyfriends. No church background. Chaotic home life, with lots of TV and video games. He graduates high school, knows he’s not college material, and thinks about what he’s going to do with his life. There aren’t many good jobs for somebody like him. He’s like the young white guys that showed up at the warehouse where young J.D. Vance worked: good jobs were available, but they couldn’t hold on to them because they had no self-discipline, and a poor work ethic. Let’s not blame our hypothetical young man for that. He was not so much raised as jerked up with no parents — especially no father — to teach him this.
So: he’s 21 years old, with no direction in life, with no good lifelong worth prospets, and no social pressure within his sphere to get a job (however unsatisfying), and start saving towards marriage and family. There is no expectation that his life is heading toward that purpose, or should. Do it or don’t do it: nobody cares. Most young men in that situation would be lost and hurting.
And along comes the heroin dealer, offering you respite from that pain and anxiety, and giving you an extremely perverse reason to live.
The deeper problem, however, is at once metaphysical and practical, and we’re going to have a very hard time confronting it. We in the sober world have, for about half a century, been renouncing our allegiance to anything that forbids or commands. Perhaps this is why, as this drug epidemic has spread, our efforts have been so unavailing and we have struggled even to describe it. Addicts, in their own short-circuited, reductive, and destructive way, are armed with a sense of purpose. We aren’t. It is not a coincidence that the claims of political correctness have found their way into the culture of addiction treatment just now. This sometimes appears to be the only grounds for compulsion that the non-addicted part of our culture has left.
Read the whole thing. Where are the metaphysicians when you need them…?
One more thing, while I’m at it. This piece speaks to why I have never bought the anti-drug war rhetoric. Let’s say you make it possible for everybody to buy heroin. Do people really believe that the addiction problem is not going to get much worse? That the only real problem with drug abuse is the lawbreaking that attends it? That society has an interest in making it even easier for people to give themselves over to an addiction that consumes their lives?
Caldwell says that we mistakenly think that all addicts want to quit. This, I suppose, is behind the thinking that says “legalize it, and let’s treat the addicts.” Well, what if the addicts don’t want treatment? What if they prefer the prison of addiction to the pain, anxiety, and purposelessness of life without the drug?
Here are the lyrics to the Velvet Underground song “Heroin,” written by Lou Reed, who was a junkie. Notice the religious longing in these words, the craving for deliverance:
I don’t know just where I’m going
But I’m gonna try for the kingdom, if I can
‘Cause it makes me feel like I’m a man
When I put a spike into my vein
And I tell you things aren’t quite the same
When I’m rushing on my run
And I feel just like Jesus’ son
And I guess that I just don’t know
And I guess that I just don’t know
I have made big decision
I’m gonna try to nullify my life
‘Cause when the blood begins to flow
When it shoots up the dropper’s neck
When I’m closing in on death
You can’t help me now, you guys
And all you sweet girls with all your sweet talk
You can all go take a walk
And I guess I just don’t know
And I guess that I just don’t know
I wish that I was born a thousand years ago
I wish that I’d sailed the darkened seas
On a great big clipper ship
Going from this land here to that
On a sailor’s suit and cap
Away from the big city
Where a man cannot be free
Of all the evils of this town
And of himself and those around
Oh, and I guess that I just don’t know
Oh, and I guess that I just don’t know
Heroin, be the death of me
Heroin, it’s my wife and it’s my life
Because a mainline into my vein
Leads to a center in my head
And then I’m better off than dead
Because when the smack begins to flow
I really don’t care anymore
About all the Jim-Jims in this town
And all the politicians making crazy sounds
And everybody putting everybody else down
And all the dead bodies piled up in mounds
‘Cause when the smack begins to flow
And I really don’t care anymore
Ah, when that heroin is in my blood
And that blood is in my head
Then thank God that I’m as good as dead
And thank your God that I’m not aware
And thank God that I just don’t care
And I guess I just don’t know
Oh, and I guess I just don’t know
UPDATE: A reader posts:
“One more thing, while I’m at it. This piece speaks to why I have never bought the anti-drug war rhetoric. Let’s say you make it possible for everybody to buy heroin. Do people really believe that the addiction problem is not going to get much worse?”
Well, as mentioned above, decriminalizing does in general make the problem better. It will not eradicate it but will limit how much the rest of society suffers. But… It wouldn’t be such a problem if the doctors and our government weren’t the initial pushers in this case, not some seedy dealer looking for wayward youth. It’s absolutely vile the way pills are handed out like they’re nothing for everything that hurts these days not from derelicts, but from the people you’re supposed to trust the most with your health and well being.
A few examples just in my own life…
I had a TMJ joint issue in high school (the 90’s) and the Dr gave me 300 Soma’s with three refills. I was already a high functioning drug fiend at the time, but coming off those was brutal.
10 years ago one of my grandmothers from Kentucky was Dr shopping and taking nearly 60 pills a day. When my grandfather tried to leave her as he couldn’t get her to clean up it lead to her having a psychotic breakdown resulting in her murdering him and and herself.
A cousin my age ended up with a long lasting heroin addiction after hurting his back carrying feed bags. He’s functioning but a shell of a man with low chances of ever getting a decent job or having a stable relationship.
My fiancé was prescribed by her doctor a weekly bottle of both pills and liquid Loritab in high school for menstrual cramps.
Her little sister we recently had to detox after a different doctor was prescribing her up to 8 oxycontin a day for a pain issue. She’s 12.
When doctors are pushing the opiates and government backs them you cannot fix these issues properly and they are far worse drugs than a little pot, cocaine, or LSD will ever be.
“Addiction involves the addict. It does not present itself as some externally imposed condition. Instead, it comes toward the addict as the addict’s very self.”
This is what’s so hard to grasp to non addicts, and why it’s hard to ever really put yourself back in moral and spiritual shape. When you first get sober you no longer recognize who you are. You know the addict in the mirror. You don’t know sober you, and it’s scary to be so alienated not just from the world but from your self. You’re left with the silence, the shame, and lots of overwhelming unanswered questions about just what the hell you have been up to. It’s better to shut that voice up and get back to normal. Your psyche feels threadbare. It’s a shirt stretched out way too far that doesn’t quite ever go back into shape. The chaos, far from being scary, becomes what’s completely normal. You all know people like that, who when things get too good can’t help but blow their lives up. The madness is like a warm blanket. The physical and mental pain cycles back and forth and piles up on itself. If you’re going to change you have to want to and you have to be willing to be terrified of whatever normalcy entails. There IS a moral choice involved. It’s an incredibly hard one to make but it does get easier over time. It’s also the same type of one that most people need to do to get off their devices. You need to face the silence and what comes from it even when it’s hard.
Father Barnabas Powel said something … “Heaven and Hell are the same place, the only question is whether you’ll enjoy it.”
The addict, and I would guess most Americans, most assuredly if they had to stand in the truth of their current situations would not enjoy it.