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Tragedy of the American Dreamland

(Forgive me for light posting. I’m dealing with some family health issues — nothing urgent, but time-consuming all the same.)

In his new encyclical, Pope Francis says repeatedly that “everything is connected,” and argues that a big part of our problem is that we err in seeing phenomena in isolation. As a result, he says, our approaches to addressing these problems are partial and insufficient.

An acute, deeply depressing example of this can be found in the recent nonfiction book Dreamland, [1] by Sam Quinones. A writer friend e-mailed me the other day and said it’s the most important book he’s read in years, and that he can’t get it out of his head. I literally have four different books going right now, books I need to read for the Benedict Option book I’m starting on. But the way my friend talked about Dreamland, I ordered it immediately on the Kindle and read it in a day or two. It really was hard to put down.

It’s the story of the contemporary heroin epidemic nationwide, especially in small cities and towns that had never known the presence of heroin until now. What it’s really about, though, is a culture that opened the door for this catastrophe, in complicated but all too familiar ways.

The suppliers are not, as you might have thought, ruthless members of Mexican drug gangs, but a sprawling network of farm boys from the tiny Mexican state of Nayarit — and specifically, from one town, Xalisco (pron. ha-LEES-co). They got tired of doing extremely hard work raising sugarcane, and being dirt poor and looked down on by Mexican society. Indians in the nearby mountains grew poppies. The townspeople learned how to process it into a thick, dark goo that looked like Tootsie Rolls. And through marketing and distribution genius, people in the town developed a system for getting this “black tar heroin” into parts of America that the conventional drug gangs had overlooked. They figured out how to tap family and friend networks from Xalisco, and mobile phone technology, to set up a hard-to-police system of reliable local dealers who distributed heroin like pizza.

No guns, no threat of violence. The dealer comes to you. Customer service is the No. 1 priority. It’s a diabolical scheme, but looked at from a pure business perspective, a brilliant one.

How did the “Xalisco Boys,” as Quinones calls them, pull it off? They only used people from back home that they could trust. They insisted that nobody involved in selling could use the drug — and in fact, there was a taboo back home against it. All the local dealers were salaried, so there was no incentive to cut the drug. They provided consistent quality, which earned customer loyalty. They would not use guns, and avoided violence to keep the cops from noticing. In fact, they had a rule against selling heroin to black customers, on the belief that blacks are likely to be violent in drug deals. They kept their client base restricted to whites. Maintaining these disciplines helped their business expand tremendously.

And the Xalisco Boys tracked where prescription opiate use — OxyContin, mostly — was big, and moved into those markets. Oxy is expensive, but once people are hooked, they’ll do anything for the pill. Black tar heroin — chiva, they call it — gives the same kind of high as Oxy, only more intense, and at a much lower price. Every OxyContin addict was a potential chiva customer. And there were a lot of Oxy addicts.

It turns out that in the 1990s, there was in US medical circles a revolution in pain management. The story is complicated, but boiled down, junk medical science came to be widely accepted as true. Doctors came to believe that opiates used in treating pain were not addictive. There were never any solid data to support that conclusion, but a single letter to the editor of the New England Journal of Medicine was seized on and repeated in medical circles as a “study” that showed opiates were non-addictive in pain treatment.

According to the story Quinones tells, this was what doctors wanted to hear. They were eager to help suffering patients. Plus, Purdue Pharma, the drug company that invented OxyContin, pushed the stuff hard. It was supposed to be a painkiller limited to cancer patients, who were dealing with the most severe pain, but doctors, falsely thinking it was safe, began prescribing it for all kinds of pain, including much more minor issues. Health insurance companies preferred to reimburse for prescriptions, versus non-drug pain therapies, providing a greater incentive for doctors to rely on Oxy.

People quickly became hooked. OxyContin is a form of morphine, and therefore extremely addictive. Unscrupulous doctors set up so-called “pill mills,” which wrote Oxy prescriptions for anybody who wanted one. Soon, huge numbers of people were strung out on the stuff — poor and working-class people, but also middle-class and wealthy people. Anybody who had Oxy prescribed to them was at serious risk of addiction. Using Oxy was so pleasurable that when those pills became widely available, teenagers started taking them recreationally. When the pills ran out, or became too hard to get, or too expensive as one’s dependence built up, there were the Xalisco Boys with black tar heroin.

This is how heroin went from being the kind of scary big-city drug that only lowlifes used in the Seventies to being a drug of choice for Mayberry.

The most fascinating part of Dreamland is how Quinones examines the cultural roots of the opiate epidemic. He writes:

In heroin addicts, I had seen the debasement that comes from the loss of free will and enslavement to what amounts to an idea: permanent pleasure, numbness, and the avoidance of pain. But man’s decay has always begun as soon as he has it all, and is free of friction, pain, and the deprivation that temper his behavior.

In fact, the United States achieved something like this state of affairs … in the last decade of the twentieth century and the first decade of the twenty-first century. When I returned home from Mexico in those years, I noticed a scary obesity emerging. It wasn’t just the people. Everything seemed obese and excessive. Massive Hummers and SUVs were cars on steroids. In some of the Southern California suburbs near where I grew up, on plots laid out with three-bedroom houses in the 1950s, seven-thousand-square-foot mansions barely squeezed between the lot lines, leaving no place in which to enjoy the California sun.

More:

Excess contaminated the best of America. Caltech churned out brilliant students, yet too many of them now went not to science but to Wall Street to create financial gimmicks that paid off handsomely and produced nothing. Exorbitant salaries, meanwhile, were paid to Wall Street and corporate executives, no matter how poorly they did. Banks packaged rolls of bad mortgages and we believed Standard & Poor’s when they called them AAA. Well-off parents no longer asked their children to work when they became teenagers.

In Mexico, I gained a new appreciation of what America means to a poor person limited by his own humble origins. I took great pride that America had turned more poor Mexicans into members of the middle class than had Mexico. Then I would return home and see too much of the country turning on this legacy in pursuit of comfort, living on credit, attempting to achieve happiness through more stuff. And I saw no coincidence that this was also when great numbers of these same kids — most of them well-off and white — began consuming huge quantities of the morphine molecule, doping up and tuning out.

Quinones tells a story about how the drug trade, on both ends, comes from a deep human desire to avoid pain — physical, emotional, psychological, spiritual. This is a normal thing, wanting to avoid pain, but when the desire to avoid pain becomes so disordered that you will do so no matter what the cost, you destroy lives, and destroy society. At one point in the 1980s, the World Health Organization, says Quinones, in its protocols, formally “claimed freedom from pain as a universal human right.” Theirs was a health policy decision, but it tracks with a deep moral belief of the rich, therapeutic, consumerist society.

Healthcare standards were changing to give patients more autonomy. If a patient said he was in pain, the doctor was directed to trust him. Besides, if opiates really weren’t addictive to those in pain, why not prescribe? Result: “Worldwide morphine consumption began to climb, rising thirtyfold between 1980 and 2011.”

Here’s the thing: the wealthiest countries, with only 20 percent of the world’s population, came to consume 90 percent of the global morphine supply. Partly this was due to irrational anti-opiate prejudices in poor countries. But there was something else going on.

In Xalisco, the poorest of the poor were sick and tired of material want and social humiliation that comes with living in cardboard shacks. When they discovered a way to lift themselves out of that pain — by selling locally-grown and processed heroin to Americans — they took it. When the money started pouring in, and the poor began living in nicer houses, and young men returned home with lots of money in their pockets, and the status that purchased them, the euphoria of all that became an addiction. Quinones:

Only the self-centeredness of addiction, she said, explained how farm boys from a traditional and conservative small town could sell a product, anathema to their parents, to sad-eyed, vulnerable junkies and not be tormented.

He quotes one former Mexican heroin dealer saying that when he arrived in the US, the older manager who introduced him to the business warned him not to think about what the drug was doing to other people’s children. If you do, he said, you will think about your own children, and you won’t be able to do this job. The drug dealers distanced themselves emotionally from the consequences of their labors, focusing instead on all the good things they could provide for their families back home in Xalisco, and the way that money elevated them from social outcasts to men of status. They refused to allow the human cost to American families and communities get to them. In time, even the people back home who knew better than to think that selling dope in America was respectable work came to ignore the moral implications, because it felt good to have money.

Meanwhile, in the US, patients came to accept that they were entitled to live without pain, and to do so without having to do anything more than take a pill. On top of that, OxyContin — and after it, heroin — really did take away more than physical pain. People in the Rust Belt who were losing jobs to outsourcing, and who had poor prospects for gainful employment, got hooked on the feeling the drug gave them. One homeless addict tells Quinones that his first heroin high “made him feel like the President of Everything.” The widespread use and abuse of OxyContin corrupted everything it touched. One doctor tells Quinones how the culture of medicine contributed to the corruption by throwing out “ten thousand years of reality” — that is, the knowledge that opiates are extremely addictive — by citing bogus science. Doctors wanted to believe that, not because they were bad people, but because they wanted to heal people’s pain. They convinced themselves that this time, it would be different.

And Purdue Pharma exploited this. It was good for business. And it was only business.

Reading Dreamland, you can see why unemployed former mill workers could fall into this kind of addiction, but it’s harder to see why the kids of the rich do. Quinones shows that the specific motivations may be different, but the basic motivation is the same: wanting relief from the perceived pain of living. For the middle class and the well-off, it’s a matter of boredom, of believing that life should be pleasurable all the time, and that instant gratification is their birthright as Americans.

The book is full of sad stories, but the saddest is the tale of Russian Pentecostals in Portland, Oregon. Massive number of these persecuted Christians emigrated from the Soviet Union to the US, and settled mostly on the West Coast. They were religious, conservative, and strict churchgoers. But their kids went to school with other Americans, and came to see church life as boring and too restrictive. They tried OxyContin, and moved into heroin. Hundreds of these Russian Pentecostal kids became addicts. Their parents did not know what to do. In one family’s case:

Two decades after Anatoly and Nina left the Soviet Union for the freedoms of America, each of their three oldest children was quietly addicted to black tar heroin from Xalisco, Nayarit. … [T]heir American dreamland contained hazards they hadn’t imagined. Remaining Christian in America, where everything was permitted, was harder than maintaining the faith in the Soviet Union where nothing was allowed. Churches were everywhere. But so were distractions and sin: television, sexualized and permissive pop culture, and wealth.

Think of it: these Pentecostals were better off in the USSR than in America, because American freedom led to extreme decadence.

I had no idea how bad this opiate epidemic was. According to statistics from the State of Ohio, which was especially hard-hit, the number of Ohioans who died from drug overdoses from between 2003 and 2008 was fifty percent higher than all the American soldiers who died in the Iraq War. Three times as many people died of prescription pill overdoses between 1999 and 2008 as died in the eight peak years of the crack cocaine epidemic.

And almost all of those pills were legally prescribed, and legally obtained.

One pain specialist tells Quinones:

Cahana believe that what insurance companies reimbursed for distilled many unfortunate values of the country. “We overtest, perform surgery, stick needles; these people are worse off,” he said. “If we work on their nutrition, diet, sleep habits, smoke habits, helping [them] find work — then they improve. You have to be accountable. If you give a treatment that kills people or makes people worse, you gotta stop. You can’t continue making money on stuff that doesn’t work.” Cahana saw “stuff” as the problem. Our reverence for technology blinded us to more holistic solutions. “We got to the moon, invented the Internet. We can do anything. It’s inconceivable to think there are problems that don’t have a technological solution. To go from ‘I can to anything’ to ‘I deserve everything’ is very quick.

“All of a  sudden, we can’t go to college without Adderall; you can’t do athletics without testosterone; you can’t have intimacy without Viagra. We’re all the time focused on the stuff and not on the people. …”

In the end, Quinones believes that the loss of community, purpose, social responsibility, and a sense of moral reality have all contributed to this problem. One doctor tells him that morphine is a great metaphor for the way we Americans approach life today:

“The bad effects of morphine act to minimize the use of the drug, which is a good thing. There are people born without pain receptors. [Living without pain] is a horrible thing. They die young because pain is the greatest signaling mechanism we have.”

Lord have mercy. Think of the truth in that. We have worked so hard as a culture to minimize pain, and to train ourselves to think of comfort and pleasure as our birthright, that we have left ourselves and our children vulnerable to this addiction. This false religion of Moralistic Therapeutic Deism is part of the package.

When Russell Moore talks about how it’s as easy to go to hell out of Mayberry as out of Sodom, this is the kind of thing he’s talking about, in part. I talked to a local physician friend of mine, asking him if we had this problem around here. Heroin, not so much, he said, but he said I would be startled by the number of people — respectable people, even older people — who are dealing with a pill addiction — and from pills that no doctor in town prescribed. Addicts find a way, even here in Mayberry.

As far as I can remember, Pope Francis doesn’t once mention drug addiction in Laudato Si, but the forces he talks about in that encyclical all manifest in the story Quinones tells in Dreamland.  [2] Everybody should read this book. Everybody. The writer friend who turned me on to it said:

It’s hard to imagine a better metaphor ​for the destructive power of an culture that has lost its spiritual moorings. When people talk about the BenOp some are terrified of repeating the mistake of the fundamentalist withdrawal. I understand why. I also understand that what Lenin, Stalin, et. al. could not do the Russian Pentecostals in 74 years, American libertine culture came close to pulling off in a few decades, if that long.

Who needs secret policemen when you have the unfiltered Internet? I don’t what the balance is or should be. I know that the Russian Pentecostals are not the only Christian families whose kids were swept up in the epidemic.

Quinones’ book barely if ever mentions religion, but my friend said that reading Dreamland and contemplating the deeper spiritual message in its pages has led him to this conclusion: the question is no longer ‘Do we need the Benedict Option?’ but rather, ‘What form will the Benedict Option take?’

UPDATE: From a reader:

I am living this nightmare right now. One of my children is a heroin addict who quite possibly is on his way to prison for a long time. My other children struggle with other drugs.

I know other families, nice middle class all-american families, who have had children overdose, be imprisoned and die from their drug use. Most of the time, these kids started on marihuana and moved on to pain pills they got from friends. Often, they have untreated emotional or mental issues and they use drugs to avoid the pain.

Nothing can prepare you for the nightmare of parenting a drug addict- particularly if they use heroin. The toll on the family is devastating. Nothing is left untouched. All relationships are poisoned, finances devastated, and marriages are often ruined.

Yet, resources available to addicts and their families are almost non-existent. All the while, in some states, more people are dying from opiate overdoses than car wrecks.

But what about rehab, you ask? A decent rehab typically costs around $25,000-$30,000 for one month of in-patient treatment. And your insurance will NOT pay for it. And only one month of in-patient treatment is usually a waste of time. Heroin addicts typically require 18 months of some level of active treatment, not necessarily at $30k per month, but at a cost most people cannot afford.

Who can do this?

I laughed at the recent national hysteria over the Ebola “crisis”. More kids are dying every day from opiate/heroin overdose than died in the entire Ebola outbreak in the US. Yet, where is the proportionate response?

Constantly grieving for your lost child and wondering if he may die on any given day is pure anguish. And like I said, for the most part, the family is ruined and alone. It’s indescribable.

How I wish we could somehow as a society attack this problem with all the relish we reserve for other, less lethal concerns.

As far as the culture is concerned, I discovered as a parent, that you’re on your own. There’s precious little support for parents trying to teach the values required for a child to navigate the cess pit they must wade through in order to reach maturity in the USA. Everything shouts you down, whether it’s TV, music, politicians, or the schools. And now, I guess the pharmaceutical companies.

UPDATE.2: Mike W. writes:

I was talking with a friend at work who is just bewildered at the kinds of issues his 14-year-old teens are dealing with. His daughter, in particular, has multiple friends in the hospital over failed suicide attempts, other friends who are cutting themselves, someone else who has decided to be gender neutral, and on and on. He lives, by the way, in the suburbs around the Microsoft campus in Redmond, Wa — so we’re talking about kids who are the products of the best that money, power and affluence can buy. He is at a loss of what to do and how to help his daughter. I suggested that he send his daughter to a convent. He thought I was kidding. I wasn’t. These kids have everything and yet they have nothing. No wonder they gravitate towards zombies and end of the world scenarios. There are no hard edges to their existence, no bottom lines, no safe places they can hold fast to, everything is negotiable and open to interpretation, and so they are flailing around, trying to find something solid, and their high functioning uber-educated parents are no help because they’re not doing any better.

So, “Dreamland” is now on my list. I’m still working through Crawford’s new book, and slowly reading “Christ the Eternal Tao,” and finding passage after passage where Crawford and the Ancient Sage and the Way echo one another.

137 Comments (Open | Close)

137 Comments To "Tragedy of the American Dreamland"

#1 Comment By Fran Macadam On June 25, 2015 @ 10:49 am

Obviously our biggest priority as an increasingly good society (every day, in every way, we are getting better and better) must be to extirpate every trace of the evil Jesus Christ from it. Once all of us have lost that oppressive sense of guilt, the vestige of what the manipulative snake handlers try to load us down with as their construct of “conscience,” we will finally begin to be able to have the possibility to be truly free.

#2 Comment By Mike Alexander On June 25, 2015 @ 10:51 am

Oxycontin is not morphine. It is oxycodone an opiate that is like a strong version of hydrocodone. I have taken hydrocodone lots of times in my life. It works on pain, but doesn’t make me high or anything like alcohol can, if you drink too much). The one time my wife took two tablets she got bedspins (she didn’t know what they were as she abstains from alcohol) and then dreamed she was married to Jimi Hendrix.

Me if I take two tablets I feel just a wee bit slow. But that can happen from ibuprofen too. I don’t get what the big deal is.

#3 Comment By MH – Secular Misanthropist On June 25, 2015 @ 10:57 am

@KD, adherents of a religion need to proselytize the truth of their religion. Using the [3] makes your position sounds weak because it is a logical fallacy. Don’t expect a secular non-believer to proselytize because there might be a possible benefit. To a non-believer this is at best a placebo effect, and won’t scale to a culture that finds a specific religion outside of its plausibility structure. At worst it is possibly some dodgy social science by someone with an ax to grind.

#4 Comment By KD On June 25, 2015 @ 11:02 am

I didn’t write this, it is a quote from a modern heroine:

Having been a student of A Course in Miracles for more than a decade, my favorite prayers come from the Course:

“Holy am I, eternal free and whole, at peace forever in the Heart of Goddess.”

“I am still Goddess’ holy Daughter, forever innocent, forever loving and forever loved, as limitless as my Creator, completely changeless and forever pure.”

(These prayers have been altered from the original by changing them from the second to the first person, i.e., “you” to “I”, and the masculine to the feminine.) Shame has been one of my biggest challenges. These prayers have been so powerful for me because they declare the truth of my innocence as a Child of Goddess and counter shame in all its aspects.

Finally, I will share with you the prayer that eventually led to my own transition. This prayer is addressed to the Hindu goddess Kali ,* she who destroys in order to free us from illusion to see the truth:

“Kali, please remove all that is not real.”

I said this prayer every morning during my time of prayer and meditation for two years. Its effect was not immediate, but I know that, without it, I would not have found the truth about who I am, and be living that truth, today.

Here is the rest at this link:

[4]

#5 Comment By KD On June 25, 2015 @ 11:22 am

Grammatical comment on what distinguishes mere Christianity from MTD is revealed in the above quotation:

(These prayers have been altered from the original by changing them from the second to the first person, i.e., “you” to “I”, and the masculine to the feminine.)

#6 Comment By K. W. Jeter On June 25, 2015 @ 11:23 am

Per panda:

(Quoting me) “High school athletics, particularly the football team. Privileged BMOC’s, whose misdeeds get overlooked by coaches, parents, school administrators, just about everybody. And of course, injuries and the perceived need to keep ’em playing on the field is more often than not the trigger for a lot of it.”

Why are all those SJWs so race-obsessed????

Where is the racial component in what you quoted from me? “BMOC” is a pretty common acronym for
Big Man on Campus,” not “Black Man on Campus.” The addicted football players that Quinones writes about are white kids.

And as for football players not being privileged characters in high schools — hoo boy. Why do you think those kids compete to be on the team, if not for the privileges derived from that status?

And of course, if you’d read Quinones’ book, you’d have a handle on this. As he writes near the beginning of Dreamland:

Via pills, heroin had entered the mainstream. The new addicts were football players and cheerleaders; football was almost a gateway to opiate addiction.

Quinones did his research; what’s yours?

#7 Comment By K. W. Jeter On June 25, 2015 @ 11:27 am

Oops — I responded to panda’s comment before reading his subsequent retraction. Let’s forget the whole thing.

#8 Comment By Venice On June 25, 2015 @ 11:29 am

I’ve seen a lot of this, both in my law practice and, sadly, in my personal life. Yes, I’ve seen friends and family struggle (and lose) to addiction.

Gretchen,
yours is an interesting example, but I don’t think it illustrates that poor medical care has anything to do with it. I’ve known family members who got addicted to Oxy, and they had the best care money could buy, including many stints at very fancy rehabs. I think that you are your husband are just strong people. For some reason, Person A and Person B can both take Oxy and A gets addicted while B is fine. I’ve been told it is to some extent a neurological thing. Also, I am not sure Oxy addiction is going to be more common in poor places for much longer: as many of the commentator’s here can attest, it is a growing problem in even the most affluent communities. The wealthy, of course, have more ways of dealing with it.
I wish I knew what the solution is. I do think that people in stable, happy relationships with family and friends stand a better chance, if only because they have more to loose.
Honestly, I think there is going to be a huge reckoning on this issue in the next 10 or 20 years. People have no idea how widespread the problem is, because it is never going to happen to good people like me… until of course it does.

#9 Comment By KD On June 25, 2015 @ 12:13 pm

MH-Secular Misanthropist:

I suppose you believe that the moral truth of condom use must be established prior to arguments about the consequences of condom use, too. . .

What do you mean by truth? There are certainly no context-independent moral facts that ethical or theological propositions can be compared with to verify their truth. One can say there are no ethical or theological truths in that sense, but such a viewpoint is, of course, disastrous for society-try telling people that the holocaust can’t really be said to be right or wrong.

However, what if moral and theological truths cannot be disentangled from social consequences? Faith leads to certain social outcomes, Doubt leads to different consequences.

Suppose societies based on true moral and theological beliefs grow and thrive, and societies based on false moral and theological beliefs become sterile and begin to destroy themselves?

If something is revealed, based on a specific historic and cultural context, then I don’t know how you would establish its truth, except through the empirical fruits that the purported revelation bears. This can be observed and measured empirically. A House divided against itself cannot stand, therefore, what endures across time and cultures and languages is true in this sense.

If we think of life as a game, then we imagine the strategic rules of the game reflect the intentions of the game designer. This does not eliminate the fact that good strategy can only be developed by experience, moreover, even if you reject a game designer, your strategy still tells you how to stay alive. You don’t have to believe that chess is a game designed by man (perhaps it is divine in origin) to follow sound opening techniques, nor is it an objection to a good opener. Experience supplies the “is”, belief in God supplies the “ought”. Why shouldn’t a person or a society kill themselves after all?

By why kill yourself off just because you haven’t been satisfied with some evidence for a Creator? Most people want to live, at least at birth, and most children, and most societies, naturally have religious affinities, until that gets beaten out with secular modern education.

As you probably know, even if you accept a version of the cosmological argument or the ontological argument, you still have to connect the God of the philosophers to the God of Revelation, and that can only be done by historic experience. Finally, even if we reach some moral consensus, I don’t see how you resolve the question of how to make the sign of the Cross, so even faith seeking understanding can only takes us to a certain point, and then we simply have to accept.

#10 Comment By Ben H On June 25, 2015 @ 12:23 pm

“…the number of Ohioans who died from drug overdoses from between 2003 and 2008 was fifty percent higher than all the American soldiers who died in the Iraq War.”

That’s really extraordinary. I knew that oxy was a big thing but had no idea about h being so widespread in those areas.

#11 Comment By KD On June 25, 2015 @ 12:37 pm

Secular Misanthropist:

Bottom line, morals, theological doctrines, laws, are all based on conventions. A decision on the true convention can only be based on a personal judgment about the consequences of the contenders.

If you look at the debate on what is a man or woman, it is a debate about what the societal convention should be for someone being a man or woman (external genitals, Y chromosomes, or introspection). You can’t “prove” which is true, only the consequences of a decision. Moreover, others will judge differently.

We don’t have to establish the Truth and Justice of the Laws of the United States through scientific evidence before we can argue about what the law should be on Church and State. We accept the laws, and we argue from within the law based on historic precedent. This is the same way Church theology and Canonical law develops. The only question in a pluralistic society is in what ecclesiastical institution you should put your faith in.

(How would you choose your government, BTW, is anarchy like Somalia more rational than the US, because no civil institutions have any authority, and civil authority can’t be proved in a non-circular way that doesn’t look at consequences?)

A strategy is good, and we can say true, because it works. You can’t extract the truth of the strategy away from the rules of the game in which it is enmeshed. Change the rules, the strategy is no longer good.

Christianity is the Way, but that Way cannot be disentangled from the human condition or human nature, at least not by humans, because we are in the game whether we want to be or not.

#12 Comment By KD On June 25, 2015 @ 12:51 pm

Secular Misanthropist:

BTW: I don’t make arguments based on traditional philosophy of religion because understanding a so-called “proof of God” really presupposes an ontology. Before you get to an ontology, you really need a philosophy of language, ground zero, meaning. That is where the conceptual problems emerge. When you get a satisfactory understanding of meaning, then you arrive at an ontology, and then you have a way of understanding the concept of God (not a proof).

You can’t really develop a satisfactory way of conceptualizing mathematics or language with a naturalistic ontology. But to develop that would take a book, and a reader with an open mind and basic rationality.

#13 Comment By KD On June 25, 2015 @ 12:57 pm

Secular Humanist:

You should check out Charles Pierce’s work on “abduction” which discusses the same fallacy you accuse me of. In philosophy of science, this same fallacy is usually referred to as a “hypothesis”.

#14 Comment By C. L. H. Daniels On June 25, 2015 @ 1:24 pm

Thanks for this post, Rod. Really interesting, and I think I’ll buy that book…

#15 Comment By Mary Russell On June 25, 2015 @ 2:14 pm

Karth:

“Do you honestly think there will not be a push to deal with said costs by removing the nonproductive elderly from the benefit rolls?”

Yes. I honestly think that.

#16 Comment By JonFraz On June 25, 2015 @ 3:58 pm

Re: The costs of dealing with Alzheimer’s disease will start a serious upward spiral as well.

We may well have effective treatments for Alzheimers in the next couple of decades– it’s one of the few areas of medicine where there’s reason for optimism.

#17 Comment By Elrond On June 25, 2015 @ 4:17 pm

I live in Ohio and can confirm the heroin problem. According to this article there are 18 deaths weekly in Ohio from heroin overdose:
[5]

#18 Comment By M_Young On June 25, 2015 @ 5:13 pm

Wait, I thought they were just here to pick our crops, wash our cars, and change the diapers of our babies/old folks.

#19 Comment By Zorro On June 25, 2015 @ 5:29 pm

I think addiction is one of those poorly understood phenomena of the human psyche. For some people opiates relieve physical pain while making them mildly queasy.

It might not be psyche. It might be genetic. We know that alcoholism runs in families – why couldn’t a predisposition to opium addiction be inherited? If that is an important factor, then strength of character might be irrelevant either way. You’re not “weak” if you got hooked; you’re not “strong” if you didn’t. Just lucky maybe.

The trick is, figuring out which kind of genetics you have before you become addicted. I have seen percentage numbers all over the lot, which tells me we don’t have a clue about these things yet.

For post surgery I was taking oxycontin (which is just the time-release version) up to 30 mg every 12 hours, and oxycodone (quick acting) up to 15 mg every three hours as needed. It made me a little fuzzy – I wasn’t performing any feats of mathematics – but it cut the pain down to being bearable. And I could sleep, which was important. And later, do rehab, also important. They reconstructed my entire ankle with metal, people.

I didn’t experience any “high” from the drug. I’ve always assumed that was because I wasn’t taking enough quickly enough, but I might not be susceptible to it. I hear the addicts grind up the oxycontin and snort it to get the hit all at once. Needless to say I didn’t do that.

I’m down to one oxycontin in the evening (10 mg) and maybe one or two oxycodone during the day (5 mg each).

It’s wonderful stuff. It enabled me to heal and get my life back after a catastrophic injury.

Anything can be misused. Still, it’s important to remember in the midst of all this scare talk that these drugs play a vital role in modern medicine, particularly in trauma recovery and joint replacements. I personally would not be the same without their help when I very much needed it.

#20 Comment By KD On June 25, 2015 @ 6:02 pm

MH-Secular Misanthropist:

I am glad you mention the placebo effect. It goes something like X believes that Y will cause Z. Now we can study Y, and determine that Y does not cause Z in the absence of this belief. So placebo demonstrates that a system of language and symbols, itself, has the power to alter material reality.

A older term might be something like “magic” or “grace”, and it goes to establishing that the soul acts on the material universe, just as surely as the material universe can equally act on the soul.

#21 Comment By newyorker On June 25, 2015 @ 6:49 pm

Many here have spoken about the use of opioids after surgery or in hospice, but what about the more frequent sub emergency use for those in chronic pain, such as back pain or lingering pain after bad accidents where function may be restored but not w/o residual chronic pain.

What do you tell these people? Who may depend on pain relief to continue working and whose sole alternative is to go on disibility?

In the rural maine countryside people try to hold onto their crappy Walmart jobs instead of surrendering to becoming a ward of the state because of pride or maybe they can’t afford it. If opioids are allowing them to hold on, either thru heroine oxytocin Fenton or methodone, I say more power to them.

I’m a 64 yo knee replacment patient and back pain sufferer. Since I don’t have a job I rely on aspirin and an occasional g&t to handle it, but if I had to work I would insist on something more effective. Should I just suffer and be less effective at a job?

#22 Comment By MH – Secular Misanthropist On June 25, 2015 @ 7:36 pm

@KD, I read all your replies twice to put in a good faith effort to understand them. I have to say that they’re kind of all over the place, so a proper response is kind of out of the question.

But the short version is that people don’t consider abstract philosophical principals when adopting a religion. Cultural contingency plays a major role, but so does how the adherents present their beliefs. There are presentations that seem weak and those that seem strong.

Utilitarian concerns are usually about consequences that people don’t think are going to happen to them anyway. So they’re a weak presentation. It’s also a logical fallacy, but most people aren’t going to bother with that level of analysis.

#23 Comment By Julien Peter Benney On June 25, 2015 @ 9:01 pm

The story of the Russian Pentecostals is fascinating and revealing about the long-term aims of the Enriched World’s working classes.

People do not realise that the limited monarchies before World War I (though never supported as such by working men) had extremely strict restrictions on what people could do, at the same time as they failed to provide any welfare for the unemployed or old. Their basic goal was to create equality before what were viewed as divine laws – an equality which the urban workers saw as a total farce that obscured the luxury monarchs lived in. This is also what Christianity and Judaism and Islam defined themselves as upon development, whereas Enriched World working classes have always sought equality of outcome and have gradually defined it to encompass more and more differences – firstly class, then race, then gender, then sexual behaviour.

Dismantling moral laws to allow female voting, birth control, homosexuality, violence on films and in music, even income taxes (viewed as theft by some Christian ethicists) is a critical part of the democratisation process that is an inherent part of dense Enriched World cities with reliable water and protein supplies. Pope Francis is 100 percent correct that secularisation cannot be seen in isolation – not even from those environmental traits that critically distinguish Eurasia, the Americas and even more Francis’ native Southern Cone from almost all environments in past geological history, and also from the arid Middle East where Christianity, Judaism and Islam have their roots. The thing is to understand how Christianity – like no other religion – was able to civilise these naturally uncivilised lands and counter their natural egalitarianism to build civilisation. Such is a defence of Christianity that few could grasp but which has dawned on me as genuine.

#24 Comment By Laurelhurst On June 26, 2015 @ 12:29 am

One thing you need to understand about the Russian Pentecostals is that they have a really hard time acculturating to the US — most of them were poor, oppressed, and uneducated in the former Soviet Union and they have a hard time learning English. Plus, they are extremely conservative while living in the Bluest parts of some very Blue states. So their kids have a hard time bridging the gap between their heritage and the local culture. It might be better to think of them like conservative Muslim refugees from East Africa or transplants from Appalachia — they’re not like the urbane Russian expats at all.

Also, I wanted to mention that there are some decent treatments for opioid addiction, but the most effective ones involve taking a legal opioid every day — Suboxone or Methadone. The brain seems to have trouble readjusting to life without drugs.

#25 Comment By KD On June 26, 2015 @ 12:48 am

MH-Secular Humanism:

I guess I said too much, without saying enough.

1. The Good can not be apprehended from the outside, only the inside, just as a good chess strategy cannot be apprehended except within a game of chess.

2. One should not be religious because of the social consequences, but if one is not religious, one should recognize political the host of evils that are unleashed by removing religion from the public square.

3. The truth of religious claims cannot be divested from the individual and social consequences of religiosity, any more than the definition of words can be divorced from their use in ordinary language.

4. There is a consistent stupidity in the atheist/skeptic community concerning the concept of truth, usually mired in some kind of “correspondence” “theory” of truth, which basically takes the verification of the proposition “it is raining outside” and views this as the only use of the concept of truth. This is daft, because that is not how religious people use the term (it is not anthropologically descriptive), and it is confusing, because one does not “verify” the existence of God the same way one confirms that a cup of coffee is hot. (It’s like saying people are wrong for referring to cooked sausages as dogs.)

5. All the great axiological statements people like to fight about are based on social conventions, and conventions are true because we agree they are true. Moreover, conventions conceptually precede empirical descriptions (you need a language and customs before you can describe anything), so they must be treated as ontological prior to any empirical description of a “world”.

Platonically, one would make a distinction between intelligibles and sensibles. One is certain knowledge, e.g. based on conventions, regarding the second we can only have opinions which may change.

The manifestation of the word precedes the creation of a world (e.g. language is autonomous). The word and the surrounding conventions are not created by people, rather, the meaning of the word is revealed, for example, to children, who learn through imitation. Mastering a language is about receiving a historic and culturally particular tradition.

I hope this clarifies my comments.

As far as the comments on Placebo (and Nocebo), they are simply intended to point out the absurdity of any materialistic conception of mind. The empirical evidence is staring us in the face, yet it is shunted aside. How can one meatbag kill another meatbag by pointing a bone at them (as has been witnessed by anthropologists)? It’s not all in the head if the shaman can kill anyone he or she wants so long as they share a similar system of acculturation.

#26 Comment By JonF On June 26, 2015 @ 6:14 am

Re: People do not realise that the limited monarchies before World War I (though never supported as such by working men) had extremely strict restrictions on what people could do, at the same time as they failed to provide any welfare for the unemployed or old.

Bismark’s social welfare provisions in Germany are obviously an exception to the above statement

#27 Comment By MH – Secular Misanthropist On June 26, 2015 @ 6:24 am

@KD, better and that still covers a lot of ground. Points 2 and 3 are most relevant to the discussion. Points 4 and 5 are interesting in a philosophy 101 way, but are too involved for a comment box discussion.

Point 2 strikes me as the necessary fiction argument you often hear from religious conservatives (especially David Brooks). It’s obviously not fiction to the conservatives, but that’s how it sounds to the nonreligious.

Point 3 Religions make truth claims with social consequences like: “God exists and doesn’t want you to eat pork” or “God exists and doesn’t want you to work on Sunday”. I’ve done both of those and the world didn’t end. Does my doing that undermine the truth of the religions that make those claims?

Conversely if a religion makes a claim such as “God exists and doesn’t like people to have children out of wedlock”. Does the fact that I find the latter clause reasonable somehow imply that the former clause is true?

It seems to me that the metaphysical claims and the pragmatic claims aren’t really linked to one another.

#28 Comment By grumpy realist On June 26, 2015 @ 8:37 am

KD–the problem with the proclamation of truth claims by religions everywhere is far too often the proof of such truth claims boils down to “because The Holy Book said so, that’s why.” (If they’re more realistic, they’ll say “because my interpretation of The Holy Book says so.”)

In all cases, it’s a subjective truth. Very convenient to have around if you’re the member of a priestly caste who has decided a) other people should support you b) gee the daughter of your local farmer looks tasty c) you’d like to keep yourself immune from secular law.

#29 Comment By KD On June 26, 2015 @ 11:26 am

MH-Secular Misanthropist:

We have a internalized metaphor for ethical principles, that of positive laws. For a positive law, you have a law-giver who promulgates a law, which is accepted by the subject. We critique positive laws generally based on the consequences of those laws. [This is not utilitarian, in the sense that some of us oppose torture because the consequences of torture are ugly, and it fills us with disgust. We might oppose torture despite utilitarian arguments against it, because we love beauty more than utility.]

Internalizing the metaphor of positive law, you have a structure, law-giver, law, and subject. Now we can look at the consequences of the law to judge whether it is good or bad (or true or beautiful), but there is a separate question of the legitimacy of the law-giver. If a law-giver promulgates bad laws, we may begin to revolt against the law-giver. On the other hand, we might just be wicked people, and ignore the law, even if it is good, and right, and just. However, in ethics, theoretically, we can’t justly revolt as subjects, we can only be bad actors.

If there was universal agreement on morals, then we would be all set, you don’t need to worry about who the law-giver is at all. Everyone agrees, and those that dissent are simply operating in bad faith. However, in fact, we have real value pluralism, people in good faith cling to morals that deviate from mine. The problem is not in the ethical subjects (bad faith), but between the sources of law as manifest in the different forms of law.

To talk about moral pluralism requires at least polytheism in my assessment, because laws and morals are not idiosyncratic but unify individuals, they are trans-personal. People agree on morals, but in limited communities, so we have to postulate a source that brings about that agreement, say devotion to a common ideal. Moreover, if we are to avoid relativism, we have to conceive of a hierarchy amongst the sources, we leads us to something like a greatest source imaginable.

So if we imagine the greatest source of goodness in this sense exists (defined as the ultimate unifying power, say Love itself), then how do we distinguish which of these diverse sets of moral customs comes (mostly) from this source? I would say that we are stuck looking at the consequences, not in the sense of utility, but in terms of beauty and goodness.

Note the above analysis is not a logical proof, it is an explication of a particular (but common) metaphor for ethical principles, analogizing them with positive laws. Moreover, it depends upon acceptance of certain empirical features of the world (real, good faith disagreements on moral differences). But the bottom line for me is truth, beauty and goodness, not power, utility and comfort. The technique is to attempt to stimulate remembrance of the beautiful, which reconnects the person with the source of beauty. It is not an argument, but as someone once said, a reminder for a practical purpose.

#30 Comment By KD On June 26, 2015 @ 11:39 am

You can see the monkey wrench pluralism and critiques of ethno-centrism throw into the Enlightenment project. “Ethical” secularism requires moral universals that everyone agrees upon or is irrational. You either have to declare most people irrational, except the one’s sharing my limited education and cultural background, or you have to have pluralism. If you are to escape relativism, you have to have hierarchy, but it can’t be based on universal agreement (democratic) because your morals are WEIRD, and even if you brain-wash everyone, that is merely a contingent event. So you need real hierarchy, and the hierarchy must be objective in some trans-personal sense, which brings you back to deity.

#31 Comment By KD On June 26, 2015 @ 11:55 am

A god is simply the forming principle that generates the instantiation of a shared communal ideal. You can know the face of the god (beautiful/ugly) from the form of the community. The existence of the gods in this sense is obvious. A part can’t make the whole, only the parts working together in harmony can form a whole. Denying the gods is similar to denying the existence of music. [“gods” here being equivalent to the angelic hosts.]

#32 Comment By KD On June 26, 2015 @ 2:54 pm

We don’t have to prove the existence of imaginary numbers, we only have to demonstrate their use, and the consequences for mathematics and science if we refuse to invoke imaginary numbers.

#33 Comment By KD On June 26, 2015 @ 3:00 pm

Grumpy Realist:

A preference for vanilla ice cream is subjective.

A preference for the absence of genocide is not subjective, it is a matter of inter-subjective consensus. At the same time, the basis for this preference cannot be established by quantitative measurement.

You need to open the book. It’s not just quantitative 3rd party it statements versus 1st person preferences. There are some things that only emerge when the 1st and 2nd and 3rd person converge into a consensus–like the sufficiency of a proof in mathematics.

#34 Comment By Kathleen On June 26, 2015 @ 6:13 pm

Rod,

Doctors are eager to prescribe psychotropic medications, including sedatives like Ambien, to their patients but offer little help getting off of them.

Will Hall, alternative mental health activist, educator and counselor has written a terrific guide on how to go off prescription medications. His council, in a nutshell, is titration — get off the drugs slowly.

Will offers his guide for free here:

[6]

You can also scroll down for a video version.

Will does great work on his own as well as contributing to Mad in America, a great resource of information on the abuses perpetrated on patients by the collusion pharmaceutical companies and psychiatry.

[7]

#35 Comment By Joanna On June 26, 2015 @ 7:33 pm

I am a nurse and have worked in several community hospitals, as well as, and two large county hospitals. I have seen the devastation of drug abuse as well as the collateral damage from “The War on Drugs” and thought similarly. But after reading [8] I had to rethink everything I had been taught as a citizen and a health care provider about drugs themselves, addiction, and those who use them. Drug abuse is a medical issues and social issues and their solutions (like mental health issues) will not be found in punishments, isolating tactics, prohibition, prisons, or prayer.

#36 Comment By Tina On June 30, 2015 @ 2:21 pm

Rod, This is an excellent piece. I’ve read quite a few reviews and responses to Dreamland; I look forward to reading it myself. Your article stands out.

On a sidenote: I am not a conservative. When I googled ‘Dreamland reviews’ and saw The American Conservative as one of my choices, I have to admit, I hesitated. And I am ashamed of that.

There are some great comments here. And some…well..

We have a very real crisis in this country that needs more attention. And division of any kind is/can be an unfortunate detour. I hope religious and political ideologies can be set aside. They have no place in this discussion. Rx drug addiction, heroine addiction, alcoholism (which ranks as the #1 most harmful drug); these are serious problems that have no political or religious affiliation.

On a final note, I think KD and MH should get a motel room. Good grief…..

#37 Comment By Richard M On August 19, 2015 @ 5:58 pm

“This false religion of Moralistic Therapeutic Deism is part of the package.”

Indeed it is.