We are once again falling into the trap of waging war against inanimate substances. And we will continue to lose.
It was about three months after I had a major surgery, and I had just stumbled upon the surplus Percocet tucked away in my parent’s bathroom closet. The surgery was called the Nuss procedure, which necessitates the controlled fracturing of the entire sternum and most of the upper ribs. Pain management is a serious concern. Oddly enough, my pediatric surgeon sent me home from the ICU with exactly double the amount of oxycodone that my painkiller regimen actually called for. He also made a cheeky joke about “being careful” because these “sell for a lot on the street”.
I imagine it was just a miscalculation of the sense of humor a 15 year old might have. But I knew the truth behind the quip. I had already experimented with numerous drugs at that age, but never an opiate. Opiates were the forbidden fruit. I fancied myself an “educated” drug consumer, and all of the others like me that I had met online repeatedly said never to play around with benzodiazepines, methamphetamine, or opiates. Too risky. When I found the bottle of 30 five-milligram oxycodone tablets in that closet, my first thought was “well, I better just be very careful”.
That is how I found myself googling the proper dose for a first time recreational user of oxycodone. You see, I was very methodical about it all. I was certain that addiction was a consequence of carelessness, and could be avoided with the prerequisite knowledge and planning. Two friends of mine and I took 15 milligrams of oxycodone that summer before high school, and I ate the fruit.
Those three white tablets were the final handshake I made with the devil. When I felt the first wave of euphoric bliss pass over me, I had the keen sense of making a secret agreement. The feeling of relief from existential angst, depression, soreness, embarrassment, and insufficiency was so profound that my barely developed brain absolutely folded in submission.
I tell stories like this to other addicts seeking recovery, because it highlights a type of powerlessness over substances that I have found crucial to recognize in my own recovery. In the wrong hands however, stories like this throw gasoline on to a media-hype inferno that can contribute to policy decisions that hurt addicts. I spend a lot of time reading news and editorials on the opioid epidemic, and I am continually unimpressed. There is something about the narrative surrounding it that is eerily familiar. I’m just old enough to remember the last drug epidemic: crystal meth. There was a blueprint for writing about it:
- A (not-so) new drug- crystal methamphetamine
- A new demographic being ravaged- rural Midwestern communities (which is supposed to be shocking because it is not the inner city)
- Someone to blame – first clandestine meth labs, then imported Mexican cartel meth.
- Subtle support for the status quo – “crack downs”, raids, new laws.
If you have read any reporting on the opioid epidemic, you might recognize that pattern. We have a not-so new group of drugs being pitched as a new scourge on society, a new demographic being effected, an evil cabal of pharmaceutical companies fueling the epidemic, and some status quo interventions being marketed as revolutionary.
So I ask myself, is this a case of an evil drug, or just a continuation of a general addiction epidemic that responds to demands for different substances from decade to decade? I think it is almost certainly the latter. Dr. Joseph Lee of the Hazelden Betty Ford Foundation agrees. In an interview with MinnPost he says “Addiction has never really been about drugs. Addiction is about the people who are at high risk for becoming addicted to those drugs.” Dr. Lee, a psychiatrist and expert on addiction, thinks the focus on specific drugs or classes of drugs is completely misguided and will lead to more panicked tail chasing while people continue to die. “If we invested in people as opposed to focusing on drugs, I think we’d have a much, much smaller problem on our hands”, Lee explains.
The focus on opioids in isolation is not exclusively the product of ignorance and hype. The fact is, someone that becomes addicted to heroin is at a much higher risk of an early death than someone addicted to cocaine. This is just a function of the physiological effects of opiates (overdose, combining with other respiratory depressants). Despite my concerns, the urgency of watching a rising death toll has been put to good use. As far as I can tell, there has never been so much media and political attention on recovery and addiction treatment. Public acceptance of Narcan distribution is incredible. There have also been real crimes and failures of foresight in the medical industry that needed to be brought to light. But along with the good, there is some bad. Besides addicts, many people get caught in the crossfire. Legitimate pain patients have a harder time getting effective medication and impoverished neighborhoods get more dangerous as the drug war increases in intensity. We are once again falling into the trap of waging war against inanimate substances. And we will continue to lose.
When I took those three tablets, and felt all of my teenage discontent vanish, I was having an entirely different experience than my two friends. My brain was primed for addiction long before that day and no single person or entity is to blame. We can do better when engaging in public discourse about addiction. Well known recovery writer and researcher William White recently published a piece spelling out just how we can do that. To him, the one-at-a-time method of talking about drug addiction does not work, never has worked, and never will work. The blind spots we produce when talking about addiction that way turns drug policy into a game of whack-a-mole. Bill says “As the opioid epidemic evolves, all of us involved in the front lines of policy responses and clinical or recovery support interventions should remain aware that it is more than an opioid epidemic and that we must be prepared to respond as it continues to evolve in ways not yet clear. “
When the media subtly anthropomorphizes heroin and other opiates as predatory agents in society, it props up the narrative which justifies the draconian, misinformed and (most importantly) failing policies of the war on drugs. Nobody has been more thoroughly failed by these policies than the addicts themselves. Approaching addiction this way is myopic, and will once again catch us by surprise in the next decade when a different drug becomes popular. Whether we are using the framework of hereditary predisposal, economic despair, corrupt pharmaceutical giants, or spiritual maladies, we must never forget what we are actually talking about when we talk about addiction: human beings.