In 2019, an average of 194 people died from drug overdoses per day in the U.S., and among them, 137 involved opioids.1
According to preliminary findings, these numbers are up by nearly 50% the same time this year, making for an estimated 291 overdose deaths per day as I write.2
At the same time, reports warn of increasing right-wing3 radicalization4 as youth in lockdown face a choice between the drone of remote learning and the thrill of ever more polarizing online (dis)content.
The same factors that drive people to illicit substances — mass anxiety, economic crisis, decreased mobility, political instability, isolation, a sense of powerlessness1 — are also what drive them to fringe ideologies.2
At a time when overdoses mount and polarization escalates, as increasingly lethal synthetics enter the drug supply and steadily militant conspiracies infiltrate the mediasphere, when the peddlers of dope and misinformation alike lace their products with volatile adulterants of obscure provenance, as we grow inured to our usual doses of clickbait and seek out headlines of increasing potency, when the giving up of self is an epidemic and seems a mass movement … I sometimes wonder if these are not maladaptive coping mechanisms slanted at different angles of destructiveness.
Somewhere between substance and idea is sense. Sense of sight, common sense, sense of hearing, good sense, sense of taste, sense of worth, sense of smell, the sense that something is wrong, sense of touch, sense of out of touch. As the world increasingly defies our senses, so swells the lure of intoxication and habit, the giving of meaning and the taking away of the need for it.
We already have these sorts of books. It does not take much more stretching of the imagination to come back from the pharmacy with your little bag of prescription politics, or to entertain the suspicion that the suburban housewife next door is surreptitiously popping redpills,
or to speculate that the “good life” might be the most tried and true fix this country resorts to.
And is American exceptionalism not the stimulant, the palliative, the pick-me-up, that we keep coming back to, through the defeats of days and decades?
… Need I still mention Marx and his thoughts on religion?
Except, of course, that public health and political science are ultimately not the same thing. White powder is not white power, or even populism, and no liters of bleeding-heart liberalism should drown out that distinction. One is stigmatized, the other stigmatizes; one is criminalized, the other criminalizes; one is disenfranchised, the other self-entitles; one wants to be let live, the other seeks to make die.
Further stark differences in substance and ideological disorders abound in terms of their relationships to community, culpability, roleplaying, (false) empowerment, belonging, sense of purpose, and ambition; their diametric relationships to escapism and scapegoating.
Although former white supremacists may compare their shed attachments to lingering addictions,1 perhaps the most direct way to differentiate these two dependencies — both arguably “chronic, relapsing disorders characterized by compulsive behavior despite adverse consequences”2 — is simply that in one case, the consequences fall mostly on the user; in the other, they fall on the target.
So let us turn to another possible analogy.
How about the seesawing between bailouts and austerity?
The stock market gets high and overdoses. Then banks and big businesses get narcanned with bailouts, sent out from the ER on their merry tottering way, and can expect to be back in the next four years. All the while, the feeble heart pumps its vital blood, the struggling lungs circulate their essential oxygen, and the mind deepens its doubts.
The revolving door here is twofold: while personnel alternateEric Holder was the US Attorney General when the Justice Department settled out of court with Wall Street banks like Bank of America and Citigroup following the 2008 crash. In 2015, he returned to Covington & Burling, “the white-shoe law firm that he left in order to join the Justice Department … which counts among its clients Bank of America, Citigroup, and Wells Fargo.” between government and business,1 people with substance use disorders (SUD) cycle in and out of imprisonment/treatment and discharge, or sobriety/withdrawal and resumption.
What syndrome could this be? How many times must we repeat the same mistakes while expecting different results? When will we finally admit we have a problem, and go into treatment? What insurance will cover beyond 14 days of care? How many times will we relapse?
There is a disturbing parallel between the way we talk about community and recovery in addiction and in recession. In addiction, we talk about “tough love” and weigh the benefits of “cutting off” one’s addicted loved one(s), at the same time as we pour tens of billions of dollars into the prison industrial complex and exporting drug wars. In recession, we talk about “toughing it out” and weigh the benefits of cutting off welfare, at the same time as we pour trillions of dollars into corporate bailouts.
In both cases, people make take the tough decisions and absorb the costs, while institutions commit the lapses of judgement and collect the profits. Banks were bailed out because we couldn’t bear the costs of their “hitting rock bottom.” Yet when it comes to individual application, we insist that you have to hit rock bottom before true recovery can begin.
But each bottom lurches lower than the last, and anyways, who’s to say the impact won’t kill you first?
And here, it becomes obvious that this analogy too has been a forced one, that corporations are not people after all, for
1) corporations have easier access to lifesaving infusions than people1
2) corporations aren’t charged with felonies Here I would like to further note that the jailtime overdose survivors face is up to 2 years and 6 months. It just so happens that former Credit Suisse executive Kareem Serageldin’s sentence was also 2 years and 6 months for his role in the 2007-8 financial crisis.2 and thrown into the prison system for the “probable cause” of having had their lives saved3;
3) corporations’ “recklessness and poor judgment” aren’t throttled with mandatory4 minimums,5 but are instead let go as “not fraud”6
4) corporations don’t have their overdoses livestreamed and go viral on facebook7 without even the formality of blurring their faces,8 but instead get their dirty laundry sealed and bankers’ names anonymized in out-of-court settlements9
5) only corporations have the audacity to sue their first-responders for damages of 40 billion dollars,10 or, right after being resuscitated, to file a suit11 challenging the IRS’s decision to disallow their bogus, tax-haven Speaking of accommodation — what is the ratio between homeless shelters and tax havens?-generated tax credits12
6) only corporations are “offered less punishing terms [for] being bailed out in order to limit the market freefall”13 when human freefall is met with forced withdrawal,14 adult diapers, and death and furthermore is then posthumously ridiculed by the culpable correctional officer on the deceased’s facebook tribute page with: “I find this so funny that people want the tax payers to pay for people going through withdraw [sic] in prisons… So, I say let them do there [sic] 'hard' withdraw and spend the money on someone that is gonna appreciate it!!!! You do the crime, it is up to you to do the time!!!!" in a jail cell15
7) only corporations “too big to fail” are recognized as too weak to save themselves and lent a helping hand on their day of reckoning, where people too small to matter are told to just deal with it, get locked up, have their kids taken away by social services, and are banned for life from federal benefits,16 even during a pandemic that is killing them right17 now18
8) only corporations are neither persecuted nor prosecuted by a “tough-on-crime” policy, but instead have their punishments mitigated by their “systemic importance”19 to the global financial system20
9) over and over again, only corporate personhood escapes liquidation where natural personhood is interdicted and indicted, over and over again.
So no, corporations ultimately are not people, and this seems as good a place to end this false analogy as anywhere else.
This country has long espoused a view of the speech-body relationship that is sometimes fantastical, sometimes fanatical, and always hypocritical. On the one hand, we have “Just say no,” that willfully ignorant attachment to performative speech uttering, as though the sounds emitted from the mouth govern a one-to-one relationship with the substances that go in. What sort of magical thinking, or bad math, or double standard, is this, that we can believe that free speech means free bodies, or rather, that the right kind of speech makes for the right kind of body? More than anything else, this slogan shows that its advocate has a lower tolerance for heroin than for people dying.
On the other hand,* we are virtuosos at divorcing mind and matter. That is why here, nothing is free, and everybody is. Free speech is the only public good, or space, that people deserve. It is like saying people can live on1 air.2
Or on-air.
What is the difference between free for all and free fall?
Having encountered the saying that “the grain problem is an ideological problem” in my research into the Great Chinese Famine, I cannot help transposing an American counterpart: “the drug problem is an ideological problem.” Prosecute those who would harbor aberrant opioid receptors!
Though really, such a way of thinking comes naturally from the casting of addiction as the simple consequence of a series of bad choices and moral failures. From the shoulder-shrug of "It's a shame, but they did this to themselves"1 to the finger-wag of cancelling needle exchange programs to force people with SUDs to “turn from their wicked ways,”2 it is no wonder that the solutions arrived at from such premises are more punishment than public health.
“she let the beast of drug addiction take over her”1
“The drug [heroin] drains its host”2
“it’s the devil, and once it gets ahold of you, shaking it is almost impossible doing it by yourself.”3
When addiction is cast as a form of invasive “mind control” by a parasitic drug, however, an opportunity for redemption narratives unfurls.
“They are people injured at work who became addicted to opioids, eventually losing their jobs, homes and family.
“They're adults who became addicted after being prescribed painkillers for injuries sustained in a car accident as a teen.
“They are women with health conditions – perhaps they had a knee replacement, heart problems or joint pain – who became addicted in midlife.
“They are professionals who'd been to rehab and back more times than their loved ones could count.
“They are people living in daily, grinding physical and psychological pain.”1
In case you missed it, they are also, by and large, suburban whites.
In the face of mounting overdose deaths in this population, media coverage has consolidated a new genre of sorts: the overdose biography. Generally accompanied by a humanizing photo (or multiple), these accounts often go into great depth about the lost loved one's life: their wealth of academic and extracurricular activities, their friends and family, their dreams for the future — and sometimes, their struggles with dysfunctional family, mental illness, and trauma.
It’s not that the subjects of these reports didn’t lead such lives.
It’s just that, as one study found, there are “no stories of overdose deaths in black and Latino communities, although we know overdose happens in those communities as well. Rather … we found arrest stories. The only details of the individuals involved included name, age, and criminal charge. The individuals in those stories were not afforded particulars about their lives, their families, their hopes and aspirations.”2
Could it be that people who aren’t white and suburban don’t also become addicted, or don’t also lose their jobs, homes and family, or don’t also overdose, or don’t also leave behind loved ones when they die, or don’t also struggle?
So, when I survey this catalogue of people whose hands I am meant to feel I could clasp without flinching,
I can’t tell if what I feel is more tender or sore.
"There was no end to what she could have become," the father of one addicted woman in suburban Massachusetts said.
"Now she's locked up in a women's prison. She hasn't seen her kids in over a year. It crushed my family and it's ruined her family."
"And we don't see any end in sight.”3
Because of addiction’s intersection between choice and disease, attitudes towards it are particularly telling about not just what we think about these concepts, but with whom we associate them and how.
I will just be blunt. Illicit drugs take turns standing in for the unknown of various biopolitical subjects, an expression of their latent enmity and anti-American neurobiology — opium for the Chinaman’s fiendishness, marijuana for the Mexican’s madness, cocaine for the negro’s craze. (Catch the different tone for oxycontin, where it stands in for the Caucasian’s despair?)
These narcotics mark their associated users’ exclusions from prevailing notions of futurity — these people’s conflation with the drugs is seen to reveal, rather than beget, their nonproduction, their idleness, their loitering. They are always the origin of their own downfall. They were never going anywhere, except, god willing, away. "People say that heroin went away. It's never gone anywhere," said a DEA agent. "But the user group has changed. The old time heroin user was the guy on the street corner. Now we have kids from the suburbs."1
Another way to put this is that mind-altering substances work their spells on only a certain demographic of minds. When it comes to BIPOC, they lose their efficacy and do not alter but merely unsheathe a hereditary “nature.”
Transcript: “What you really need to do is go back in the ’30s, when they outlawed all types of drugs in Kansas [and] across the United States. What was the reason why they did that? One of the reasons why, I hate to say it, was that the African Americans, they were basically users and they basically responded the worst off to those drugs just because of their character makeup, their genetics* and that.” — Republican Rep. Steve Alford of the Kansas House, 2018
The fear of mind control and losing one’s mind is the privilege of those who can take their intellect for granted, after all. Even if such a point of view can no longer be espoused in so many words, the practical results of the criminal justice system show that there still is a line, spongy like a buffer zone, between the victim who is extenuated by circumstance, and the “accomplice to murder”5 who is profiled “into prison and throw away the key.”6
(It just so happens that beyond metaphor, in the realm of statistics, black people are over 3 times more likely than white people to lack access to a car,7 are less likely to possess driver's licenses,8 and pay arond 70% more for auto insurance.9)
In the current opioid crisis, the fall from grace metanarrative is once again being brought out to service its reservation for white victims. It goes without saying that this population naturally inhabits the state of grace known as normalcy. Their stigma regains the Christian connotation of the word, reflecting the sins of the beholders in our blindness to their suffering. They take opioids only to feel normal again, the plea goes, to palliate a deep state of psychical, if not also physical, pain. Substance abuse is self-medication gone awry.
And truly, one cannot talk about substance abuse without talking about trauma and precarity — the snarl of early adversity, child abuse that winds towards substance use, poverty that debilitates sobriety, toxic stress to intoxication, neglect to narcan. That the world could keep people at such arm’s length as to drive them into the heroin hug.1 That a drug dealer, herself addicted, would casually link the generalized precarity of scraping by under neoliberalism with her own — “And if I wasn’t dealing, I’d probably be living dime bag to dime bag, like, paycheck to paycheck, you know?2
But this awareness is already being spread in mainstream news reporting, and so my focus is not so much on its content as its timing.
The same appeal was not made for any of the more pigmented populations affected by the previous waves of opium, marijuana, heroin, or crack consumption in the 1900s, 1930s, 1960s-70s, and 1980s. Time itself, is segregated.
At what pitch does a cry for help escalate into a shriek for incarceration?
aaaaaa
You see, even though trauma as a concept is relatively recent, the notion of social abrasion and hardship leading to addiction is not.
In the late 19th century, most morphine addicts in the U.S. were middle-aged, middle- or upper-class white women. At the time of this majority, “morphinism” was attributed to a condition termed neurasthenia (literally, nervous weakness), which in turn was associated with “brain workers” and a “delicate nervous organization” exclusive to whites. Amidst the constant abrasions of industrial civilization, “the unending struggle for professional and social success drained them of what reserves they had”1 and thereby thrust the thus nervously-depleted towards morphine.
On the flipside, “ladies of culture” excluded from professionalization also had their own justifications, as one anonymous representative explained:
"I am the last woman in the world to make excuses for my acts, but you don’t know what morphine means to some of us, many of us, modern women without professions, without beliefs. Morphine makes life possible. It adds to truth a dream. What more does religion do? Perhaps I shock you. What I mean is that truth alone is both not enough and too much for us. Each of us must add to it his or her dream, believe me. I have added mine; I make my life possible by taking morphine."2
Today, dreamless truth continues to drive the same demographic to morphine.
“Some cohorts, particularly less than college educated whites, have lost faith in the American Dream, have little hope for the future, and low levels of resilience and coping skills. This is the population that is most vulnerable to opioid overdose and other deaths of despair, while minorities, who still face objective disadvantages and discrimination, are much more hopeful and resilient.” — "The role of despair in the opioid crisis," The Brookings Institution1
“If you feel like the American dream is no longer accessible, then one may also feel that, ‘Well, it’s not really worth investing (Financially speaking, then, opioid use disorder is a wasting disease.) in myself ... because investing* in yourself is one way to access the fruits of the American dream.” — "The True Cause of the Opioid Epidemic," The Atlantic2
But let us return to our 19th-century neurasthenic ladies of culture. Around the same time as these ladies were assuaging their nerves with morphine, Chinese immigrants were arriving in the U.S. for the 1850s Gold Rush. When it came to the Chinese opium smoker, reasoning went in a simpler direction:
“Chinaman likee be with Chinaman and smoke opium.”1
More eloquently,
“The Chinaman is a thorn in the side of society — a foreign substance that seems incapable of assimilation and absorption into the body.”2
No appeals to frayed nerves or an impossible life were made in his defense, even though these “muddy-colored human beings”3 mostly came to American shores as solitary indentured laborers; could expect little to no contact with family back home or even women here after the 1875 Page Act banned the immigration of all East Asian women; and performed backbreaking labor in a land that declared them “an absolute alien”4 with “no power of assimilation, because he is not a desirable citizen, and because he keeps away those who are desirable citizens.”5
And yet, and yet, and yet …
... in response to the inquiries of the concerned onlookers who gathered as George Floyd was losing his breath, Hmong-American officer Tou Thao told them, “This is why you don’t do drugs kids.”6 A minute and a half later, as the crowd demanded the officers check Floyd’s pulse, again, simply: “Don’t do drugs, guys.”7
African-Americans’ cocaine use was also not neurasthenically rationalized.
“It has been authoritatively stated,” a 1910 Federal survey asserted, “that cocaine is often the direct incentive to the crime of rape by the Negroes of the South and other sections of the country.”1
In this hierarchy of understanding converge all the usual associations of Caucasians with interiority, psychology, harmlessness, and pain. Complementing these assumptions is a view that, unlike hypersexualized but undersensitive people of color, white Americans are as far removed from sensory pleasure as bandaids. Hence their addiction is pain-relieving rather than pleasure-seeking, a symptom rather than a condition, enriched with all the philosophical, socioeconomic, and geopolitical complexities of a world.
But you can’t lose a world if it never belonged to you to begin with, now can you?
In this crisis people are dying “deaths of despair.” Have people not been dying, to say nothing of despairing, all these years?
The Fermi Paradox is really not much of a paradox at all. The aliens have not visited us simply because they are loathe to leave their gated cosmoses.
“I’m afraid to ride the space shuttle,” says one indignant extraterrestrial. “You’re constantly afraid that young terrestrials are going to get on and terrorize people - rob, beat them up, even shoot people. Why should ordinary galaxens be endangered just because terrestrials live in bad conditions?” this commentator asks, warming to its subject.
“Sure, I’m sympathetic, but my sympathy has its limits. If drugs are the main problem, why can’t responsible terrestrials keep drugs under control in their planet?”
One may accurately point out that in the current opioid crisis, the first wave of addiction and overdose was indeed set off by a pursuit of pain relief shepherded by physicians and pharma. 19th-century matronly “morphinism” was also mostly iatrogenic.
Which leads us into another set of questions: Who gets to participate in the culture of medication? Who gets to be prescribed, rather than proscribed, into addiction? Who gets to descend from licit to illicit substance use? Who has access to experts, and therefore is not expected to have known any better?
And then, who gets to be prescribed out of it?
Who will be equipped, rather than bombarded by, the artillery necessary to ultimately survive the War on Drugs, this “battle for liberty from the enslavement of drug addiction”?1 Which casualties of war will be shrugged off as collateral damage, the budget deficits cut from their flesh?
“… outreach workers in several cities say that while funds and attention have been directed to aid white opioid and heroin users in the suburbs, they are still struggling to get the resources they need to support minorities who are dealing with the same addiction.”2
“Attention to this epidemic has focused primarily on White suburban and rural communities. Less attention has focused on Black/African American communities which are similarly experiencing dramatic increases in opioid misuse and overdose deaths. ... From 2011-2016, compared to all other populations, Black/African Americans had the highest increase in overdose death rate for opioid deaths involving synthetic opioids like fentanyl and fentanyl analogs.”3
“This lower access to prescription opioids for Black/ African Americans contributes to at least two adverse outcomes: a myth of Black/African Americans being “perversely protected” from the opioid crisis is spread and the potential for severe under-treatment or mistreatment of pain for Black/African Americans with severely painful medical conditions such as sickle cell disease, certain cancers, HIV/AIDS and other autoimmune diseases. The data show that Black/ African Americans are not “protected” from this epidemic. And, under-prescribing in some cases may have life-threatening consequences for people affected with pain disorders.”4
“Indeed, not only are black and brown people who use drugs more likely to be incarcerated than white drug users, they are also less likely to be seen by healthcare providers and offered addiction treatment, counseling or tools for prevention of overdose and injection related infections. If they do receive medical treatment for opioid dependence, they are more likely than their white counterparts to receive methadone, under DEA surveillance in stigmatized methadone clinics, than to receive buprenorphine, which is pharmacologically similar to methadone but can be prescribed in the privacy of a doctor’s office and taken at home.
“… to legalize the use of buprenorphine by private doctors required associating it with less stigmatized suburban white populations, and where economic motivations led buprenorphine’s manufacturer to market to insured, employed, largely white clientele. As a result, methadone clinics and office-based buprenorphine have carved out two different clinical spaces for two opioid maintenance therapies: public versus private practices, tightly DEA regulated versus less regulated, symbolically associated with poverty versus affluence, urban versus suburban or rural, and black versus white.”5
People with a substance use disorder who meet the criteria of skin and suburbia can therefore be grieved and succored as hostages to their own biology, whereas those who fail the qualifications remain stuck in the default characterization — inseparable and irredeemable from it.
How far away are we from a 1:100 sentencing disparity between prescription opioids and fentanyl?
This is not just a question of whose death can we live with.
It is, whose death can we shrug off and say they had it coming?
From opium dens to “negro cocaine fiends” to “Reefer Madness” to the “crack epidemic” to the War on Drugs to now, these tired narratives about addicted and addicting “others” turn out to not be so tired out after all. What are these if not habits of thought? Relapses of the political imagination in moments of crisis? Is there not pleasure in this for someone?
These ways of thinking and governing are as institutional as they are individual, and so the comparison with the subjective condition of addiction is perhaps not the best fit. But if we were to allow for loose analogies, and bring back the metaphor of the body politic, then does this too not match the biological processes of addiction, the way in which it rewires the body’s neurological pathways so that even when the “mind” knows, the “body” still craves and goes through the old motions? That it is a chronic relapsing disease? That denial and a want of vigilance are more than enough to return to our old ways? And that recovery and relapse(that is, relapse that is not deadly) are not mutually1 exclusive?2
Now, war.
“The toll [of 2015 drug overdoses], as the White House commission on the crisis put it, is the equivalent of the 9/11 attacks every three weeks.
“Addiction is at its essence a hijacking. Parts of the brain that are dedicated to rewarding behavior and triggering feelings of satisfaction and calm are kidnapped by opioid drugs to induce a temporary state of ease and even euphoria.
“Opioids are particularly adept at such snatching and seizing. The body has its own SWAT team that swoops in when pain erupts: receptors on nearly every cell in the body are primed to sound the alarm when you, say, put your hand on a hot stove or stub your toe. Opioid receptors populate cells not just in the body, but in the brain and spinal cord as well. Their job is to tone down the firing pain signals—the fast breathing, the feeling of panic and the excruciating feeling of ouch!—as quickly as possible. Opioid drugs target these receptors and magnify the body’s natural painkilling response.
“Ron still considers getting high every once in a while. But now his thinking brain takes over and quells the urge that rises from the deeper, baser brain that is ruled by the mission to feel good at all costs.”1
I do not think it a mere coincidence that the language of terrorism and military litter, nay organize, Time’s description of addiction.
Along this line of thought, in a society that has always taken the metaphor of the body politic literally, drugs are the biochemical equivalent of terrorists, illegal aliens, and other designated enemies of the state. As opioids cross our porous borders, hijack our brain chemistry, and sabotage our usual reward circuits, our protector-governments ramp up the specter2 of the “narco-terrorist,”3 a menace justifying further militarization.
And we are already bringing the war home. Federal prosecutors proclaim that “the growing national plague of Oxy addictions, overdoses and deaths caused by the illegal activity of some doctors, pharmacists and patients has been focused on like a laser beam …. If any person falls into one of those three categories, our office will try our best to root that person out like the Taliban. Stay tuned."4
This is a world-ending scenario I am building. It is still in progress.
This is the latest working installment. Future notes have yet to be written, though you are welcome to scroll further.