Although there have been many valid explanations for why we have an opiate epidemic on our Drug-Warring hands, I have not yet heard anyone mention what the primary reason actually is, so I’ll tell you what it is:
And I’m not talking just about the physical kind – I’m talking about the mental and financial and social kinds of pain which are more devastating than physical pain. The vast increase in prescribing opiates is certainly a big driver of the crisis, but many people take opiates for the duration of an illness or injury and then stop taking them. They don’t become addicts; but a lot of other people can’t get off them ever again.
I had the dubious benefit of “attending” court-ordered drug treatment (in my case it was for alcohol) in my Southern state. I took careful notice of the people I met and spoke with in both jail and treatment, and I was shocked to hear the stories they told about their lives. Absolutely every woman was a survivor of some kind of repeated sexual assault, sexual abuse (by a family member, caretaker, or significant other), violent trauma, total estrangement, or sexual exploitation. Most were mentally ill. All were very poor and underserved if not completely unserved, because of the many institutional system failures in America.
Most people got locked up on paraphernalia charges, theft under $500, probation violation, and/or insolvency. The people in treatment with me (some of whom I also met in jail) were suffering from some of the worst life experiences and situations I’ve ever heard of. Even though some people exaggerate for sympathy, if you have to drag someone’s tale out of them after laying groundwork over weeks in stir or in group therapy, they are not making that shit up.
In jail, I slowly got to know another woman there who finally told me she was a “trick baby” and didn’t even know what ethnicity she was. (Asian? Native American?) She was also epileptic, mostly deaf, an addict, and a member of the hidden homeless. These are the “precariously housed” meaning, at least for her, that she had to submit to sex to crash on various guys’ couches. She complained in her innocent way that what she hated most was always having guys “bothering” her when she just needs a place to sleep other than her car.
Every human has a breaking point when they will seek out ANY relief from unbearable pain, and everybody has a finite amount of resources to battle it.
Speaking of the deaf and/or developmentally disabled, I met a surprising number of people with these problems, and all of them had resorted to substance abuse to numb the pain of deep isolation, the resulting poverty, and repeated victimization. The issues of substance abuse and police brutality are very real for the disabled and largely ignored as well. Almost half of all people killed by police are disabled and usually not in an immediately visible way.
Baby steps, I guess.
The most punishable offense to many cops is lack of a prompt response, difficulty following or understanding orders, and perceived disrespect. Lots of cops are delicate, but thuggish, flowers who require deference and unquestioning obsequiousness at all times.
But back to our national love of getting high.
I figured out that substance abuse is directly related to the degree of isolation and trauma a person has experienced, and the more you have suffered the less able you are to summon the considerable internal and external resources that are absolutely needed to heal from the severe issues at its root. Addiction is a symptom of other serious conditions. If you put someone in rehab or jail but don’t address the financial, familial, mental, social, housing, employment, and physical problems they have, you are setting that person up for relapse or death.
Here’s a helpful TED Talk about why people (and other animals) develop maladaptive coping mechanisms when they suffer isolation and pain which reflects current evidence-based research. Our “moral” and “disease” models of addiction have at the very least been harmfully inaccurate.
By far, the worst thing about my entire odyssey was the degree of toxic shaming we were subjected to. Initially trying a drug is your fault because you chose to “make a bad decision” and break the law. You’ve sinned. Relapse is really, really your fault because you are supposed to know how to resist temptation with the (largely useless) advice they gave you about “avoiding triggers.” The 12 Steps used in most American treatment programs is outdated, ineffective, poorly studied, and loaded with negative, shaming attitudes and more bad advice. The addict is always solely to blame rather than the life conditions and intractable illnesses they deal with.
Here’s the bottom line:
Fifty percent of Americans in 2017 are struggling to pay for housing and having enough to pay for food and sundries. A health care or car emergency can utterly wipe them out. These are people who take out loans for college and well into adulthood the jobs they studied for have simply not materialized. Their debt exceeds their assets. These are also people for whom the dismantling of the mental health system by Reagan has left them without a place to get help and has simultaneously criminalized the sick, the poor, and the different.
I could go on. Things have been getting worse for average Americans so gradually that we didn’t realize we were being cooked alive and quietly robbed of more and more of our rights and political agency. The labor unions were broken, the push for women’s rights stalled, and anyone requiring social entitlements was demonized. What we DON’T need is more tough love, shame, religious censure, and socially conservative policies.
What we DO need is:
- MAT (medically assisted treatment)
- nonjudgmental, sympathetic counseling that addresses the specific reasons women and all other predominantly non-violent offenders (men, the disabled, LBGTQs, POC) end up in the system
- comprehensive mental and physical healthcare (good luck on that one, I guess)
- the 12 Steps replaced with a recovery philosophy that uses evidence-based methods rather than faith-based ones
- safe rental housing we can afford
- better jobs that pay enough to live on
- an end to the Drug War and the decriminalization, Portugal-style, of personal substance possession and use
- forgiveness of past non-violent drug-related offenses or at least removal from background checks so to prevent the stigma that leads to un- and under-employment (and relapse)
- prompt, free legal help that doesn’t suck or favor domestic abusers
- childcare and community supports
- better treatments for chronic pain
Tall order, am I right? This is true:
Every human has a breaking point when they will seek out ANY relief from unbearable pain, and everybody has a finite amount of resources to battle it. Even the people who are “living the right way.” Thanks for being honest, Mo!