(Translation into most languages at tab to the right.)
Eleven years ago today my husband John and I woke up thinking it would be just another normal, hot August Saturday morning. But when the sheriff knocked on the door, the day – and our lives – were no longer normal. It is surprising how quickly our lives can go from normal to abnormal.
I was sorting through some files and found a drawing that our son, John Leif (JL) had done when he was around nine. It was obviously of Van Gogh’s “Starry Night” but it was also obviously done by a normal nine-year-old – not an artistic prodigy. And it made me think about how JL was just like any other normal kid growing up in middle-class America in the 1990’s-2000’s. He learned to ride a 2-wheel bike at around five, he played with Lego’s, he took swimming lessons, he loved monster trucks and lasagna and macaroni & cheese with ketchup. But something so abnormal for normal young teenagers ended up ruining some of what should have been the best years of his life and ultimately taking his life – and the lives of many of his friends and hundreds of thousand other normal kids.
What was abnormal was the criminal promotion and availability of highly addictive medicine to young kids by Purdue Pharmaceuticals and the Sackler family. Never before had American kids been exposed to legal drugs (that were promoted as “non-addictive”) that they experimented with as if they were simply trying a joint. And the results were the devastation of the Opioid Epidemic. Which is not over, especially for the once normal kids who are still alive and living with the cancer of addictions. We see many of them on the street corners and under bridges, living from hand to mouth, barely surviving, living anything but a normal life.
Sadly, seeing these shells of once normal kids has become a “new normal” as our society doesn’t seem to agree on how to best provide lasting recovery options with a continuum of care – or whether we even should. In my last Substack podcast and article with special guest Sam Quinones we discuss some ideas from his book “The Least of Us” for how to help get these once normal kids from normal families the help they need to try to return to something like a normal life. (1) Let’s not forget that those addicted people were once normal kids.
(Translation into most language at tab to the right)
Sam Quinones is a quintessential storyteller in an investigative journalists’ body. And he uses his skill to weave in stories from families and communities along with the “true tales” from recent history of greed, corruption, deceit, and the politics surrounding the drug epidemic we are living with today. It is his reason for hope that I want to focus on now. Heaven knows we need some hope for The Least of Us… In the Time of Fentanyl and Meth. (1)
Part of the hope he feels comes from positive changes beginning in how drugs and addiction are viewed now compared to previous decades. ‘…greatly expanded drug treatment is part of what America needs…recovering addicts face scary odds as long as the drugs that torment them are widely available, potent, and almost free. The now-cliché is “We can’t arrest our way out of this.” We can’t treat our way out of it, either, as long as supply is so potent and cheap.’ (2) He discusses the mistake of drug criminalization, the possibilities and problems associated with drug legalization and drug decriminalization – all very well thought through and discussed. He traveled across America and interviewed professionals in every field to gain insights into this nightmare that is swallowing lives from every socio-economic group. (For those unclear about what opiates or meth do to our brains, there are detailed explanations woven in throughout the book.)
But his biggest reason for hope came from when Quinones traveled and also extensively interviewed another segment of American society: the addicted, their families, and those working in the many fields who are trying to restore the lives of those taken captive by these powerful substances. I have to say, many of the stories were hard to read, but it is from these people in the trenches and their stories that Quinones began to have hope.
Drug courts are one reason to hope. Because synthetic dope today does not allow users to hit rock bottom before seeking treatment – because ‘Today, rock bottom is death. We can use arrests – but not as a reason to send someone to prison. Instead, criminal charges are leverage we can use to pry users from the dope that will consume them otherwise.’ (3) It helps to put some space between their brain and dope so they can embrace sobriety where life repair can begin. Drug courts are not a luxury – they are a necessity.
Yet Quinones found that ‘…our best defense, perhaps our only defense, lies in bolstering community. America is strongest when we understand that we cannot succeed alone, and weakest when it’s every man for himself…That’s why the lesson we must learn is that we’re only as strong as the most vulnerable, as people who are in pain.’ (4)
As he traveled and listened, Quinones saw that it was people who loved those who are ‘the least of us’ who were making the sacrifices on a daily basis to help in ways they could. But they need help and support – from others and from the policies that are in place in our country.
Recently, I was sharing with a woman the contrast we experienced while we lived in Australia with our daughter and family for two years from the beginning of the Covid pandemic. I said that we were struck by the self-centered mentality – in private life and politics – we encountered when we returned to America and how different it is from the sense of being part of a community and responsibility to others that pervades Australian society. She responded: ‘I’d rather be selfish and self-centered than have my rights and freedoms taken away.’ I was literally speechless. What have we become?
Bolstering community will take a change from our self-centered culture where we who have plenty think we don’t have enough. Where we at the top of the food chain, instead of helping to maintain our communities, have corroded them in isolating and insulating ourselves by abandoning the places where we used to come together like neighborhood parks and community gatherings. ‘We need to again make policy of the belief that we can’t go it alone. The spirit of community needs to be built out, collectively, not just a shift of heart, which is necessary, but in taxation, in health care, in improved infrastructure – in other words, a shift in where the resources go…much of what neuroscience has learned about our brain confirms religion’s truths:humans need love, purpose, compassion, patience, forgiveness, and engagement with others. We’re built for simple things – for empathy and community. That is our defense.’ (5)
He ends his book, his plea to all of us, with this:
‘Community reconstruction doesn’t have to always be complex. It comes down to the unnoticed “constant habit of kindness” that French observer Alexis de Tocqueville, in the mid-1800’s, saw strengthened us locally and kept Americans from destructive isolation and the worst of individualism…The lessons are that we are strongest in community, as weak as our most vulnerable, and the least of us lie within us all.’ (6)
Thank you, Sam.
The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth by Sam Quinones
The Ohio Society of Addiction Medicine is a chapter of ASAM - A professional society actively seeking to define and expand the field of addiction medicine.