The opioid epidemic
For anyone interested learning more about the opioid addiction epidemic, I strongly recommend this very comprehensive article. It’s long, but it covers a great deal of territory rather succinctly, and illuminates some of what was previously unclear.
Rather than post excerpts, I’ll just link to it and suggest you read it. It’s the best thing I’ve read so far on the subject.
I pick up my parents’ prescriptions from the drive thru window at Kroger here in Oak Ridge, TN, and I can always tell who in front of me is picking up pain medications- they take 2 to 3 times as long as any other routine pick up because they require the passing over and recording of photo ID information and a mandatory pharmacist consultation. It has been my observation that well over half of the drive through pickups are for pain medications.
This is very balanced, detailed article written by a well meaning psychiatrist who obviously wants to understand and explain the opioid epidemic. She covers all the usual reasons from overworked doctors who prescribe without follow up, to easily available and cheap street drugs. The article is excellent but still leaves us asking why so many people fall into addiction.
In a recent piece on the same subject in the theological magazine First Things, the question is addressed from a moral perspective. In American Carnage by Christopher Caldwell, the reasons for addiction are placed on the individuals who very often choose to be addicted. Instead of excusing it as mostly a weakness needing medical and psychological treatment, in other words as a “disease” outside the average person’s ability to combat, Caldwell suggests it is a purposely desired state. He quotes from Addiction and Responsibility by Seeburger:
“Something like an addiction to addiction plays a role in all addiction,” he [Seeburger] writes. “Addiction itself . . . is tempting; it has many attractive features.” In an empty world, people have a need to need. Addiction supplies it. “Addiction involves the addict. It does not present itself as some externally imposed condition. Instead, it comes toward the addict as the addict’s very self.” Addiction plays on our strengths, not just our failings. It simplifies things. It relieves us of certain responsibilities. It gives life a meaning. It is a “perversely clever copy of that transcendent peace of God.”
The founders of Alcoholics Anonymous thought there was something satanic about addiction. The mightiest sentence in the book of Alcoholics Anonymous is this: “Remember that we deal with alcohol–cunning, baffling, powerful!” The addict is, in his own, life-damaged way, rational. He’s too rational. He is a dedicated person–an oblate of sorts, as Seeburger puts it. He has commitments in another, nether world.
That makes addiction a special problem. The addict is unlikely ever to take seriously the counsel of someone who has not heard the call of that netherworld. Why should he? The counsel of such a person will be, measured against what the addict knows about pleasure and pain, uninformed. That is why Twelve Step programs and peer-to-peer counseling, of the sort offered by Goyer and his colleagues, have been an indispensable element in dragging people out of addiction. They have authority. They are, to use the street expression, legit.
The deeper problem, however, is at once metaphysical and practical, and we’re going to have a very hard time confronting it. We in the sober world have, for about half a century, been renouncing our allegiance to anything that forbids or commands. Perhaps this is why, as this drug epidemic has spread, our efforts have been so unavailing and we have struggled even to describe it. Addicts, in their own short-circuited, reductive, and destructive way, are armed with a sense of purpose. We aren’t.
https://www.firstthings.com/article/2017/04/american-carnage
If you want an interesting book on the topic, I suggest “Dreamland” by Sam Quinones. Yes, he’s a reporter for ABC, and now and then drifts off into liberalspeak (I can’t believe that a Republican governor cares about addicts!).
But he’s done his research, and takes it all the way back to the 1970s and a one-line letter to the editor of a medical journal. He points out that Mexicans from one town figured out how to bring customer service to heroin dealing, and spread it across the country. And he shows how Medicare made the problem much, much worse, by giving addicts pills for free, which they could then sell profitably.
It sort of ends before the current Fentanyl et al epidemic, but it lays a solid foundation, and it’s a very entertaining read.