How to Create a Crisis

Edmund was such a bratty kid the first time I read The Lion, the Witch and the Wardrobe.  I loved Lucy, since I was a girl her age, but his relentless effort to embarrass her only made him half villain.  What was really repulsive was his ignorance to temptation. He didn’t even try to defend himself against White Witch! How could a person so shamelessly seek after evil, trudging through snow with no coat, just to sell out his siblings for some nasty candy?  I understood that he represented me as a sinner, but I couldn’t bear being lumped in with someone so oblivious to an evil plot.

People feel kind of the same way about opioids in the Appalachians. People’s resentment builds as heroin abuse bashes away at the infrastructure of rural life. It’s not that they’re unfamiliar with addiction, or the depression that leads people to it. They’re just tired of the unrelenting pain that heroin brings, and of lacking the resources to fight back.  People wonder, why can’t addicts just say ‘no’? They did DARE in school like everyone else, so how could they be so helpless against such an obvious evil?  Maybe if addicts just thought about their choices, money wouldn’t be wasted on Narcan, social services and jail.  A town in Ohio went as far as suggesting a 3 strike policy for people who overdose, coming to revive them three times, but not the fourth.  It’s callous and simplistic, but people are so annoyed that heroin is even an issue.

The applicable moral of that first Narnia book for the fed up population of Appalachia is that every life is precious, no matter how many idiotic mistakes have been made.  What was funny to me was that when I read the book to my boys, thirty years after I read it for myself, they saw him as a victim, not as a dimwitted bully. Through their eyes I could see he was just an emotional little boy, frightened by the war and annoyed by his seemingly perfect siblings.  He was nursing wounds caused by circumstance, being separated from his parents and scared for their safety.  Adding to Edmund’s plight, he’s sacrificing joys he’s been entitled to since birth- sugar, chocolate, tin cans, rubber… even new shoes and socks.  He wasn’t wandering Narnia looking for a one up on his siblings, the chance just found him, cold and lonely in the woods with an unsettled heart.  All it took was a small promise of escape, and suddenly his greed was insatiable. 

The enchanted treats perverted Edmund’s character similar to the way heroin would.  The more of the treat he ate, the less remained of his virtue.  Reality became distorted to the point he could no longer decipher the good from evil, or truth from lie. His disposition became increasingly combative, even when he was obviously wrong.  Of the Turkish Delight, Lewis says, “…anyone who had tasted it would want more and more of it, and would even, if they were allowed to, go on eating it until they killed themselves.” His greed for it left Edmund with an empty container, making promises he couldn’t keep, to a woman he couldn’t trust, just to live in a fantasy.   We scoff at people who fall prey to addiction, the same way we do at Edmund, but truthfully we know more about this scenario than we’d care to admit.  

The creation of today’s Heroin crisis is rooted in the same oblivion as Edmund’s.  He didn’t know that the Witch’s treats were enchanted.  He’d probably eaten Turkish Delight before without feeling the urge to sell his soul, so why would he suspect danger? The Witch may have been exuding evil, but it was just candy.  Similarly, the increase in heroin use today is attributed to the mass abuse of OxyContin, which originally no one thought would be habit forming.   For a decade doctors were encouraged to prescribe it to anyone with chronic pain (which opioids had never been used for before) and then even for smaller things like tooth extractions.  The lie was so pervasive even primary care doctors started prescribing it.  Finally, an FDA approved, non-addictive solution for any and all debilitating pain.  Maybe we should have been more wary, but doctors prescribe all kinds of drugs that heal and help, so why should this be different? Even after 1000’s of years of experience with opium and its derivatives, we never stopped to question if these claims were true.

In the time that it has taken OxyContin to rise and level off in popularity, our culture has seen an abundance of fraudulent schemes fail. Our economy imploded as the housing market crashed.  Record breaking athletes almost all turned out to be bogus, even our olive oil was fake.  We wanted so much, we even ruined kindergarten in our quest to have the smartest kids.  Ignoring fraud and then being horrified at the consequences is our national pastime.  The American Dream is one of consumption. It sounds decent and non habit forming at its inception, and sure most people handle it well, but what starts as a little piece of land to call your own becomes a desire for a bigger piece of land.  After that its a nicer car, and then maybe some fancier clothes, a few dogs, and a pool, too. People who would otherwise be satisfied are suddenly not when they walk in to Target and see how cute the Magnolia line is.  The dream is habit forming, and the danger comes when the lack of fulfillment festers so deep, it becomes impossible to maintain a moral code and satiate the desire.  In this way we know Edmund and the addicts on the street, universally we suffer from blinding greed.  

The story of how we legalized drug dealing reveals this greed as the root of the  epidemic, and the drug abuse as a symptom of it.  The easiest villains to target in this story are people struggling with addiction, but a pill prescription doesn’t magically appear. As the opioid story unfolds, it reveals layers of villainy, shared between doctors, crooks, marketing departments and a struggling pharmaceutical company.

*  *  *

The first people to absorb blame are usually doctors, since they introduced many unwitting patients to opioids without any warning about the possibility of addiction. Dr. William Hurwitz was one of the first to be penalized.  The star of the documentary “Dr. Feelgood: Dealer or Healer”, has an impressive resume.  He was educated at Columbia and Stanford, and then volunteered with the Peace Corp in Brazil. When he came back to the States, he specialized in chronic pain, became an expert in the field, and opened his own clinic in an affluent D.C. suburb.  His patients were people whose pain was so crippling they were unable to do basic things, like walk or work. They were grateful for his support, but traditional treatment involved multiple types of surgeries and therapies in addition to some meager medication.  It was a long, expensive road, lined with tiresome insurance battles, and no promise of relief.  Everyone was desperate for an easier answer to the problem of chronic pain.

In 1996, sales reps from a company called Purdue Pharma showed up in doctor offices across the country, and the problem was solved.  They promised their new pill, OxyContin,  was the first ever non-addictive opioid, thanks to its fancy new time release capsule. They wooed doctors during special conferences at fancy resorts, and cited a few loosely applied studies to substantiate their claims.  At these conferences they promised even a primary care physician could prescribe it safely.  It’s so harmless, people could use it after a tooth extraction.  Purdue trained its sales team to ingrain the message that the risk of addiction was “less than one percent.” They even made up a term to describe skeptics: ‘opiophobic.’

Hurwitz was  enamored with the pill. After years of repeated appointments with little progress, his patients were finally happy, and he was overjoyed. “It’s a miracle from heaven,” they’d tell their friends.  They can go back to work, walk without a cane, and play with their grandchildren again.  But soon they would become tolerant and ask for a higher dose, and Hurwitz would oblige.  He started to ignore signs that his patients were abusing the drug.  When a nurse would point out a patient with track marks, or an unclean urine sample, he would argue didn’t an addict also need pain relief?  If a patient ran out of pills before their prescription ended ( a sign of pill abuse), Hurwitz would assume the patient was developing more severez pain, and increased their dosage.  After two of his patients overdosed and died, the DEA opened an investigation. His abundance of patients taking abnormally large doses led them to shut his practice down.  Soon after the medical board revoked his license, and eventually he went to jail.

Even after losing everything, including his marriage and career, he still thinks OxyContin is the answer for chronic pain.  When they interviewed his ex-patients, ones who were lucky enough to have recovered from their habit, they all regretted their addiction and understood how the pills had made them suffer more.  Hurwitz showed remorse for the people who had died, but was unwilling to assume any blame. He was sad that people had taken the drug incorrectly, mostly because it ruined the chance for others to use it for relief.  In his post jail interviews, he still did not feel that large doses, extended use, or increasing tolerance had anything to do with creating epidemic addiction. He shows we can be greedy with excellent motives, and what’s scary is that will blind us all the same.

*  *  *

Well meaning doctors have absorbed a lot of the initial blame, but once people realized  the draw of OxyContin and its generic oxycodone, anyone with a prescription pad had the ability to get rich quick.  In fact, you didn’t even have to be a doctor to profit, you just had to employ one. Jeff and Chris George owned and operated the U.S.’s  largest chain of pill mills, profiting $40 million in just two and a half years.  Twin brothers from Florida, who had no medical experience and had only ever worked as housing contractors, opened shop in 2008. They hired desperate doctors who were bankrupt, literally and/or morally, and told them if they wrote a lot of prescriptions they could make $2 million a year.  At this point many people were relying on the black market for pills, but once patients realized how easy it was to obtain drugs without getting arrested, American Pain exploded.   People drove down by the van full from as far away as West Virginia and Kentucky.  All a patient needed was an MRI (done for $50 in a trailer behind a nearby strip club) and a clean cup of urine (didn’t have to be yours). A visit would require one to act civil in the waiting room, and 15mn with the doctor to make up a story about what hurt, but as long as someone followed the procedure they could go home with a month’s worth of pills.

Since pain is relative and mostly invisible, you can’t prove someone is lying about their pain, making it difficult for the DEA to build a case against pill mills such as American Pain. It wasn’t until the brothers violently threatened people that agents were allowed to wiretap their phones and prove the clinic was a sham.  At any point before that, the George’s certainly could have walked away with a fortune, but when recounting the story they said their love for profits and power became insatiable. They wanted to stop, but they couldn’t give up the excitement of large stacks of cash.  By the time the clinics were shut down and everyone was arrested, the DEA estimated that 20 million doses of opioids had been prescribed, an average of about 10,000 per day.

In the end, the George brothers regretted what they had done, but from jail they asked the question, why were they the only ones in trouble? The drug distributors all knew what was happening, because the clinics demand for meds was so much higher than the average doctors office, but they all turned a blind eye.  And what about the people who made the drug? For every pill the George’s sold, a portion of their profit went to them too, so why weren’t they in trouble?

*  *  *


That company the George’s were talking about is called Purdue Pharma.  In the early 90’s they were still a small company, whose primary product was a painkiller called MS Contin given mainly to dying cancer patients. It was profitable, but the patent was about to expire, and with it’s limited market it wouldn’t be able to compete with its generic versions. The company needed something new to keep them afloat, preferably something with a bigger market so they wouldn’t be in the same position ten years later. OxyContin, was their answer, a new opioid drug that would release its potency slowly into the bloodstream, to prevent the bodies dependence on it.  In clinical tests they decided it would be mellow enough for chonic pain, which happened to be a very large, untapped market.  Soon enough, its popularity turned them into superstars, and opioids became a billion dollar a year industry in just a few years.  Today their reach is global, and the Sackler family, who owns the brand, is the 16th richest in the nation according to Forbes.

It’s unclear what their original intention was other than trying to stay in business. Did they create their product to help people or did they know they had found a way to legalize and profit off of heroin? By 2000, people began to realize that OxyContin actually was addictive, and started filing lawsuits.  In 2007 The U.S. Attorney General’s office in Virginia took up the case, against the advice of superiors, and Purdue Pharma pleaded guilty to criminal ‘misbranding’, which included mislabeling the drug, fraudulently promoting it, and marketing it for an unapproved use.  They paid $635 million dollars in fines to stay out of jail, which was the biggest penalty at the time, but has lost its meaning compared to the $35 billion in revenue that Purdue Pharma earned from OxyContin to date.  Several other affected places have successfully filed for damages since, including Kentucky, New York, Ohio, West Virginia and Canada.  Most recently the town of Everett, Washington has filed a new lawsuit, this time claiming the company purposely fueled the black market in order to increase profits.  

Why did it take almost two decades for Purdue to admit their guilt or do anything about it? Could they really not see that their product was destructive?  It’s difficult to judge where the distinction between evil intention and ignorance lies.  The CEO’s themselves were so caught up in the success of their product, it’s possible they didn’t understand the long term consequences of their actions.  Even once the effects became undeniable, the profits were too blinding to ever admit the pill was causing problems.  29 claims for damages were fought off before a single case was settled.  With bank accounts growing into the billions, morals became subject to the desires of stockholders.  The company’s  polluted motives became a classier version of those addicted to the drug they were selling.  For some reason though, there aren’t any CEO’s behind bars yet like there are street dealers, pill mill operators, or unscrupulous doctors.  Maybe we’re more comfortable with their sin, all they wanted was there company to stay afloat. and then just a little more money after that.


After Purdue Pharma was convicted, their profits and the rates of pill abuse continued to increase for 3 more years.  I think the most frightening part of this story is how little we care.  Even with the landmark court case, opioids were not a top news story in 2007, or listed in the top 10 headlines for any year before or after.  Most headlines were about elections and their related issues, the war on terrorism, sports or celebrity gossip.  The housing crisis and the ensuing recession have been a top story almost every year since 2008 because of the mayhem it caused, but opioids have devastated almost as many.  It’s estimated that 7 million have struggled with dependency since the release of OxyContin, many cases resulting in death.  On the surface this seems about equal to recession unemployment or foreclosures, but the statistic grows exponentially when we realize that addiction is a family problem.  For every dependent person counted, there are several more suffering the consequences, like kids in foster care, babies in withdrawal, and/or relatives spending a fortune on their loved ones in rehab.

After such a traumatic experience, you would think we would make an elaborate effort to keep history from repeating.  Some progress has been made; OxyContin now has a tamper resistant coating, and databases have been formed to track prescriptions and prevent abuse.  Doctors now have strict guidelines for prescribing opioids for chronic pain. Rates of abuse have leveled off, but at the same time so have profits.  Instead of being satisfied with the money that’s been made, there is now a global campaign for OxyContin, using the same misleading and aggressive marketing techniques that proved so successful in the U.S. In a terrifying quote from a promotional video, the company claims, “We’re only just getting started.” 

At the end of The Lion, The Witch and the Wardrobe, when Peter confesses that he was partially to blame for Edmund’s actions, and Aslan doesn’t deny it.  The uniting sin behind every facet of the opioid epidemic is as much in my soul as it is that of addicts, over-prescribing doctors and Purdue Pharma’s.  Like Peter, we all have a part in contributing to a culture that values material gain with low tolerance for pain or misfortune. The most terrifying part of raising four little boys is to see how deeply embedded in our human nature greed is, because it feels so impossible to teach them to see others needs before their own, and to be content with what they already have.  Everything else, from their friends to our junk mail, teaches them they need more: more activities, brains, ambition, muscles, toys, fun, food, gifts and then also more money…to pay for it all.

In the aftermath of OxyContin we find ourselves like Edmund, standing alone in a frigid wasteland, desperate for hope and lamenting the greed of our actions.  Heroin addicts may receive the worst of our scorn, but those that can find recovery are the most blessed, for they’ll have seen their problem clearly enough to be freed from it.  Unfortunately, greed pushes us to live in denial. Maybe we suffer the consequences for a while, but in the end we learn nothing.  The opioid disaster probably won’t be a catalyst for lasting change.  Historically speaking there is not much precedent, since this same exact problem happened when heroin was released by Bayer Pharmaceutical in the early 1900’s.  But it might, and we could be louder and more emphatic in our prayers that it will.  Celestially there may be hope, but individually, our power against is in choice as individuals to be satisfied, and our ability to teach our kids, friends, and neighbors to do the same.  Many of us know the serenity prayer, recited in almost all group recovery meetings. God grant us serenity…courage…wisdom…, but the heart of this prayer is contentment, a plea for peace with and about the world as it is, and freedom from the desire to control or escape it. It is fitting, since contentment is also the antidote to greed. The true fight against addiction epidemics begins with this. I pray above all else that contentment will become our heritage we cherish above all, not chasing illusive, unfulfilling dreams.


“Dreamland”: Parenting Lessons From a Drug Epidemic

When we moved to the Shenandoah, I heard neighbors complaining about heroin, how they were disgusted about finding needles around the playground, and watching drug deals take place in parking lots.  I’d heard that heroin was popular again, but I greatly underestimated the extent of the epidemic, especially in Appalachia.  My own kids found a few needles in places that were supposed to preserved for their innocence and for community, and I couldn’t get my head around how this had become such a problem. When I was growing up, I was terrified by heroin.  Mostly it was the needles, ‘Trainspotting’ and that scene in ‘Pulp Fiction’ that made me never want to go near it; even in my teenage arrogance I respected its deadly power.  My stupidity about trying different substances always stopped at heroin because people said it would kill me, and I actually believed them.  I couldn’t understand how the generation following me could not see through its thin veneer of bliss to understand these same things, especially to the point where heroin use has become an epidemic.

The book Dreamland:The True Tale of America’s Opiate Epidemic by Sam Quinones helps people who didn’t personally witness opiate use escalate around our country understand how it happened.  What sets this book apart is that in addition to the facts and stories that fed into the epidemic, he also theorizes about the cultural trends that made us susceptible.  It’s a pretty depressing read for parents, but these theories offer important insight about what we teach our kids. We may not be able to help directly with helping people fight their addiction, but parents are on the frontline of making cultural changes to prevent it. What has happened makes it’s clear that our part is more than just warning about the dangers of drug use. We have great influence in teaching and modeling to our kids what is valuable and what is not, and maybe in this way we can help reverse the trend.

Definite Lessons

Be aware of what’s in a pill bottle.   Do your research on what a doctor prescribes your child,  especially if something is possibly habit forming. Even if big pharma or your doctor tells you an opioid, benzo or amphetamine is not addictive, that it has a special time release formula or some other mechanism to keep people from abusing it, take it with caution and lots of education.  Assume that it is still is addictive, because that’s the nature of these drugs.  

Shame intensifies the problem. In Portsmouth Ohio, the city that Quinones identifies as ‘ground zero’ of the epidemic, parents didn’t speak out about what was happening because they were embarrassed. They were trying to navigate things they knew nothing about: rehabs, prison systems, probation, but silently, without help.  They were too ashamed to ask for it, which was silly, because their friends and neighbors were going through the exact same things, but also silently and no one knew.  It took 10 years before a parent in town was able to speak up about it, and form a support group.  If one good thing comes from the opiate epidemic, it’s that there’s a light shining into the hidden worlds of middle and upper class addiction. Because it’s heroin, you can’t just send a kid to rehab silently and expect when they return, life will go back to normal.  Heroin is not just bad behavior at parties and DUI’s, it’s cops, multiple stints in jail, and ambulances in front of your house. You have to have help to support a person through recovery; knowledge and honesty from a community are essential. And since addicts are overdosing more often than people are dying in car crashes, there is no longer time for any parent to shame or be ashamed.

Possible Influences

Kids had their own rooms. Because of our increased affluence and the real estate boom, many kids had their own rooms, which was less common in previous generations.  Kids said that their room was the perfect sanctuary to get high in, away from the cops, nosy neighbors, tattling siblings and any other person who could tell their parents what they were doing.  

And their own cars.  Having a car gave suburban teens easy access to drugs.  You call a number, like you’re ordering pizza, you drive somewhere and meet another driver, and exchange money for drugs. Quinones mentions that the cars also had the added benefit of becoming a place to live when the parents wised up, and kicked their kids out of the house.  

Sports.  I hate to mess with something that has become sacred to so many people. I’m not denying that athletics can be beneficial for children, but that it can be overdone. Quinones noticed that in the middle and upper class communities he was studying youth athletics had been elevated to the point where the problems began outweighing the benefits.  After interviewing an addict in one upper-middle class town he said,  

“It was a place of gleaming mansions, but he felt no sense that education was of value in providing choices for life, much less a love of learning. These kids’ futures were assured. So sports were what mattered. Dads would brag to friends about their sons’ athletic exploits, then berate their boys for poor play, urging greater sacrifice. From the athletic director down to parents and teachers they heard, ‘you need good grades so you can play…’”(291)

Quinones saw that sports were becoming a gateway to opiate abuse because of the pressure and the injuries.  Because of how important sports had become, kids were playing year round starting in early elementary school, and were then more likely to have chronic injuries by the time they reached high school.  And because of the pressure to succeed, they were encouraged to play through their injuries and ignore their pain. They were often prescribed painkillers just so they could finish a season and Quinones noticed that the local football star was quietly becoming the face of teenage opioid abuse. Medicating injuries has always been done, but with oxycodone being prescribed for chronic pain, many sports teams, (and football especially since the players are prone to injury) were developing their own addictions.

Philosophical Questions

What are the consequences  of isolation?  The book is named for the community pool in Portsmouth, Ohio, where generations of kids would hang out all day every day over the summer, surrounded by their neighbors and elders.  It closed in the early 90’s because people began installing their own pools, tucked away neatly in their backyards. People stopped meeting their neighbors and letting their kids roam the streets until dinnertime.  The lack of neighborhood made it easier to hide a drug addiction, away from the watchful eyes and accountability of the community.  Quinones sees this as a metaphor, because it wasn’t just Dreamland that closed, people everywhere started staying in their homes and becoming more isolated. Closed doors made it easier for people to pretend they were perfect, which fueled secrecy and shame about all of their hidden defects.

What happens when we have too much stuff? Maybe not so coincidentally, the peak business years of pill mills coincided with the boom and bust of the housing market.  Quinones theorized that our increasing consumerism created a culture that was fertile for an opiate epidemic.  Unfortunately, parenting has not been immune to this, and the increase in teenage heroin addiction shows the consequence. In an interview with a man running a rehab clinic, the man explained,

“‘Spoiled rich kid syndrome’ seeped into America’s middle classes. Parents shielded their kids from complications and hardships, and praised them for minor accomplishments-all as they had less time for their kids….’You have a lot of kids who have everything and look good, but they don’t have any self-esteem. And you put an opiate addiction in the middle of that?’” (p.293)

Is it possible that minimalism could be an antidote to rampant drug use?  If we wanted less and were satisfied more would we still crave chemicals to fill the gap? Thanks to ‘Charlie and the Chocolate Factory’ we can see that spoiling children is detrimental to their behavior, but maybe we don’t understand that the gravity of the consequence goes far beyond the warnings given by the Oompa Loompas.

What do we lose when we stop accepting pain as part of life? Our culture has also become less tolerant of pain, not just chronic pain, but any pain.  People started getting oxy prescriptions for things Tylenol would normally take care of.  Quinones said,

“In heroin addicts I had seen the debasement that comes from the loss of free will and enslavement to what amounts to an idea: permanent pleasure, numbness, and the avoidance of pain. But man’s decay has always begun as soon as he has it all, and is free of friction, pain, and the deprivation that temper his behavior.” (p.37)

This idea has also trickled into parenting, because we can’t handle watching our children feel pain, physical or emotional. The man Quinones interviewed from the rehab clinic thought that parents today are making recovery even more difficult than usual.  He believed there was a simultaneous epidemic of parents addicted to rescuing their children, and that their kids maturity was stunted because of it.  He had seen too many parents enable addictions by rushing to their kids aid with money, food and shelter when they should’ve been capable of providing it for themselves. People do this because its been their habit since birth, every time a child cries from a scraped knee or because someone was mean to them, we jump to their aid.  He warned, “I tell parents it’s real important to say no, but say no way back when they’re young.” (p.293)

I think most people have heard this before, but have not thought about it in this context.  Whose pain are we really medicating when we come to our children’s rescue, and could the consequences not only lead to irresponsibility, but also to early death? Is it possible to walk the line of being compassionate toward our children without enabling them, starting when they’re still young?

I wish I could offer you a parenting guide, and not just a book review. My kids are still in elementary school and unaware that heroin is even a thing.  I have no credentials other than being able to keep four boys from destroying a house, but I know there’s no sure way to keep kids from trying drugs.  I also know enough about addiction to know that the blame never lies in one place, or on one parent’s shoulders.  The book also reflects that the epidemic has many influences that are far beyond parental control.  There are many kids who had their own rooms, drove their own cars, played sports year round, had lots of stuff, and grew up to be healthy adults. Just as there are kids who grew up with none of these privileges that are still battling addiction.  The influences above are not ways to place blame on the last generation of parents, only cultural observations that the book brings to light with the hope that history might stop repeating itself.

Although you could never place the blame all on one influence, I do think the epidemic shows that it’s important to have conversations about the long term consequences of parenting trends. What do you think of his warnings? Have you seen these things enable addiction? Will you debate the consequences with your friends? I know it’s not a great conversation starter, but we owe it to the parents who have suffered already- to respect the education they earned, and the pain they have endured.

To Fight a Scourge

I was only 19 when I became a bike messenger.  I didn’t know anything about what I was doing, or the other people who I worked with, but the lifestyle and the community were fascinating.  Everyone was so radically different from each other, but still they were bonded together through the experience of doing such a weird, hard, adrenaline-inducing job.  There was a haunting among them though, a sad undercurrent that I couldn’t understand.

In defense of my naivete, I had little experience with addiction.  In my suburban middle class life, I knew people struggled with it, but never publicly.  Occasionally someone’s parents would freak and they would disappear from school. Rumors would be whispered, but the official story was usually something about boarding school, or visiting an aunt’s house. Being a messenger exposed me to people who didn’t have the stigma caused by class, who laughed and enjoyed their addictions, and who were too abused by life to care about what I thought of them.

Messenger work is different than an average labor job. Most companies hire you as an independent contractor, meaning you’re free to accept work or not, and you can call out hungover without getting fired. Because you work on a voluntary basis, the job can be an easy way for an drug user or an alcoholic to make enough money to get by and support their habits, without being penalized for missing a day of work here and there, or for clocking in around 10 instead of 8.  At the same time messengers struggle daily against their own companies, traffic, building security guards, and the elements. Because the job is physically hard, the challenges unique and potentially fatal, they become their own tribe.  People I knew outside the tribe tended to think of messengers as seen on TV, tatted up psycho punks, but the reality was more diverse.  I worked with some, but there were also Rastas, semi-pro cyclists, high school drop-outs, philosophy majors, hippies, immigrants, drug dealers that needed a cover, kids from poor neighborhoods, hillbillies, artists and people who were just lost in life and wanted some thrill.   Regardless of background, there was always a lot of booze and a variety of other substances being passed around. On payday people might go to a bar to celebrate, but we’d be equally happy brown bagging it in a park or an alley.

What I realized in time was that whenever community bonds include substance abuse, tragedy follows. There was always somebody or something to worry about- a person in jail, an injury that might not heal, or someone living on the street because their girlfriend dumped them. Messengers die, but not from getting hit by cars as my parents assumed.  Some die from being poor, having treatable health conditions that they can’t afford to get proper care for.  But more often they die slowly from the side effects of addiction: cirrhosis, seizures, heart attacks or cancers. Sometimes the cause is an intoxicated accident, an overdose, or a head injury. The first funeral I remember was for a boy that lost his life in a drunk bar fight.  Since then, at least a dozen people I worked with have passed away, at least one for every year I’ve been sober, making my own sobriety feel bittersweet.

Losing friends makes me angry, but what its opened my eyes too is the grief in my town, up and down the Appalachians, and throughout the country as a whole. It breaks my heart to know how pervasive that anger from grief is.  Every week I hear a story about someone who overdosed, or a parent who doesn’t know how to help their child.  People talk about needles found around town, or kids who are living in squalor because their parents are trapped. 

Anger and grief is everywhere, but yet there are many people still who don’t understand. They see the destruction and the town budget drained. They’ve had their houses broken into. They see the litter or bottles and needles in places they like to hang out.  While we can always do a better job of educating youth for prevention, most people already know that drugs and alcohol are bad. Most sober stories begin with that very sentence, “I knew what I was doing was wrong, but…”  People know the consequences of their actions, but other things stop them from caring. Meanwhile those around them, who have been making an effort to take care of themselves, bitterly carry the burden. Many people don’t know addiction is a mental illness, and since they haven’t suffered from it or watched a loved one try to break free, it’s hard to find compassion. 

0905-2017-08067014994580798And their bitterness is real. Between the lost productivity, the health care costs, and the criminal justice fees, we spend an estimated $520.5 billion dollars because of people’s addictions (That’s just drugs and alcohol.  I won’t even go there about smoking.)  That’s an incredible amount of money that could be used for schools, or roads, or just about anything but cleaning up a preventable mess.   The real pain isn’t even in the money wasted though; it’s in the destruction of our neighborhoods, the broken families, and the trauma it inflicts on children.

The pain causes a hardening of hearts. Churches around here don’t pray for addicts, and many have no group counseling or rehab focused programs, despite the second step being a calling to higher power. In conversations about what to do, at least one person will usually chime in that we should let them suffer their own consequences, like a person with addiction is not a life that needs sparing. Help should be diverted to people who appreciate it, or who have earned it more. Legislation in Ohio was proposed to create a 3 strike policy. Paramedics will revive an person from an overdose only twice before they just let them die.  But Addiction is an illness. No one wakes up saying, “I want to cause pain and suffering to all those around me today.” It’s more like an enslavement to self destruction that can be cause by a variety of reasons.  People need help, and while they may not always be ready to receive it, it’s our duty to give them the opportunity to find it when they are.

May is Mental Health Awareness Month and that includes addiction.  It’s not a purposeful descent into madness to wreak havoc on the rest of us, even though it can feel that way at times. The National Institute on Drug Abuse (NIDA) explains,

“Many people don’t understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.”

Currently, out of the 20 million people suffering from addiction, less than 3 million will actually seek treatment, which is pathetic.  Many people attribute this to the stigma surrounding addiction. That middle class culture where everyone is perfect makes it impossible for people to admit you have a problem. And the shaming of addicts for being morally reprehensible, for being villainous has made it embarrassing to confess to being one of those people.

Substance abuse has always been a problem in our country, but lately trends show that it’s getting worse, and the consequences have become more deadly. It’s not just my friends that are dying. Overdose deaths have quadrupled since 1999, largely to the opioid epidemic. Overdose is the leading cause of accidental death, surpassing deaths by car accidents, guns and AIDS at its peak. 

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 These statistics are horrifying, but they are only half the story.  Like my friends, people die twice as often from the long term damage of substance abuse. According to the CDC, the rate of alcohol related deaths is about about 88,000 people a year, and this article in the Washington Post cites research showing that this rate is at a 35 year high.


The other reason it’s important to talk about substance abuse during Mental Health Month is that many people who are addicts have a dual diagnosis of another mental health issue, like depression, PTSD, anxiety, bipolar disorder, or schizophrenia.  When we’re scratching our head in anger, wondering why someone is using drugs even though they knew better, this is often why.  It’s hard to determine an exact percentage of how many people are self medicating, but according to the National Survey on Drug Use and Health in 2014 (p. 32), at least 8 million people have co-occurring disorders.  In my experience that’s a low estimate.  Almost all people I knew with addictions were self medicating, and attempts to become sober were often short lived because they didn’t have resources to address the underlying cause.  

It’s hard to know where and how a person can fight against it,  because what feels like helping an addict is often enabling them, and what’s actually helping they will insist is ruining their life. The root of the addiction in our country spreads twice as far as the branches and trying to solve the problems it brings, for even one person, is like trying to rid the yard of dandelions. It seems like this evil is winning, that we are not powerful enough to fight against it, but we are not that way.

Pray.  “...We do not wrestle against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this age, against spiritual hosts of wickedness in the heavenly places.”(Ephesians 6:12)  This is addiction.  It’s undiluted evil, and it’s a spiritual battle for an person to break free. I am stunned about how few people are publicly praying on behalf of addicts, especially when you consider that almost everyone knows and loves someone who is struggling. We can pray for addicts seeking treatment, that they will find the support they need to get clean, and we can pray for the families that are broken and suffering in silent isolation. The people surrounding them need our prayers, too. Churches need resources for outreach; therapists and counselors need wisdom to diagnose; people running treatment centers need strength and patience. Also, the police, the first responders, jails, local leaders, and elected officers who are overseeing community efforts to fight addiction are understaffed and underfunded.

Pray for this evil to be crushed, but also pray about how you can fight against it.  As I mentioned in my last post, there are grandparents now raising their grandchildren who need babysitters.  There is a nationwide shortage of foster parents. Rehab centers have waiting lists and need beds, money and volunteers. Mentors are needed to teach people in recovery life skills, like how to budget or write a resume. Support a newly sober person by offering them a job or a second chance at friendship. Reach out to someone whose child or spouse is suffering. Sit with them at the hospital and teach them they have nothing to be ashamed of.  Many families have no idea where to look for help or answers, and they may need a shoulder to cry on, or someone to pray with them.  

Educate.  I’m stunned at the people who have been caught off guard by the power of addiction and the drugs on the market today.  Heroin is a problem today is because people had no idea that Oxycodone was almost the same thing in a prescription bottle. How many people would have avoided their addiction altogether if they had first been able to diagnose a mental disorder? The more we know about substance abuse, the stronger our communities will be against its influence.  The more we know about the warning signs of what addiction looks like, the less we will enable people to continue in it.   If we were an educated community, we would offer more support to the parents and relatives who feel isolated. Substance abuse is all over the news if you look for it.  Make an effort to research and read about what’s happening in West Virginia, Kentucky, Ohio, Florida, New Hampshire, and in your own state too. Don’t ignore this problem because it’s not happening to you.

Speak.  Lawmakers don’t tend to fund research for addiction recovery because it’s not on the lips or the minds of their constituents, so the cause gets shorted compared to other medical research.  There are no big 10K races or silicone bracelets sold to raise money for research on substance abuse disorder.  If we speak out, if we make this a major issue, lawmakers will fund more treatment centers. Advancements can be made to understand what addiction does to your brain and how we can counter those effects to help people find effective treatment. Teenagers may be more aware of the risks involved. So share articles you find that are important on social media. Talk to people in your church and community about what can be done for outreach. Speak out and make other people aware of what’s going on around you.

In addition to being a voice for legislation and action, you will also be a voice for people who still need help.  One reason the number of people seeking recovery is so small is because of the stigma surrounding it. Every single sober person can help to end that, by coming forward with their own recovery stories, or by listening and not judging those who have been through it. Sadly, stigma doesn’t end with addicts themselves, for the families that surround them are often ashamed to ask for help too.  In Portsmouth, Ohio, a town plagued by overdose, it took almost eight years of living with epidemic heroin use before any parents were willing to confess what was happening in their homes and form a support group.  Don’t let that be your town.  If you’ve recovered or have supported someone who has, tell your story.  Hiding it compounds the consequences. People who are struggling are listening whether you realize it or not, and they need encouragement, so speak out.


Faces & Voices of Recovery is an organization dedicated to lobbying on behalf of recovery and ending the stigma, because its not just an issue for vagrants and rock stars. Respected people everywhere- leaders, politicians, businessmen, athletes, etc. are in recovery too.  To share your story on social media use #ourstorieshavepower or #recoverymatters or go to their website  to learn more about joining their movement.

Substance Abuse is a scourge, not just an epidemic, but as a church we don’t treat it this way.  People even within our congregations are dying, kids are being raised by grandparents and towns across the country are crumbling under the cost. Spiritually speaking, how can we ignore that? Address it in your churches and with your friends. Pray about it and talk about what’s happening, because this evil grows in the presence of our apathy, anger, and resignation. Refuse to believe that the fight against addiction is hopeless, either for yourself, a loved one, or your community.  This is your problem, even if it doesn’t feel like it.  1 in 10 people have a problem which means no community is unscathed. So pray, educate, speak and step up.  Root the bitterness out, to love the brokenhearted, end the stigma and fight the grip of this pervasive evil.