Healing America’s Opiate Epidemic with Community

Journalist and author Sam Quinones visited Thacher recently to share the insights he gained while researching his most recent book: Dreamland: The True Tale of America’s Opiate Epidemic. After delivering a head’s invite lecture in the Milligan Center he held a follow-up Q and A session in the Thacher Room. (See below for a sample of the exchange.)

 

Despite what we often hear, Quinones said, the crisis is not confined to communities facing extreme economic hardship. Instead, he argued, the epidemic has been fueled by a breakdown in our social fabric and the increased isolation faced by many Americans, regardless of their socioeconomic situation. 

 

Quinones concluded his talk in the Milligan Center on a hopeful note and reported that the grass roots organizations that have mobilized in response to the crisis—such as churches, local associations, and chambers of commerce—are collaborating with law enforcement and healthcare to reestablish some of the communal ties needed to reverse the epidemic and help the healing.

 

 

Reported by Ian ’20

 

The problem with the opioid crisis as a whole is that big pharmaceutical companies are constantly looking for something to solve. They don’t tend to have a problem then solution mindset—the solution is often there and they try to match it to a problem. As a result, we now have pills for almost everything.

The issue with this is that we are, or a large number of the people are, relying on drug companies for wellness, and they basically help fuel the growth industry of drug treatment as a result of their addiction. In reality, wellness is up to us. It’s up to our ability to connect with other people and to stop being cooped up.

I actually lived in México for 10 years, and having done so, I developed a very nuanced view of the place.

Regarding the immigrants that try and come to the United States: people have risked death to leave Mexico. They don’t immigrate just for the fun of it. They move with seriousness, with reason, but at the same time, it’s very complicated. It has to do with the fact that if you are born in America without power, there is a chance to rise to power. If you are born in Mexico without power, there is no chance. People who work the hardest are, unfortunately, the poorest and the ones who make the least. Mexico, essentially treats the poor people poorly—and they can find justice here in the States.

Another complication is the potency of our economy. A lot of what goes down in Mexico is a direct result of our drug demand and a large portion of the guns used to kill people in Mexico are made in the United States as a result of our very liberal gun laws.

Working and living there has given me a complete view of Mexico and I think that my books can give you a complete view that is complicated. The ideas are not easy to distill into tweets, and the ideas are not easy to polarize. Both people who say, “I love Mexico because the people are nice,” as well as, “I hate Mexico because their people are stealing our jobs” have flawed views, because neither one is accurate nor complete. And so, I have a love-hate relationship with the country.

Methadone, vivitrol, whatever else: these drugs are tools. You cannot solve addiction with a pill and be done, dropping the problem. Addiction is also about relapse, and relapse is trickier now. I met a fellow in 1996, who quit smoking. It took him nine tries. He didn’t die from relapsing then, but now, relapse is deadly.The larger issue or goal at hand is life repair, which needs to be combined with something else. 

Such drugs are important, but they cannot be the only thing. There needs to be a wide array of programs, especially the need for a community approach. It’s about filling the little cracks. You need help getting clothes, paying off paroles, driving licenses, etc. The primary thing is a continuum of care. I had a heart attack—I was a cardiac patient, but I also won’t stop being one. I go to the doctor for post checkups, health questionnaires, etc. I am not just a patient during surgery.

A large part of the solution is the power of going outside and just doing things with other people—particularly during this time when people are isolated. There are a lot of reasons for people to be alone, and it is a lot easier to do so. People, however, need an excuse to have contact with others. Having started Street Head [an event in Quinone’s neighborhood], I see it as an easy way for people who might want more contact but didn’t know how to get started. After doing this for a while, I think it’s good to see that people are now growing up with others around them.

None of this can happen all at once, but I know I can do small things step by step.

I think that being hard doesn't work, and that people have a misconception about cops. I see a lot of communities thinking that they don’t care, but in reality, the police are the ones who see those addicted every day. They want to help, and they are people after all—a lot of them are filled with compassion for their fellow man, and they also just don’t want to be blamed any more.

What I am not saying, however, is that we should just be lax on crime. We should definitely be tough with violent crime: rape, murder, etc., but there is another large segment of the population where being tough on crime doesn’t apply. In cases like drug court, there are so many people there. I see cops, probation officers, social workers, prosecutors, judges, and more. People were there to help, and they all knew everything and wanted to know what was going on with their specific client. The attention for people undergoing the addiction crisis is and should be more individualized—it isn’t a matter of numbers.