mad citizen
Aug 8, 2017 · 9 min read

The story almost never changes: I find myself in a vaguely familiar place — an empty lot, a bus stop, an alley — copping. A faceless figure stands before me, and as I hand over an ambiguous quantity of crumpled cash, I feel the foreplay of shiny folded foils slip into the cradle of a trembling palm.

That’s when the clock begins.

In frantic anticipation, I search for a place to fix — a bathroom, a parking garage, an empty apartment building. Sometimes, I’ll find myself sitting on the bus, drowning in waves of anxiety, waiting for a stop that never comes. On the rare occasion that I do make it somewhere safe to cook, I’m missing something critical — a spoon, clean water, a cotton — and suddenly I’m up and running again. The details may vary, the specific shapes of shadows shift, but the feeling is always the same. I’m always just this close to spiking a vein and turning the whole grey wasteland into beds of golden honey.

And that is when I wake.

Even now, with my last hit years behind me, dreams like this come nearly nightly. My life today is boundless, filled with love and support, with passion and opportunity, with housing and stability — filled, that is, with everything a junkie eventually remits. It takes years of struggling, against sickness and statistics, to rebuild a life ravaged by addiction. And yet the ghosts of heroin haunt relentlessly: I can still taste the faint metallic sweetness creeping up the back of my throat, I can still smell the sour musk of quality dope, I can still see the blood swirling like smoke in the barrel of a syringe. Time, it seems, is incapable of dulling their weaponry.

Like most people today, my introduction to dope came in the form of pharmaceuticals. Opioid painkillers like hydrocodone, morphine, codeine, and oxycodone were relatively easy to find on the street, and so for a while prescription drugs like these were enough to maintain my habit. Eventually, however, the convergence of negative factors — like the linear correlation between tolerance and cost and the increase in abuse-deterrent formulas — drove me to conclude that switching to heroin was the fiscally responsible choice.

In retrospect, it is easy to see the extent to which regular substance abuse had already begun to change my psychology. The conversation of conscience was no longer about doing or not doing drugs, but rather how to stay high in the most reliable and affordable manner. There is still much to learn about individual predisposition to addiction, but certain common experiences among addicts point to preexisting mental illness as a substantial factor worth investigating. Perhaps the most profound pieces of anecdotal evidence are those that describe the holistically curative effect of heroin: My whole life, I felt like something was out of balance, like something fundamental was missing. I didn’t find it in religion, or relationships, or work, or school. I found it in dope. I remember my first hit vividly, as a wave of ecstatic relief washed over me — this is what I’ve been looking for all along.

This sentiment has been echoed by countless addicts, but its significance derives from more than its ubiquity. The conception of the opiate high as both physically and psychologically restorative contributes a great deal to justifications of habitual use, providing the addict with a sincere belief in self-medication. Especially once the glow of the honeymoon phase begins to degrade into the crumbling rubble of maintenance and sickness-prevention, the ability to frame the drug as medicine is an essential factor in the continuation of use. This justification is easily made for those who become addicted to pharmaceutical opioids, even once their use reaches beyond prescribed guidelines. Moreover, society has long been taught to accept the use of prescription drugs, and therefore remains inclined to generally acquiesce to their misuse. The widespread “social availability” of these drugs casts our communities as collective enablers, and highlights the imperative to pursue alternative treatments for chronic pain, prevent the over-prescription of opioids, and hold Big Pharma accountable for their aggressive campaigns of misinformation that continue to flood our most vulnerable communities with deadly chemicals.

While an unprecedented degree of compassion has coalesced around the current opioid epidemic, it remains unequal and, at times, misguided. Many have pointed out the double-standard between the national discussion of addiction today, and the frame of crime and victimization that dominated the crack era in they heyday of the War on Drugs. To be absolutely clear, the correct way of approaching a crisis of substance abuse and mental health is one of compassion; and just because entrenched structures of racism and capitalist oppression excluded that approach decades ago, doesn’t mean we can’t do better now. But if we are naive enough to believe that those very same engines of injustice are somehow now behind us, we will absolutely fail again.

Hypocrisies like these abound, but it’s more than just the “opioid vs crack” comparison. Here, on the West Side of Chicago, the illicit heroin market has been a fixture in poor communities, especially those of color, for decades — and the conditions that engender and sustain it are not unlike those of the Rust Belt or Appalachia. Neoliberal policies like privatization and globalization have enriched the billionaire class and devastated local economies and working families; inadequate funding has crippled public school systems and left countless young people behind; and disinvestment, social instability, and limited political power have further isolated these communities. According to the NIDA, environmental stressors like these greatly increase an individual’s potential for addiction (1) — but they also contribute greatly to the expansion of the drug market. As a society, we’ve begun to understand the addict’s need for support and access to rehabilitative programs, so why have we continued to persecute street dealers who’ve been backed into a corner by capitalist exploitation? Jimmy Simmons, a veteran community organizer from west Humboldt Park, was straight to the point: “Jobs, education — that’s what we need. Some of these guys, they say, ‘I’d love to have something else’” (2).

Indeed, readily available and publicly-supported treatment is fundamental to helping addicts kick the habit, but we need to go much further if we are to respond proportionally to the scale of the epidemic. If we are to achieve meaningful change, we must be open to radical solutions. Couldn’t petty dealers be diverted into job-training or -placement programs, rather than funneled into the open jaws of the criminal justice system? Smart reforms, from the way we treat chronic pain to the way we think about illicit markets, are necessary if we are to lift our communities up and out of these desperate cycles of pain, crime, and addiction. Even though the Trump campaign managed to rally parts of the Rust Belt around empty promises to “spend the money” on opioid treatment, the truth is even if he were sincere, it wouldn’t be enough. The reality of our situation is one of collective suffering — and so any policies rooted in traditional right-wing individualist ideology will prove insufficient.

Beyond treatment for those who have already been struck by the illness of addiction, we must take proactive measures to prevent its spread. In 2012, 259 million prescriptions for opioids were written in the US — enough to provide a bottle to every adult in the country (3). Taken together with the fact that 80% of all heroin users begin by abusing pharmaceutical opioids (1), it is painfully clear that we must stem the flow of these chemicals into our communities. The first step in this direction is to ensure the right to healthcare for all, educating those with chronic pain about alternatives to opioids and providing long-term solutions for health management. In addition, we must finally hold the Big Pharma cartel accountable. Multiple lawsuits have been brought against pharmaceutical giants for scamming both doctors and patients, downplaying the addictive risks posed by the drugs they manufacture and push (4).

More broadly, we must emphasize education and recommit to the empowerment of our communities. Beyond teaching our children the honest truth about substance abuse (not the failed fear-mongering of DARE), we must radically reorient our collective priorities. We cannot resign our educational systems to the profiteers, nor can we allow the format of public education to be one of bleak standardization and compartmentalization. We must abandon the metric of wealth in determining worth so that young people may be free of the manufactured stresses of imposed expectation and encouraged to develop their uniquely human capacities — regardless of socioeconomic class. But even beyond long-overdue curricular reforms and educational prioritization, we must envision a public system that empowers and nourishes the whole student, compensating in support for those who may lack it at home. The fact is we have not yet seen the true scope of the opioid crisis — an entire generation of young people are now coping with the trauma of growing up surrounded by its wreckage. Among other things, exposure to drug abuse during childhood significantly increases an individual’s chances of developing a substance abuse disorder themselves (5). If we fail to provide the love support our children require, a legacy of dope may prove to be the most tragic consequence of our national addiction.

It is certainly easier for some to place blame on the junkie for being weak — making poor choices, lacking self-control — rather than to identify the disease as a failing of society writ large. Indeed, for most of human history this was the case, and only recently have we begun to resist the self-righteous impulse to continue the course of marginalization. And though the rhetoric of compassion now dominates government press releases, the public conversation still profoundly lacks an existential understanding of addiction. While the compulsion to self-medicate is multifaceted and unique to the individual, it is nevertheless rooted in interpersonal relationships and societal structures. Relative positions like class, race, and gender produce pressures of expectation that manifest as self-imposed criteria, tying our conceptions of self-worth to the people and institutions that surround us. Perhaps most insidious is the weight we attribute to employment status and the accumulation of wealth and property — the ability to “provide” for one’s family as a determining factor in quality of being. A direct consequent of capitalist indoctrination, personal labor value has become one of the most fundamental parameters of personal identity and corresponding self-esteem. Depression, unemployment, and financial instability all correlate significantly to higher rates of substance abuse; and while a handful of politicians debate in dollars and talk of treatment, the rest of the neoliberal system keeps our communities awash in both pain and the painkillers to treat it.

Systematic racism, anti-poverty bias, dogmatic capitalism and the predatory markets it spawns have all conspired to create the national crisis of the opioid epidemic, and we will accomplish nothing if we fail to adopt a holistic strategy of both treatment and prevention. Yes, addiction is a disease in and of itself, but the exponential increase in its prevalence is directly caused by its ability to spread through the toxic and devastating framework of our current socioeconomic systems. As Pastor Michael Eaddy points out, the drugs won’t go anywhere until we address “systemic racial oppression and economic and educational deprivation” (6). Self-liberation will allow us to build collective power, and that collective power will serve the liberation of all. We must consider the profound despair that a crisis of this magnitude feeds on and perpetuates, and seek to humanize its sheer statistical scope. Doing so should make it absolutely clear that the only path forward is one of radical social redevelopment, radical rejection of capitalist indoctrination, and a radical redefinition of national values.

  1. Abuse, National Institute on Drug. “National Institute on Drug Abuse (NIDA).” NIDA, www.drugabuse.gov/.
  2. Dumke, Mick. “Besieged.” Chicago Reader, Chicago Reader, 8 Jun. 2017, www.chicagoreader.com/chicago/besieged/Content?oid=6141461
  3. Frostenson, German Lopez and Sarah. “How the Opioid Epidemic Became America’s Worst Drug Crisis Ever, in 15 Maps and Charts.” Vox, Vox, 23 Mar. 2017, www.vox.com/science-and-health/2017/3/23/14987892/opioid-heroin-epidemic-charts
  4. Berger, Sam. “The Senate Health Care Bill Would Give Millions to Drug Companies Accused of Helping Fuel the Opioid Crisis.” Center for American Progress, 30 June 2017, www.americanprogress.org/issues/healthcare/news/2017/06/30/435351/senate-health-care-bill-give-millions-drug-companies-accused-helping-fuel-opioid-crisis/.
  5. Lurie, Julia. “Children of the Opioid Epidemic Are Flooding Foster Homes. America Is Turning a Blind Eye.” Mother Jones, 5 July 2017, www.motherjones.com/politics/2017/07/children-ohio-opioid-epidemic/.
  6. Holpuch, Amanda. “A Chicago Neighborhood’s Endless Battle to Stop Open Air Drug Markets.” The Guardian, Guardian News and Media, 20 Dec. 2015, www.theguardian.com/us-news/2015/dec/20/chicago-street-drugs-garfield-park

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