I like this particular series as it allows me a less formal mode of discussion. This is an imperfect piece told in a halting style. Confessional really. It is also somewhat cathartic. To be able to casually air my opinions thus frees mental space and emotional energy for my more formal commitments. This particular piece is about a revolution that never happened. It is about the loss of potential energy. It is about a historic moment that occurred, and one that we largely missed. It highlights our failures, but it also highlights our strengths. Unlike other populations, we share an identity and a set of values that allows us to reconnect, whenever we choose, to the roots of who we are as a community. I believe this re-connection is upon us. And I believe if we return to this, we will find our way forward again as a social movement.
When the Cavalry Never Came.
The opioid crisis brought forth the discussion of addiction and recovery with such force and immediacy that a revolution seemed around the corner. The Recovery March in Washington, and Obama, on stage with advocacy leaders at the Heroin Summit in Atlanta. Suburban Moms were politically active and organized in ways not seen in years.
But it never arrived.
Instead, Big Pharma dusted off decades-old medication, rebranded, reformulated, and co-opted the message. “Death Prevention!” (for a small fee) became the rallying cry.
For the first time in a long time, white suburban folks were riled up as their “good kids” with “bright futures” were stolen from them. A massive flood of prescription drugs made experimentation easy. Street heroin was cheap. Then came the poisoned supply. The deaths evolved, multiplied, spread. Middle- and working-class American families united in a way that has not occurred in a long time. Why did there seem to be such force for a revolution that was so quickly diffused?
The revolution never arrived. Treatment didn’t get easier to access, or better, or longer.
For the first time, a classically empowered demographic bore the brunt of corporate greed and government glad-handing. Having always been empowered in middle-class liberal American society, they quickly turned to the experts. Having little experience with the shady and unpredictable treatment space, the age-old mutual-aid societies that spoke of God, the exorbitant cost of care, and the rejection by insurers to actually pay for treatment in any equitable way- this population was forcefully reminded about the ways our society has always treated those with addiction. They saw how dangerous, precarious, and what a gamble recovery really was. They demanded “something must be done” lest they suffer the senseless and preventable loss of a loved one. They felt for the first time: ineffectual — not a position they were familiar with. Their fear drove them back to the white coats who so easily offered opioids in the first place. They turned to the politicians who took donations from the pharma industry. They were bedazzled by terms like “evidence-based” and “randomized control trial” and “gold standards.” These folks shouted from the rooftops, with all the power amassed at their fingertips through class, politics, and power- that they were NOT going to lose THEIR child to THIS!
Their children died despite this. They died despite medication, despite hundreds of thousands spent on treatment, despite their activism and despite their letters to their representative. There were a few voices lifted. Tragedy, grieving mothers, giving inspirational talks to clinicians and community organizations. They donated money to causes, created RCOs, were rewarded with time behind closed doors with influential people to share their heartbreak. They told their story over and over to people who could do something. And yet, more children continued to die.
Marginalized populations, people of color, communities of color, vulnerable people: They already knew that when the chips were down and lives were on the line that a handshake and a smile meant nothing. Overlooking their wisdom now haunts White Suburban America.
Despite having roused a classically privileged class of Americans to a singular social cause, uniting them with those already suffering, even this could not spark a real revolution in healthcare, treatment, or expand free community services. Sure, some stigma was challenged, limited grants were given, limited lifesaving medication was expanded. There were some wins. Local wins mostly; small pockets of social innovation, here and there, but no cataclysm. Politician were at least paying lipservice.
And now, new narratives emerge rehashing a (new) meth panic (Hint: Meth never went away), trying to create the next wave of outrage to shore up funding and grants. The die has been cast. This will now be the way cycles of panic, medicine, finance, and science will go regarding drugs. At least for a while. It’s marginally better than the “tough on crime” stance and “superpredators” discourse of the 80’s. But even then, it took white victims to even open the door.
But, in the end, those that have been around the world of treatment and recovery know the truth. People with substance use issues will always be left behind by the corporations, the politicians, the establishment. This has always been the case. If this crisis didn’t spark revolutionary change, little will. It’s too easy to placate with half measures, too easy to look away, and it is just too easy for a politician to shake your hand, offer some money to the cause, and move on. Moneyed interests are too deeply entrenched in our political system. White suburban victims prompted begrudging overtures masked as genuine concern.
Let’s be honest. From the top down: What has changed? The average person tonight, right now, struggling to survive addiction, struggling to keep it together, struggling to create a life despite their addiction, struggling to raise a family, struggling not to get sick, struggling to find even a warm place to sleep- is that person any better off today, than they were ten years ago? Do they suddenly find themselves awash in a plethora of opportunities to be safer? Connect with others? Find a home? Find a community? Get medical attention? Have the nation’s treatment centers suddenly flung open their doors and welcomed, triaged, and embraced everyone seeking help? For most, the answer is no.
The cavalry is not coming.
So what do we do? What should we do?
We start with what is working. We do more of it in more places. We shelter in place; we look after one another, we donate our time, we give freely of ourselves, we make late-night phone calls, we pull favors, we get people into treatment- In short, we do what we have always done. We just have to do more.
But most importantly, we need to think deeply about the endgame. Why are we going to dry wells to drink? Why do we insist that behind the next blue-ribbon commission, after the upcoming summit, the next working group, the next trip to DC, that somehow, just around the next corner, the doors will open, and we will get what we need? All we have ever acquired; we have created ourselves- by and for ourselves. We are the revolution. What we have always done is revolutionary. We need to think hard about our roles. How can we best serve those still struggling? Right now.
Naivety may have cost us time and lives. Our belief that the system MUST respond THIS time was perhaps misplaced. We need to consider the facts. We need to look at history.
Some of you are already doing this. Some of you already know this. I see you. In those dark alleys, handing out syringes that you are not supposed to, giving away free overdose reversal, offering tips and intelligence to the street, highlighting the injustices of the drug war, calling out corrupt politicians, cops, pharma, and the general establishment bullshit. Some of you are organizing and activating your community, establishing places, and organizations that are the vanguard of the future. And you’re doing it ethically, with grit, in the interest of the people for the benefit of those who suffer.
We all need to do more. Even if that just means dusting off your old Big Book and hitting meetings again to sponsor a few people, even if that just means offering your time to an organization, or getting trained as a SMART facilitator, and even if it just means getting back into the practice of daily compassion. We all need to do more. We are all we have, and we are all there ever has been. We must make use of what is offered, but we do not fool ourselves about the consistency or motives of the source. We must build our shelter as if the cavalry may never arrive. Solidarity is our only hope.
Courtesy: AP News Photo
2 thoughts on “Back To Basics- Vol 2: Losing the Revolution”
Wow. You have eloquently expressed many of my innermost thoughts. As a family member of one of the appropriately defined privileged new addicts & also as a career practitioner of community pharmacy I have had the unfortunate perspective of this drama unfold in 3D. However this isn’t new. The world has always liked its morphine. It’s just a new consumer this time around. It’s a game changer in our lifetime. We have now achieved a shorter life expectancy in the U.S. Amazing!!! And do we think that it’s just from heroin & meth!!! No but we gotta start somewhere. I wish that I had written your essay but Thank You for your words! They are the truth & only we can be our own calvary…starting today. God Bless.
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