Over time, AIDS worked its way through the political system.
More than anything else, it destroyed the closet and massively accelerated our culture’s acceptance of the dignity and humanity of homosexuals. But with the opioid crisis, our politics has remained curiously unmoved. The Trump administration, despite overwhelming support from many of the communities most afflicted, hasn’t appointed anyone with sufficient clout and expertise to corral the federal government to respond adequately.
The critical Office of National Drug Control Policy has spent a year without a permanent director. Its budget is slated to be slashed by 95 percent, and until a few weeks ago its deputy chief of staff was a twenty-four-year-old former campaign intern. Kellyanne Conway—Trump’s “opioid czar”—has no expertise in government, let alone in drug control. Although Trump plans to increase spending on treating addiction, the overall emphasis is on an even more intense form of prohibition, plus an advertising campaign. Attorney General Jeff Sessions even recently opined that he believes marijuana is really the key gateway to heroin—a view so detached from reality it beggars belief. It seems clear that in the future Trump’s record on opioids will be as tainted as Reagan’s was on AIDS. But the human toll could be even higher.
One of the few proven ways to reduce overdose deaths is to establish supervised injection sites that eventually wean users off the hard stuff while steering them into counseling, safe housing, and job training.
After the first injection site in North America opened in Vancouver, deaths from heroin overdoses plunged by 35 percent. In Switzerland, where such sites operate nationwide, overdose deaths have been cut in half. By treating the addicted as human beings with dignity rather than as losers and criminals who have ostracized themselves, these programs have coaxed many away from the cliff face of extinction toward a more productive life.
But for such success to be replicated in the United States, we would have to contemplate actually providing heroin to addicts in some cases, and we’d have to shift much of the current spending on prohibition, criminalization, and incarceration into a huge program of opioid rehabilitation. We would, in short, have to end the war on drugs. We are nowhere near prepared to do that. And in the meantime, the comparison to ACT UP is exceedingly depressing, as the only politics that opioids appear to generate is nihilistic and self-defeating. The drug itself saps initiative and generates social withdrawal. A few small activist groups have sprung up, but it is hardly a national movement of any heft or urgency.
And so we wait to see what amount of death will be tolerable in America as the price of retaining prohibition. Is it one hundred thousand deaths a year? More? At what point does a medical emergency actually provoke a government response that takes mass death seriously? Imagine a terror attack that killed over forty thousand people. Imagine a new virus that threatened to kill fifty-two thousand Americans this year. Wouldn’t any government make it the top priority before any other?
In some ways, the spread of fentanyl—now beginning to infiltrate cocaine, fake Adderall, and meth, which is also seeing a spike in use—might best be thought of as a mass poisoning. It has infected often-nonfatal drugs and turned them into instant killers. Think back to the poison discovered in a handful of tainted Tylenol pills in 1982. Every bottle of Tylenol in America was immediately recalled; in Chicago, police went into neighborhoods with loudspeakers to warn residents of the danger. That was in response to a scare that killed, in total, seven people. In 2016, twenty thousand people died from overdosing on synthetic opioids, a form of poison in the illicit drug market. Some lives, it would appear, are several degrees of magnitude more valuable than others. Some lives are not worth saving at all.
* * *
One of the more vivid images that Americans have of drug abuse is of a rat in a cage, tapping a cocaine-infused water bottle again and again until the rodent expires. Years later, as recounted in Johann Hari’s epic history of the drug war, Chasing the Scream, a curious scientist replicated the experiment. But this time he added a control group. In one cage sat a rat and a water dispenser serving diluted morphine. In another cage, with another rat and an identical dispenser, he added something else: wheels to run in, colored balls to play with, lots of food to eat, and other rats for the junkie rodent to play or have sex with. Call it rat park. And the rats in rat park consumed just one-fifth of the morphine water of the rats in the cage. One reason for pathological addiction, it turns out, is the environment. If you were trapped in solitary confinement, with only morphine to pass the time, you’d die of your addiction pretty swiftly too. Take away the stimulus of community and all the oxytocin it naturally generates and an artificial variety of the substance becomes much more compelling.
One way of thinking of postindustrial America is to imagine it as a former rat park, slowly converting into a rat cage. Market capitalism and revolutionary technology in the past couple of decades have transformed our economic and cultural reality, most intensely for those without college degrees. The dignity that many working-class men retained by providing for their families through physical labor has been greatly reduced by automation. Stable family life has collapsed, and the number of children without two parents in the home has risen among the white working and middle classes. The internet has ravaged local retail stores, flattening the uniqueness of many communities. Smartphones have eviscerated those moments of oxytocin-friendly actual human interaction. Meaning—once effortlessly provided by a more unified and often religious culture shared, at least nominally, by others—is harder to find, and the proportion of Americans who identify as “nones,” with no religious affiliation, has risen to record levels. Even as we near peak employment and record-high median household income, a sense of permanent economic insecurity and spiritual emptiness has become widespread. Some of that emptiness was once assuaged by a constantly rising standard of living, generation to generation.
But that has now evaporated for most Americans.
New Hampshire, Ohio, Kentucky, and Pennsylvania have overtaken the big cities in heroin use and abuse, and rural addiction has spread swiftly to the suburbs. Now, in the latest twist, opioids have reemerged in that other, more familiar place without hope: the black inner city, where overdose deaths among African Americans, mostly from fentanyl, are suddenly soaring. To make matters worse, political and cultural tribalism has deeply weakened the glue of a unifying patriotism to give a broader meaning to people’s lives—large numbers of whites and blacks both feel like strangers in their own land. Mass immigration has, for many whites, intensified the sense of cultural abandonment. Somewhere increasingly feels like nowhere.
It’s been several decades since Daniel Bell wrote The Cultural Contradictions of Capitalism, but his insights have proved prescient. Ever-more-powerful market forces actually undermine the foundations of social stability, wreaking havoc on tradition, religion, and robust civil associations, destroying what conservatives value the most. They create a less human world. They make us less happy. They generate pain.
This was always a worry about the American experiment in capitalist liberal democracy. The pace of change, the ethos of individualism, the relentless dehumanization that capitalism abets, the constant moving and disruption, combined with a relatively small government and the absence of official religion, risked the construction of an overly atomized society, where everyone has to create his or her own meaning, and everyone feels alone. The American project always left an empty center of collective meaning, but for a long time Americans filled it with their own extraordinary work ethic, an unprecedented web of associations and clubs and communal or ethnic ties far surpassing Europe’s, and such a plethora of religious options that almost no one was left without a purpose or some kind of easily available meaning to their lives. Tocqueville marveled at this American exceptionalism as the key to democratic success, but he worried that it might not endure forever.
And it hasn’t. What has happened in the past few decades is an accelerated waning of all these
traditional American supports for a meaningful, collective life, and their replacement with various forms of cheap distraction. Addiction—to work, to food, to phones, to television, to video games, to porn, to news, and to drugs—is all around us. The core habit of bourgeois life—deferred gratification—has lost its grip on the American soul. We seek the instant, easy highs, and it’s hard not to see this as the broader context for the opioid wave. This was not originally a conscious choice for most of those caught up in it: most were introduced to the poppy’s joys by their own family members and friends, the last link in a chain that included the medical Establishment and began with the pharmaceutical companies. It may be best to think of this wave therefore not as a function of miserable people turning to drugs en masse but of people who didn’t realize how miserable they were until they found out what life without misery could be. To return to their previous lives became unthinkable. For so many, it still is.
If Marx posited that religion is the opiate of the people, then we have reached a new, more clarifying moment in the history of the West: opiates are now the religion of the people. A verse by the poet William Brewer sums up this new world:
Where once was faith,
there are sirens: red lights spinning
door to door, a record twenty-four
in one day, all the bodies
at the morgue filled with light.
It is easy to dismiss or pity those trapped or dead for whom opiates have filled this emptiness. But it’s not quite so easy for the tens of millions of us on antidepressants, or Xanax, or some benzo-drug to keep less acute anxieties at bay. In the same period that opioids have spread like wildfire, so has the use of cannabis—another downer nowhere near as strong as opiates but suddenly popular among many who are the success stories of our times. Is it any wonder that something more powerful is used by the failures? There’s a passage in one of Brewer’s poems that tears at me all the time. It’s about an opioid-addicted father and his son. The father tells us:
Times my simple son will shake me to,
syringe still hanging like a feather from my arm.
What are you always doing, he asks.
Flying, I say. Show me how, he begs.
And finally, I do. You’d think
the sun had gotten lost inside his head,
the way he smiled.
To see this epidemic as simply a pharmaceutical or chemically addictive problem is to miss something: the despair that currently makes so many want to fly away. Opioids are just one of the ways Americans are trying to cope with an inhuman new world where everything is flat, where communication is virtual, and where those core elements of human happiness—faith, family, community—seem to elude so many. Until we resolve these deeper social, cultural, and psychological problems, until we discover a new meaning or reimagine our old religion or reinvent our way of life, the poppy will flourish.
We have seen this story before—in America and elsewhere.
The allure of opiates’ joys is filling a hole in the human heart and soul today as they have since the dawn of civilization. But this time, the drugs are not merely laced with danger and addiction. In a way never experienced by humanity before, the pharmaceutically sophisticated and ever-more-intense bastard children of the sturdy little flower bring mass death in their wake. This time, they are agents of an eternal and enveloping darkness. And there is a long, long path ahead, and many more bodies to count, before we will see any light.
Just Say Yes to Drugs
May 25, 2018 | NEW YORK magazine
The great mystery to me of psychedelic experiences is the centrality of love.
I mean, why is it love exactly—overwhelming love—that so many experience under the spell of these molecules? When I first dabbled in the expansion of consciousness, I assumed it was simply some kind of wish fulfillment. Maybe as your ego relaxed a little, and your eyes opened for a while, you felt what you always wanted to feel, loved. But that wasn’t quite right, because at the same time, I found myself overwhelmed with the feeling of love for others, for boundless compassion, sometimes almost painful empathy. I felt more nearly the hurt I had caused others, but instead of being convulsed with guilt, as was usually the case, I experienced only the urge to ask forgiveness and love some more. As I grew more experienced with MDMA (aka Ecstasy), and then psilocybin, and eventually LSD, this sense of love only deepened.
In Michael Pollan’s astounding new book, How to Change Your Mind, he expresses the same thing: “The flood tide of compassion overflowed its banks… a cascading dam break of love… ‘I don’t want to be so stingy with my feelings.’ And, ‘All this time spent worrying about my heart. What about all the other hearts in my life?’ ” And yes, this all sounds unbelievably trite. Pollan, who writes seamlessly about his own experiments in psychedelics as well as the exciting discoveries in mental health now opening up before us, puts this perfectly: “Love is everything.… A platitude is precisely what is left of a truth after it has been drained of all emotion. To desaturate that dried husk with feeling is to see it again for what it is: the loveliest and most deeply rooted of truths, hidden in plain sight.”
I have felt this every single time I have ingested a psychedelic. Sometimes it overwhelms me as a metaphysical truth; at others it seems to be incarnated in everything around me, especially when I take what I blasphemously call my annual “Jesus Day” alone in the dunes at the end of Cape Cod, and invite the beauty inside of me. And then there are the moments when this love simply fuses with awe—watching the dawn break over the mountains surrounding the playa at Burning Man; sometimes it comes to me in the form of the Holy Spirit, on the wind and in my oddly opened lungs.
Much of my religious upbringing and strict moral code had informed me that this kind of experience was wicked. I am too young to have experienced the sixties, but old enough to come of age in their aftermath, and to absorb the counterrevolution of the time. This stuff made you crazy; it wrecked an entire generation; it leads to social breakdown; it can lure you into a vortex of addiction—you know the drill by now. Above all: God forbade it. And yet all I can say is that in reality, when I gingerly ventured into the kaleidoscope, this was precisely the opposite of what I felt. This, it immediately impressed upon me, was an intimation of godness; it opened my heart to the divine; this was a sacrament, a fusing of the material with the ineffable. Pollan tells the story of a woman called Mary who ate two or three spoonfuls of mushrooms one day and, she told him, “had the most profound experience of being with God. I was God and God was me.”
The neuroscience of this is fascinating, as Pollan pellucidly explains: psychedelics disarm what’s called the Default Mode Network in your brain, the part of it that keeps you alert to danger, performing tasks, scanning the future, remembering the lessons of the past, doing, doing, doing. Some argue that this is the part of the brain we developed later in our evolution, the ego, the engine of natural selection, harnessing our intelligence to order and survival. It edits your experience, stripping out the unnecessary, ordering the whole. It is the governing reason of which the ancients spoke. But behind that DMN is the rest of our consciousness—the being, not the doing. We are much more in touch with this when we’re children, when we have not developed the experiences that allow us to predict easily, edit swiftly, and get about our business. The child’s wonder, her simple, unfiltered absorption of the world’s mystery and awe: this is what a psychedelic experience can mimic in a way. Unless you are like a child, you will not enter the kingdom of heaven.
And so you see things as if for the first time. There were times in my adult life when this happened before, without any assistance: strange, fleeting moments of transcendence. I was walking through a garden in college one day, and noticed a daffodil. The spell lasted less than a minute, but for that time I actually saw it. It seemed suspended in time and space, shimmering, communicating, alive. Wordsworth finally made sense! It came again years later in Boston, when a tree rustled in front of me: I can’t re
ally explain it, but it filled me with a sense of gratitude and awe. Pollan describes taking a piss in the middle of a psilocybin session: “The bathroom was a riot of sparkling light. The arc of water I sent forth was truly the most beautiful thing I had ever seen, a waterfall of diamonds cascading into a pool, breaking its surface into a billion clattering fractals of light.” Imagine that every time you go to the bathroom!
And then there was the vividness of the trees and fallen leaves in the forest surrounding the meditation center I spent ten silent days in a couple of years ago. I realized then that the insights I had gained from psychedelics were indeed available without the drugs. Meditation disarms the ego as well, unpicking the Default Mode Network, bringing you back to your more basic self (“waking up,” as Sam Harris would put it) and to the joy of reality. That’s why the Buddhists talk of the nonexistence of the self, a doctrine I have had a devil of a time wrapping my DMN around most of my life.
But for me, the psychedelic experience is also deeply Christian. This, it seems to me, is how and who Jesus is and was: the incarnation of the love that these experiences reveal to you—and always suffused with it; not romantic love or friendship, but that universal agape that seems abstract to me at times, but that some small mushrooms have sometimes uncovered. My DMN knows, of course, that this is heresy, that there is only one sacrament that you can eat and enter into godness. The rest of me knows that the idea of heresy itself is the DMN’s work.
And the word “drug,” like “psychedelic,” is horribly loaded. Like the miraculous weed, psilocybin comes from the earth. LSD comes from bacteria. They are not addictive; yes, they can be abused, but very few who have had a psychedelic experience want to have it again and again. There is something profound about it that stays with you, for a long time. You see something you cannot unsee. And that space of unity and compassion is always something you can reach back to, a mountaintop you can see from a distance. It helps the most addicted smoker quit, simply because, in the context of awe and love, smoking becomes irrelevant. It reconciles people to death, the way religion used to. It can break depression—by scrambling the furrows and rigid patterns of thought that keep us in a groove of self-orbiting misery. The medical potential is extraordinary.
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