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JUNK WINS BY DEFAULT: Dealing with stigma, treatment, prevention, and enforcement of the opioid epidemic in Wilmington

John Wolfe attends a panel about the opioid crisis in ILM.

In 1953 William S. Burroughs published a book, which, 65 years later, still has remarkable insight into some of the problems facing society today. Titled “Junky,” it details Burroughs’ experiences as a heroin addict and pusher in mid-century New York City. The book is one of the earlier texts to come out of the Beat Generation of writers (a.k.a. Beatniks), which includes Jack Kerouac and Allen Ginsberg. In the prologue, Burroughs asks himself the question people in his position frequently ask: Why does a person become a drug addict?

“The answer is he usually does not intend to become an addict,” Burroughs writes. “The question, of course, could be asked: Why did you ever try narcotics? Why did you continue using it long enough to become an addict? You become a narcotics addict because you do not have strong motivations in the other direction. Junk wins by default. I tried it as a matter of curiosity. I drifted along taking shots when I could score. I ended up hooked. Most addicts I have talked to report a similar experience. They did not start using drugs for any reason they can remember. They just drifted along until they got hooked. If you have never been addicted, you can have no clear idea what it means to need junk with the addict’s special need. You don’t decide to be an addict. One morning you wake up sick and you’re an addict.”

Given that our city held the dubious accolade of the highest rate of opioid abuse in the nation in 2016 (11.6 percent of the population which receives prescription painkillers abuse them; over half of the opioid prescriptions in the city are abused), perhaps his quote can help us frame the issue with a little compassion. There are many examples of works of art which try to give a human element to a horrible situation: Eugene O’Neill’s master play, “Long Day’s Journey Into Night,” describes an upper-middle-class family as it deals with the mother’s addiction to morphine. David Foster Wallace’s mammoth tome, “Infinite Jest,” centers around a halfway house in Boston and broken lives of the people there as they search for healing and recovery. They are difficult reads, but necessary if we are to think of people affected by the crisis not as drug addicts who deserve their fate, but as human beings like ourselves, who suffer from bad decisions and circumstances, but still are capable of change.

Removing the stigma surrounding drug addiction was one of the topics breached at the opioid crisis symposium meeting held last Monday evening. Coordinated by Congressman David Rouzer and hosted by local newscaster Francis Weller, the first of the four-panel discussion dealt with the stigma of addiction. “Bad opinions of a group of people cause those people to hide,” said Kenny House, a clinical addiction specialist who works with Coastal Horizons. “When stigma decreases, hope rises.”

For people to get help, he continued, it needs to become normal to talk about drug addiction like any chronic illness, such as diabetes or hypertension. The sooner it’s taken hold, the better, according to House. Representing the faith community was Pastor Mark Allen of Port City Community Church; Allen’s in recovery still from his own 22 year battle with addiction. He spoke of needing a spiritual component of recovery. “Church is for broken people,” he said.

The second panel discussion dealt with treatment and resources, and three recovering addicts were invited to the stage to share stories. They spoke of heartbreaking losses of family members and children, of “praying for death” every time they used, of accepting the life and labels of “criminal” and “addict.” One young man, who threw away a football scholarship for heroin and opiates, prompted Ms. Weller to describe him as an All-American kid, someone who every mother wants their son to grow up to look like. “You don’t look the part of an addict,” Ms. Weller noted.

“No one looks the part,” said House, emphasizing how addiction can happen to anyone, of any race or socio-economic group.

On the subject of prevention, Anne Hazlett of the US Dept. of Agriculture spoke of the particular impact the crisis has had on rural America. Rural communities often lack treatment facilities and are isolated, two factors which can lead to increased addiction. To combat it, she says the Dept. of Agriculture is looking for ways to increase prosperity in rural communities, and find new ways to use existing community infrastructure like schools, churches, rotary club and 4H to get out an anti-drug message. She ended with a powerful quote from writer Sam Quinones, from his book about the opioid epidemic, “Dreamland”: “The antidote to heroin is community.”

Dr. Phil Brown, the chief physician executive for the NHRMC network, listed some encouraging statistics to show the epidemic has gotten better since July 2016. Between January and March, there were 79 first-responder calls for overdoses, down from 124 in the same period last year. Through June there were 34 visits to the emergency department, down from 100 last year—a 64-percent decrease.

For the final panel, dealing with enforcement, Ms. Weller was joined by Jon and Ben David, the twin district attorneys for Brunswick and New Hanover counties. They spoke of the need to differentiate between drug users and dealers, and between opioids and heroin. The “War on Drugs” has changed into a “War on Drug Dealers”; the DA’s office intends to combat the problem by going after the supply of drugs available. And there’s no difference in their eyes between a gang member selling heroin on a street corner or a doctor writing unnecessary prescriptions. “If you’re peddling poison for profit in this county,” Ben David said, “we’re coming after you.”

So if, as Burroughs wrote, “you become an addict because you do not have strong motivations in the other direction,” what will it take to improve conditions in our society so people have something to live for besides heroin or pills? Is the reason why the problem is so widespread from the decay of our collective spirit … or of our value system … or lack of economic opportunity … or something else we’re not seeing? People are responsible for the consequences of their own decisions, no doubt; there can be no exoneration or excuse from that. If we want to claim we live in a civilized, compassionate society, though, we have to ensure the ladder upward and out of such a dark situation is in place … when an addict decides to reach for the rungs again.

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