by Mark Gabrish Conlan • Copyright © 2016 by Mark Gabrish Conlan • All rights reserved
My “feature” last night was a two-hour Frontline special, “Chasing Heroin,” based on an epidemic of
heroin abuse that has grown to such proportions it has even made the
Presidential campaign (it’s been mentioned in the Republican and Democratic
Presidential debates, from which this show features clips of Carly Fiorina,
Chris Christie — remember them? — and Hillary Clinton discussing it). Written,
produced and directed by Marcela Gaviria, and narrated in the usual comforting
tones of Will Lyman (PBS’s go-to narrator when he isn’t doing BMW commercials),
“Chasing Heroin” is a peculiarly schizoid show. The first half is a relatively
conventional exposé documentary about how Purdue Pharmaceuticals, the inventor
of Oxycontin (its root drug, oxycodone, is not new but they patented a
time-release version that they claimed would make it more difficult to become
addicted), marketed the drug with a big-time campaign that told doctors they
were undermedicating people with severe cancers and other diseases that caused chronic
pain. A large part of that was due to the U.S.’s “War on Drugs” mentality and
the belief that even people who were terminally ill shouldn’t be put on opioid
pain medications for fear that they would become addicts. So under the lash of
Purdue’s ad campaign (including a video filmed with a doctor who’s since had
second thoughts), prescriptions for Oxycontin, Vicodin and other easily abused
painkillers went up. Then people started noticing that folks were offing
themselves on these drugs, and even when they weren’t O.D.’ing they were buying
or selling pills on an illegal black market and “doctor-shopping” (seeing more
than one physician at once) to get more of these drugs, while some doctors were
setting up “pain mills” in which prescribing opioids had become their main
business and source of income. So, partly because as expensive as
pharmaceutical drugs are in the U.S. they cost even more when you have to get
them illegally; partly because the Mexican drug cartels were looking for new
markets and finding them in the nice white suburbanites who had become addicted
to opioid pills; and partly because the “hard stuff” was actually cheaper and
had lost much of its stigma, many people who’d become opioid addicts through
pain pills turned instead to illegal but easily obtainable heroin.
The result
was that heroin has leaped out of the communities of color that are the first
people most Americans think of as being vulnerable to illegal drugs (never mind
that in the real world whites are just as likely per capita, if not more so, to become drug abusers) and not
only into white communities, but white suburban communities whose members (the ones who weren’t
using, anyway) had long thought of their towns as safe havens from all the
evils of the inner city, including drugs. The second half of the show dealt
with a pioneering program in Seattle (our friend Garry Hobbs, who lives there,
watched the first hour and 15 minutes of the program with us and recognized a
lot of the locations; he also noticed that he’s personally seen discarded
needles in areas where none existed just two years ago) called LEAD (which
stands for Law Enforcement Assisted Diversion), whose mantra is harm reduction. Specifically, under LEAD the cops
involve social workers who not only assist addicts in finding treatment
programs and other kinds of help (including housing, since a lot of drug users
end up on the streets) but are willing to work with them even if they’re still
using, knowing that you can’t expect a heroin addict to quit cold turkey until
they actually are admitted to treatment and can detox and go through withdrawal
with professional help. What’s more, the treatment can include methadone,
suboxone, buprenorphine or some other opioid substitute drug — the cops and
staff of LEAD aren’t insisting that people live a totally drug-free life — even
though methadone treatments are hard to come by because there’s been a lot of
NIMBY’ism towards where they’re
located, which means a lot of people on methadone have to start their day by
driving (or having someone drive them) three or four hours just to get to the
treatment center. (Federal law prohibits doctors from simply prescribing
methadone for use at home; if you’re on it, you have to get it at a licensed
clinic so professional staff can see you’re taking it and not abusing it or
taking it off premises to sell it — which may be why it’s generally dispensed
as a liquid, much like those old vending machines that sold soda by dropping a
paper cup into place and then automatically pouring soda into it.)
We follow
three people in the LEAD program: Johnny Bousquet, who used to be a successful
music producer in Seattle until he got hooked first on pills and then heroin
following his breakup with his wife (and his addiction has meant he hasn’t been
allowed to see their kids in years), ultimately ending up on the streets; Cari
Creasia, a heavy-set, black-haired suburban wife and mother who got hooked on
pills, eventually started using heroin, and ended up in a filthy drug den where
she and 20 other people slept in a small house and lived in squalor; and
Kristina Block, a 20-year-old who’s been on heroin for about three years, makes
$1,000 a week (which is considerably better than I’m doing these days!)
stealing and turning tricks, and of course shoots virtually all of it into her
arms, since one of the cruelest effects of heroin is you totally lose all
interest in anything else,
including food. (That’s the main reason heroin users generally — though not
always — become incredibly thin: both the drug itself and the constant struggle
to make enough money to score kill off any normal appetites, not only for food
but sex as well. The Andy Warhol-Paul Morrissey film Trash dramatized this quite well in its opening scene of
the addict couple, played by Joe Dallessandro and Holly Woodlawn, at home alone
and interested in nothing else but their next score.) Eventually the LEAD
officials get Johnny into treatment — after a 40-mile journey to a facility in
which he’s been promised a bed, only to be turned down once he arrives because
there’s no room (“at the inn,” I couldn’t help but joke) — only he relapses
after he’s apparently got clean, not on heroin but on methamphetamine (an even
worse drug from what I’ve heard of it, including users I’ve known), and gets
kicked out of the sober living facility he was in just when it looked like he
was getting on his feet and starting to play music again (his room at the sober
living facility contained a guitar and an electronic keyboard). Cari gets
busted for small-time dealing (a lot of users, like Amway distributors, sell in
order to finance their own supplies) just a few days before her scheduled
“graduation” from drug court, so her release is delayed four months. At the end
Kristina tells the LEAD people she’s finally ready for treatment — though if
nothing else the show has demonstrated that “treatment” is hardly the panacea
it’s often depicted as in the media; people are constantly getting “treated”
and then going back to drugs, and it seems that once you become addicted there
will be a tug-of-war between you and the substance for the rest of your life,
whether that’s drug-shortened or not.
The film offers a mixed view of 12-step
programs, saying they work for some people but not for others (I remember
reading once that for alcoholics — not drug addicts, though the numbers may be
similar — AA had only a 25 percent success rate, and the only reason the
program is held in such high repute is every alternative method does even
worse), and to me the most chilling scene was an interview with researcher Dr.
Nora Volkow, who claims that vulnerability to opioid addiction is 50 percent
genetically determined. “Fifty percent of our vulnerability to become addicted
is genetically determined,” Dr. Volkow says. “And the other 50 percent relates
to multiple factors, including the age at which you start taking the drugs or
the alcohol. The younger you are, the greater the likelihood that you will
become addicted.” Dr. Volkow also claims that drugs — not only opioids but
other commonly abused substances, like cocaine — literally change the shape of your brain: “All of these drugs
will with repeated administration erode the function of the frontal cortex. The
easiest metaphor is driving a car without brakes. You may very well want to
stop. If you don’t have brakes, you will not be able to do it.” She even showed
colored X-rays of brains, comparing those of drug abusers with those of
non-using controls, and the grim sight of certain parts of the brain literally
lighting up more in users than non-users was chilling to me: if your likelihood
of becoming addiction is largely genetically determined and the drugs physically alter your brain to make it
harder to function without them, the future of people who get hooked is grim
indeed. The one thing I was hoping for on this show and didn’t see was any
ideas on anti-drug education, on how to get people never to use opioids or
other addictive substances in the first place — as much as she was ridiculed at
the time (and as hard as it would be for the already addicted to follow her
advice), Nancy Reagan seems to have been on the right track when she advised
people, “Just say no!” (Then again, maybe that’s easy for me to say because
I’ve been saying “no” to potentially addictive substances all my life: I gave
up drinking alcohol in 1978, I’ve never smoked tobacco, and my whole experience
with illegal drugs is having tried marijuana as a teenager twice and feeling nothing except intense nausea. I’m sure that was a
physiological reaction because to this day I get queasy when I’m around marijuana smoke.)
I’m becoming convinced that we
won’t conquer the illegal drug problem until we start conquering the legal drug problem — and one thing I would strongly favor
is reinstating the ban on advertising prescription drugs directly to consumers.
I was amused when after the Super Bowl there were people complaining about the
commercial for a new drug designed to reduce the constipation frequently
associated with use of prescription opioids (though one person I know said that
when he was prescribed opioids for pain, the constipating effects of the
opioids and the diarrhea-producing effects of his anti-HIV medications canceled
each other out and rendered his bowel function normal for the first time in
years), and some of the anti-drug types had their usual hissy-fits to the
effect that the CBS network should be using the Super Bowl to advertise the
dangers of prescription opiates rather than to hawk a product to control their
unpleasant but not life-threatening side effects. What amused me about that is I’d been watching that commercial on various
programs for weeks — it’s only when it was put on during the Super Bowl that
enough people saw it to engender a negative public reaction, just as one could
argue that all the current attention towards the heroin epidemic is a function
of its spreading to white people. Just as I was grimly amused when, after Ebola
has been endemic in Africa for decades, it was suddenly hailed as “the greatest
health threat on earth!” once two white people got it, so the unconscious (and
sometimes conscious) racism which seems to affect everything we say or do about each other has led to the sudden
“discovery” of heroin as a major social problem now that white people — and
nice white suburbanites instead of countercultural or Bohemian white people, at
that — are getting addicted and dying from it.
