There Is No Opioid Epidemic

Rachel Maddow has done solemn, suit-clad journalism
on the awfulness of opioid addiction

I'm sick of hearing about the "opioid epidemic." Repeating this claim has become a sure-fire way for media professionals to prove that they're serious about fixing the problems in American society today. Mainstream journalists like Dan Rather and Rachel Maddow have done somber think pieces about opioids, while humorists like John Oliver and Adam Conover approach the problem from a satirical, but still po-faced, angle.

There's just one problem. It's a bunch of crap.

Pause a moment and think about this: what do we call somebody who can't stop taking pain medication? Somebody who continues popping pills long after it's become measurably clear that their appetite for the medication drives a wedge between themselves and their family? Somebody who would rather pop pain medications than hold down a job, have a place in the community, or pursue constructive hobbies?

Modern medicine calls such people addicts. But I suggest another name altogether: patients. A person consuming pain medications with such dogged desperation, probably needs the pain to go away. Calling this person a moralistic name like "addict" implies the person has suffered a failure of ethical character, and we need to punish that person—an attitude which uses medicine and law to enforce moral values. Calling this person a "patient" lets us seek the root underlying pain.

We do need to distinguish here between addicts and recreational users. Some people take pain medication, mind-altering drugs, or prescription stimulants and steroids to enjoy the altered state of mind. Such people creep me out, but they aren't addicts; they just enjoy seeing the world from another perspective for a few hours, usually in the company of friends. As long as they harm nobody but themselves, stopping them feels pretty high-handed.

John Oliver plays the story for laughs, but
clearly has the same self-serious intent

But addicts have a completely different situation. They cannot stop taking whatever substance they're addicted to, because without it, they feel incomplete, pained... inhuman. Addicts don't want to feel good; they want to feel normal.

Consider what people become addicted to. Besides opioids, the most common addictive substances include alcohol, heroin, cocaine, and codeine. All of these are, or were at one time, prescription painkillers. Other addictive substances include nicotine, marijuana, and Valium, which all have anti-anxiety properties. Even lowly methamphetamine, the one drug I'd like to see permanently forbidden, began life as a prescription anti-anxiety medication, Benzedrene.

Besides substances, people can become addicted to behaviors. Psychologists have observed and treated people demonstrating addictions to gambling, sex, eating, work, and more. Each of these behaviors creates an internal reward system: the giddy rush of waiting for your pony to win, the sense of accomplishment from a job well done. They also give addicts something to think about other than the mundane, and possibly painful, circumstances of their day-to-day lives.

Opioid addiction, when considered in news or late-night comedy, seems inextricably entwined with two circumstances: medical trauma, or chronic unemployment. I've noticed a persistent trend of connecting opioids with West Virginia coal country, where declining revenues have forced many former miners, many suffering black lung and other work-related injuries, out of the workforce. The physical pain of illness, and the psychological pain of uselessness.

Journalist Nick Reding, author of Methland, correlates the most widespread consumption of methamphetamine with America's rural communities, where dwindling economic opportunities and declining wages make grasping at straws a necessity to get by. Addiction specialist Gabor Maté, based in Vancouver, British Columbia, notes how many of his destitute patients come from physically or sexually abusive backgrounds. Pain and addiction go hand-in-hand.

So God forbid we actually address the real problem.

The phrases "opioid addiction" and "coal country" keep coming up in the same news stories,
usually without any comment on the connection between addiction and despair

America's policy for dealing with addiction, largely unchanged since the days of Harry J. Anslinger, remains to jail offenders, regardless of their suffering. The isolation of prison, where prisoners lack social networks, meaningful work, or even sunlight, will only compound whatever pain got them addicted to begin with. Rather than helping addicts deal with their problems, our criminal justice outlook only doubles down on the underlying causes of addiction and other diysfunction.

Solemn, tedious think pieces about opioid addiction allow journalists to look engaged with America's diffuse suffering. But they exonerate a socioeconomic system that devalues humans and profits off their pain. Prescription pain meds cannot advertise on broadcast media, so blaming them doesn't hurt revenue. Media professionals thus excuse their own complicity in an economy that encourages resource hoarding, devalues labor, and treats humans as interchangeable parts.

And buying that crap lets us, the audience, off the hook for profiting from that system. Stripped of glitz, the problem is us.

The Doctor Is Still In

Peter Capaldi as the Twelfth (current) Doctor

I have seen more people shaming the Doctor Who haters than I’ve actually seen Doctor Who haters. With the recent announcement of Jodie Whittaker’s nod to play the thirteenth (or fourteenth, or fifteenth) version of the title character in the BBC’s Doctor Who, social media has been alight with people mocking and belittling those tender souls who cannot stomach a woman in the role. Actual tender souls, however, have been rare and hard to find.

Perhaps that’s because I haven’t been looking for them. The Internet allows such fungal undergrowth to flourish beneath various rocks on Reddit and 4Chan, but unless one of their number gets elected President, few actually venture into the sunlight, knowing the general cultural trend has moved away from them. Their sexist, homophobic, bigoted attitudes belong to a long-gone era, and they know it. They have the common decency to stay away from us normal people.

Yet rather than let such attitudes fester and die quietly, members of the progressive call-out culture feel obliged to share, retweet, and otherwise publicly announce the existence of such attitudes. They qualify the shares with snarky comments or condemnations of regressive attitudes, which maybe gives such shares the vestments of sanctimony. But as working journalists discovered last year in sharing Donald Trump’s message, vocally refuting regressive attitudes doesn’t change the value of free media attention.

Every time some white, male yob claims that a female Doctor, female Ghostbusters, or female Jedi “ruined my childhood,” they get free publicity from those who purportedly oppose that position. I’d think having a childhood so brittle that you’re still hanging “No Girls Allowed” signs on your door, would be ruined without outside intervention. But by giving these self-proclaimed martyrs sunlight, my fellow progressives allow these attitudes to flourish and propagate, past their sell-by date.

Paul McGann as the Eighth Doctor

Weirdly enough, while rewarding such conservative crybabies, progressives nourish their own crybaby culture simultaneously. I’ve witnessed liberals whining that the female Doctor doesn’t count because she’s too late, or because she’s white. In other words, progress doesn’t really matter unless it happens on my timetable. Besides being just plain arrogant, this attitude overlooks the commercial demands of media. Even a publicly owned resource, like the British Broadcasting Corporation, is still a corporation, beneath the surface.

Richard Walter, professor and chair of screenwriting at UCLA, writes that “American television seems to love last year’s— or last decade’s— controversy.” In other words, media won’t embrace a position until it’s safe enough to handle without getting burned. Hollywood refused to touch the anti-racist message of Broadway plays like Finian’s Rainbow until history had made the message essentially harmless. The BBC is British, yes, but it suffers under the same constraints as American television.

So yes, a character created in 1963 will carry the whiff of the white, patriarchal influences under which he (she?) was created. Though original showrunner Verity Lambert was a twenty-something woman, the character she oversaw was old, male, and white, reflecting the British power structure in her era. The Doctor didn’t get a black traveling companion until Mickey Smith in 2006, or an openly gay one until Bill Potts in 2017. Hispanic? Sorry, not yet.

But the show planted seeds for the Doctor’s more inclusive regenerations years ago. We saw our first on-screen Black Time Lord in 2008, two years after Black actor Patterson Joseph was briefly considered to play the Doctor. We saw a male Time Lord regenerate into a woman in 2016, demonstrating that such transitions were possible. (Don’t bring me Steven Moffett’s “The Curse of Fatal Death,” where Joanna Lumley plays the Doctor. Gag episodes don’t count.)

Tom Baker as the Fourth Doctor

So. Progressives who’ve already seen that the Doctor will become more diverse in the future, complain that such diversity isn’t happening right now. Simultaneously, crusty back-numbers who want Doctor Who to remain a museum piece of their supposedly bucolic, girl-free childhoods, complain that diversity happens at all. The BBC must satisfy the largest number of viewers, so change has to happen, but it cannot alienate large audiences, so change happens slowly. That’s what corporations do.

Which is why I cannot take either side seriously. Calls to make change happen instantaneously, even when such change is legitimate and overdue, are as unreasonable as demands to forbid change and keep things static forever. The Doctor will become a non-white woman someday soon. Possibly even a gay woman. (I favored Sue Perkins for the role, after all.) Conservatives cannot stop it, but progressives cannot rush it. Corporations are slow, but change is inevitable.

Stephen King, Imperialist Ignoramus

Stephen King in 1977, the year he publishe
"Children of the Corn" and The Shining

Stephen King’s short story “Children of the Corn” pisses me off. There, I said it. King admits, in his collection Night Shift, that the story found him while driving through rural Nebraska: he found the miles and miles of corn, planted in ruler-straight rows, highly intimidating, largely because this clearly human landscape was seldom interrupted by anything as humane as houses. Note, he drove through Nebraska; he never mentions bothering to speak to actual Nebraskans.

I always dismissed this shortcoming as a fluke, though, an oversight by a busy, highly popular novelist who didn’t notice his own blinders. That is, until someone recently pointed out to me that, in King’s novel The Shining, the all-important Overlook Hotel closes for the winter. In Colorado. Let me repeat that: a hotel closes for the winter, during the peak of Colorado’s lucrative ski season. What the hell? That’s two states King gets wrong!

Thinking about this, I realized: in both cases, King projects Greater Northeast values onto the American West. In New England, where King lives, white colonial communities were deliberately planted within walking distance, because they were planted in the Seventeenth Century, when twenty miles was a time-consuming overland slog. Farmers lived in towns, and walked brief distances to their fields; human habitation is the norm, not the exception. (It gets more complicated inland, but not much.)

And, in the Northeast, resort hotels do close during winter. Partly, this reflects brutal Northeastern winters, where soil sometimes freezes solid, while blizzards isolate neighboring communities. But it also reflects the Northeastern tourist business, driven primarily by New Yorkers and Bostonians fleeing sweltering big-city summers. The Borscht Belt mainly offered tourists mild countryside temperatures. Even if people could visit tourist resorts during winter, they mostly don’t want to. Winter, in Northeastern cities, is almost pleasant.

Jack Nicholson in Stanley Kubrick's
adaptation of The Shining

King failed to understand that Colorado tourism derives from completely different drives. People band together through shared love of braving the cold to test their athletic endurance. In 1977, when King published both The Shining and “Children of the Corn,” inexpensive transportation was moving Colorado skiing from a regional pastime to a national destination. Formerly an agricultural state, Colorado was slowly transitioning to a tourist economy. Stephen King showed up right during that intermediary stage.

According to legend, which he propagated himself, King chose Boulder, Colorado, as the setting for his next novel by selecting a random location from an atlas. King and his wife spent one October night as the sole guests of the otherwise vacant Stanley Hotel, which inspired The Shining’s massive, sprawling, vacant halls. October is prime foliage-gazing tourism season in New England, where King lives; one wonders whether he even realized he’d chosen Colorado’s off season.

Thing is, if you understand Northeastern history, King’s Overlook Hotel makes perfect sense. He describes a run-down hotel of the 1970s that peaked during the Jazz Age. The building, basically a preserved museum of its heyday, is haunted by the ghosts of big-band musicians and bartenders passing liquor off the books. Jack Torrance stumbles into a tuxedo party and gets handed rotgut booze. The hotel King describes belongs not in Colorado, but the Catskill Mountains.

My memories of the Catskills are dominated by Cub Scout adventures, which is about all that happens there anymore. Ruins of grand hotels built between the world wars remain, but few still do business. Neither particularly tall nor unusually beautiful, the Catskills benefitted from being within driving distance of Manhattan and Boston; when plunging fuel prices before the Arab Oil Embargo made Colorado and Utah viable tourist destinations, the Catskills’ storied hotels fell into disrepair.

Steven Weber in Mick Garris's adaptation of
The Shining, with a script by Stephen King

Follow my reasoning: King can’t handle Nebraska because, in his mind, human habitation means towns; Nebraska’s spread-out human geography looks demonic to him. He can’t imagine tourist business that isn’t circumscribed by warm weather, or haunted by Jazz Age glory. In both cases, he projects regional values onto regions he doesn’t understand. Regions he can’t understand, because he doesn’t bother speaking with locals. If he did this to non-white people, we’d call him an imperialist.

I moved from California to Nebraska at age 18, so I understand the shock of transitioning to spaces sculpted by human activity, but vacant of people. It’s scary… for a while. But I didn’t have to live in Nebraska, near the Colorado border, for very long, to realize the circumstances King describes aren’t horrific. If he’d bothered meeting any Nebraskans or Coloradans, the horror would’ve worn off quickly. Instead, King looks like a world-class dick.

First of the Texas Troubadours

1001 Albums To Hear Before Your iPod Battery Dies, Part Six
Townes Van Zandt, Live at the Old Quarter, Houston, Texas

Townes Van Zandt was a notoriously unreliable performer. Before his death in 1997, audiences reported he had only two modes: an unbelievable clarity and rapport with the audience, coupled with sublime lyrical sensitivity, or an absolute drunken mess. Throughout his career, his attempts to numb his bipolar disorder with substances always undermined his performance persona. But for four nights at a Houston dive-bar in 1973, he produced something unmatched in the history of Texas music.

Country music fans may remember Townes Van Zandt as author of such classics as “Pancho and Lefty,” “If I Needed You,” and “White Freight Liner Blues.” He produced six albums in five years between 1968 and 1973, often working at a feverish pace made possible only by mental illness and cocaine. His songs bespoke a bleak pessimism that, paradoxically, gave his cultish fans great hope that they weren’t suffering alone. He became an underground legend.

As this prolific period wound down, Van Zandt played four shows at the Old Quarter, a venue co-owned by his friend and bandmate Rex Bell. Producer Earl Willis recorded these shows on a portable four-track system, apparently for posterity, never intending to release them. However, Van Zandt descended into a creative dry spell, corresponding, probably not coincidentally, with a healthy new relationship. Without his malaise, and the drugs, he lost much of his creative motivation.

The recordings feature Van Zandt, alone on stage with just his guitar, uncharacteristically sober and receptive to his audience. The recording, chosen from Willis’ crude recordings, involves such concert business as announcements about where to find the cigarette machines, and apologies for the broken air conditioning. But it also includes some of the most tender and insightful recordings a damaged genius ever put forward. The austere arrangements and clinking background emphasize Van Zandt’s lyrical complexity.

He opens with “Pancho and Lefty,” his then-current single, about a Mexican bandit’s betrayal. Both Emmylou Harris and Willie Nelson had hits with this track, but both embroidered it with radio-friendly flourishes highlighting their own celebrity. Van Zandt, playing solo, keeps focus on his lyrics, a mournful exploration of the forces with make a criminal into a folk hero. The idea that we need heroes only after they're dead is poignant, coming from Van Zandt.

Townes Van Zandt

This track list reads like Van Zandt’s Greatest Hits. He plays several of his classics, like “Rex’s Blues” or “Tecumseh Valley,” with the unornamented authenticity of somebody producing work he loves. Between his own classics, Van Zandt also includes tracks by artists who influenced him, like Merle Travis, Bo Diddley, and Lightnin’ Hopkins. This remarkably inclusive set of influences goes heavily toward explaining Van Zandt’s unusual style, quirky songwriting, and widespread fandom outside genre circles.

Part-time fans and corporate executives long classed Townes Van Zandt as country music. This isn’t entirely unfair, considering how many of his songs have been covered by artists like Don Williams and Steve Earle. But like many artists most immediately impacted by his music, including Lyle Lovett and Gillian Welch, he fit poorly into country’s mold. The distinctive mix of country, folk, blues, and other roots genres has some fans speaking of just-plain “Texas Music.”

Because of its essential austerity, this album provides insights into not only Van Zandt’s influences, but also his artistic vision. His classic studio albums were larded with Nashville sidemen and sophisticated productions, presumably to create chart hits. But this overhandling not only produced no radio-friendly singles, it frequently pointed up Van Zandt’s weaknesses as a vocalist. Like Bob Dylan, Van Zandt had a vision, but wasn’t a pretty singer. What he had, was insight.

Van Zandt’s production team released this album in 1977, four years after it was recorded, five years after his last studio album. Basically, he needed the money. Though he’d pulled some songwriter’s royalties from cover versions, his period of happy inactivity left him functionally penniless. Van Zandt released only one studio album between 1972 and 1987. Unfortunately, his eventual return to the studio would result in more overproduced pablum, presumably to capitalize on increasing name recognition.

Standing between his career bookends, this album, the most stripped and honest he’d ever record, highlights not only Van Zandt’s artistry, but also the way he created a pinch-point of Texas music. Though others blended the state’s reach of country, blues, and folk before him, Van Zandt coupled that with raw poetry few peers ever approached. Without the studio crutch, this album makes plain his stylistic vision, and keeps his music alive for coming generations.

A Classic Comic Resurrection Beneath the Earth

Jon Rivera and Gerard Way, writers; Michael Avon Oeming, artist, Cave Carson Has a Cybernetic Eye, Vol. 1: Going Underground

Former spelunker and part-time action hero Calvin “Cave” Carson hung up his spurs and became a family man several years ago. But the excavation company that now employs him has ulterior motives for keeping Carson on a short leash. When a ghost from his past appears on his doorstep, Carson realizes his adventuring days aren’t through. But his employers won’t let Carson go so easily… nor his daughter, either.

DC Comics introduced Cave Carson in 1957, alongside other adventure-oriented titles, featuring heroes without superpowers, like Challengers of the Unknown and the Sea Devils. But Carson never got sufficient traction to become his own franchise; he fought alongside Superman, but always as a sidekick. Lead writer Gerard Way admits he needed to consult a concordance of obscure classic characters to find someone worthy of reboot for his Young Animal imprint.

Newly widowed at the start of this story, Cave Carson struggles to maintain connections with his college-age daughter. He goes through the motions of workplace diligence, but they mostly keep him around for nostalgia: he taught his followers everything they know about underground adventuring, before they eventually outgrew him. Now Carson has the kind of slow, melancholy conversations we recognize from action movies, right before everything hits the fan.

And fan-hitting does occur. One night, tired, frustrated, and alone in his formerly full house, Carson hears a knock. A loincloth-wearing emissary appears at his door. Seems the Muldroog, a lost civilization of mole people, are under attack, and only Carson’s late wife, with her panoply of ancient secrets, can save the underground. But with her gone, apparently a blood quantum is sufficient, because they’ll accept Carson’s daughter instead.

It’s difficult to read this graphic novel without recognizing the debts it owes older stories. Besides reviving an almost forgotten character from the Eisenhower era, and connecting him to characters borrowed from Edgar Rice Burroughs, the art suggests a combination of Peter Max and Astro-Boy. The story has hints of old EC horror comics, a tendency emphasized by sudden jarring images of amorphous fungus people savaging the peaceful natives.

Original promo art,
click to enlarge

Yet this obsessive borrowing doesn’t undercut the story. Like many serial science fiction franchises that don’t bother concealing their roots, like Star Wars and Doctor Who, this story’s connection to older pulp traditions gives it a sense of continuity. We aren’t just reading something generated last weekend like the transient comics of the 1990s that are largely unreadable today. This story connects science fiction’s past to his evolving present.

The emissary at Carson’s doorstep warns him that his employers, EBX, committed the attack on his subterranean nation. So Carson doesn’t even bother bringing his bosses into the discussion. He calls his oldest ally, Wild Dog, an Uzi-wielding maniac who plainly copied his image from the first Quiet Riot album, and goes rogue. Getting off the grid proves easy for a scientist accustomed to caves. Bringing his daughter along proves harder.

Deep underground, the Muldroog have buried a secret for generations. Why else would a nation, apparently blessed by technology but attuned to natural rhythms, continue living in caves? Seems the Muldroog civilization is based upon a lie its people tell outsiders, a curse that keeps giving, provided nobody ever finds out. But what the Muldroog have spent centuries keeping locked up, EBX wants to make into a profit engine.

For all the sci-fi-adventure trappings, this story essentially isn’t about that. Cave Carson’s cybernetic eye, which sometimes goes unmentioned for several chapters, isn’t a driving force behind the story, it’s a metaphor for a man who’s seen things he cannot forget. Carson and his wife told their daughter lies to protect her from hostile reality. Now Eileen’s gone, Cave must bear punishment for those lies alone when truth rushes forth.

This book carries a “Suggested For Mature Readers” label. Please take this seriously. Besides violence, language, and very brief nudity, the themes of long-simmering family tensions shouldn’t be taken lightly. This story introduces themes that most grown-ups will recognize from their own families. Though we perhaps won’t discover our connection to forgotten mole-people civilizations, we all struggle to accept and understand our roots.

Cave Carson is only one among several classic DC characters getting reboot treatments from Gerard Way’s Young Animal imprint. Formerly lead singer of My Chemical Romance, Way’s recent reinvention as a genre writer has made visible several themes always implicit in his music. He admits his comics deal preponderantly with strained parent-child relationships. Well, this story ends in motion; it’ll be interesting to see where he takes these themes next.