Complicating the Narrative


For my recent New York Times story profiling a group of runners recovering from opioid addictions, I spoke with a couple people who are deeply informed on the opioid crisis.

The death tolls are staggering. Forty-two thousand people in 2016 in the U.S. 

Almost four times as many Americans died overdosing from opioids in 2016 than from gun murders that year. 

Leading minds studying the effect of opioids prefer to call it the opioid crisis. Calling it an opioid epidemic, they said, can lead people to believe that opioids themselves are the problem—and therefore fighting the supply of opioids must be the leading way to cure or mitigate the problem. When in fact, like most things, it’s much more complicated.

David Herzberg, a history professor at the University at Buffalo, studies the effect opioids are having on American society. He said addiction numbers in the current opioid crisis began rising in the 1990s, following pharmaceutical oversales of opioids. But deaths from opioids began rising sharply around 2010, likely due to reactionary cutbacks on prescription opioids, said Mr. Herzberg, who is working on a book called The Other Drug War: Pharmaceuticals and Addiction in American History.

In that case, the well-intentioned decisions of lawmakers—responding to the rises in prescription opioid addiction—killed a lot of people. Curbing over-prescribing doctors around 2010 led a lot of people, who were addicted to their medications, to go “somewhere else to buy them, and that somewhere else was quite dangerous,” Herzberg said.

The first wave of opioid abuse in the U.S., Herzberg said, was in the late 19th century following the Civil War. In those days, opioids were used to treat all kinds of suffering.

He said there are three leading causes of the current opioid crisis.

1: A freer reign given to the pharmaceutical industry, beginning in the 1980s and ’90s. In the ’80s, in an interesting coalition, people wanting smaller government and less regulation joined with HIV/AIDS activists and advocates who felt there needed to be cuts to the bureaucratic red tape that was keeping life-saving new medications away from droves of dying patients. The pharmaceutical industry meanwhile, Herzberg said, had been trying for decades to push more opiate medications into circulation. “You had the federal government take its eyes off the road, or its hands off the wheel, just long enough for the industry to go, ‘All right.’” OxyContin, also called Hillbilly Heroin, is introduced as a pain reliever in the mid-1990s.

2: A drug policy that’s not designed to help people but to punish or control them. People in power thinking we can arrest our way out of the problem minimize the reality that it takes very little raw materials, when seen against the thousands of shipping containers that come into our country each day, for producing heroin to be smuggled into the country to keep up with demand. It’s hard to imagine, barring a world war that shuts down all international trade, an end to the availability of illicit opioids. 

3: “The third problem that intersects with those two—there is a lot of suffering, there is no doubt about that,” Herzberg said. “There’s young people—up until quite recently it was very difficult to find a job, especially commensurate with their education or training. So you have a lot of young people metaphorically twiddling their thumbs. And that actually causes a lot of suffering. And these drugs are really good at relieving that. So, you’ve got a trap there as well.” 

Leo Beletsky, a law and health sciences professor at Northeastern University and the faculty director of the Health in Justice Action Lab, also believes the opioid crisis is a symptom of a larger and broader problem. He said overall drug overdose rates in the U.S. have been climbing steadily since the mid-1970s.  The “broad availability of prescription opioids helped to catalyze the problem,” he said. 

Beletsky and Herzberg shared a belief that imprisoning those with addictions and limiting the availability of prescription opiates at this point to people who are addicted, both fall on the harmful side of ways to deal with the opioid crisis (If you’re goal is to keep people alive). More effective ways to keep people alive include openness to methadone (and other safer and legal alternatives to heroin), things like needle exchange programs, and a deeper exploration of the structural causes leading so many people toward addiction in this country. 

While reporting for the Times story, I was a bit worried about what could be seen as an implicit oversimplification of addiction—here’s a group of people who were addicted who are running the New York City marathon. Does that make it seem like people who are unable to overcome addiction simply lack the necessary willpower? Or that addiction is less a disease and more a personal weakness? I hope I found the right wording in the story (a real challenge in 900 words) to hint at the deeper complications.

As for the Odyssey House running team, I’m told all of the runners finished the marathon yesterday.

John Kane, who is featured in the story, said in a text message today that he came within 33 seconds of his goal to finish the run in under four hours. “More importantly,” he wrote, “we had five first-timers finish. That’s what it’s really about. Changing lives through running. That’s why we do what we do.”

The photo below, sent to me by Isobelle Surface, a vice president and communications director at Odyssey House, shows Ryan Stevens, who is featured prominently in the Times story. She’s standing at the Mile 19 watering station in East Harlem with Steven Miller.

For the three or so miles in Central Park that I ran with the team at a recent practice, I mostly stuck with Mr. Miller. It was his first marathon and Ryan Stevens, who had run three prior, was his running partner, guiding him to finish all 26.2 miles.


Related Links:

They Were Addicted to Opioids. Now they’re Running the New York Marathon

A 2011 profile of the late Laura Thompson of the Odyssey House Running Team