The motel room reminded me of an old kitchen rag: warm, in a sticky, humid way, and permeated by stale cigarette smoke, which the carpet and curtains had thoroughly absorbed. Heroin paraphernalia was strewn around the room. I sat stoically on a chair in a corner of the room, waiting for the three occupants to do what they needed to do so we could start the interview.
The story of the American opioid epidemic is personal for me. I've never used opioids myself, save for brief medical purposes after I had my gallbladder removed, but I've seen one of my best friends nearly lose his life to an opioid addiction. When I first met George, he was gainfully employed, beloved and respected by all his friends and pursuing a degree at the local community college. He tells me now that he had been struggling with addiction even at that time, but I didn't pick up on it until his dependency on opioids went into overdrive. There was one period of several weeks in 2016 when it seemed like every pillar of his life toppled in rapid succession: he lost his job, his car, many of his friends and eventually his freedom.
That was the moment when the opioid epidemic became personal for me. I could talk about how opioid addiction is a hot-button political issue, and how as a resident of Pennsylvania the experiences of the opioid addicts I've met provide valuable insight into our American moment. All of these things are true, but there is a deeper reason why I followed this story. I need to understand this problem in a personal way.
George wasn't in that raggedy hotel room to help me understand it, though. Instead I was talking to three people — "Nikki," a strikingly pretty brunette who has made the local news several times due to various drug-related offenses; Jade, whose eyes always seemed to be quietly sobbing even as the rest of her face remains stoical; and Matt, the only thirtysomething present besides myself, whose sharp-tongued intellectual demeanor contrasted starkly with the bleak surroundings.
I asked them how they became opioid addicts, hoping to find parallels in their stories. There were none — each developed their dependency for frustratingly different reasons.
Nikki told me she had been sexually abused as a child — by her stepfather and her uncle — as well as socially rejected and bullied in school.
"For some reason I wasn't really liked as a kid, and I feel like when I was first molested, it made me very awkward and a little bit too shy to actually open up to people, and rejection has been one of my things I can't stand as well," Nikki explained. "But I was more scared of pretty much it ever happening again because I knew that my uncle wasn't supposed to do that. I don't know. I guess I was just very scared. So I wasn't very lively or anything like that, I didn't want to do mostly anything with the kids and stuff, and later on I never really felt like to be happy. So when I first started getting high, that was my first time I ever experienced anything like feeling happy."
She explained that the first time she got high it was on marijuana, followed by "Triple C" — Coricidin Cough and Cold. She was 12 when she first tried the former and 13 when she experimented with the latter — and it was right around this time that she sought help from her mother in dealing with the sexual abuse.
"When I came onto my mom about my stepdad, she talked to him. All he told her was that he had mistaken me for her on the couch, and then we were like, 'You can't mistake a 13 year old for a 35 year old. There's no way.' But my mom believed him, so she made him apologize," Nikki told me.
She added, "So I told my mom about it and she talked to him. She said she spoke to him and she made him apologize to me like as if anything was going to get any better, and of course it didn't. It kind of started happening more and more after we moved in with him, and she was pregnant with his kid. And my mom, she doesn't like to acknowledge the fact that she knew about it. I guess maybe it breaks it down, I don't know, but she definitely tried to block it out or she'll probably do the blame factor, and blame me for it."
I expressed dismay at the fact that her mother could blame her for the abuse, and Nikki elaborated.
"She blames me by telling me, well, pretty much that I should have kept to myself. I should never had said anything, I should never talk to him, or I should have my own room. But it wasn't right, you know what I'm saying. It wasn't my fault that I didn't have a room. I had to sleep in the living room when we moved into his house with her. It's really hard to talk about it," Nikki said.
She later described how, when the cops became involved in Nikki's life as she struggled with her early drug and alcohol problems, "my mom told me she would do anything for me to say that I was just wanting attention.... now I think she feels shitty about that, but instead of taking responsibility for not being a mother and protecting me, I feel like she just protects him, passes the blame on me."
Matt's story was very different from Nikki's. By his own admission, he had no one but himself to blame for his addiction.
"Yeah, [it was] just curiosity," Matt explained as he told me about the Percocets he first popped when he was a young teen. "My parents, when I was growing up, they were both teachers and they were both very... the war on drugs was like, 80's, was ... you know, the [commercial with the] egg and frying pan, that was real. And they spent so much time and effort telling me what to do if somebody lit up a joint or this or that, that what it did was it made me curious. Because I couldn't figure out, especially marijuana, how is a plant so dang bad? And so curiosity, I was just very curious as a child. And that, just at that point in time, seemed like a logical step."
He added, "What I didn't count on was after I took the first two or three of them in the first day, how much I liked the feeling. That part ... I didn't expect that. That first bottle, I took two or three the first time, and in five days I'm thinking I went through the whole bottle of 30. Didn't want to, but did. Knew my mom needed them for pain, didn't give a rat's ass really, because I wanted to feel the way that I wanted to feel. I was a selfish little bastard."
Matt also made no bones about his background, which he described as privileged.
"I was fortunate enough that I was adopted at birth from what would've been a real shit-ass freaking upbringing to a pretty nice upper-middle class North Jersey upbringing where .... there was money. And still is," Matt added. "There was also, you know those 'speak no evil' types of upbringing? I'm that spoiled little brat f**king kid that most people hated in their teenage years. And when I was 16, going to private school, decided I wanted to do drugs. That's what I wanted to do because this other shit seems boring. That's pretty much what I did."
Whereas Matt gravitated toward drug use by choice, Jade described how she developed an opioid addiction at the age of 19 because of the painkilling medicines she was prescribed after undergoing surgery for carcinoid syndrome — "liver cancer, basically."
"I honestly can definitely say I would never have been on it, no," Jade said when asked if she would have taken opioids in any other situation. "When they gave it to me I had no clue that they were giving me opiates. I didn't even know what an opiate was. There's people out there that don't even know what, that opiates can be addictive. Or not only that but the withdrawals."
"They won't even tell you that it does shit," Matt interjected.
"Because they don't tell you," Jade agreed. "They say 'Here, you know, this is pain medication. It can be addicting, we're not going to have you on it for long.' But they never tell you, 'by the way, this is what's going to be,' so you're sitting at home being sick not knowing what the hell is going on.
"Then when somebody... At that time, my boyfriend was the one that told me 'By the way, you're having withdrawals because of the opiates. They took away your pills.' I asked, 'I wanted the pain to go away.' What did he say? 'I have a way to make the pain go away. I mean, it's not legal, but it'll make everything go away and make everything better.'"
When I asked what withdrawal feels like, all three of the room's occupants instantly chimed in.
"Turns your skin inside out, flip your stomach upside down. Your bowels are all over the place, and that's the good part," Matt said.
"It's basically like the worst cold/flu that you ever have," Jade added.
"Super flu, yeah," Matt concurred.
"It's puking, it's having diarrhea, it's being cold, it's being hot at the same time," Jade added. "It's being sweaty. It's being weak. It's having anxiety."
Matt: "The restless leg."
Jade: "The restless nose."
Matt: "Restless body."
Nikki: "The constipation whenever you're trying to take a shit..."
"The constipation, everything," Jade summed up. "And then not only that but in my case I have the cancer on top of that so my cancer gets aggressive. Now, I have carcinoid syndrome which is ... there's different kinds of symptoms on that cancer. Mine is, I get hot flashes. I get really red, really hot. And then my heart starts going like if I'm having a mini heart attack. It goes really quick and it hurts. And going through the withdraw, that just makes it ten times worse."
She concluded, "So I'm honestly, I'm ... even for someone who doesn't have cancer, doesn't have any type of other issues going on, they're ... not incapable but they're not able to move as a person not having withdrawal symptoms. For them, going up, going just upstairs or going to the kitchen is a workout."
When I asked Nikki, Jade and Matt about what could be done to stop opioid addiction, they were all pessimistic.
"Purdue Pharmaceuticals still runs Connecticut," Matt explained. "The Sacklers [who own Purdue] are still roaming around, developing new drugs. The Chinese are still making billions of dollars making phenol in labs. Sending it over here. And flat-out, everybody is addicted to something that takes away the pain. And it's just become so readily available in the form of Percocet, to kids who get their wisdom teeth pulled, or Darvocet, to people with skin issues. Dilaudid for people with more breakthrough-type pain with cancer and whatnot."
He added, "The pharmaceutical industry is never going to let it go away. There's just too much damn money in it is the problem. And that's what that all comes down to. It was created. It was freaking created. And there's too many people that got their hands in the pot. There's too much damn money in that pot for anybody to ever really take it away."
Nikki and Jade weren't as well-informed as Matt about the politics and finances behind the drug industry, but both nodded in agreement as he spoke. Each one also told me that, as far as they were concerned, the opioid epidemic would not be eliminated as long as addictive painkillers could be sold for profit.
Desperate to find some kind of solution, I asked if they thought things might be better if opioids were legal.
"I think legalizing it would make a big difference in a lot of things in this country, and I don't know exactly how and why but I think the forbidden fruit story, you know, the more you tell somebody something is forbidden the more they kind of want to go see what it's about. That's very real," Matt mused.
Jade wasn't so sure that legalizing drugs would have made much of a difference, at least when it came to whether or not she developed an addiction.
"It doesn't really matter. Honestly I don't think if it matters if it is legal or not. I mean, if he can get it, and I can't get it, I know I can go to him and buy anything off of him," Jade surmised.
She later added, "I didn't do it because I wanted to do it, I did it because it was either be in pain and the withdrawal at the same time, or trying to find a way to either stop the pain or the withdrawal."
I also talked with Jade and Nikki about how they had prostituted themselves for drugs.
"I felt bad for putting myself in the position that I have to do that in order to just feel fine for a day," Jade said. "Not even for a day, for a few hours. Because I put myself in that position, and it's just the worst feeling. Not when you're high because when you're high, everything just goes away, everything gets numb. And not when you're sick because when you're sick, you're thinking of your next move. It's that little bit of clarity that you have when you're between feeling good and about to get sick that just gets you back to yourself, your real self."
Nikki showed me passages from her journal describing doing sex work in order to pay for drugs.
Finally I spoke with George, my close friend, to see how his story matched up with those of the three occupants in that grungy Allentown motel room.
"Well, the first time I ever did any drug at all I was about 15, that's when I smoked pot for the first time," George told me. "When I was 18, I was introduced to alcohol and I started drinking daily by the time it was 19 and I'm probably around 19, as well, I did cocaine for the first time and I took Percocets for the first time. And probably around 22, 23 that's when I started really doing opiates daily, with pills first and then eventually heroin."
He added, "I never really liked pot that much. That was never really an issue of mine but when I was drinking regularly, I was introduced to Percocets by a roommate at the time and it was the best feeling in the world. And from that point on it was mainly alcohol, but when I had to chance I would take opiate medication and eventually when I was able to do that regularly, I began doing it regularly because I thought it was the best feeling in the world."
When I asked him to describe the feeling of being on those drugs, he said that it was "insanely euphoric. No pain physically or mentally. I felt like I had all this energy that I could do whatever I wanted to and things were perfect. That's how it felt. It felt like things aligned perfectly."
Then he answered the question that I'd been dying to ask for years — why he turned to those drugs in the first place. He described "the depression, the anxiety, the worthlessness feeling, the feeling hopeless, and social anxious, that all went away and I became social. I became happy. I wasn't anxious about anything, everything just felt perfect."
Why did he feel this way?
"Part of it's probably hereditary because mental illness runs in my family," George said. "Part of it could be so my environment being poor and not really growing up with any money or resources for anything. And my father being abusive when I was younger and me remembering that, feeling that I would be abandoned by people."
George also offered some thoughts on how to effectively address the opioid epidemic.
"I really liked the idea of decriminalization, which they've done in a few countries, namely Portugal, and it helps the addiction rate go down because there are more programs set up to help people with addiction, rather than just throwing them in jail," George explained. "So people are more willing to ask for help because it's not stigmatized as much by relating addiction to criminality."
He added, "Also, I think the entire harm reduction scene is very helpful. People setting up needle exchange programs and safe injection sites for users, because at those places they also offer help. You can go there to use or you can use, you could get clean things to use your drugs with, but also they offer help. If you need to go to rehab, they have ways you can do that there. It's a place you can go to not only be safe in your use but also to get the help that you need when you need it."
George, who at the time of this writing has been clean for eight and a half months, offered perhaps the best synthesis of the purpose behind this article.
"You know when I was first using, I had this idea that addicts were these people living under bridges. You know, skinny, and pale and looked like they were emaciated and dying. And they stole to support themselves and they were criminals, like I had that idea, that all addicts were criminals," George recalled. He added, though, that "I wanted to believe that I was using because I wanted to, that I was using because it was my thing, that I was just a drug user. I was even proud of it at some points," because when you're an addict "you're so self-centered that you still think you're better than everyone and that's one of the symptoms of the disease of addiction is total self-centeredness."
George also had a message of hope for other addicts — a belief that, based on his own experiences, there is a path that can yield results.
"Yet, I have found recovery from drug addiction in the rooms of Narcotics Anonymous after an extended stay in a treatment facility," George told Salon by email. "There is hope for those struggling with addiction in many different fellowships, and without NA in my life, I'm easily the next one dead."
Self-centeredness may be a symptom of addiction, but it is hardly limited to the world of addicts. When we discuss the opioid epidemic as a society, we frequently do so in a way that looks down on addicts. We use terms like "junkie," we condemn them for their poor life choices, we fear them and feel disgust for them. We not only make it very easy for a drug user to be thrown in jail, but we pass laws that block them from ever reconstructing their lives once they are out of prison — thereby making it far more likely that they'll return to drug use.
Yet the sheer diversity in the backgrounds of the opioid addicts with whom I spoke — economically, racially, in terms of what drove them to start using — shows there is no one type of person who becomes addicted. And there is something remarkably self-centered about a society that can look at its most vulnerable citizens, the people most desperately in need of help, and decide that they should be thrown in jail as criminals or labeled with a stigma because of the things they do in order to survive.
This isn't to say that addiction isn't a problem, or that addicts shouldn't be held accountable for the people they hurt in order to feed their addiction. The point, I suppose, is that we don't know exactly what needs to be done. There is no simple answer. But the solution has to start with asking the right questions, and with being compassionate toward those who are struggling with this illness.
They, but for the grace of God, could be any one of us.