Seven Days of Heroin
September 11, 2017 12:14 PM   Subscribe

Seven Days of Heroin: This is What an Epidemic Looks Like The Cincinnati Enquirer sent more than 60 reporters, photographers and videographers into their communities to chronicle an ordinary week in this extraordinary time.
posted by OmieWise (66 comments total) 32 users marked this as a favorite
 
"Cincinnati" rather than "National," for anyone with reservations.

reservations of a different sort are advised, however. Pretty grim.
posted by aspersioncast at 12:21 PM on September 11 [6 favorites]


The agents don’t have time to dwell on what went wrong

Because they are too busy with paperwork for compensating the innocent person whose car they just tore apart looking for drugs, no doubt!
posted by thelonius at 12:48 PM on September 11 [1 favorite]


[Clarified which Enq. in the post.]
posted by cortex at 12:56 PM on September 11


tfw u trollin for Pulitzers by doing real journalism
posted by radicalawyer at 1:08 PM on September 11 [1 favorite]


I got through to the first "Lost Boys" part. One of the nicest, kindest people I've ever had the privilege of calling my friend went clean for a year before OD'ing nearly nine months ago. Fucking sucks.

.
posted by threetwentytwo at 1:09 PM on September 11 [11 favorites]


From the editor: Why we did this

We undertook this work – spreading our staff throughout courtrooms, jails, treatment facilities, finding addicts on the streets and talking to families who have lost love ones – to put the epidemic in proportion. It is massive. It has a direct or indirect impact on every one of us. It doesn’t discriminate by race, gender, age or economic background. Its insidious spread reaches every neighborhood, every township, every city, regardless of demographics. And it is stressing our health-care systems, hospitals and treatment capacity.

Brilliant reporting. Thanks for sharing.
posted by matrixclown at 1:16 PM on September 11 [9 favorites]


tfw u trollin for Pulitzers by doing real journalism

Or maybe they're trying to cover an epidemic that people have gotten used to, and people that society often considers throwaway?

Halfway through this it's hard to read of many tragedies happening all over to these families, all of which is now routine to some other people.
posted by lesbiassparrow at 1:17 PM on September 11 [7 favorites]


I've never taken drugs or even been drunk in my life, but my best friend since we were literally in the crib, the only person I've ever called my best friend, died of a fentanyl overdose in June.

I suspect a lot of people think they'll come through this epidemic untouched and they're wrong. All of them.
posted by klanawa at 1:22 PM on September 11 [12 favorites]


Drug overdose is now the leading cause of death for Americans age 25-34, ahead of car accidents, suicide, murder and cancer.

In terms of years of potential life lost before age 75 (YPLL75), 6.1% are due to unintentional poisonings (the CDC's death classification for non-suicide drug overdoses). That makes it the third biggest cause after cancer and heart disease.

For comparison, of all YPLL75 since 1999:
  • Cancer: 21.5%
  • Heart disease: 15.3%
  • Suicide: 5.2%
  • Gun homicide: 2.5%
  • Terrorism: 0.0%
posted by justkevin at 1:27 PM on September 11 [9 favorites]


As some of you know, my wife works for an adoption agency. More often than not, if a birth mother has a drug problem, it's heroin. It's just so damned cheap compared to other drugs now.
posted by Thorzdad at 1:34 PM on September 11


I will say that there are more heroin addicts in our neighborhood than I've ever seen before, most of them pretty young. But honestly, I view this as more the result of gentrification and displacement than anything else. Almost everyone I've ever known who has become addicted to heroin had some other big source of suffering in their life first - abuse, chronic pain, some other life trauma, precarity.

This year I've also noticed a huge uptick in homelessness. I'd noticed that there were more people begging these past few years, but this year there have been homeless people all over the place. Just this morning I biked past people sleeping rough on the lawn of the church down the street.

This country - this city! - is polarizing so much and so fast. Downtown and in the rich part there's tons and tons of new construction. The poorest part of town (over North) is gentrifying fast - a formerly Black neighborhood now whitening as richer people buy up the nice old houses. Lots of fancy stuff for fancy people - there's new money from somewhere, people in their twenties who can afford fancy condos, expensive meals out, etc. And everyone else is getting screwed and displaced. I see people all the time looking for housing who can only afford about $400 a month for a room, and guess how many rooms there are at that rate? Not tons and tons, let me tell you.

Heroin is part of this whole mess, not a separate thing. Anyone who isn't rich is losing ground, and anyone who didn't have much ground to lose is in bad shape.
posted by Frowner at 1:56 PM on September 11 [30 favorites]


Yes... and this story, like most drug coverage, is skewed towards the grim side. Although fentanyl is certainly making things worse, most people do recover eventually, particularly if they have resources and family left.

The problem is that the way America deals with addiction is so punitive that families are told to simply cut their addicted children off, have them arrested or send them to rehab— and all of this is often counterproductive.

We know how to cut the death rate from opioid addiction by 50% or more: make access to methadone or buprenorphine as easy as buying street drugs. If we also allowed prescribed heroin and supervised injection facilities, we could reduce harm even further.

But we don't really care about people with addiction— we like to stare at the crash and follow the cops and robbers. If we actually wanted to help, we'd have to do things like reduce inequality, provide universal health care, improve schools, stop arresting people for having medical and psychiatric problems. Instead, we prefer to confuse the symptom (drug use) with the disease (despair, trauma and psychiatric problems, mainly) and blame people who are in pain for trying to feel just a bit OK.
posted by Maias at 2:04 PM on September 11 [52 favorites]


That was gut wrenching to read. I don't know of anybody in my life dealing directly with heroin abuse, but like they said in the article, that likely means I just don't know, not that it isn't there.
posted by COD at 2:04 PM on September 11


Welp, that's where I'm from. My stepmother was a social worker in Hamilton County for decades. My cousin is a police officer in Cincinnati. (On the phone with Dad: "Oh, do you know about the drug called gray death?" "...NO." "Well your cousin found a pound of it during a traffic stop.") As far as I know (insert one million asterisks) I don't know anybody who uses heroin, but in every one of those pictures I was afraid I'd see a vaguely familiar face, someone from high school or something.

Headed there for a visit in a week and staying in OTR for a couple nights. A little afraid of what I'll see.
posted by little cow make small moo at 2:05 PM on September 11


That was ... powerful. I feel really glib just writing that. I think the worst part of it was the update on the mother in the video who is playing with her baby, the mother who had quit cold turkey when she learned she was pregnant and who looked like she was doing everything right, the mother who looked so alive and so loving and even happy - dead, just 10 days later. I nearly sobbed reading that.
posted by widdershins at 2:07 PM on September 11 [9 favorites]


"The agents don’t have time to dwell on what went wrong. About 7,000 kilograms of heroin are seized in the United States every year, three times as much as a decade ago. They will be hunting someone new tomorrow."

Ok, so that's your problem right there. You don't arrest your way out of an epidemic.
posted by happyinmotion at 2:22 PM on September 11 [17 favorites]


..."most people do recover eventually, particularly if they have resources and family left."

No. No they don't.
posted by shockingbluamp at 2:25 PM on September 11 [6 favorites]


I read this article this morning.

I live in Cincinnati and work night shift in the city's academic hospital. I only work weekends so, thankfully, I only see this stuff 3 days a week. Just last weekend two patients came through the ER that were so bad off they required a Narcan drip (continuous Narcan, because Narcan injections given in the field wear off too quickly). One of these patients had to be intubated and was sent to the Medical ICU. Our MICU always has several OD cases and not all of them survive.

Last weekend two pregnant, addicted women came into the hospital. One was on methadone from a treatment clinic, the other was still using heroin up until she went into labor. Both babies will go to the neonatal ICU after birth and we'll send up tiny, tiny doses of buprenorphine to prevent what is called neonatal abstinence syndrome. Our NICU always has several addicted newborns.

Of course those are just the patients that came to my attention. More cases came into the ER and were treated and released, or treated and left against medical advice. Many of these will show up again later, but some of these people will die.

A year ago there was an unprecedented spike in overdoses - 174 over a week due to a single batch of heroin laced with carfentanyl. As the Enquirer article points out this is now a typical week in SW Ohio and as bad as the crisis is here it is even worse in Eastern Ohio, West Virginia and Kentucky.
posted by codex99 at 2:33 PM on September 11 [13 favorites]


Many do. (although that study did not track opioids)
posted by praemunire at 2:41 PM on September 11 [3 favorites]


..."most people do recover eventually, particularly if they have resources and family left."

No. No they don't.


Yes, actually they do. The reason we think otherwise is that most research is conducted on convenience samples— people in public treatment or who are incarcerated. These are likely to be the worst cases and these samples contain disproportionately high numbers of people with few resources.

Middle class people who have jobs and social support are less likely to be in those groups— but they can be found via epidemiological surveys, such as NESARC, which sample the non-institutional U.S. population. When you do that, you find that most people do recover— or at least, this was very clearly the case, pre-fentanyl.

I myself had a heroin addiction in my 20s, for example. I am not saying this to dismiss the severity of the problem, but I am saying it because making people feel hopeless about the odds of recovery is both inaccurate and unhelpful.
posted by Maias at 2:46 PM on September 11 [47 favorites]


Here's the NESARC data on prescription opioid recovery. Rate is 96%!!!

Now, it's lower than that for heroin, but that has historically been because heroin is so stigmatized that the vast majority of people who become addicted are extremely marginalized, generally poor and have the highest rates of trauma and other psychiatric disorders. (These rates are elevated among all people with addiction— 2/3 have childhood trauma and half have other psych disorders: these numbers are more extreme for heroin).

These days, the middle class is collapsing and high rates of unemployment, wage stagnation and other sources of economic woe have meant that heroin is more widely used (although the media all too often uses "middle class" to mean "white person of any economic status). All of these factors suggest that recovery will be more difficult for many— but it is not accurate to suggest that the majority of people with opioid addiction are doomed.
posted by Maias at 2:57 PM on September 11 [30 favorites]


Many people DO recover Maias. MOST do not. It is neither unhelpful nor negative to be a realist here. Having worked in addiction recovery for more that 25 years and in direct care for most of that time I can tell you that statisics don't lie. They don't. Under reporting facts for the sake of giving hope is just bad science.
posted by shockingbluamp at 2:58 PM on September 11 [1 favorite]


Ok, where are your statistics then?
posted by Maias at 3:00 PM on September 11 [27 favorites]


Also, it's important to note here that for pregnant women with addiction, going cold turkey is NOT recommended: it can kill the fetus, so the best treatment approach is to be on buprenorphine or methadone.

Used long term, these treatments cut the risk of OD death by 50% or more for the moms, also. If we understood this and stopped trying to shame mothers who do the right thing and stay on maintenance, we'd see a lot less harm to mothers and children. It's also cruel that these mothers often lose custody because child welfare systems see being on maintenance as "still using," even though it's actually the safest course of action, particularly with fentanyls out there.
posted by Maias at 3:04 PM on September 11 [6 favorites]


I thought about using heroin once. I was going to use it to commit suicide. The idea of passing out and never waking up... that was something I wanted. But I was scared of the aftermath - my friends and family having to deal with it, having to explain it to other people, and what if I lived.

Part of me wonders if some of these people are like I was.
posted by mephron at 3:12 PM on September 11 [6 favorites]


My—admittedly very sample-biased, but biased quite differently than a study using people in public drug treatment—experience is that there's sort of a tipping point to opiates, or maybe just a cliff, but it doesn't have anything to do with the drug and almost everything to do with economics and where the drugs are coming from. You can use opiates for a long time and never have anyone even suspect that you're using, and check all the boxes for success in life (or, you know, try to conquer Europe). I don't think those people ever really get counted as "addicts" by their friends and neighbors, certainly not in government studies. And the people whose drug dealers have medical licenses don't either, of course.

It's when something happens that interrupts the high-quality supply—e.g. having your insurance or your doctor cut you off—that you end up getting black-market drugs, and that's when the overdoses happen. I doubt we'd have people ODing on H if they could get pharma-grade Oxy instead, but because we're terrified as a society of "addiction", that's not possible. (Ignoring that if you had a choice between getting on a bus where the driver was dependent on opiates or dependent on alcohol, you'd be stupid to prefer the latter, and in either case you'd probably want them maintaining and not choosing that moment to go cold turkey.)

So instead we have to watch the world burn while we vainly try to control supply against unstoppable demand, and whatever horrors may ensure are just collateral damage.

But I know I'm preaching to the choir, here. I don't have any solution that's politically workable.
posted by Kadin2048 at 3:16 PM on September 11 [7 favorites]


the highest rates of trauma and other psychiatric disorders

The friend I lost to opiate abuse was sweet and smart and funny. He cared about people and people cared about him, but he hurt in a way nothing seemed to permanently reach. My brain rebels and insists that he doesn't belong in a class with these losers, but of course he does. Maybe they weren't all as sweet or as smart or as funny, because he was a prince, but they were still... better than this, once, weren't they? They were all better than this.

Which is to say: I don't see what good it does to say that people who aren't in catastrophic amounts of emotional pain tend to recover okay while people are dying like this. The people who recover okay without progressing to heroin and in particular without ever getting to fentanyl--so, great, middle class people with social supports are going to be okay, as usual, and everybody can pull themselves up by their bootstraps. Not that I think you're actually suggesting that, Maias, but would we be in this position right now if comfortable middle-class taxpayers didn't feel safe from this? I don't think people really need to be reassured that the middle class is safe.
posted by Sequence at 3:20 PM on September 11 [3 favorites]


I myself *was* in a catastrophic amount of emotional pain and had major psych issues when I became addicted to heroin in my 20s. I am in no way suggesting that we should just leave middle class white people to it because they'll recover any way— I am not sure how you could get that from what I posted.

What I am saying is that this article gave an overly bleak picture of the odds of recovery. And comfortable white middle class taxpayers avoid this issue not just because they feel safe from it but because historically, they have seen it as a "black" issue—spurred by racist politicians and complicit media.

Until we stop seeing people with addiction as "other" and "losers," we're not going to do much better.
posted by Maias at 3:36 PM on September 11 [24 favorites]


Christ.

I tried this stuff once, at a pretty low and confused point in my life, when I was much younger. It was pretty easy to see how it might take hold, because it felt very good. Thankfully (?) I was effectively completely broke at the time and had no slippery slope to head down, money-wise, so it was a choice between Marlboro reds or heroin. Also thankfully (!) the drug of choice of the people who provided it to me (with my consent) and who I lived with at the time was speed, which I also tried, and which did nothing for me at all, and which furthermore rendered them completely insufferable and swore me off injectables for life. Plus, who would I even buy it off, if I'd wanted more? Apart from every third person on Smith Street in Fitzroy/Collingwood I mean?

Anyway, this is sad stuff.
posted by turbid dahlia at 3:44 PM on September 11 [3 favorites]


Weird, it's only white people. Wonder why that is?
posted by petrilli at 4:30 PM on September 11 [5 favorites]


tfw u trollin for Pulitzers by doing real journalism


I for one am glad they did this. I hear about the "opioid epidemic" and from my neighborhood in hip midtown Sacramento it's only abstract for me. Not that I don't believe its a thing but I am so insulated and removed from it, unless its hard to see even in plain sight, that it seems like something that only exists on the news.
This piece made it much more real for me. As someone that can't imagine having the sand to jab himself with a needle I can't imagine the desire for anything that could make me do that. It's chilling all the way round.
posted by Senor Cardgage at 4:59 PM on September 11 [2 favorites]


Weird, it's only white people. Wonder why that is?

It's a good question, actually. My wife says that heroin, meth, and benzos are almost exclusively used by the white birthmothers, while the black birthmothers are generally coke and weed users. This is in Indiana, so YMMV, obviously.
posted by Thorzdad at 6:02 PM on September 11 [3 favorites]


Weird, it's only white people. Wonder why that is?

Yeah, I get the "[i]t doesn’t discriminate by race, gender, age or economic background" thing in the editor's note, and I also know that papers like the Miami Herald did award-winning journalism of the 80s crack epidemic, but if we're meant to come away from this story's reporting with a sense of the big picture from an ordinary week, the picture is of a kind of biblical pestilence upon white people.
posted by holgate at 6:53 PM on September 11 [2 favorites]


A thing that can make a brain feel happy?
When there's nothing else to look forward to?
That's a problem that will take some work.
posted by ovvl at 7:02 PM on September 11 [6 favorites]


just for the record, I was complimenting the paper on doing this project, trying (and apparently failing) to make a joke about how the Pulitzers reward papers with prestige for getting away from the daily news cycle and digging deep into important shit that affects people's lives--the "comforting the afflicted" half of the old saying. been a bit cranky lately; probably should have just said what I meant.
posted by radicalawyer at 7:40 PM on September 11


I was with you, radicalawyer.
posted by greermahoney at 8:53 PM on September 11


I was in cincinnatti for several weeks last June. Terri Byrd looks like the woman who menaced me after 12am in front of the downtown hotel where I was staying after I told her that I wasn't going to give her money. I have absolutely no sympathy for her.

In NY I give money to City Harvest and the NY Times neediest cases, which funds 7 other programs in the city. I refuse to enable those who won't seek out those resources...and I have seen outreach vans for several of these orgs helping those physically unable to do so.
posted by brujita at 9:22 PM on September 11 [1 favorite]


In NY I give money to City Harvest and the NY Times neediest cases, which funds 7 other programs in the city. I refuse to enable those who won't seek out those resources...

Let's hope that if you ever suffer from a serious mental illness, you get more compassion from those around you than you are willing to offer others. Of course, if you're the kind of person who loftily only gives to the worthy, you probably can't imagine how you could end up being in need and deemed unworthy of help.
posted by praemunire at 10:53 PM on September 11 [20 favorites]


Heroin is part of this whole mess, not a separate thing. Anyone who isn't rich is losing ground, and anyone who didn't have much ground to lose is in bad shape

Yep. Everyone I've ever known who became an addict decided to at some point along the line. There is a decision point and the sided with their drug of choice over a normal life. And there's always a reason: trauma, depression, glamour, raw addiction potential etc is what middle or upper class people think of. But if your best hope for a normal life is being poor with no health insurance in a shit hole with a wrecked body? well maybe deciding to stay high till you die isn't such a terrible decision. Maybe it makes quite a lot of sense.

One of the things that always strikes me in these stories of lower class white america is the total lack of respect people have for their bodies. They eat poorly, dress poorly, have no fashion or style, don't exercise or take care of themselves or their children. Yes, I know they are poor etc but it's a uniquely american thing to just not give a shit about your body. Maybe it's a relic of protestanism, I don't know. It's got to affect people being raised like that, in a culture where they are taught not to care about their physical selves at all. Or taught to prioritize their feelings over their body's needs.
posted by fshgrl at 11:10 PM on September 11


Praemunire, I see that you didn't bother to repost the rest of my comment about the orgs which do offer outreach.

You weren't there, given the way this woman came up behind me I have good reason to believe that she thought I was an easy mark. Here is Cincinnati's panhandling ordinance:
http://www.ilivedowntown.com/panhandling.html

And yes, I have been hospitalized for depression, where I learned that psychiatrists are assholes.
posted by brujita at 11:45 PM on September 11 [2 favorites]


In my novel, Never Kill A Friend, I have an ethical drug dealer. He sells a mix of fentanyl and LAAM premixed in needles. LAAM is basically equal to methadone but with a half-life of 2.6 days. The fentanyl gives the immediate high to draw in the addict and the LAAM prevents the addict from withdrawal for a day or two: less drug seeking needed.
posted by dances_with_sneetches at 6:28 AM on September 12


I had a dear relative with bipolar disorder. Fortunately for her, she found sympathetic help, was able to manage her condition and (she was of an older generation) in fact hid it from us all until very late in life, when she had a serious episode due to stress over insurance. During that episode she was a mess, she said cruel things and she threatened people (and it was a damn good thing she did, since we were able to get her hospitalized on that basis - otherwise there was nothing we could do). (And I add that this option would not have been open to us if we weren't middle class and white, because getting the cops involved would have been too risky.) (She recovered.)

But my point is that when I see people flailing and threatening on the street, I am reminded that really, truly, there but for the grace of god went my relative. What would have happened to her if she had been poorer, sicker or more disadvantaged?

When you see people who are addicted and ill, those people are aunts and mothers and cousins. Sometimes, also, when you see an intensely respectable elderly bohemian lady with a long and successful career in the artier end of business behind her, sipping her little glass of wine in her vintage high-rise condo with the midcentury furniture that she purchased in the actual mid-century, you might also be looking at someone who is not that far from flailing around on the street.

If you don't feel sympathy, you can fucking think it. We expect sympathy to arise like love or hunger, but it is okay to force it. It's okay to push down negative feelings and think, "I remember this person's full humanity and I see that they have possibilities within them, so I will sympathize". You don't have to feel, you can think.
posted by Frowner at 6:48 AM on September 12 [37 favorites]


fshgrl: you think only Americans dress poorly (by your standards)? That junk food is found nowhere else?
posted by The corpse in the library at 8:15 AM on September 12 [8 favorites]


I think Americans on average have far less interest in their health and appearance than people in any other country I've ever been to outside the third world, yes.
posted by fshgrl at 9:00 AM on September 12


What does how they dress have to do with whether or not they succumb to an opiate addiction? Seems a bit harsh, no?
posted by bigstace at 9:03 AM on September 12 [6 favorites]


well maybe deciding to stay high till you die isn't such a terrible decision

This is a misconception and misleading. At this stage, most of these people are probably not getting "high" -- if they even can, anymore. They are probably just trying not to get sick. (See also, functioning addicts.)

When you are an addict, heroin is never really an escape, it's a daily, or even hourly, hell battle to make sure you have your next fix before your body starts getting really, really pissed off..
posted by Room 641-A at 9:25 AM on September 12 [2 favorites]


And I have mixed feelings about the idea that "caring about your appearance" is an uncomplicated good. If anything, IMO one of the strengths of various American strata is the disregard for fine clothing and so on. "Caring about your appearance" and "taking care of your health" (to the extent that you have the resources) are not the same thing.

Also, bear in mind that both dental and medical care are very, very expensive in the US - dental care is out of reach to a lot of people (said the person who has dental insurance and is still going to have to pony up four or five hundred dollars next month for a crown, and probably for additional crowns as I age, and I actually have pretty good teeth).

And consider things like sleep quality - if you sleep in a noisy place on a broken-down mattress at irregular hours due to your work schedule, that's going to impact your overall health and appearance, but you can't "take care of yourself" into a better job, apartment and sleeping situation.

And consider chronic pain. Chronic pain impacts your health, appearance and sleep in all kinds of ways. If you have a bad job your body starts to give out and hurt (or even if you don't have a bad job) and the likelihood of affording PT and time off is pretty low for a lot of people.

You work sick, you work hurt, you sleep badly, you're tired a lot with no real possibility of holidays or rest, if there's care work to be done in the family you do it with no assistance or respite because we don't really provide those things as a society...all that stuff changes your physicality to a tremendous degree.

Also, working class Americans are routinely told that they are garbage, ugly, degraded, etc. I surmise that the decline of unions and other social formations means the decline of positive images of working class people and in particular working class bodies.

Of course, patrician distaste for the bodies of working class people - except when they're desirable for sexual exploitation, naturally - isn't really going to change whether people dress up or not, so one can take all that "American working people are the ugliest and most slovenly" stuff with a grain of salt anyway.
posted by Frowner at 9:30 AM on September 12 [26 favorites]


Further: It so happens that I am in a union. A lot of people in my union would probably strike an affluent American or European as people who "don't take care of themselves" - they look like middle-aged working class people, fat or skinny rather than ideal, wash-and-wear haircuts, plain clothes that were obviously selected from a limited range of sizes and cuts and were obviously chosen for ease of care as much as anything else.

Every time we're in a room with our betters - for certain values of "better" - I see how clearly class is marked out - that we are fatter, more stooped, more likely to walk with a limp, more likely to have ill-fitting clothes and cheap accessories, less likely to have glossy hair and whitened teeth, etc. You know why we don't have those things? Because our betters withhold them, or rather the money and time to get them. Our choices are between care for our families and fancy clothes, tooth whitening and so on. The richer people with professional class jobs - the ones who boss us, whether they're smart or dumb, informed or ignorant - don't have to choose, and they won't have to work until they drop in the traces, either.

Seeing this written on our bodies - seeing my own body go this way - gives me particular disdain for the rhetoric of "caring for your appearance" as a sign of personal worth.
posted by Frowner at 9:48 AM on September 12 [22 favorites]


I have called 311/911 when I have seen people in physical/mental distress or being physically abused. This was NOT my experience with this woman.
posted by brujita at 10:04 AM on September 12


Yes, I know they are poor etc but it's a uniquely american thing to just not give a shit about your body. Maybe it's a relic of protestanism, I don't know.

i dunno...maybe it has something to do with the american healthcare system being insanely crappy and prohibitively expensive? nah, it must just be that poor americans are dumb as shit and can't be bothered to exercise
posted by burgerrr at 10:20 AM on September 12 [9 favorites]


Or, also maybe they grew up eating and dressing just fine until they started spending all their money on drugs.
posted by Room 641-A at 10:23 AM on September 12 [1 favorite]


I think Americans on average have far less interest in their health and appearance than people in any other country I've ever been to outside the third world, yes.

Why don't people in developing nations care more about their health?!
posted by beerperson at 10:23 AM on September 12 [7 favorites]


One of the things that always strikes me in these stories of lower class white america is the total lack of respect people have for their bodies. They eat poorly, dress poorly, have no fashion or style, don't exercise or take care of themselves or their children. Yes, I know they are poor etc but it's a uniquely american thing to just not give a shit about your body. Maybe it's a relic of protestanism, I don't know. It's got to affect people being raised like that, in a culture where they are taught not to care about their physical selves at all. Or taught to prioritize their feelings over their body's needs.

America. Where we can blame the poor for their problems rather than the shitty infrastructure under which they live. What a country.

Careerbuilder study: Seventy-eight percent of full-time workers said they live paycheck to paycheck.
Nearly 10 percent of those making $100,000 or more say they can't make ends meet.
Overall, most workers said they are in debt and many believe they always will be.


GoBankingRates' most recent study came up with a more conservative number: An Estimated 122 Million Americans are Living Paycheck-to-Paycheck.
"But these issues aren't as scary as the data GoBankingRates released in its latest study on the after-effects of the Great Recession. GoBankingRates asked six pressing yes-or-no questions that pertain to recession preparedness to more than 1,000 Americans, and each and every answer was worrisome. Here's a sample of the results:

64% of those surveyed did not have multiple sources of income.
61% did not have enough saved to cover six months of living expenses.
78% aren't ready to search for a new job with an updated resume.
68% said their investment strategy doesn't account for a recession.

But here's the crème de la crème of statistics: 49% of Americans are living paycheck-to-paycheck. Considering that the Census Bureau estimated a U.S. population of 323.1 million last summer, 77.2% of whom are adults 18 and older, this suggests that up to 122 million Americans are currently living paycheck-to-paycheck. That's a horrifying statistic."


Try getting sick without health insurance and see how much it costs you. When you're living paycheck to paycheck and have a family to support. For that matter, try needing dental surgery without insurance.

Yes, I know they are poor etc but it's a uniquely american thing to just not give a shit about your body.

Sadly, it isn't. But when you're done blaming Americans who are struggling to make ends meet for their poor health and appearances, perhaps it would be worth pondering the nature of privilege.
posted by zarq at 10:49 AM on September 12 [14 favorites]


Yes, I know they are poor etc but it's a uniquely american thing to just not give a shit about your body.

Let's not also forget that certain types of mental illness come with an extreme aversion to, or disinterest in, personal hygiene. My partner used to work in homes for people with mental illness and addictions, and one of the most difficult tasks is helping people to recognize the incredible health and social disadvantages that come with poor hygiene and to take a shower, do laundry and wash their bedding. When the whole therapeutic system revolves around respect for one's agency, you cannot simply force them into a shower like you could in the days of institutionalisation. It's a difficult problem that has no easy solution, but shame is no solution at all.
posted by klanawa at 11:06 AM on September 12 [3 favorites]


One of the things that always strikes me in these stories of lower class white america is the total lack of respect people have for their bodies. They eat poorly, dress poorly, have no fashion or style, don't exercise or take care of themselves or their children.

I pulled my clothes out of trash bags that were rounded up by the women of the church. I was always tall and a different shape than my peers so I looked pretty funny in those clothes until I could start buying my own stuff (from thrift stores). My family for a time ate the Tyson pressed turkey product that's behind the deli case - except they were they ones cut in half or quarters for quality testing - again donated by someone from church. These also came out of giant plastic bags. We'd spend an evening as a family portioning them and freezing them so we could put them in casseroles or what not later. The casseroles were put together from the dented unlabeled 5c/10c cans bought out of the back of the warehouse. We'd shake the can and hope it was stuff that went together because we could only really afford to open 4 or 6 a day and we couldn't waste any of them. At this time we were living out in the country - on well water - well water that has been so contaminated by Tyson that they later had to help pay for a whole rural water system because the wells are not safe for human consumption anymore. At the time ours was a sulfur well which didn't smell great to bathe in. So I'm really sorry if it hurt someone's sensibilities to look upon me, my family, or others like us. I had little options in my fashion, the appearance of my body, or even the way I smelled. That must have been so difficult for people like to you gaze upon.

And just to be clear, in my home growing up there were never any drugs, alcohol, or cigarettes. But I guess we still ate poorly, dressed poorly, and had no fashion or style. Later on my own I would find drugs, booze, and smokes but according to you I chose that deliberately out of trauma or some shit.
posted by I'm Not Even Supposed To Be Here Today! at 11:07 AM on September 12 [26 favorites]


You realize there's a wide range of choices between "report the person to the authorities" and "do nothing but think judgmental condemnation of them"? Off the top of my head, there's "try to feel some compassion for the experience and pain that has brought them to this point" as a start.
posted by Lexica at 11:12 AM on September 12 [3 favorites]


[Folks, gonna suggest that throwing out negative generalizations about addicts/Americans/whatever is really not going to be the seed of a good conversation in here; a bunch of rebuttals already given. Gonna suggest we leave it at that and maybe let's move back to the actual articles that have specifics we can ground our discussion in.]
posted by LobsterMitten at 11:20 AM on September 12 [2 favorites]


[Also, I had deleted and then undeleted a few comments, so please reload.]
posted by LobsterMitten at 11:21 AM on September 12 [1 favorite]


I know exactly what it's like to have been abused and have sympathy for those others who have been.

I have very little tolerance for those who refuse to respect my right to be left alone, which in addition to addicts thinking that I'm an easy mark includes: prosleytizers, charity muggers and those who think women are public property.
posted by brujita at 11:58 AM on September 12 [1 favorite]


which in addition to addicts thinking that I'm an easy mark includes: prosleytizers, charity muggers and those who think women are public property

Some of these things are not like the others.
posted by klanawa at 12:08 PM on September 12 [7 favorites]


And consider chronic pain. Chronic pain impacts your health, appearance and sleep in all kinds of ways. If you have a bad job your body starts to give out and hurt (or even if you don't have a bad job) and the likelihood of affording PT and time off is pretty low for a lot of people.

And chronic pain doesn't care about poverty or lack thereof. I'm extremely fortunate to have a great job that gives me all the time off I need for doctors appointments, amazing health insurance, etc. But still my options are (a) take opiates [hydrocodone] or (b) quit my job and hope that helps. Since (b) means giving up good healthcare and enough money to actually do something about the pain for the hope that the pain is purely work-related, it's not a real option IMO. I've _also_ been fortunate to somehow not develop a real tolerance or problematic addiction to opiates after 10+ years on them, but it could have gone the other way.

And the government's solution to this involves making it harder to get prescription drugs, which makes the likelihood of turning to illegal opiates much higher. It's become a huge chore to get even a small hydrocodone prescription, if I wasn't able to take off work a couple times a month for doctors appointments and so on I'd be forced to find a black market alternative (up until a few years ago it was the same as any other prescription, now very few doctors are willing to prescribe it at all).
posted by thefoxgod at 2:42 PM on September 12 [2 favorites]


Klanawa, some of these things overlap.
posted by brujita at 5:37 PM on September 12


Did the OP remind anyone else of the middle chapter of 2666?
posted by panama joe at 6:42 PM on September 12


Dressing poorly is a way to not stand out. When you're in that position you don't want to draw attention to yourself. I work with a lot of women in these situations and when I bring clothes for them the one thing they insist on is that it not be nice. Dressing nicely puts a target on them for theft, assault, or worse.
posted by Marinara at 10:02 PM on September 12 [3 favorites]


These articles never mention the constipation that comes with opioids.

It feels like a shot put hanging in your gut.

I wonder if fewer people would try it if that were more well known.
posted by poe at 5:07 PM on September 13


Michael Young, 40, stands on the corner of Massachusetts Avenue and Melnea Cass Boulevard. On his left, cars whir past; on his right, about two dozen people line up along the chain link fence overlooking Boston’s Interstate 93, some drifting in and out of consciousness, others plotting their next high.

Within a two-block radius of this street corner is the Boston Medical Center, homeless shelters, numerous methadone and suboxone clinics, and an open air drug market. “They have everything right here,” says Gwendel Wilson, 54, with his arms stretched. Wilson, along with Young, sleeps on this dusty strip of grass some nights. “It’s all condensed.”

While many cities cluster health services, and have hotspots for certain kinds of drug use, Boston is unique in that here the two clusters overlap, creating a longstanding culture of both illicit opioid use and rehabilitation. “It’s bringing together people who are both seeking solutions and those that may not be in treatment but are struggling with drug addiction,” says Robert Sampson, the co-director of the Boston Area Research Initiative.
posted by ChuraChura at 9:36 AM on September 14


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