INTRODUCTION
WHAT’S THE TRUE SCOPE OF THE OPIOID CRISIS? WHEN I try to describe it to someone who hasn’t experienced it themselves, I find myself falling back on the terms we use to encompass genocide, natural disasters, and global war. It’s a tsunami of loss.
It’s so big that words fail to describe it.
Imagine that, every three weeks, 9/11 happens again. That’s how many people are dying due to opioids in this country.1 Or, imagine that a full jetliner crashes every three days: every man, woman, and child on board is erased. Dead. Gone. That’s what the opioid crisis is doing. But it’s not just in one city: It’s everywhere, killing people from every walk of life. And we’re not hearing those planes hit the ground. Most people go about their lives without thinking twice about these catastrophic losses. They are unaware of the tragedy happening all around them.
In 2017 alone, according to the New York Times, “about as many Americans are expected to die this year of drug overdoses as died in the Vietnam, Iraq, and Afghanistan wars combined.” That’s an increase from 2016, when 59,000 lives were lost to drug-related causes. Drug overdoses are now the leading cause of death for Americans under the age of fifty.2 It’s a massive crisis, gaining momentum every day.
If we do not take action now, predictors show that another 500,000 people could die of opioid-related causes within the next decade.3 Half a million people. That’s a sharp increase, even from the record death tolls we experience today. Easy access to synthetic opioids, a new generation of extremely potent prescription painkillers, and the prevalence of fentanyl all contribute to the daily body count. Ultra-strong painkillers have become the norm in our country, and we take them at obscenely high rates. In 2016, 236 million prescriptions were written for opioids in the United States. That’s about one for every American adult.
As America’s dependency on prescription painkillers has increased, our overdose rates have grown as well. That’s not a coincidence. The pharmaceutical companies that dump millions of dollars into our advocacy programs, launder money through local and national nonprofits, and buy elected officials in every branch of government have created a national drug crisis. Our dependency on those pain pills was supposed to garner higher profits. And it did—but it also spiraled into a massive public health crisis, spurred by irresponsible prescribers, ignorant lawmakers, and ineffective treatment centers.
The American drug epidemic has further exposed the deep inequity of race, class, and gender in our country. Who gets help for their substance use problems, when, and how are all reliant on how white and well-off they are. Although addiction is a universal problem in America, we don’t have universal care to combat it. We’re on the Titanic, and there are no seats in the lifeboats for the people in steerage. Soon we’ll all be underwater. That’s why we haven’t stopped the crisis in its tracks: The people who have the most power to make noise, call for help, and effect change get just enough help to maintain the status quo. The system is set up to privilege them, but that help doesn’t trickle down. The rest of us are too poor, sick, and ashamed to take on the deeply flawed system that criminalizes addiction, pushes Big Pharma’s agenda, and doesn’t educate people about harm reduction or recovery options.
We cannot stop a crisis that we do not understand. American Fix will help you understand what the opioid crisis is, why it is happening, who it affects, and how we can stop it. We must find a solution; this is our Black Plague. It’s our AIDS crisis. It is real, and we are sinking fast. If we are going to survive, we can’t wait.
It’s easier to explain and express what’s happening inside the opioid epidemic through personal stories. After all, we’re not statistics. We’re people.
I walked into treatment for the last time on Thanksgiving Eve, 2014. It wasn’t exactly a Kodak moment. I was terrified, exhausted, and sick of myself. My addiction had ruined every aspect of my life. I wasn’t proud of who I had become. As I filled out the intake form, I swore I’d never speak about this moment or the years leading up to it ever again. I wanted to get help, get my life back together, and just move forward. I didn’t ever want to think about what I’d been through, much less write a book about it.
But as I began to heal from my addiction and lost some of the people closest to me to overdoses, I became more willing to share my experience. I learned that my story was a jumping-off point. It created connection and community. So I started reaching out. Yet every time I spoke up, many people told me to keep my mouth shut. They said I had nothing to offer. They lectured me to wait until I was “ready.” But when would that day come? Ultimately, it wasn’t up to them. It was up to me. I stopped waiting for permission to tell my story. And when I began speaking up, it opened the door for many others to do the same.
However, my recovery didn’t begin and end with me. If anything, it opened my eyes to the extreme difficulties my peers were experiencing. Recently, I found out that Mikey, one of my best friends who’d been sober for three years, had relapsed on heroin. He was kicked out of his sober living and was couch surfing. That hit me hard, right in the gut. Mikey was my first roommate in sober living. We were in rehab together multiple times, both trying for years to reach the other side of our addiction. Mikey’d just had a kid. Things were going really well for him. But then his relationship soured, and he picked up something to cope with his emotional pain. Without insurance, his options for treatment were incredibly limited.
Although I talk to literally hundreds of people every day about their friends, kids, and family members, and speak to groups about recovery and advocate for policy reform, I was totally unprepared to deal with Mikey’s relapse. I was dumbfounded. I panicked. I found Mikey and put him in touch with his mom, and only then did he feel comfortable asking for help.
He was homeless. At the bottom again. But his voice was so ashamed and scared. I could tell what it had taken for him to actually admit he needed help.
If Mikey hadn’t made that call—if his mom hadn’t talked to him first—if his family hadn’t had the cash to cover part of his treatment—if he hadn’t qualified for a scholarship at the rehab—if I hadn’t been able to jump into my car and pick him up—what would have happened? What happens to people who don’t have an immediate safety net in place?
We know what happens. They don’t make it.
I have lost many friends to the disease of addiction, and each time, it’s like another part of my heart is ripped out of my chest. It hurts. But there are certain friends, like Mikey, whose death would permanently alter me. My ability to love, to be close to others, would change forever. I didn’t want to feel that pain. But because I feel it, and because I know so many moms and dads in America are feeling it right now about their own children, I need to share this story.
I can’t be silent, knowing what I know about the opioid crisis. I can’t sit still. It’s just not who I am; the mentality of standing by while hundreds of lives are lost every day is an injustice to the dead and the families who mourn them. This book is for them—for the people who didn’t make it—and for those of us who did. This book is for our parents, friends, families, and the vast network of people who are working for justice in recovery.
I set out to write this book with the intention of bringing you into my world. It’s closer to yours than you think. It’s a multibillion-dollar industry built on seedy rehabs, struggling families, jails and prisons, emergency rooms, community centers, syringe exchanges, methadone clinics, pill mills, and pharmacies. It is a place with a lot of pain in it—but a lot of hope too. This book will introduce you to the world of addiction and recovery and explain what it’s like to live there.
This book is not about me. It’s about you. It’s about the people you love, the friends you’ve known. It’s about your neighbors and the people who work in your office. It’s about your kids, your parents. It’s about the secret America that is all around you, whether you realize it or not.
Throughout this journey, I questioned myself every day. Why haven’t we been listening to recovery? Why are the same old stories being told about addiction? Most of them are dead wrong. Now we have a new way to talk about this illness and the crisis that feeds off our silence. Some of the solutions to it have been staring us in the face, without our acknowledging them.
The opioid crisis is at your doorstep. It may not have impacted you yet, but it is just a matter of time before addiction touches your life. One in three Americans is affected by this crisis. If you do not have substance use disorder, you can be certain that at least one person you know does. That person may be suffering in silence, unable to ask for help—as I did, for more than a decade. They may have chosen to live in the dark, isolated from their friends and family.
This book is for the person who does not have a voice.
Please keep an open mind. Put aside your assumptions. Forget your prejudices and preconceived notions. You don’t need those old ideas. Everything you think you know about this public health crisis is wrong. Believe me: I’ve lived it. Let me show you what I’ve learned.
1. IT STARTED WITH A PILL
A Single Irresponsible Prescription Initiated the Perfect Storm of My Addiction
IN 2005, I WAS LIVING IN FLORIDA, directly in the path of Hurricane Katrina. As the storm closed in, the blue sky faded to yellowish gray. My town’s streets were empty. News stations played nonstop warnings about staying inside, stocking up on water, and preparing for the high winds and heavy rains that the hurricane would bring. Normal people complied. But not my people. We were out in the storm. Because the thing is, drug addiction doesn’t take a day off. It doesn’t matter what the weather is like. As the local news played yet another dramatic clip of palm trees being buffeted almost sideways, I was carefully counting my pain pills and wondering how long the storm would last.
The number of pills I had wasn’t enough. It was never enough.
A day before Katrina hit, I got a last-minute appointment at a pain clinic. The place was crammed with people, standing room only. I was rushed through a ten-minute “checkup” and given a prescription for the medication I desperately needed. Then it was on to the pharmacy. However, I was out of luck. Most businesses had shut down due to the hurricane. I tried my usual pharmacy and called a dozen more, but no one answered. Then the storm came, and the whole city lost power. Two days later, when the rain and wind had eased up, I was strung out, shaking, and desperate. The people I knew who would sell me extra pills or trade prescriptions with me told me about a new pharmacy that had opened right before Katrina hit the Florida coast.
Clutching my scrip in my sweaty hand, I drove as fast as I could to this new place. Fort Lauderdale was still a ghost town. Fallen branches, debris, and even parts of houses littered the abandoned roads. I saw downed power lines and trees that had been crushed by the storm. Yet my addiction gripped me so strongly that I didn’t give a single thought to my own safety. I made it to the new pharmacy and pulled into the already full parking lot. Sure enough, this was the place—and I wasn’t the only person who’d heard about it.
Inside, the power was still out. Fluorescent bulbs powered by a plug-in generator lit the pharmacy with a ghostly, flickering glow. The waiting area was crowded with people moaning, complaining, sighing, fighting, and just waiting for their number to be called. This place charged almost double what I paid at my usual pharmacy. I didn’t care. Nobody here cared. We just wanted our drugs.
Without power, there was no way to operate a cash register or any kind of computer. A huge, heavily muscled bodyguard stood next to the pharmacist’s counter, arms crossed over his chest, glowering at anyone who moved. He wore a pistol in a shoulder holster. I had no doubt that he knew how to use it. I slid into a chair. The pharmacist called someone’s name, and I watched them hurry to the counter, eager to collect their pills. The pharmacist took a wad of hundred-dollar bills from the person, put them into a lockbox, and noted the purchase in a long, thin ledger. Next. Another bottle of pills. Next.
Copyright © 2018, 2020 by Ryan Hampton
