The Opioids of the People

The United States government has launched a new anti-opioid campaign featuring true stories of people so desperate that they inflicted gruesome injuries on themselves to get another prescription.

Such stories have already been more effectively told in poetry. The epidemic’s most searing skald is William Brewer, a son of Oceana, West Virginia, a post-industrial town so gripped by addiction that it is nicknamed Oxyana.

We were so hungry; Tom’s hand
on the table looked like warm bread.
I crushed it with a hammer
then walked him to the ER to score pills.

The United States has now experienced its second consecutive year of declining life expectancy. A significant part of the change is driven by what have been called ‘deaths of despair’ among middle aged White people: as well as drugs, alcohol and suicide are also spiralling. Death rates among White Americans aged 45-54 increased by 0.5% per year between 1999 and 2013, and there is no sign the trend has reversed since. While the death of celebrity chef Anthony Bourdain this week has brought fresh awareness of suicide, rates have been rising for years, especially among middle-aged men, and are now 25% higher than they were at the turn of the millennium.

The suicide rate has spiked most sharply in a belt of states across the northern tier from Pennsylvania to Idaho, but the increase in overall middle-aged mortality is more widely spread, with hotspots along the West Coast, swathes of the South, and the Midwestern rustbelt, regions that otherwise have little in common.

Such a turn to self-destruction is not unprecedented in recent times. In the years immediately before and after the collapse of the Soviet Union, most of the countries that made it up saw a staggering decline in life expectancy dwarfing what has been seen – so far – in the USA. Particularly at risk were the same type of people: middle-aged working-class men from the ethnic majority.

Many simply drank themselves to death. Alcoholism in Russia was hardly a problem that suddenly emerged in the 1980s. But some concatenation of factors occurred in those years that made hundreds of thousands of people simply seek oblivion. Suicide rates also reached historically high levels.

Where once was faith,
there are sirens: red lights spinning
door to door, a record twenty-four
in one day, all the bodies
at the morgue filled with light.

Whatever its brutalities, for much of its existence, the USSR provided its people with hope. Their present travails were simply necessary sacrifices on the way to new and better world, where each would give according to his abilities and receive according to his needs. I remember my old Soviet politics lecturer at Queen’s talking about her granny in Leningrad, a victim of many years in the Gulag on no other grounds than that a quota needed to be filled, who still cried when Stalin died.

Then, even before the system collapsed, people stopped believing in it. Without faith, people considered their existing condition, which was often dreadful, and the prospects of it ever improving, which were remote.

The American Dream is often impenetrable to those of us from other countries. Italians are Italians and Chinese are Chinese. People in Catalonia, Northern Ireland and Kurdistan wage bitter, sometimes violent, disputes about sovereignty and identity.

But Americans are defined by hope. Like the Soviet Union, the USA has since its inception been a national project with eschatological intent, aimed well beyond its shores: the shining city on the hill that would be a beacon guiding the whole human race to a better future.

The dream had three main strands – liberty, morality, and materialism. Without the fetters of the Old World, without its restraints on free expression and immobile class systems, free men would become better men, in the process obtaining two chickens in the pot and a car in the garage.

Of course, this incipient Eden was built on the twin original sins of extermination of the Natives and enslavement of Africans. Yet for a long time, it was always possible to discern an arc of American history bending, in fits and starts, towards justice.

The material side of the project has been in trouble for nearly half a century. The median American is poorer and, I think more importantly, much less secure than he or she was in 1973.

At about the same time, the moral side of the project went into overdrive after the cultural revolution of the 1960s. Americans are freer from cultural restraints than their ancestors could have imagined; those from traditionally persecuted minorities enjoy legal protection and affirmative action that would once have seemed utopian; the country elected a Black president twice; and technology has allowed people means of self-expression and potential companionship with kindred spirits that is truly revolutionary. Access also to sexual expression in myriad arousing ways that would once have been considered taboo or outright illegal.

The technology, perhaps most of all, is toxic to the dream. America leads the world in what might be the most significant technological revolution since the emergence of agriculture. The technology has made some Americans Croesus-like riches and new realms of personal autonomy. But most Americans are poorer and miserable as a result.

If an empire is based on liberty, what happens if liberty simply reveals the tawdriness of humanity without restraint?

As the IT pioneer Jaron Lanier recently said, “We’ve disrupted absolutely everything. Politics, finance, education, media, relationships — family relationships, romantic relationships — we’ve put ourselves in the middle of everything, we’ve absolutely won.” He didn’t mean it in a good way.

Germany can be lead to crushing defeat by Nazis but remain Germany. England could lose not only its empire but the rest of Britain and still be England. But an America that is not great and that leading the world to further greatness is no longer the United States of America.

Hence the power of Trump’s message, doubled precisely because it is opposed so fiercely by the liberals of left and right alike who promised that civil rights, technological advancement, and global free trade would lead America to the brightest Golden Age in human history.

Who can stand another night
stealing fistfuls of pills
from our cancer-sick neighbors?

Nobody can. Which is why something was always going to break. Trump is not the cause, but merely the most toxic symptom of a nation, indeed a whole Western civilisation, in crisis.

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