(reported and written with Jack Hitt)
Day 3: The Epidemic and the Election
Primary day in New Hampshire turned crisp and clear in the morning, bringing out the crowds and the enthusiasts and the crazies. In the lobby of our hotel, we encountered a pair of young journalism students from Ohio thrilled to be involved in their first election, and a 72-year-old woman with bright red toenails showing through her sandals who told us how handsome Donald Trump is.
“Just look at that great smile,” she cooed.
After running into a mob of infectiously youthful Sanders supporters in Concord, we made our way to The Millyard, an enormous complex of old mill buildings that the city of Nashua is now trying to remake into “mixed-use.” Signs on doors and offices offered up fencing lessons and lighting fixtures and barre, and we could hear a piano being plunked in the distance as we sat around a table and talked about how swiftly young lives can be derailed, and what might be done to put them right.
Six of the eight people at the table with us with us were heroin addicts. Another was a meth addict. Another an alcoholic. All attend the Nashua chapter of Heroin Anonymous as part of their recovery. None of them look like what most people think of when they think about a heroin addict, which was one of their main points. Ranging in age from 21 to 38, they all appeared young, healthy, even beautiful. All of them worked, and several were in college. Seven of the eight were white.
Seven of them were also supporting a candidate in the primary: two for Sanders and one each for Clinton, Cruz, Rubio, Christie and Bush. Not all of them could vote. “I’m a felon,” Jasmine, a 31 year-old Sanders supporter, told us in the blunt fashion of those who are serious about their recovery programs. For years, she said, she had embraced the “lifestyle” and even the idea of her own, early death. Now she works at Chick-fil-A and sports lovely, cursive tats on her forearms, reading, “Only God Can Judge Me” and “God is Love.”
How to help people like Jasmine is the issue that has sandbagged all the candidates this election cycle. In the national media, the problem of widespread drug addiction among respectable (read: white) people emerged seemingly out of nowhere, and now it piles up more bodies every day than driving fatalities. But “the heroins,” as the Nashua addicts refer to themselves, know that it’s been there all along.
“It’s not like in the movie when the alcoholic in a trenchcoat is under the bridge drinking, and the heroin addict is in the alley overdosing,” says Brion, an engineer and the smooth-faced, 37-year-old moderator of the group. Unlike Jasmine, he did not embrace his own self-destruction. He got hooked when he was 14, and continued to use as a family man working a full-time, high-powered job.
He told us how at the end of the day he used to run into many of the other professionals and tradespeople he worked construction projects with on the streets of Lowell, Massachusetts: “You’d see ’em and say, ‘What’re you doing here?’ and they’d say, ‘Same thing you are!’”
The numbers are crazy: in New Hampshire, one person will die of an overdose almost every day this year. In Manchester, the cops seized 200 grams of heroin in 2010; in 2015, it was 27,000 grams. The pattern is so alarming that in October, participants in a WMUR Granite State poll ranked drug abuse as the most important issue in the 2016 presidential campaign, surpassing jobs and the economy. From 2003 to 2013, the number of heroin deaths nationally has quadrupled, to 8,000.
The exposure of our collective “dirty laundry,” as Maggie called it, left the candidates in New Hampshire sounding uncharacteristically empathetic. Nearly half of the Republican candidates had personal stories of their experience with the addictions and deaths of loved ones. Carly Fiorina spoke movingly of losing a step-daughter, Ted Cruz a half-sister, Chris Christie a dear friend. Jeb Bush recounted how his daughter Noelle went to jail for abusing anti-anxiety medication and smoking crack cocaine: “She went through hell, so did her mom, and so did I.”
All right, so Donald Trump, congenitally unable to sympathize with anyone, vowed that his famous wall would solve the problem: “[Drugs are] pouring across the Southern border, and we’re going to stop everything.” Still. Most of the candidates addressed the subject with rare nuance and insight.
Yet welcome and rare as such moments are in elections, the politicians have carefully avoided the issue of just how this scourge reached such proportions in the first place. Much of the media has cast it as a heartfelt cry of white despair, and/or that of a displaced middle class. This is undoubtedly part of the story, one the massive, abandoned mills of Nashua bear mute testimony to.
But the mills started moving out of New England even before the Great Depression of the 1930s. The other, dirty little secret of our new epidemic is that it was planned and marketed in the boardrooms of Big Pharma, as cunningly as the sales campaigns of rotten mortgage bonds that tanked the world financial system in 2008.
“Opioids”—or painkillers, as normal human beings call them—hit the market in the late 1990s. Drug executives at Purdue Frederic later conceded—under oath, in court—that they actively deceived doctors by marketing Oxycontin early on as “abuse-resistant,” insisting that the number of users who got addicted was “less than one percent.” Some drug companies may have been more well-intentioned—or willfully naïve. Fenatyl, for instance, was marketed as a “time-release” drug that would give patients carefully limited doses of painkillers at safe intervals. Grind it up and take it altogether, though, and it provides a kick 30 times more potent than most street heroin.
Purdue targeted doctors who prescribed painkillers most liberally, and sales reps were incentivized with bonuses that could reach as high as a quarter-million dollars. The bonus money was a drop in the bucket when compared to the soaring profits. So were the fines that the federal government meted out when it tried to rein in the campaign to addict America. After pleading guilty to fraud in a 2007 lawsuit, Purdue paid a $600 million fine, which sounds like big money until you understand that the market for Oxycontin alone last year was $3 billion.
The human cost of this has been appalling. From 2003 to 2013, prescription painkiller sales quadrupled, and so did overdose deaths.
Everyone around the table was extremely conscious of what an industry not just drug peddling but drug recovery has become, especially in New Hampshire, which ranks 49th out of the 50 states in public—and affordable—programs to help addicts. Many private programs cost a small fortune, forcing addicts into all sorts of ruses to secure treatment.
Tracy, a slight woman with dirty-blonde hair pulled back in a tight ponytail, remembered fellow addicts who would get drunk, even though they didn’t like alcohol, “because that way they could fail a breathalyzer test and get help for alcoholism on their insurance.” John, a dark-bearded 23-year-old now studying psychology, talked of how others would cross the border and “pretend to be homeless, down in Massachusetts,” which has started a number of groundbreaking programs to fight drug abuse and keep addicts out of our bulging prisons.
All wanted the federal government to support supervised, effective, long-term programs, instead of the shorter-term state and private programs that now punt addicts back out onto the streets in as little as two weeks. “I’m not a huge fan of Big Brother and going straight federal with everything,” said Tracy, a Cruz supporter. “But I do think that as serious as it is, it needs to be taken away from the municipalities and states. Someone needs to man up and federally govern this.”
“If you could come up with a pill that would cure this, I would take it. But then I’d probably think, ‘I wonder how two pills would make me feel.’”
She wrote up an entire detailed paper for our meeting, on the sorts of things she thought might work, while Brion compared the problem to our recently renewed war on cancer. “If you look at the federal money that goes into these cancer research departments, they are closely monitored. ‘What are you doing with the money? Is there a program?’ ” he said. “Can we guide these research centers for addiction so that they are not under the rule of thumb of whoever owns it?”
No one believes there’s such a thing as a cure-all. Jessie noted that he was in a long-term program for two years, but the day after he came out, he picked up his old addiction and “died” on a hospital table before being revived.
“If you could come up with a pill that would cure this,” John said ruefully, “I would take it. But then I’d probably think, ‘I wonder how two pills would make me feel.’” No pill is likely to come anytime soon. President Obama has recently proposed spending a well-targeted $1.1 billion on drug addiction nationwide, but like almost every other major initiative he has floated since 2011, it is likely dead-on-arrival in Congress. Several of the candidates have developed plans for tackling the problem—John particularly liked Hillary Clinton’s idea to set up a database that would keep addicts from “doctor shopping” for liberal prescribers.
But even with bipartisan support, reforms are likely to encounter strong obstacles. A few weeks ago, the Centers for Disease Control (CDC) was set to issue new guidelines that would limit how doctors could prescribe opioids. Then it was hit with a lawsuit from the Washington Legal Foundation, a libertarian advocacy group that regularly litigates in the interests of drug manufacturers. The group was outraged that one of the CDC’s decision-making bodies included the president of Physicians for Responsible Opioid Prescribing. She was, the foundation raged, an “opponent of opioid prescriptions.” The CDC has delayed the guidelines.
We left The Millyard at sunset, around the time of the heroins’ scheduled meeting. Through the lighted windows of the old mill floors, we could still see boys wielding epées and girls pivoting on pointe. All over New Hampshire, people were still queuing up to vote. The message they sent included nothing about drug addiction. Exit polls showed that they cared most about jobs, and the economy and—among Republicans at least—terrorism. Donald Trump promised to build his wall again in his victory speech, and keep all the bad things, and all the bad people, on the other side.
Big Rosie was so depressed by his missed predictions that today he forewent his usual breakfast—eight scrambled eggs, a rasher of bacon, a steak, a small stack of pancakes, toast and a pitcher of orange juice—in favor of a fruit cup. We tried to console him by pointing out that he was one of the very few pundits to pick Kasich at least as high as second. Big Rosie will bounce back.
If Bernie were to face off in the general election against Trump, it would be the first all-New York race since FDR ran against Thomas Dewey in 1944, a match-up of giants. Before that, the only such all-New York contest was between another Roosevelt—Teddy, the sole president ever born in New York City—and one Alton Parker, an obscure Tammany Hall judge nominated by the Democrats in 1904 (mostly to stop William Randolph Hearst). Don’t bet the house on this happening. And what if Michael Bloomberg jumped in, too, generating an all-NYC “battle of the boroughs”? (Trump is from Queens, Bernie from Brooklyn, Bloomberg from Manhattan, or sometimes Bermuda.) In 1944, New Yorker Norman Thomas finished third, with 0.16 percent of the vote, running on the Socialist Party ticket. Bloomberg would probably do better. A little.
Jack has become a mobile germ factory, a walking, breathing collection of disease. I mean, this is like something out of The Strain. His coughs and sneezes have become Bunyanesque, and I expect at any minute that his pupils will dilate and his six-foot long, insect-like proboscis will snap out at someone’s throat (hopefully, Chris Christie, remember him?) and vampirize them. Sharing a hotel suite with the man is now like living in a tubercular ward. In Russia. In a prison. Nonetheless, he can still drive, wheeling down the icy, wet highways of New England like a NASCAR driver. We are on our way, thankfully, to the wafting tropical breezes of South Carolina, where we can immerse ourselves in his relatives’ hospitality and home cooking. I intend to jump directly into a full vat of she-crab soup.
Another of our distinguished contributors, Steve from Brooklyn, writes in: “Last night I was treated to Brian Williams saying that Hillary Clinton’s use of a teleprompter was ‘diminishing.’ Tell us about the ways that people can diminish themselves on TV, Mr. Williams.” And West Coast Kev notes that, “A socialist and a fascist each won by 20 points. Might not be the best year to be a triangulating centrist.” Keep the cards and letters coming, folks.