Saturday, January 12, 2019

Review: Dopesick: Dealers, Doctors, and the Drug Company that Addicted America

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America Dopesick: Dealers, Doctors, and the Drug Company that Addicted America by Beth Macy
My rating: 4 of 5 stars

In some very tight-knit Appalachian communities heroin has become a social contagion. The epidemic has changed the region now to the point that the crisis has become ingrained in the culture itself and nearly everyone here has ties to someone who has struggled with addiction.
Opioid addiction is often described as an “equal opportunity” problem that can afflict people from all races and walks of life, but, while true enough, it obscures the fact that the opioid crisis has particularly affected some of the poorest regions of the country, especially in politically unimportant places, places such as Appalachia, a place that now feels mostly forgotten, where a huge number of Americans, many of them poor rural whites, have died in the last couple of decades of what one Princeton researcher has called “diseases of despair,” including alcoholism, suicide, and drug overdoses.
Appalachia itself is no stranger to exploitation by faraway captains of industry and Beth Macy has done an excellent job in exposing the corporate greed and regulatory failure that has played such a heavy hand in our current crisis and places the responsibility for the epidemic squarely on Purdue Frederick, makers of OxyContin, and its sales division, Purdue Pharma, which engaged in largely predatory marketing practices to sell a drug that has wreaked havoc on the lives of 2.6 million Americans. In the first section of the book, she addresses “big pharma” in telling detail, outlining how the overprescribing of pain medication created a market demand that was then met by illegal drug peddlers on the street. Section two follows the spiral of addiction as users of prescription pills, who are no longer able to afford their habit, turn to heroin, a cheaper and more lethal solution to feed their addiction and then in the last section, switches the focus to the addiction treatment industry itself.
People who are living in poverty are
especially at high risk for addiction and its consequences and if we want to be serious about reversing the opioid crisis and preventing future drug crises of this scope from happening in the future we will also need to address the economic disparities, housing instability, poor education quality, and lack of access to quality health care, including evidence-based treatment, that currently plague many of America’s disadvantaged individuals, families, and communities.
Marcia Angell, writing in The New York Review of Books, said, “As long as this country tolerates the chasm between the rich and the poor, and fails even to pretend to provide for the most basic needs of our citizens, such as health care, education, and child care, some people will want to use drugs to escape. This increasingly seems to me not a legal or medical problem, nor even a public health problem. It’s a political problem. We need a government dedicated to policies that will narrow the gap between the rich and the poor and ensure basic services for everyone. To end the epidemic of deaths of despair, we need to target the sources of the despair.”
It would however be too simplistic to blame a town’s opioid epidemic directly on the recession and loss of employment opportunities. But, nevertheless, it did create the social vacancy and desperation that we see in so many of these communities. People here no longer feel like they have a purpose. Many drug addicts are solely trying to escape the reality that the place they call home can no longer offer them anything and that’s a hard reality to live with. People are slowly becoming aware that the American Dream has been taken from them. That the American Dream is no longer theirs to dream.
The opioid crisis, as well as the national response to it, has also forced us to confront our conflicting cultural logic about whether addiction is a moral, social, or biological problem, or some combination of the three. But addiction is not something that people choose. It’s a disease and it’s one of the hardest diseases to fight. While many people have embraced this idea of addiction as a disease, a vocal cohort still dismisses this as a fantasy and regards addicts as community embarrassments. But if they had a heart problem or cancer it’d be talked about in school and with teachers, there would be support, other families would be offering to help with childcare, bringing casseroles over. However, since there is a shaming element embedded in small-town culture, and with this problem in particular, and because it is perceived to a be a problem of choice and morals, the addict is shamed. There’s no sense of community support and addicts end up becoming further and further isolated.
My own father was, and by every measure, still is, an addict and will likely be for the rest of his adult life. As Macy explains, “Opioid addiction is a lifelong and typically relapse-filled disease. Forty to sixty percent of addicted opioid users will achieve remission with medication-assisted treatment, according to 2017 statistics, but sustained remission can take as long as 10 or more years. Meanwhile about 4 percent of the opioid-addicted die annually of overdose.”
I relate this, because I know what it is like to live on the periphery of addiction, the potential danger of being neglected, taken advantage of, or even raged against and I know the real costs of addiction to families. Aside from dollars spent, addiction costs a great deal of time, energy, and emotion. Whether it is numerous stints in rehab, trips to court, or new and mounting responsibilities, addiction can dramatically change family dynamics. It can affect every facet of a person’s life and can lead to martial problems, divorce, loss of employment, and criminal charges. As these negative outcomes build, a person may fall deeper into the grips of substance abuse, using it as a means of comfort and escape, ultimately creating a self-fulfilling cycle. “Nothing’s more powerful than the morphine molecule,” Macy writes, “and once it has its hooks in you, nothing matters more … the only relationship that matters is between you and the drug.” As one user says, “It’s like shooting Jesus into your arm.”
Macy is certainly not the first to write about the opioid crisis, but she does bring a new level of humanity to a story that is too often carelessly splashed across headlines and just as easily dismissed and Dopesick, if it does nothing else, forces us to revise our image of what an addict actually looks like.
There are times when a book needs to be written, but there are also times when a book needs to be read, even though it hurts. Dopesick is one of those books.

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Friday, December 28, 2018

Review: The Hate U Give

The Hate U Give The Hate U Give by Angie Thomas
My rating: 3 of 5 stars

Starr Carter is constantly switching between two worlds; the poor, mostly black neighborhood where she lives and the wealthy, mostly white prep school that she attends. There is an uneasy balance between these two worlds however and soon what little balance there is shatters after she witnesses the fatal shooting of her childhood friend at the hands of a police officer. Starr must then struggle to find her own voice and decide to stand up for what's right, not only for herself, but also for her community.
In most liberal discussions about the recent police killings of unarmed black men, there is always an underlying assumption that the police are supposed to protect and serve the population. That is, after all, what they were created to do. If only decent relationships between the police and the community could be re-established, this problem could be resolved. But this liberal way of viewing the problem rests on a misunderstanding of the origins of the police and what they were created to do. The police were not created to protect and serve the population. They were not created to stop crime and they were certainly not created to promote justice. They were created to protect the new form of wage labor which emerged under capitalism in the mid-to-late 19th century from the threat posed by that system’s progeny, the working class. In other words, the police were created to be the domestic enforcement arm of capital.
Sam Mitrani, an Associate Professor of History at the College of DuPage, wrote that, “Before the 19th century, there were no police forces that we would recognize as such anywhere in the world. In the Northern United States, there was a system of elected constables and sheriffs, much more responsible to the population in a very direct way than the police are today. In the South, the closest thing to a police force was the slave patrols. Then, as Northern cities grew and filled with mostly immigrant wage workers who were physically and socially separated from the ruling class, the wealthy elite who ran the various municipal governments hired hundreds and then thousands of armed men to impose order on the new working class neighborhoods.”
At least since 1855 the Supreme Court has ruled that law enforcement officers do not have a duty to protect any individual, despite their motto of “protect and serve.” Their duty is to enforce the law in general. For example in 2005 the Court ruled, 7–2, in, Town of Castle Rock v. Gonzales, that a town and its police department could not be sued for failing to enforce a restraining order, which led to the murder of a woman's three children by her estranged husband. And just this month a federal judge has ruled that the school district and the Broward County Sheriff's Office had no legal duty whatsoever to protect students during the shooting earlier this year at Marjory Stoneman Douglas High School. U.S. District Judge Beth Bloom dismissed the lawsuit brought by fifteen student survivors of the shooting against six defendants, including the Broward School District, the Broward Sheriff's Office and school resource deputy Scot Peterson as well as campus monitor Andrew Medina, who knew Cruz and saw him arrive on campus, but did not confront him.
We are uniformly inundated with the notion about the need for police in our communities, but if the police do not even have a duty to protect our children, then what purpose do they serve and, more importantly, who’s interests do they serve? That answer, at this point, should be self-evident. For instance if your landlord refuses to fix your kitchen sink or if your boss refuses to pay you in a timely manner, do the police jump in to help you out? No. If you do not pay the landlord on time however will the police show up to evict you? Yes. If you strike with your fellow workers over unfair labor practices will the police show up to escort you off of the property or force you back to work? That answer again is unquestionably yes. The Police fully represent only the interests of the ruling power and of the ownership classes, almost never the average poor or working class person. The primary function of the police is to simply uphold the status quo, enforce property rights and collect revenue for the state through enforcing largely arbitrary and predatory mandates. Most of their crime fighting efforts amount to responding to violence with more violence, almost no effort is ever spent towards preventative methods and when they do try to prevent crime, their standard tactic is prejudiced profiling based superficially on class. However, it’s almost always the case that those who enact this repression on behalf of the powerful are working class themselves. Soldiers, policemen, bailiffs, prison officers, and border control officials are amongst those who perform jobs antithetical to the interests of the working class. The inherent contradiction is in the fact that these people share the plight of the workers whilst being the most powerful instruments of established power to maintain that plight.
But how should we respond to this problem? I don’t have an answer really and neither does Angie Thomas, who has written a largely overhyped book with no emotional, let alone sociological or historical, payoff. Her book is a didactic issues filled novel directed at young adults and yet, even at this level, I was still hoping for something a little more profound and nuanced concerning the complexities the novel is attempting to address. But it remained however an overly simplistic and idealistic depiction of current events in modern America, especially concerning the relationships between poor communities and the police.

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Thursday, December 27, 2018

Review: Capital Gaines: Smart Things I Learned Doing Stupid Stuff

Capital Gaines: Smart Things I Learned Doing Stupid Stuff Capital Gaines: Smart Things I Learned Doing Stupid Stuff by Chip Gaines
My rating: 3 of 5 stars

What really separates those who make it from those who don’t? It’s difficult to say. There are just too many variables.
But to be successful, you can't just surround yourself with low-frequency people for very long periods of time. You can't just keep eating the same crappy food just because your spouse or colleague is making those same choices. Your days must consistently be spent on high-quality activities. Success requires balancing the essential, spiritual, relational, financial, and physical things in your life and removing everything else.
Saying "No" to great but ultimately irrelevant opportunities is hard. Giving up bad habits is hard. Changing your belief system and expanding your vision is hard. But so what, life is hard, get over it.
Hard work, the ability the pick yourself up after experiencing a failure, and a passion for what you’re doing, is the only sure way to get anywhere in life and seems to go quite a long way in defining an individuals level of success.
This book has given me a true appreciation for just how much Chip Gaines has accomplished in his life and I admire who he is as a person. His depth and humor are both bolstered by a consistent message of optimism and hope.
I am by nature a very pessimistic person, and optimism of any kind generally annoys me, but I didn’t find Chip’s optimism cheesy, cloying, or eye-rolling. For me it was an optimism based in realism and a logic rooted in a “don’t sweat the small stuff” mentality.
Ultimately, Chip’s message is a simple one really: “Don’t let the fear of failure keep you from your pursuits. I know I wouldn’t be where I am today if I hadn’t taken a few chances—sometimes they panned out, but even when they didn’t, I never let failure break my focus. If you believe in something, you gotta go after it.”

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Friday, December 14, 2018

Review: Vox

Vox Vox by Christina Dalcher
My rating: 1 of 5 stars

Most of us begin our lives seeing our parents as the ultimate authority, and we incurred their wrath whenever we questioned that authority. Unfortunately, this bad habit is often carried over into adulthood where we replace our parents with either a boss, a teacher, a commander, or a god. Rather than question their authority, we blindly follow it. This fallacy alone has likely resulted in more deaths, pain, suffering, and misery than we would perhaps ever be willing to appreciate.
This is the latest speculative thriller to jump on The Handmaid’s Tale bandwagon. It opens during the administration of a totalitarian leader elected after the term of America’s first black president. The Pure Woman movement has hijacked the capital and the culture. American women are allowed to utter no more than 100 words a day. Any more and a wrist strap fitted with a counter zaps its wearer with an electric shock, relatively mild for first-time infractions, but intense enough to cause serious injury later on. Women who campaign against the newly installed regime or commit other offenses against the gender based laws become slave laborers in scarcely populated states. However just when Vox needs to sink in and give a fuller sense of its own political and social world, the story becomes fatuous. As the narrative progresses it just gets further and further away from anything that is interesting or meaningful and ends up morphing from a glum prophecy into a Hollywood-style action movie, complete with gun-toting bad guys howling, “Don’t do anything stupid, Jean”, and a wrap-up that is so convenient it beggars belief. Carrie O’ Grady, writing in The Guardian said, “If Dalcher wants to scare people into waking up, she would do better to send them back to the history books, rather than forward into an overblown, hastily imagined future.”
Dystopian fiction is supposed to function by holding up a mirror to our world showing us our sins, the worst things about the way we’ve built our society highlighting our concurrent systemic problems. One of the ways they do this is through exaggeration, taking a trait we can easily recognize in our own communities to its logical extreme: The Handmaid’s Tale exaggerates the rhetoric of the Reagan-era “moral majority” while Vox exaggerates the way women are taught not to speak up.
One theme of feminism that has never quit made sense to me , even on a gut level, is that of the oppressive patriarchy. I agree that men are powerful and are more often in positions of leadership making the decisions for the group. However, it has been my experience and I have been witness to far more examples of this leadership being one of protection and concern for the well-being of others than one that oppresses and seeks to harm women. But what concerns me the most about Vox, and it should concern you as well, is it’s remarkably conformist outlook. The main character Jean openly admires her lover Lorenzo’s aggression and dislikes her husband’s more mild-mannered demeanor. At one point she celebrates the idea that “Lorenzo would beat the living shit out of someone” who attacked her. But surely these are the very same patriarchal values a novel decrying the patriarchy should eschew. Women aren’t allowed to speak but, even in this imaginative flight of fancy, men are still required to speak with their fists. It’s a striking reminder of the limited roles we’re all still required to play.
I was instructed all throughout grade school, as every child is, that silence is golden. But now, as an adult, I know that maxim only applies in libraries and reading Vox has at least made me keenly aware of just how deep that conditioning goes. Even though I disliked the book and it’s themes immensely I did find myself wondering how often I choose to remain silent when perhaps I shouldn’t.

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Sunday, December 2, 2018

Review: Bird by Bird: Some Instructions on Writing and Life

Bird by Bird: Some Instructions on Writing and Life Bird by Bird: Some Instructions on Writing and Life by Anne Lamott
My rating: 4 of 5 stars

Some years ago, not long after I moved to Illinois from Kentucky, I was being interviewed for a job. When the interviewer asked me, what would I do with my time if having to earn a living wasn’t an issue, one of those off the wall questions designed to reveal some quirks of personality, I told him that I would be a writer. He sipped his drink. There was a long silence. And he ended the interview. That’s generally been the response I’ve always received to that answer. Silence and incredulity.
Writing never seems like a real profession to anyone, unless you’ve actually been paid for something you’ve written, most of the time not even then. Sometimes I do get asked the follow up question, why do I want to be a writer, and my answer, without fail is, “I will not be silenced again.” Writers are very angry people. When you sit down to write you’re basically shouting to the world, “Listen to me you sons of bitches I have something to say!”
Flannery O’Connor once said that anyone who survived childhood has enough material to write for the rest of his or her life. I think she was mostly right.
When I was younger I accepted being alone quite a bit and so writing ended up becoming a way for me to prove that I existed. “Writing and reading decrease our sense of isolation. They deepen and widen and expand our sense of life.” As Lamott says. But writing also provided me with the opportunity to be taken seriously when there was no real cause for anyone to do so.
I’m not a “real writer” myself, but I do spend quit a bit of time writing. I first started writing when I was probably around seven or eight. I was very shy then but loved reading and writing above everything else. I remember in the first grade I even went dressed as a writer for career day. What a writer was supposed to look like I had no idea, but for me it consisted of wearing a sweater vest, glasses, slacks, and penny loafers. I even had my grandfather’s old tobacco pipe I carried with me in order to complement the ensemble. I must have looked more like a college professor because that’s what everyone kept calling me. But no, I was a writer dammit! Don’t you see the sweater vest? I was also in the habit of writing and illustrating my own novels and would bind them with what seemed like the cheapest staples you could possibly buy and distribute them to the family for their enjoyment, whether they did or not is still up in the air. The stories typically revolved around the same characters, my dog was always the main protagonist followed by a revolving cast of characters consisting of other neighborhood pets, and they would all come together to solve some mystery that seemed to be plaguing their small community of misfits. I was a big fan of James Howe at the time so I ended up basing most of my stories on his. I was very serious about the whole endeavor and thought about the stories and characters quit a bit.
It has occurred to me that maybe the problem with saying you want to be a writer is that you’re really talking about something else. Maybe what you mean is that you want to be a successful writer or a published writer, but those are two very different things, to write and to write something that’s meant to be read, are two very different forms of writing and as Lamott cautions, "Publication will not make you more confident or more beautiful, and it will probably not make you any richer." Adding, “Publication is not going to change your life or solve your problems.”
J. G. Ballard in an interview once said, “Don’t regard yourself as being anyone special, as having any right to even a modest financial success, because you’re a writer. Also, I’d warn anyone beginning his career, that the days when a writer could have a career, are probably over. I think it’s going to be more and more difficult for the novelist and short story writer to make a living of any kind over the next 20 years.” Adding that one should be, “very wary about committing yourself entirely to being a writer. I think the writer’s role is very much in decline, at least for the time being.”
So why in the hell would anyone want to be a writer? I think it’s because of what Chinua Achebe once said about the power and importance of writing, “If you look at the world in terms of storytelling, you have, first of all, the man who agitates, the man who drums up the people — I call him the drummer. Then you have the warrior, who goes forward an fights. But you also have the storyteller who recounts the event — and this is one who survives, who outlives all the others. It is the storyteller, in fact, who makes us what we are, who creates history. The storyteller creates the memory that survivors must have — otherwise surviving would have no meaning… This is very, very important… Memory is necessary if surviving is going to be more than just a technical thing.”
Lamott says that, “We are born astride the grave and this planet can feel as cold and uninhabitable as the moon.” So if writing and reading can lessen our anxieties then thats reason enough to pursue them.
One main draw back to Lamott’s book however, is that it’s more of a memoir than an instructional guide and she doesn’t really offer any advice on revision, which is one of the most important skills a working writer could ever master. Good writing evolves, through revision, and is not a process of sudden, inspired, irrevocable statements but one of incremental and iterative explorations. And I actually find this notion kind of exciting, this notion that we find out what we think by trying, however ineptly at first, to write it.
I am first and foremost a reader and one of the principal reasons for becoming a writer, that I’ve come across, is that it helps you to become a better reader, which is the real payoff and Lamott’s book is well worth a read. It’s actually well worth several reads.

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