National Reviews Kevin Williamson for a Discussion on the Opioid Crisis

'True Tales of America and Hope in the Time of Fentanyl and Meth." So reads the subtitle of Sam Quinones's latest, The Least of Usa. I am not entirely convinced these tales are true—by which I do not at all hateful to propose that they are something other than factual, that they are inventions and fictions. Quinones is not that kind of bad writer. He is a different kind of bad writer, the kind who is capable plenty—and sometimes much more than capable—when it comes to relating the stories recounted to him past the feckless deplorable sacks with which his terrarium of homo failure is populated but, at the same time, utterly unable to organize those deplorable stories into anything other than the tired, hackneyed, shady-back-alleys-of-capitalism narrative that i expects from a 62-yr-old Berkeley graduate.

Both men would probably loathe the comparison, only Quinones is in a sense a version of Tucker Carlson, another child of the quondam California aristocracy. Quinones is the son of a Harvard-educated Claremont professor, and he'due south a former president of the Association of Literary Scholars and Critics later appointed to the board of the National Council for the Humanities past George W. Bush—only one who offers himself as a journalistic tribune of the plebs, a vocalization for a marginalized underclass he knows in an essentially anthropological fashion, who are not his people just his profession. I do not fault Quinones for being born to privilege; I blame him only for his failure to overcome the difficulties imposed by such an upbringing.

These deficiencies are both intellectual and moral, and, consequently, narrative. The Least of Us is mainly a series of potted biographies of junkies. There is Tom Ruah, who graduated from prescription painkillers to injecting heroin and described the experience equally "similar seeing God." (One of the problems with telling junkies' stories in their ain words is that their accounts are almost invariably silly and self-aggrandizing, and packed with clichés on the level of "like seeing God.") Ruah steals and cons his style through life until dying from an overdose of acetylfentanyl. There's Lou Ortenzio, the junkie doctor who acts as a pipeline for other addicts and dodges prison house but loses his medical license, becoming a pizza deliveryman before going on to piece of work with other recovering addicts.

And there's Joss Sackler, a standard-upshot society-page grotesque. Well-nigh her, Quinones writes:

The oversupply tonight is hither for a operation-art piece. The piece centers around Joss Sackler. Ms. Sackler has a PhD in linguistics; she owns a vesture line; she employs an unabridged PR team; she is said to be very interested in "women's bug." She is, above all, the wife of David Sackler, who is the son of Richard Sackler. Both men had resigned from Purdue Pharma's board of directors a twelvemonth earlier. This evening's event is billed every bit Joss et Ses Amis. That is French for "Joss and Her Friends." But the event also has a subtitle. It's in English: "Undeterred."

Mrs. Sackler appears in a blue Elizabeth Kennedy evening gown, which is cut from her trunk slice by piece and burned as she stands on a rotating platform in the pose of an Olympic discus thrower. She is then spray-painted. The performance is photographed by Lynn Goldsmith, reported in Town & Country, and, of course, applauded. "Curated" wines are served, and Mrs. Sackler schmoozes with Keith Richards's daughters before flashing her breasts at the audience, to additional applause.

The Sacklers are the villains of the book, and they are easy targets. Purdue Pharma'south executives and lath members, the Sacklers prominent among them, took an attitude of indifference toward prescription drug abuse that was as Olympian every bit Joss Sackler's discus-thrower pose. The business firm has not exactly covered itself in glory. Quinones reports that opioid pain medication is "virtually its but product," merely that isn't quite right; Dun & Bradstreet puts the sales of its Avrio Health subsidiary at near $200 million a year, plenty to buy a truckload of Elizabeth Kennedy evening gowns and truckloads of curated wines. Avrio's big products are Senokot, Colace, and Peri-Colace—all laxatives—Betadine antiseptics, and magnesium supplements, presumably a by-product of its laxative business. That's an all-American portfolio: hillbilly heroin and laxatives, Betadine for life'southward trivial scrapes, and dietary supplements, the communion wafer in the Reformed American Church building of Self-Improvement.

The Purdue story is familiar enough by this point, an hands digested (hold the Senokot!) morality tale with corporate villains in black hats. That Quinones and much of the residue of the media, and the land, have accepted this simplistic tale more than or less at face value is a very expert example of why it is that we 21st-century Americans, owners of vast wealth and controllers of immense power, cannot grapple in a direct mode with common, longstanding social bug.

It is non as though this is our first get-round with a national episode of socially subversive substance corruption. The Temperance League of yore didn't just spring upwards out of atavistic Puritan cloy—widespread public drunkenness and private alcoholism were major social issues in the 19th century, and not only for old-stock Protestants worried well-nigh drunken Indians and Irishmen. The commercial press at the fourth dimension was full of advertisements offering phenomenon cures for the scourge of dipsomania, including such famous and now forgotten products every bit the "Double Chloride of Gold Cure for Drunkenness."

And this is inappreciably our first trouble with heroin, opiates, or opioids. In the late 19th century, Bayer's heroically named chemical compound—Heroin—was offered equally a treatment for morphine addiction, among other ills. Businesses have always institute a way to profit from human misery, compulsion, and decadence, and, in that sense, Purdue is not so dissimilar from Anheuser-Busch InBev, Yum! Brands, or Pornhub. The Sacklers, comical and obscene equally they are, are very much similar the ugly rich who came before them and the ugly rich who will, nosotros may predict with metaphysical certitude, come after them.

Quinones, whose 2015 book Dreamland proved to be key in alerting American elites to the opioid crisis, here demonstrates an unfortunate determination to strength the complex facts of social life into a simplistic morality tale. In his rendering, addiction is something that simply happens to unhappy people.

Opioids may rob them of their health, their families, and even of their lives, just it is shallow moralists such as Quinones who would rob them of their humanity by recasting them as amoebae swept along by market forces without any sort of meaningful moral autonomy or personal agency. And it is, of course, precisely this abandonment—or rejection—of personal agency that is most characteristic of the personality of the modern American drug aficionado. Opioids are, in this telling, but a storm that rolls into town to rain misery on those who practice not take the resources to get in out of the weather. But the workaday publicists downwards in the marketing department do not, in fact, have the godlike powers ascribed to them by our voguish anti-capitalists. Purdue wanted to sell more pain pills and was willing to put considerable resources into pushing those out the door; Barnes & Noble would like to sell a lot more books than it does, but all the marketing money in the world is not going to become Americans to purchase a book of poetry written by someone not named Dr. Seuss.

Religious writers and preachers ofttimes run across trouble with metaphor and analogy. Considering God is then mysterious and then entirely alien to the human experience, religious writers often cease up leaning very heavily on metaphor. An example is the metaphor of the judge for the enervating moral aspect of God, which Christian writers in particular often internalize so thoroughly that they reduce the Almighty to something like a literal approximate in a court of law. Journalists writing well-nigh complex social bug often fall victim to the same tendency, taking the metaphorical "wiring" and "rewiring" of the human encephalon as literal, fifty-fifty though the similarity of the man encephalon to a computer or some other electronic device is only superficial and analogical. Quinones has learned a little about the neurobiology of addiction, and he writes about the brain equally though information technology were a literal mechanical apparatus, with parts that are "shut downwardly" by drugs. He personalizes neurotransmitters and hormones: "Dopamine tells us" this, while "serotonin says" that. This is a mode of transferring the agency away from human beings to neurobiological processes. But human beings are not mechanisms, and even the most powerful social force in modern American life—by which I mean moral cowardice—is non sufficient to make them then.

Quinones'south need to brand everything about everything else leads him downwardly some silly roads, i.e., his occasional impuissant forays into presenting capitalism and habit as aspects of each other:

Drugs … shut down the prefrontal cortex.… An fond encephalon is ane where a raging primitive advantage system has silenced the prefrontal cortex's wise counsel. The reward system, unbalancing the natural competition among encephalon chemicals, gains a monopoly on the brain.

You can see the railroad train wreck approaching, and then it arrives: "Adam Smith, in describing capitalism in The Wealth of Nations, called monopoly a 'derangement' and 'hurtful to the society in which information technology takes identify.' That sounds to me like what's going on in the addicted brain." Normal stupidity cannot account for those sentences. That kind of nonsense requires a carefully cultivated mind.

I do not demand reporting well-nigh opioid addiction to be a morality story that fits in with my own moral assumptions—in fact, I do not need it to be a morality story at all. I call up of the placid Buddhists contemplating the end of the human species—and, hence, the end of human suffering—in Michel Houellebecq's The Simple Particles: "The Enlightened One, if he had meditated on it, would non necessarily have rejected a technical solution." Mitigating destructive behavior, including the corruption of opioids and opiates, is likely to bear witness as much a technical (pregnant medical) question as a moral 1, in the long term.

What I do demand is for the story not to be a morality tale with a cowboys-and-Indians level of moral sophistication that obscures the facts of the example. The Least of Us is an set on on intelligence in places, but mostly it is a missed opportunity—because there is much that is of involvement in information technology. What happens to saccharide-addicted rats when you give them a drug used to treat heroin overdoses? That very interesting scenario comes up in the book, but Quinones is likewise much of a dabbler—a neuroscientific dabbler, a moral dabbler, and a tourist—to make the most of it.

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Source: https://www.commentary.org/articles/kevin-williamson/the-denial-of-agency/

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