A few Saturdays ago, my wife and I spent the morning volunteering at a community garden in our San Francisco neighborhood. After a few hours of casual labor, we and the other volunteers dispersed to our respective destinations: tasty brunches, day trips to wine country, art-gallery tours. It was a perfectly normal day, by San Francisco standards.
That very same Saturday, in the small Ohio town where I grew up, four people overdosed on heroin. A local police lieutenant coolly summarized the banality of it all: “It’s not all that unusual for a 24-hour period here.” He was right: in Middletown, Ohio, that too is a perfectly normal day.
Folks back home speak of heroin like an apocalyptic invader, something that assailed the town mysteriously and without warning. Yet the truth is that heroin crept slowly into Middletown’s families and communities—not by invasion but by invitation.
Very few Americans are strangers to addiction. Shortly before I graduated from law school, I learned that my own mother lay comatose in a hospital, the consequence of an apparent heroin overdose. Yet heroin was only her latest drug of choice. Prescription opioids—“hillbilly heroin” some call it, to highlight its special appeal among white working-class folks like us—had already landed Mom in the hospital and cost our family dearly in the decade before her first taste of actual heroin. And before her own father gave up the bottle in middle age, he was a notoriously violent drunk. In our community, there has long been a large appetite to dull the pain; heroin is just the newest vehicle.