A Visit to Opioid Country

Aaron Thier contemplates the connections between privilege, addiction, and recovery.

Aaron Thier | Longreads | October 2018 | 8 minutes (1893 words)

 

In early November, I got a mild cold. I felt bad for a day, then felt better, then started coughing and didn’t stop coughing for a whole month. As if by way of compensation, the doctor gave me an orange flask of codeine cough syrup. This was a problem for me because I’m a recovering addict. But I didn’t mention this, because I’m a recovering addict. I said to myself: Think of it as medicine.

I was supposed to take 5 mL every four hours, “as needed.” I knew 5 mL was either one teaspoon or one tablespoon, and this confusion was more or less genuine, but I strategically avoided looking up the answer and chose the larger dose. This led predictably to a drug experience. My eyes turned red, I felt a buzzing sensation, I stumbled and walked into walls, I couldn’t relax enough to pee, I couldn’t speak at the right volume, I craved sugar. I was aware that I was behaving more cheerfully than usual, but I did not experience a feeling of good cheer. My head hurt very much. After four hours, I drank what I judged to be a second tablespoon directly from the flask.

I’d been sober for almost eight years. I had not forgotten the danger that opioids represented for me, and I was mostly operating in good faith. I really was desperate to stop coughing. For the next two days, I took the cough syrup more or less as directed, the right dosage at the right intervals. During this time my wife and I had an unusual number of meetings and social obligations, and my own feeling was that I met these obligations with tremendous dignity and grace. True: My eyes were red, my head was buzzing, my equilibrium was disturbed, my voice was either too loud or too soft, sometimes I couldn’t keep my eyes open, and my behavior was manifestly the behavior of a person who was on drugs. But it was OK because I was following the doctor’s orders.

Four days after I filled the prescription we left our cosmopolitan New England town and traveled to the woodsy corner of opioid country where my wife grew up. The occasion was our niece and nephew’s birthday party, but because of the complexity of the interpersonal relationships in opioid country, where families get blown apart and then reconstitute themselves in surprising ways, there were many overlapping family units, and lots of people I’d never met. It was my first visit since the 2016 election. I had some feelings I wanted to express, and I knew I should try not to express them.

We parked outside the house. My wife went in with our son, and I lingered by the car, where I drank a dose of cough syrup from my flask. It had only been an hour since the last dose, but luckily I was coughing and coughing, and I could justify it on that basis. I also knew that the cough syrup would help me to behave well — another benefit. I went inside. My mouth tasted like despair.

I’d been sober for almost eight years. I had not forgotten the danger that opioids represented for me, and I was mostly operating in good faith. I really was desperate to stop coughing.

It wasn’t that I had no idea what to expect out there in rural Pennsylvania. The problem was that I knew exactly what to expect. In the kitchen, a man and a woman were discussing the repeal of the Affordable Care Act. They didn’t know that the repeal effort had failed in the Senate. They thought they were rid of that controversial law, and they were happy about it. But life was no better than it had been. They were both in bad health. The man, who was no older than 55, said he couldn’t walk up two sets of stairs without “huffin’ and puffin’.”

In the living area, my sister-in-law was playing Guess Who with another adult. She said, “Is your person black?” A man in a Spyder parka, overhearing this and apparently deciding that the word “black” seemed racially charged in this context, said “Whoa! That’s not PC!” I think he was hoping to catch my liberal sister-in-law in some kind of hypocrisy. She said, “It’s OK to be either black or white,” and she said it in a nice way, but the man seemed very insulted.


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My eyes were stoplight red. I almost fell down. My head hurt. I felt a great need for water, but I didn’t drink any. All of this was the result of taking opioid painkillers. And all of the family dynamics in the room had also been shaped by opioid painkillers. Nor was I the most impaired person at the party. My nephew’s biological father was sitting at the kitchen counter with a distant smile on his face. He had signed away all his parental rights, recognizing that it was the best thing for his child. It was an act of great decency, but it was also an act of despair.

I discussed my cough syrup with my brother-in-law, who’d had his own terrible problems with opioid painkillers.

“It’s not even good,” I said, either too quietly or too loudly. “I’m not even getting anything out of it.”

He understood.

“I’m not sleeping, even when I’m sleeping.”

He understood.

“And my head. But I want to take more.”

He understood, but he had to go away now and complete a task. I stood in the center of the room, doing nothing, talking to no one. I wanted to drink water, but I didn’t or couldn’t. Instead I ate too much cake. After a while I went downstairs and drank more cough syrup right out of the bottle. I wasn’t sure how much time had passed since the last dose, and I didn’t care.

It should not have been a surprise that the mood out here, post-election, was no better than it had been pre-election. It certainly did not seem as if they had won and we had lost.. Everything was the same. Some of us were eating cake, some of us were not. Some of us were taking drugs, some of us were not. We were still struggling with the stuff we’d been struggling with in 2016.

Somebody said, “They’re fixing all that about taxes.”

The man in the Spyder parka kept talking about refined sugar, and the depth of his misunderstanding in this respect was so complete that I couldn’t understand what he thought he was talking about. He said several times that the birthday cake had no refined sugar in it, but it was full of ordinary white sugar. It was so sweet that it made my jaw ache. He too had been discussing the Republican tax plan, but he didn’t know what he meant about that either. One reason he didn’t know anything was that he was not media literate. I had a lot of advantages over him, but I had never thought hard about what this particular advantage really amounted to: I knew how to evaluate news sources, which meant that I had access to information about reality and I could aspire to a greater understanding of my world. This man watched Fox News and had been conditioned by Fox News to think that Fox News was all he could watch, which meant that he didn’t have access to information about reality, and the only understanding he could aspire to was just a set of politically charged conspiracy theories. It’s one thing to say that he had his opinion and I had mine, and he did say so, several times, but reality is reality. He didn’t know what sugar was in a biological or biochemical sense, and because of that he had no hope of improving his diet, even though he wanted to.

Now the party seemed to evaporate, and we were alone with my brother-in-law and his family. I craved salt. If I sat still for too long, my brain would just shut right off. I’d lost all sense of time. It seemed like it was early evening. I took more cough syrup, and more after that. Eventually we inflated the air mattress and I slept the sleep of the drugged.

In the morning, I felt so bad that I could hardly believe it, and I lay in the cold thinking about that man, with his Fox News and his handful of fake dietary facts. I’d learned that he was my nephew’s biological grandfather. I thought about this, and I thought about sugar and opioids, and I thought about my own ability to sift confidently through different sources of information. That ability is not innate, obviously. It is a matter of education, which is a matter of privilege, which is a matter of luck.

Addiction is also a matter of luck. It’s difficult for a regular person to understand this. Regular people want to say: Stop doing that. An addict knows at some level that there is no moral or intellectual component. By the same token, overcoming addiction has little to do with courage or strength. You get lucky. External factors align. Arbitrary circumstances matter. This is how AA and NA work: They create new circumstances within the existing constraints of a complex life, and in that way they give you half a chance.

I thought about my own ability to sift confidently through different sources of information. That ability is not innate, obviously. It is a matter of education, which is a matter of privilege, which is a matter of luck.

As for me, I happened to reach a crisis point at the end of a graduate school semester, which meant that I’d had nothing to do for three months and it was easy enough to fly home and sweat for a while as I got sober. I had money to protect me from daily life. I had parents who understood what was happening. My nephew’s biological father will never be in that position; he needs to hope for some other kind of luck. More likely than not, he won’t get it. I knew very well that my advantages over him were circumstantial, but I had not previously understood that for me this was probably the difference between life and death.

We only stayed one night in opioid country, and I didn’t take any cough syrup the next morning. I didn’t want to have to tell my wife that I was too fucked up to drive. But not taking it in the morning meant that I continued to sober up as the day went on, and the perspective I gained in that way meant that I was much more wary of the cough syrup by the afternoon. The cycle was broken; I didn’t go down the rabbit hole. The next morning I poured it all out.

That guy had been talking about refined sugar throughout the birthday party. He talked and talked, loudly and incoherently. You heard him from across the room. But he wasn’t talking about it for no reason. He was very fat, with that strange hardness of the abdomen that speaks to a deep and dangerous ill-health. He was essentially dying of his ignorance. He was dying of Fox News and bad luck, just as his son was dying of the same bad luck, just as I myself would probably have died if I’d grown up poor in rural northeastern Pennsylvania. Privilege is a complex sociological phenomenon, but in the case of an individual it isn’t hard to get right down to it: I wasn’t born knowing what glucose and fructose are, but my parents taught me.

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Aaron Thier is the author of three novels, most recently The World is a Narrow Bridge.

Editor: Sari Botton