A cursory reading of national media seems to confirm this long-standing narrative of White, middle-class drug users as victims, not criminals. For example, the New York Times’ coverage of suburban drug users has invited sympathy and identification with the people in the stories, encouraging the reader to see themselves, their child, or someone they know in the stories of good people raised in loving families who became opiate addicts almost by accident. The accompanying pictures to these articles show white people hugging as they leave drug treatment and well-dressed parents looking at pictures of the son or daughter they’ve lost to heroin. Photos of attractive and smiling teenagers—someone’s children—remind us of the promise and potential extinguished by an overdose. And yet, the Times is also savvy enough to contextualize this new drug panic when they write, “In Heroin Crisis, White Families Seek Gentler War on Drugs” (Oct. 30, 2015). They subtly remind the reader that non-White addicts get punishment and harshness when they refer to the White opiate crisis as a “new era” characterized by “striking shifts… some local police departments have stopped punishing many heroin users.” It is only because the users are White that a redemptive narrative of families and police coming together to stop opiate use can gain traction in print and in legislative bodies.
“Heroin or nothing,” as Steven, a man I met at the syringe exchange, put it. Those were his options. He’d broken his back several years before, and opiates helped with the lasting pain as he continued in manual labor, working odd jobs and moving furniture. But treating the physical pain now meant dealing with the “pain in the ass” of the system, of the methadone treatment providers and probation officers. Steven was among the many people I encountered who had initially started using legally obtained opiates to treat pain from work-related injuries, only to find their access limited by increasingly stringent state prescribing regulations. People like Steven turned to heroin not because they preferred it, but because they could no longer get prescription painkillers.
Conversations with addiction medicine providers echo the judgment about which some of the drug users I’ve spoken with complain. In the New York Times’ coverage of the suburban opiate panic, doctors identify with their patients, perhaps even knowing them socially. This is not the case in Vermont, where the class divide between doctors and patients is wide. Even the most sympathetic physicians I spoke with endorsed monitoring and coerced treatment. One said that there was “no high-level thinking in Vermont” and “no one understands the medical piece.” When I asked about the best way to treat addiction, this doctor told me it was suboxone (buprenorphine) combined with “tight control… put an ankle bracelet on them and tightly monitor them… If you mess up, you go to jail. Folks do best when there are consequences.” Other medical providers were frustrated with their patients, viewing their poverty-related struggles such as lack of transportation or difficulty finding employment as “excuses” for not succeeding in recovery. Their patients’ continued smoking and poor eating habits are also a regular source of frustration. One doctor who called addiction a “disease” insists that the criminal justice oversight of a sick person is not a contradiction, but a mechanism to ensure sorely needed “accountability.”