The United States of Addiction

Across the street from my apartment is a row of some dozen or more tents usually surrounded by piles of trash and inhabited by people we typically refer to as homeless. (To me, that’s about as useful as referring to my neighbors in this building as “the housed.“) The easternmost tents have the most stable residents, while the ones to the west come and go. Some die of drug overdoses; some are hauled away by the police or ambulance; and, hopefully, some manage to escape life on the streets by happier means. They spend much of the night yelling at one another, particularly if one of the campers is a woman. It’s nobody’s idea of a stable community. Yet Los Angeles has tens of thousands of similar campers, whose numbers seem to be growing every week.

What are the causes of this phenomenon? One could certainly point to economic causes, such as the insanely rising cost of housing. There are also various social causes, such as people released from prison. In my neighborhood, many of the tent dwellers are military veterans as I live two miles from a major Veterans Administration hospital. I suspect, however, that the major causes are a combination of mental illness, alcoholism, and drug addiction.

I am currently reading a new book by Sam Quinones entitled The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth. Its author talks about how a relatively new drug called Fentanyl has taken America by storm. Not relying on growing and processing a crop, such as cannabis, cocaine, or opiois, fentanyl is produced in the lab from such substances as Benzylfentanyl and 4-Anilinopiperidine. It is now readily available and devastatingly cheap. So cheap that small amounts are frequently mixed in with cocaine and opioids. The result is twofold: .

  • A more satisfying high
  • A vastly increased mortality rate

The above illustration from the Drug Enforcement Administration tells the whole story, comparing the amount required to cause overdose deaths of heroin, carfentanyl (developed to anesthetize rhinoceroses), and fentanyl. As you can see, if a drug dealer gets a pound of fentanyl or carfentanyl, he or she can make thousands of pills with it and still have enough left over to mix with heroin or cocaine. Because so little is needed—beyond which the risk of overdose looms—one can see how a drug dealer can more easily move the drug without being apprehended and also make a killing selling it.

Most fentanyl comes from China. Although the Chinese government has outlawed its sale, drug manufacturers can evade prosecution by making slight changes to the molecular structure of their product.

I have no doubt that most of the tent dwellers across the street from me are users of fentanyl. It’s compact. It’s cheap. And it’s deadly.