I first heard the term in the county jail from a male inmate who was describing the lengths to which he would go to buy a few heroin bags when he was out and his last hit was wearing off. He was fast becoming sick for dope — dopesick, to be precise.

Today’s New York Times included a great review of a book by the same title, written by Roanoke Times reporter, Beth Macy. I haven’t read the book but I want to. The link to the review is here.

I have written before in this space that at least ninety percent of the men and women we meet in the local jail have some history with illicit drugs. All of them are regular users of marijuana and a disturbingly high number of them have been addicted to heroin.

In her book, Beth Macy notes that “four out of five heroin addicts come to the drugs … through prescribed opioids.” That is consistent with the stories I hear — endlessly it now seems — from those in custody, or recently released from custody.

We just met last week with a man who is awaiting trial who described back injuries, back surgeries and an endless supply of prescription narcotics.

In 2011 I fell down my basement steps and ruptured the patella tendon in my left knee. After surgery to repair the tear, the doctor sent me home with ten pills of a relatively mild opioid drug. The instructions were to take only two at first and then one every so often afterwards — if the pain was too uncomfortable. The afternoon I got home I felt pain somewhere between a five and a ten and took two of the pills.

To this day I can still remember how quickly those two pills erased all the physical pain. I can also remember how they erased as well any anxiety or stress I was feeling. The phrase “feeling no pain” is an apt description of what that relatively mild dose of an opioid did for me.

From time to time I share this story in my Smart Recovery group inside the jail. All around the table, heads are nodding in total understanding. But whereas I didn’t take another of those pills after the first day, most of them continued on and on until they were in full blown addiction. Heroin came next. And then came jail.

I would agree that some of the pharmaceutical companies are complicit in the opioid crisis that has engulfed so many of our young people. But I must also add that addiction to opioids would not be nearly as big a problem as it is if so many people were not in pain. As Gabor Mate so wisely suggested in his book, In the Realm of Hungry Ghosts, the question is not why so much addiction, but why so much pain?

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