‘American epidemic’

Guardian reporter Chris McGreal talks opioid addiction in Tulsa

From the “Tulsa Triangle” to the northern hills of California, the reports are the same: People are dying at unprecedented rates at the hands of opioid drug addiction.

That’s the subject of Guardian journalist Chris McGreal’s new book, “American Overdose: The Opioid Tragedy in Three Acts,” a deep dive into the opioid epidemic that has ravaged the United States for two decades. McGreal will be speaking on Jan. 14 at All Souls Unitarian Church, in partnership with Magic City Books and Booksmart Tulsa, about his latest work reporting on a deadly disease that doesn’t discriminate.

McGreal saw the horrors of the opioid epidemic up close while reporting on poor, marginalized communities for The Guardian. His work in places like rural Appalachia, where addiction rates are infamously devastating, generated a series of questions about the origins and pervasiveness of the problem.

“How is it that this epidemic had grown for 20 years and yet it’s really only now that it’s taken seriously?” McGreal asked. “Why is this pretty much a uniquely American epidemic? Why aren’t we seeing this in other countries?”

These were the questions McGreal set out to answer in his book. His reportage took him from West Virginia mining towns to the San Ramon Valley in California, following the epidemic’s spread across social divides almost as great as the physical distances between them.

McGreal notes that the toll of opioid abuse looks very different in different communities. “You go to some communities in, say, West Virginia, and you see the destruction of the community. It’s very visible,” he said. “And then you go to other places like San Ramon in northern California, which is very prosperous, and that is much more behind closed doors.”

Nowhere was the devastation of the opioid epidemic more apparent than in the mining communities of West Virginia. It was here that McGreal met Willis Duncan, who became addicted to opioid painkillers after he was prescribed them for injuries sustained at his job as an electrician at a mine. After a while, Duncan’s prescription wasn’t enough, and he began to purchase drugs on the black market. His wife began using them after a hysterectomy and quickly became addicted. Their son was next. Duncan isn’t sure if he was raiding his parents supplies or if he was given a prescription too.

“Willis describes how, particularly his wife, Debbie, would be—she’s a nurse, but she’s out of it,” McGreal said. “He would come home and he’d find her stopped in the middle of the floor like she was a robot and the batteries had run down. She was just stopped mid-movement, bent over. And it’s because she had overdosed.”

It took the deaths of his wife and son to get Willis Duncan off the pills. McGreal noted that in parts of Appalachia he found many grandparents raising their grandchildren, their parents part of a “missing generation” lost to the opioid crisis. He recognized the phenomenon from his time reporting in Uganda during the AIDS crisis.

Billions of dollars and incalculable hours have been spent by the pharmaceutical industry to pave the way for easy access to opioids. McGreal found that when physicians tried to raise the alarm, the industry fought back, painting addicts as drug abusers and pain patients as victims of government overregulation.

“And of course, often they’re the same people,” McGreal said. “They began on a prescription, they followed it through, and they became addicted.”

As McGreal notes, the opioid epidemic is basically unique to the United States. Other countries simply do not have this problem on this scale. McGreal found that factors like heavy industry lobbying, direct marketing of drugs, and the structure of the American healthcare system essentially created the perfect storm for a drug epidemic.

“I think that the nub of it is that medicine in this country is run like an industry and in most developed countries it’s run as a health service,” McGreal said. “What you have is lots of parts of the industry which govern how medicine is practiced, mostly because of financial considerations.”

A few developments may be cause for optimism: Prescription rates are down, for example, and the CDC released guidelines last August calling for further reduction. Moreover, McGreal found people like Willis Duncan all across the country who were willing to break the stigma of addiction to bring this problem to light.

“I just think one of the great things about America is that people and communities come out and fight their corner.”