Sam Quinones's Blog, page 3

Louisville: Jail Among The Solutions

I went to the Louisville the other day to see how jail was changing in America.

This epidemic of opiate addictions  calling on us to reexamine a lot about how we live, our values, culture, ideas and institutions we’ve taken for granted.[image error]

One of them is jail. Jail has always been a crippling liability in our fight against drug abuse. Jails are usually places where humans vegetate, sit around, argue, learn better criminal techniques, then get out weary and stressed and, if they’re addicted to drugs, they head straight to the dealer’s house.

This epidemic is forcing new ideas. One of them is jail turned into an asset, a place of nurturing, of communion as addicts learn to help each other.

That’s a bizarre concept. I never thought I’d write “nurturing” and “jail” in the same sentence, but it’s happening.

The state of Kentucky seems furthest along in all this. I wrote an Op-Ed column for the NY Times about a visit I paid to the jail in Kenton County, Kentucky. Yet what’s being tried in Kenton County – and a couple dozen other county jails in Kentucky — began in Louisville Metro.

Why jail?

Well, if “we can’t arrest our way out of this,” as is so often said, then we need more drug-addiction treatment. Yet this epidemic has swamped our treatment-center infrastructure. New centers are costly to [image error]build, politically difficult to site, and entering them is beyond the means of most uninsured street addicts, anyway.

I know that jailing addicts is anathema to treatment advocates. But opiates are mind-controlling beasts. Waiting for an addict to reach rock bottom and make a rational choice to seek treatment sounds nice in theory. But it ignores the nature of the drugs in question, while also assuming a private treatment bed is miraculously available at the moment the street addict is willing to occupy it. With opiates rock bottom is often death.

Jail can be a necessary, maybe the only, lever with which to encourage or force an addict to seek treatment before it’s too late. In jail, addicts first interface with the criminal-justice system, long before they commit crimes that warrant a prison sentence. Once detoxed of the dope that has controlled their decisions, jail is where addicts more clearly behold the wreckage of their lives. The problem has been that it’s at this very moment of contrition when they have been plunged into a jail world of extortion, violence, and tedium. It’s a horrible waste of an opportunity, and almost guarantees recidivism.

With this epidemic, though, we’re seeing new approaches – jail as a place of rehabilitation, a place where recovery can begin.

Several years ago, as heroin began to grip the area, the Louisville jail saw inmates dying from overdoses.[image error]

Mark Bolton, the jail’s director, said the spate of deaths forced new ideas.

“We modeled a pod on outside treatment (centers),” he said. “It became a matter of taking the resources we had and repurposing them. We sent people [to drug rehabilitation centers on the outside] and found out how they run their peer detox program. We learned from them.”

Louisville Metro began with female inmates. Those who were just off the street and detoxing, and who normally were spread across the jail, were placed together in one pod, christened Enough is Enough. This allowed more focus on their needs, and got them away from other inmates who were angered by their withdrawal symptoms, which included vomiting, diarrhea, screaming, insomnia and more.

Jail officials began allowing people in recovery into the detox pod as well. These recovering addicts mentored the new arrivals – washing and soothing them. Officers preferred it, as they no longer had to clean up vomit and diarrhea.

In addition to bathing and caring for those in withdrawal, inmates take classes in relapse prevention, understanding criminal thinking, accountability, parenting, and more; they run their own 12-step groups.

As the Enough is Enough pod began to function, there were fewer fights, less contraband. “Inmates into their recovery and into their sobriety are self-policing. The wear and tear is less,” Bolton said. “After we worked out the bugs, we began to see some of these people show progress. The inmates into their treatment appreciated the fact that they were caring for a human being that was at a place where they had been once.”

When they leave jail, they’re given a Vivitrol shot, which blocks opiates, and they were connected with housing and follow-up Vivitrol shots.

The jail now has the one women’s pod and three pods for men: 56 detox beds and 64 recovery beds, total.

I visited the pod – with about 30 women, four of whom were detoxing. The walls were covered with art work.

(Click here to hear the end of the pod’s afternoon meeting that day.)

It seemed, finally, a nurturing place in jail – far more about recovery than its connecting pod, where fights and loud noise were common until the early morning.

I spoke at length with a woman named Kara, whose addiction was more than 20 years old. This was her 17th time in jail. She had come from washing the vomit off another woman who had just arrived in the pod. Listen to our interview here:

The Louisville jail experiment isn’t a cure-all – no one thing is for this opiate-addiction epidemic. And the jail has difficulty tracking inmates who leave, so it’s unclear how well they do on the outside. What’s more, inmates by this time face a daunting uphill trudge to sobriety, hampered by family dysfunction on the outside, shredded personal relationships, a private sector wary of hiring them, and on and on.

And of course, there isn’t nearly enough in available treatment options.

“I would love to shut some of these programs down,” Bolton said. “This shouldn’t be the jail’s responsibility. [Addiction] is a public health issue. Our job is detention, protection of the public, to get people to court. When we have to become the quasi mental health facility for people who are poor and don’t have access to services, or for people who are drug addicts and who’ve created these chaotic lifestyles for themselves and can’t get treatment in the community — then we become this de facto fallback place for everybody. That’s not what jails are designed to do, nor should they be.”

Yet until a massive investment in community drug rehab and medically assisted treatment takes place, it’s likely that pods like Enough is Enough will be necessary.

Either way, as with Kenton County, it seems like a better bet of public money than the way jail has been done up to now.

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A Safe Station For Addicts in Whitehall Ohio

A couple weeks ago I was in the Midwest, speaking about Dreamland.

I decided to add a couple days to the trip to spend more time in places where I was visiting than I’ve done in the past.

First stop was Whitehall, a town of about 18,000, next to the airport in Columbus, Ohio.[image error]

I got there a little early because I wanted to see a new idea the town had instituted.

Whitehall Fire Department has established its firehouse as a Safe Station – meaning that addicts can come by, no questions asked, and will be shuttled to treatment. This has been tried by police departments elsewhere, but in Whitehall they decided on the fire department, believing that most folks would be more at ease there than showing up to talk to police.

The idea had been in place about six weeks and 54 people had made use of it. Whitehall being part of the Columbus metro area, the vast majority of Safe Station drop-ins are not from the town.

One fellow who dropped by was Matt, who grew up in a fairly difficult family but in a middle-class town nearby. He played football, baseball, basketball in high school. In his town, sports were it, he said. Young men got their identity from their participation, or stardom, in sports.

Readers of Dreamland may feel where this is going. An athletic shoulder injury led Matt to prescription pain pills – Vicodin 5mg for a year then to OxyContin 80 mg. He began selling the pills and buying more pills from his stepfather, who had a prescription, and selling those.

Many high school athletes in his town got addicted to pain pills. “The [football] coach was real big on making sure you were able to play – especially his star athletes. Out of 22 guys that started, seven or eight would have to pop a couple [Vicodins] or [Percocet 5mg] just to get through the game. Once you get involved in it, especially when you start, sitting out half the season to heal was not an option.”

Within a couple years of graduation, he was using heroin. Any recovery was hampered by the fact that he found work in the moving business. “In the moving business everybody uses – everybody does some type of drug,” he said.

So after a good decade using dope full-time, Matt walked into the Whitehall Fire Department. We took him to a new treatment center run by Maryhaven Addiction Stabilization Center (MASC). Maryhaven is a large treatment center in Columbus. MASC was its response to the big numbers of people who were being revived from overdose every day through the expanded use of naloxone, the opiate antidote, in the Columbus area. Many were being revived, but there was no place to send them.

Maryhaven remodeled an old south side hospital and six months ago opened MASC, which takes naloxone revivals from hospitals, as well as walk-ins … as well as now folks who show up at Whitehall’s Safe Station firehouse. Addicts detox for a week or so. Many transition to residential beds for a while before being connected with sober-living houses in the community.[image error]

It’s funded by a county addiction agency and private donations. All this is investment that, as a country, we ought to have made years ago. It’s happening now, though still probably not to the degree necessary.

Yet all of this is part of an effervescent feeling of change and innovation that I see in many parts of this country in response to our epidemic of opiate addiction. It’s communities daring to try new things – ideas that might not have had political support three years ago. I’m also encouraged that people in many of these places aren’t discouraged if they’re not somehow saving the world. They don’t seem to lose heart, but instead continue tinkering with these ideas.

Amid all the depressing news, the fatalism and inertia that dope addiction engenders, it’s exhilarating to see towns like Whitehall trying small things like this.

I’m always aware, too, of how daunting all this is. So much must be balanced and harmonized for one addict to kick dope, and even then relapse is always a possibility.

Will MASC or Whitehall, Ohio’s Safe Station solve the problem? I doubt it. No one thing will solve this debacle. We have to get away from thinking there’s a magic bullet answer to our most complex problems.

Nevertheless, I believe the mere fact of acting, of doing something, of working with people together in a community – that alone is a radical thing when the enemy is dope and, beyond that, inertia, negativity, and fatalism.

Next stop, Louisville — where I visited the jail.

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Pennsylvania Priests & Bebop Jazzmen

I read two things yesterday.

I opened the Pennsylvania Grand Jury report on six Catholic dioceses and the evidence of sexual abuse by more than 300 priests dating apparently to the 1950s.

I got through the introduction and the first two priests in the diocese of Allentown.

It wasn’t just the preying pedophilia. It was the craven blaming of victims, the various layers of psychological torment they endured by predators for years trying to deflect blame, and by church officials who rushed to any lie to hide scandal.

I had to stop. It was revolting, almost deadening to read.[image error]

Luckily, I’m also reading a book about the beginnings of modern jazz in the 1940s in New York City: The Birth of Bebop, by music historian Scott DeVeaux.

I found refuge there.

DeVeaux chronicles all that went into creating modern jazz out of the bustling swing-jazz era. I was in the part of the book that focuses on the jazz scene that formed around the late-night/early morning jam sessions at the many clubs around New York in the 1940s.

I’ve been reading it because I’m a long-time fan of jazz – I wrote my senior history thesis on this very period and topic. But also because I’m interested in how “scenes” are created. Places where people come together with similar interests and through intense competition and collaboration over time they create something new and unexpected and change the culture.

I view Silicon Valley as a scene. [As an aside, I think we’re seeing something like this happening around the opiate-addiction epidemic in our country: people coming together, usually in counties, and immersing themselves in the problem to then find, together, solutions to it.]

Scenes of great human creativity have usually emerged when, among other things, we are held to the highest standards and when these are not bent or weakened.

DeVeaux paints a picture of young musicians descending on the city, thirsty to improve, working in swing bands during the evening, then jamming at after-hours clubs into the wee hours. Held to the highest standards by established masters. Sometimes humiliated by them and sent home to practice when they didn’t measure up.

“Jam sessions provided affirmation for those at the top of their game and a formidable barrier to those trying to reach the highest levels,” DeVeaux writes. “Individual reputations might be made or broken, but the ultimate purpose was to raise the quality of performance all around.”

He quotes Count Basie: “If you didn’t [have something special in your musicianship] and didn’t have any better sense than to go there and tangle with them cats, that was the quickest way to get yourself embarrassed. They didn’t have any mercy on upstarts in there.”

And Mezz Mezzrow: “These contests taught the musicians never to rest on their laurels, to keep on woodshedding and improving themselves.”

There were no lies, in other words. The truth came out on the bandstand and everyone could see it. Refreshingly meritocratic.

“In this way,” DeVeaux writes, “the after-hours jam session became an integral part of an aspiring musician’s musical education.”

What emerged through this clear-eyed confronting of the truth, and enforcing standards, was an artistic achievement of the highest caliber that changed world music.

I found this cleansing after wading through the swamp of cowardly abuse and the covering for low standards and base lies that the Pennsylvania report chronicles. From it, I gather that people of power weren’t forced to prove themselves. Unlike on that late-night New York bandstand, their power and mediocrity went unquestioned. They were instead coddled, provided apologies, breaks, and ominous new beginnings elsewhere – all because of their positions.

I may try to read more of the Pennsylvania report. But I’m going to keep The Birth of Bebop close by.

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Planting Portsmouth, Ohio

[image error]Portsmouth, a small town I wrote about in Dreamland, has been slowly rebounding from years of economic decline and drug addiction.

That’s a remarkable thing. For it was Portsmouth – on the Ohio River — that led the way into our national opiate-addiction epidemic. The town was where the Pill Mill – sleazy pain clinics prescribing massive amounts of pills to almost anyone for cash – was born.

With the town blasted by this huge supply, and the sense of community shredded by job loss and more, widespread pain-pill addiction was a fact of life in Portsmouth by the end of the 1990s.

But a lot has happened since then. The town, each time I return, seems slightly more energetic, more invigorated, more about positivity and less about dope’s inertia and fatalism. A recovery culture has taken hold there that’s exciting to watch.

Not that all the problems are behind Portsmouth, Ohio. But there’s another story now competing with the “let’s get high” culture that gripped the town for so long. I wrote about the beginnings of this at the end of my book – the small clues of rebirth: new gyms, a coffee shop, lofts, refurbished buildings and more.

Along that line, the folks of Portsmouth – 500+ volunteers – get together this Saturday to wash, repaint, redo their downtown in something they’re calling Plant Portsmouth.

[image error]They’ll be painting light poles, scraping and painting all the curbs, replacing 120 streetlights, and more. “None of this has been done in 20 years,” said Jeremy Burnside, an attorney in town who got the idea started.

They’ll also be planting plants as a way of signaling the town’s rebirth.

Burnside’s hoping to set a Guinness World Record for the most people planting plants simultaneously.

(Folks — please send me photos from the day and I’ll post them here and on social media. #plantportsmouth)

Organizers have raised $75,000 from local businesses to pay for supplies. That itself is a sign of how locally owned businesses are now growing in Portsmouth. None of that money came from the chain stores and corporate fast-food restaurants that have dominated the town’s economy since things began to go bad in the early 1980s and the shops on its main street closed. (Btw, I bought a couple t-shirts, inspired by Dreamland and the community pool that was the source of my book’s title, from a company called 3rdand Court that began in downtown Portsmouth. Check them out.)[image error]

The antidote to opiates is not naloxone. It is community. I say this often in my speeches when I’m traveling around the country. We Americans have isolated and fragmented ourselves in a million ways – this in poor areas and in wealthy areas.  That left us vulnerable; it left us dangerously separate and disconnected from each other – strange to say in this time of technological hyper-connectivity.

The final expression of all that is our national epidemic of addiction to opiates – the most isolating class of drugs we know.

Rebuilding community (in a million different ways) is crucial to fighting it, I believe.

I’m glad to see Portsmouth leading the way on that, too.

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Librarians and the Opiate Addiction Epidemic

Our national opiate-addiction epidemic is different from other American drug scourges for many reasons.

It’s the deadliest and the most widespread. It didn’t begin with drug mafias, but through the promotion of narcotic painkillers by pharmaceutical companies to doctors, who were pressured by we Americans, demanding an easy solution [image error]

to our pain.

But the epidemic is also remarkable for whom it has forced to its frontlines.

Librarians make up one such group.

I’m in Ohio this week, speaking at four regional conferences of librarians around the state. Today was Gallipolis — pop. 3500, in rural Gallia County, along the quiet, majestic Ohio River.

I stayed after my talk to listen to a panel made up of a university librarian, an elementary school librarian, and a public librarian talking about their experiences with this epidemic.

We heard about needles in the bushes, about how a child who lives in a drug house smells, about calling 911 because a customer had overdosed in a bathroom, about the look of some people who come into the library high. The epidemic has made danger zones of innocuous public places.

I was also struck by the stories many in the audience (80 people or so) had to tell about addiction in their families.  Several librarians were raising their addicted relatives’ children.

Librarians are also perfectly poised, though, to be great catalysts for change – community organizers in the fight against this plague. That’s what I believe. They have the spaces, the local trust and credibility, and often small towns need folks like librarians to bring them together — and this is happening.[image error]

As I said to the group I spoke to, who better than purveyors of the book to be the leaders in this fight.

Plus, librarians are looking for new roles to play – rebranding libraries as community centers, places where people can come together. This catastrophe is offering libraries and librarians that moment to reinvent themselves towns and counties.

In the afternoon, I drove through the pristine southern Ohio farmland – white houses, white churches, silver siloes, blue sky, and acres of green corn.

I stopped at the Dairy Queen in Washington Court House, another small town with a bunch of opiate addiction problems.

Tomorrow Dayton – then Findlay and, finally, Twinsburg.

Next week I speak in Weber County, Utah, and after that Brunswick County, North Carolina.

All frontlines in America’s epidemic of opiate addiction.

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Purdue in Tennessee II: High-Volume Prescribers

From 2006 to 2015, Dr. Michael Rhodes was one of the top prescribers of OxyContin in the state of Tennessee.

His practice had many of the signs of what had come to be called a “pill mill.” Lines of people outside. A knife fight in front of his office. Investigators found he often prescribed without proper physical examinations or knowing the medical histories of his patients. Over those years, Rhodes, of Springfield TN, prescribed 319,000 OxyContin tablets. In May, 2013 had his license placed on restrictive probation by the Tennessee Board of Medical Examiners.

Still, representatives from drug-maker Purdue Pharma continued to call on him urging him to prescribe more OxyContin, their signature drug, according to a lawsuit filed by Tennessee Attorney General Herbert Slatery.[image error]

“In spite of this disciplinary action by the board (of medical examiners) and direct knowledge of his patient’s death from OxyContin, Purdue continued to call on Dr. Rhodes,” the Tennessee complaint states. They continued to “pressure Dr. Rhodes to prescribe more and more opioids, even when he expressed concerns regarding his own ability to competently do so.”

According to the lawsuit, Purdue reps called on Dr. Rhodes 126 times, include 31 times after his license was restricted.

They did so during the years after the company signed an agreement in 2007 with the federal government to be vigilant for abuse and diversion of the pills and look out for doctors prescribing in unscrupulous ways.

That lawsuit, filed in May and unsealed by a state court judge a week ago, alleges the company was largely to blame for the opiate epidemic in Tennessee by creating a public nuisance due to its marketing techniques. (See related blogpost below.)

Part of the Tennessee complaint against Purdue is cataloguing alleged attempts by the company to get high-prescribing doctors and nurses to prescribe even more of their product, despite signs that those medical professionals were behaving in unethical ways and their prescribing habits were out of control. Cultivating high-volume prescribers, the complaint alleges, was seen as crucial to the company’s business.

Among them was Dr. James Pogue, of Brentwood, TN, who prescribed 562,000 OxyContin 80mg pills between 2006 and 2013, making him one of the largest prescribers in Tennessee even three years after he stopped practicing medicine. He generated $655,000 in revenue for the company during one six-month period in 2009, according to the complaint.

Company sales reps called on him 53 times between 2005 and 2012, “more than half of those occasion coming after his license was reprimanded in 2009.”

The Breakthrough Pain Therapy Center, in Maryville TN, was known to have none of the typical diagnostic tools associated with pain clinics: examination tables, gloves, urine screens “or providers who performed independent pain diagnoses.” It also included “scant” office records and pre-written prescriptions often dispensed “without a physician present.”

While placing some staff on no-call lists, the complaint claims Purdue continued to call on other staff members at Breakthrough Pain Therapy, whose owners were federally indicted in December 2010. This included Buffy Kirkland, a nurse practitioner who worked there for several years. Between 1998 and 2017 as a nurse practioner in Tennessee, she prescribed 68,000 OxyContin tablets, of which two-thirds were of 40mg or stronger, according to the complaint.

The Tennessee complaint is one of numerous lawsuits filed in the last year or so against Purdue and several other drug companies that make opioid painkillers. The plaintiffs include Native-American tribes, small towns like Everett, WA and large cities like Los Angeles and Chicago. Most state attorneys general have filed lawsuits, as have at least 300 counties in a suit that alleges a “public nuisance” by these companies. That suit is consolidated in a federal court in Cleveland.

When I was writing Dreamland in 2013-14, I remember only three such lawsuits against makers of opioid painkillers. This was a time when the issue was largely hidden, those affected largely silent. Families were ashamed and wanted to obscure the truth of the addiction and manner of death of their loved ones. Thus the media paid scant attention and elected officials, outside those in a few states, paid less.

But the awareness has expanded in the last three years. One result is that many more lawyers across the country have turned to examining legal theories that might prosper in court.

Public agencies have been hammered by the cost of the epidemic. Indeed the epidemic costs have largely been borne by the public — by coroners and public health offices, police and sheriffs departments, jails, county hospitals, foster children agencies and more. Meanwhile profits have largely accrued to the private sector, mostly to pharmaceutical companies.

Thus, today, most state and county officials have to be seen by their constituencies as doing something dramatic about this epidemic, and a lawsuit has become an option to recoup some of those costs. None of the new lawsuits has yet gone to court.

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Purdue Pharma in Tennessee: Always Be Closing

“Always Be Closing” is the motto that salesmen live by in the movie/play Glengarry Glen Ross.

If you haven’t seen the movie, do so. It’s great: Al Pacino, Jack Lemmon, Alex Baldwin, Kevin Spacey. It’s about an office of desperate sales guys hawking shady real estate investments. ABC — “Always Be Closing” — is the way each is supposed to approach every sales call.[image error]

It’s also a motto that showed up in Purdue Pharma sales notes and notebooks in Tennessee, according to a lawsuit against the company.

The suit was filed in May by the office of Tennessee Attorney General Herbert Slatery. It alleges a lot of things, but in general that Purdue used deceptive marketing practices to push its signature drug, OxyContin. This took place, the suit alleges, between 2009 and 2012, well after the company and three of its executives pleaded guilty (in 2007) to a federal misdemeanor of false branding and paid a $634 million fine, while also committing to a series of measures to ensure they were not marketing to doctors who were prescribing unscrupulously.

The company moved to seal the lawsuit, but a judge in Knoxville recently decided against that idea, allowing the office to send me, and others, a copy.

In general terms, what I find interesting the lawsuit is how it displays the changes in pharmaceutical sales in this country, much of that coming during the life of OxyContin, though not due to it.

Up to the mid-1990s, drug salesmen in the United States were usually older men, often with backgrounds in pharmacy or medicine. They were often from the communities they sold to, knew the doctors they sold to, and became credible sources of information for those same doctors as medicine began to change rapidly.

Then the industry went another route. Those older folks were shown the door. In what can be called a sales force arms race,  drug companies hired more and more reps. These reps were usually much younger, very good looking. They didn’t know much about they were selling but they have backgrounds in sales. They inundated doctors with visits and giveaways, of pens, calendars, lunch, sometimes trips for continuing medical education seminars. The companies were aware that by massaging a doctor’s staff, the doctor would soon be an easier mark.[image error]

Many companies did this. The numbers of sales rep rose through the 1990s from 35,000 nationwide to over 100,000 by the end of the decade. But other companies were selling blockbuster drugs to deal with cholesterol, hypertension and others. Purdue was among the few that used these techniques, and this enhanced salesforce (numbering eventually 1,000), to sell a narcotic painkiller.

“Always Be Closing” was, apparently, part of that push at Purdue. So, allegedly, was mention of the movie. All of this coming after the 2007 criminal lawsuit.

In Tennessee, (pop. 6.6 million people), the company made 300,000 sales calls to health care providers in the 2007-17 decade, during which time doctors prescribed more than 104,000,000 OxyContin tablets; more than half of those tablets were at the strongest doses the company made: 40mg and above.

Those of you who’ve read my book Dreamland know that, to me, supply is the crucial factor in this, and really in any drug scourge. What the lawsuit describes is a company hard at work at creating a vast new supply of opioids.

Company instructional materials pushed sales folks to “expand the physician’s definition of the appropriate patient” to which opioids might be prescribed; to “never give someone more info than they need to act”; and to develop a “specific plan for systematically moving physicians to move to the next level of prescribing.”

“We sell hope in a bottle,” said one guide for incoming salespeople, who were also instructed to encourage doctors to increase patients’ daily doses.

The lawsuit goes on to claim that Purdue sales reps in Tennessee were urged to make frequent sales calls, as evidence showed that that increased the number of prescriptions. According to the lawsuit, the company urged its salespeople to “focus on doctors who had more patients, less likely to have pain management expertise, and have less time to appropriately monitor patients on opioids.”

During these years, Purdue sales reps, according to the lawsuit, focused their efforts on primary care doctors, nurse practitioners and physicians assistants, whom the company “knew or should have known … had limited resources or time to scrutinize the company’s claims.” Together, people in those three profession prescribed 65 percent of all OxyContin tablets in Tennessee during these years. By 2015, Tennessee had the third highest prescription rate of opioids in the country.

A major part of the lawsuit goes on to discuss specific examples of Tennessee doctors who were leading the state in opioid prescribing, often with signs that their practice was out of control or they were incompetent or unscrupulous, yet who were nonetheless aggressively marketed to by Purdue salespeople.

More on that tomorrow.

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The Orchestra of Baja California & Celso Piña

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One of the fascinating things about Tijuana is its way of absorbing almost anything and anyone from anywhere.

It has a long history of doing so, most recently with several thousand Haitians immigrants, who’ve crossed nine borders, coming up from Brazil, to arrive looking for U.S. asylum, which they did not get and so they stayed in Tijuana and have been melting into the city.

I’ve written a lot about the new Tijuana that has emerged in the last 10-15 years, focusing for a while on opera, which I wrote about in my second book, Antonio’s Gun and Delfino’s Dream: True Tales of Mexican Migration.

More recently, I’ve written about the city’s gradual turn away from making money from migration and vice tourism and toward a higher level of entrepreneurial effort to cater to the local consumer market.

As part of all of the above, the Orchestra of Baja California — which itself has its roots in a Russian orchestra that was imported to the city in 1992 with help from Eduardo Garcia Barrios, the group’s conductor for many years — this week put out an album backing accordionist Celso Piña.

Piña, born in Mexico, has made a career of playing Mexican norteño and tropical cumbias from Colombia.

The orchestra, now under the direction of Armando Pesquiera, held three concerts with Piña. Give a listen …

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An Outline In Storytelling

I’ve always wondered how novelists come up their books. Do they just start writing with a hunch and let the inspiration flow, taking them where it will? That seemed unlikely, given what I know about writing as a daily job, with inspiration playing only a minor role. (Or better put, inspiration flowing from consistent daily toil.)

Or, I wondered, do they spend days ahead of time blocking out their stories scene by scene? (Which is how my mind works.)[image error]

Each writer is different. Each follows a different path.

But I was cheered to see this outline that Joseph Heller came up with (presented in OpenCulture.com, a wonderful website, which I support financially).

It’s a chronology of events he describes in Catch-22 and it helped him keep track of the story he intended to tell in wildly non-chronological order.

(Full disclosure: I started to read the novel years ago and couldn’t finish it.)

I tried something like this with Dreamland – putting pieces of paper up on a mirror in my garage office, each representing a different chapter, which readers of the book will know are mostly 2-6 pages in length.

At one point my wife walked into the garage, saw this blizzard of paper taped to the mirror, and left thinking I’d lost my mind. But the papers helped visualize where the book was going and track the different storylines I was telling. It helped also when it came time to rearrange the order some of the chapters came in. I’d just untape a chapter and move it somewhere else on the mirror. At one point I had six rows, each with 5-7 chapters per row.

Apparently other writers find this visualizing necessary first before telling a story.

“Every great novel—or at least every finished novel—needs a plan.”

I think it’s true in nonfiction as well.

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the Original SoCal Mexican Mafia Godfather Dies

Los Angeles never had a mafia in the way that many East Coast cities did.

Regional organized crime never really took root out here. So we never had the mafia dons, running the large crime syndicates that made the headlines in, say, Cleveland or New York.

About as close as we came was Peter “Sana” Ojeda.[image error]

Ojeda, the oldest active member of the Mexican Mafia, died June 7, according to the federal Bureau of Prisons website.

Apparently, he suffered a heart attack during an operation in a federal prison medical facility. YouTube memorials are being posted.

To understand Ojeda’s importance, it’s important also to understand that the Mexican Mafia is neither Mexican nor was it, for many years, a mafia, strictly speaking. It is a prison gang, controlling Latino gang members in the state prison system. It took its name as a way of inspiring fear in others. Ojeda was part of that formation early on, as well as the spread of the Mafia’s influence across the state prison system.

The Mexican Mafia had no connection (until recent years) to the underworld in Mexico. Its members were, to begin with and for many years, like Ojeda’s, Mexican-American, who spoke only halting Spanish, if any at all, and whose families had been in the United States for generations.

For many years, in fact, the Mexican Mafia only ran prison yards and its influence was barely felt outside those walls.

But in the early 1990s, all that changed. The man who ushered in that change that was Peter “Sana” Ojeda, a long-time member of the Mexican Mafia who had grown up in Orange County.

Ojeda, who was then on the streets, organized a meeting of O.C. street gangs at El Salvador Park in Santa Ana, filmed by law enforcement, during which he stood on bleachers dressed in a black-and-white checkered long-sleeve shirt and told them all to stop with the gang killings and the drive-by shootings. He urged them to tax drug dealers in their neighborhoods as a way of funding neighborhood defense.[image error]

This stunned many in the Mexican Mafia, and they began to follow his lead, using emissaries to organize meetings from San Bernardino and Pomona out to Elysian Park in Los Angeles, where one of the biggest meetings was held.

The Peace Treaty, as all this came to be known, sounded great. Gang leaders doing what law enforcement could not. But it evolved into something sinister and lasting: A system whereby gang members would indeed tax drug dealers in their area and funnel the proceeds to Mafia members, many of whom were in prison for life.

This taxation system far outlasted the Peace Treaty and is still in place today across Southern California, described in dozens of federal RICO indictments and in interviews I’ve done with dozens of gang members.

It transformed Latino street gangs from scruffy neighborhood territorial entities into money-making ventures, though these were often fairly rag-tag and bumbling. It gave career criminals, doing life terms in prison, access to youths on the street who would do their bidding and admired them the way little leaguers look up to major league ball players. The Big Homies, as they were known on the street, could change life in a barrio with only a few words smuggled from prison in microprint on small pieces of paper.

It’s worth noting that their organizations on the streets, too, were often inept, bumbling, hampered by imperfect communications, rumor and innuendo, and the constant return to prison of Mafia members’ anointed emissaries.

But Mafia taxation changed a lot about Southern California street life.

For a decade, Latino street gangs became the leading race-hate criminals in Southern California, a culture that grew from orders by many members of the Mexican Mafia that gangs should now rid their areas of black street gang/drug sales competition. As they were interpreted on the street, far from direct Mafia control, those orders became directed at any black person, and thus in some neighborhoods campaigns were waged to get all black families to leave that included murder, firebombings, assaults, racist graffiti and more.

Taxation made Mexican Mafia members equal in many communities to the town mayor or city council, at least with when it came to their ability to affect life in those areas. Now with the obedience of thousands of gang members on the street, many of them born since those Emeros were incarcerated, Mafia members [image error]could, and did, ignite crime waves from maximum-security cells merely through letters smuggled from prison or via liaisons who transmitted their orders to the street. They drained city budgets, mangled lives, and forced young gang members to commit crimes that landed them in prison for life. I’ve interviewed several young men in such situations.

Ojeda was a contemporary of the pioneers of the Mexican Mafia (he’s far lower left in this photo). Among them was Joe Morgan (standing above him in the photo), whose story is also fascinating. Morgan was a Serbian-American who grew up in Boyle Heights/East LA and became culturally Mexican-American, and helped found the Mexican Mafia. Morgan died many years ago. So did most of the others who formed the gang.

Ojeda was the last surviving member of that generation of the Mexican Mafia.

He would remain a household name in the Southern California Latino street-gang world. He would be in and out of prison during these years.

In 2016, he was convicted a final time of conspiracy, largely on the basis of testimony from a former protégé, and sent to prison for 15 years, which most people figured was a life sentence.

But his control over Santa Ana and much of Orange County Latino street gang life seemed to me mostly unquestioned. So, too, his reputation as the Godfather of Orange County.[image error]

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