The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth

by Sam Quinones

“I never had friends over,” Kayla told me. “I found her overdosed many times. Her addiction always came before me. I went without food and toilet paper.”

Fentanyl’s greatest advantage to dealers was its potency. Very little of the drug was enough to get people high. That, in turn, made it easy to smuggle. Fentanyl’s potency was also its drawback. If minute amounts of the drug could get you high, even a tiny bit more could kill you—the equivalent of a few grains of salt.

He had come from a middle-class White counterculture where drug use was a form of adventure, particularly for a young man who had intellect and a thrill-seeking soul. That culture, however, formed in a time when the drugs were more forgiving than the street offerings of the new millennium. Attitudes hadn’t changed, but the dope had.

Later, some people would claim that the opioid addiction epidemic was only getting attention because the great majority of its victims were middle-class White people. That was true. The other truth was that the plague hid for years because so many of its victims were middle-class Whites. Families seared by the loss also had to navigate the shame. They covered up, mortified at how their loved ones had died, afraid to stain their memories.

If “Always Be Closing” was an attitude Purdue reps were urged to adopt, so was the classic salesman advice “Never give someone more information than they need to act.”

It’s why, Robert Lustig said in one lecture, “the more pleasure you seek, the more unhappy you get.”

As a culture, it seemed to me, we did more or less what she did. Not, of course, that we were all on heroin. But like a drug addict, we came to believe that we were fine alone. Communing with others was messy, awkward, put us in contact with people who didn’t look, think, or believe as we did. It meant collective effort, sharing. Sometimes it cost us more in taxes. It was hard work. Sometimes it meant limiting what we wanted in favor of the community good. But modern life and our prosperity allow us now to live in houses with empty sidewalks, knowing no one, a separate bedroom for every child. Or segregate into regions where everyone believes, looks, and talks as we do.

“When people decide to punish somebody who has behaved unfairly, we see activation in brain areas associated with reward,” Molly Crockett, a Yale University psychologist, told the podcast Hidden Brain. “There’s a visceral satisfaction in doling out punishment.”

Jailing addicts is anathema to treatment advocates. Waiting for a street addict to reach rock bottom and choose to seek treatment sounds nice in theory. But it ignores the nature of the new drugs on the street. Now, rock bottom is often death. To those facing the epidemic’s grim realities, jail came to be seen as a necessary lever, a tool to force an addict to seek treatment before it was too late.

Though other drugs and alcohol are part of the mix, many encampments are simply meth colonies.