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

by Sam Quinones

One reason overdose deaths during the coronavirus pandemic skyrocketed is that police in many areas stopped arresting people for the minor crimes and outstanding warrants that are symptoms of their addictions. Left on the street, many use until they die. Certainly the story of that death toll is as complex as those of the people whose deaths are counted in it. But I suspect we’ll come to see the last ten months of 2020 and into 2021 at least in part as one long, unplanned experiment into what happens when the most devastating street drugs we’ve known are, in effect, decriminalized, and those addicted to them are allowed to remain on the street to use them.

We need to use arrests, but not as a reason to send someone to prison. Instead, criminal charges are leverage we can use to pry users from the dope that will consume them otherwise. Our era of synthetic street drugs requires this. “You can lead a horse to water, but you can’t make him drink—however, you can make him thirsty,” said Brandon Cox, a recovering addict in Lancaster, Ohio, who is now a paramedic. “You’re not going to get better unless you’re willing to get better. Finding that emerging willingness is critical. For me, it was the threat of doing years in prison.”

The greatest foreign policy initiative in modern history was the Marshall Plan after World War II. Mostly through loans and grants, America helped resurrect ruined countries, among them Germany, which we’d only recently despised. I see no unintended consequences from the Marshall Plan. It grew from the idea that our self-interest lies in helping the ruined, the once-hated, those who are flat on their backs.

Often, I think, it’s about doing the low-tech, small stuff to pull neighbors out of their houses. It’s cookouts and block parties. On my street, we started Street of Heads a week before Halloween, in which kids and families from all around decorate wig heads and paint faces on canvas, then stick them on stakes along the sidewalk in a (now seventh) annual open-air art gallery. I believe Street of Heads has helped the block come together.

“It’s good memories for them—the world is about creating good memories for your kids,” he told me. “I didn’t forget my first time ice skating.”

Portsmouth’s rejuvenation was due to the expansion of Medicaid under Obamacare, which Ohio governor John Kasich, a Republican, had accepted over the objections of his own party’s legislators. By expanding Medicaid, Obamacare covered addiction treatment for hundreds of thousands of Ohioans. This included virtually all the clients coming south to the Portsmouth treatment centers. Kasich “saved many lives single-handedly in doing that,” said Jay Hash, director of HopeSource, one of the new treatment centers in Portsmouth, who had worked at the Counseling Center. Because of Medicaid expansion, Hash told me, “people are also now earning a wage treating a crisis. The substance-abuse professional has grown in esteem.”

Many had lost their driver’s licenses, had fines they couldn’t pay, warrants for driving without a license. Wolfe discovered that this forced many of them to live like survivalists. They walked everywhere. Without reliable transportation, they couldn’t find or keep a job. They also avoided bank accounts, which could be garnished to pay those same fines. They worked for cash only. This one predicament—the lost driver’s license—stunted their lives and kept them in addiction.