Part A/B, "Of Heroin & Other Demons."
Part B/A: 
"Montage of Heck"

One of Ten Things
By 'overcome it,' I mean I'm not dead yet. 

by LISA CARSON

1. Epidemic 

My friend Sarah[1] and I are driving north on I-89 toward Montpelier. We are looking for heroin, because Vermont is experiencing an “epidemic” of such proportions that the New York Times and Rolling Stone have been writing stories about it. Everyone’s throwing statistics—770% increase in opiate treatment since 2000, a doubling in heroin deaths between 2013 and 2014, $2 million worth of opiates being trafficked into Vermont per week.

What does that mean? Who knows. Statistics are numbing. If you tell us there’s an epidemic, we believe you.

There are plenty of explanations. Medical—there was a period of massive over-prescription of highly addictive opiates like OxyContin. Geographic—Vermont is a relatively short distance from Boston, New York, and Philadelphia, and in cities you can get shit for cheap. Cart it to Vermont and jack up the price. There’s a loose hypothesis floating around about boredom and long winters that drive people to stay inside and shoot up.

Something bothers me about the way people talk about the Vermont heroin epidemic. I can’t nail it down. The narrative is missing something, and that’s what we’re driving north to find.

2. Travis

Sarah and I walk into a bar. The Three Penny Taproom. Usual crap on the walls: “We Proudly Do Not Serve Anheuser Busch Products,” a boar’s head and alligator skull. We talk to Scotty from Colorado with his big ears and hipster glasses, and Knayte who owns the record store and has a cousin struggling with addiction. On our third try we find gold.

His name is Travis and he’s wearing a gray sweatshirt and faded blue jeans with plaster dust on the knees—he’s a carpenter, 31. He’s got a few grays but today his hair is long and messy, like a middle-school boy who refuses to get a trim. His brother owns the Three Penny. He says we can ask him anything because he’s used to answering all kinds of weird survey questions—he says that if you tell people you’re doing a study or writing an article, you get a free pass to ask anything you want. What kinds of things, we ask. He says that once he answered a forty question “research survey” about how fuckable certain gay men and lesbians were. He thinks that guy was just new to the area and wanted to scope out the dating scene.

So I go ahead and ask him about heroin, and he says, “Well, I’m not really into that scene anymore, but…” at which point I interrupt him to ask the obvious follow-up non-question, “So you were into that scene.” And he was.

The second time we meet Travis he has cut his hair. We sit on the Statehouse lawn in the bright sun. He knows we’re there to ask about heroin but we start by asking him about carpentry.

He says when you’re putting in a door you might measure in inches. He works down to a sixty-fourth of an inch, or sometimes a hundred and twenty-eighth. He likes when something is a little out of place and you give it the lightest tap with a mallet, so light you wouldn’t even feel it, and it falls right into the perfect spot.

Travis’s story: he grew up in southwestern Connecticut. He wants to go on the record stating that weed is not a gateway drug. Ecstasy, though, that did it. He tried it once and it was so great he had to do it again. And again. And he could buy it “straight off the boat from Greece” for three dollars a pill, sell it for twenty.

“As soon as you start making money, anything becomes fun and interesting.”

Ecstasy to coke, coke to OxyContin, and from there any sort of pain pill. He wasn’t ever that into heroin, only shot up two or three times. “Needles just didn’t interest me,” he claims.

Travis says that people get started for a couple reasons. "One, it’s Vermont,” he says. “There’s nothing to do here.” I don’t buy that. It’s not like you’re sixteen and you’re not into hiking or biking so your only other option is mainlining crank.

Sometimes, Travis says, kids just think, “Oh, this is something bad to do.” And you do it just because of that.

So why do you stop? Travis had a girl, a girl who he thought he loved, thought he was going to marry. They went to rehab. Got out. She still really wanted to do pills[2] and he didn’t know how else to take care of her so he got them. After they broke up, he was “like fuck this, I’m done.”

He pulls out the “I didn’t like who I had become” line, which is a cliché, but I can’t negate its validity. He was doing eight to ten pills a day, not even to get high, just to maintain normalcy. Which, by the way, he says, is why Kurt Cobain definitely could have pulled the trigger. Not that he did pull the trigger. “So you think Courtney Love killed him?” asks Sarah. He doesn’t think she pulled the trigger either. But she probably hired somebody. Side note: Travis will not willingly listen to music that is not Nirvana.[3]

“Most addicts that you know, if they’ve been an addict long enough, they don’t want to be on it. It’s just something that they’re held onto. If you’re able to continue doing it, you’re going to continue doing it.” He says he got tired of lying to everyone about everything. But that when you’re doing drugs, “You lose practice if you start telling the truth.”

“The idea of being clean is awesome,” Travis says. “The thought of going through what it takes to become clean will scare the shit out of anybody.” Withdrawal is the worst. He notes that Sarah and I are both women. “I have no real basis for this statement, but, it’s gotta be worse than childbirth. Every muscle hurts. Everything you do hurts. You feel thirsty and you take a sip of water, that hurts.” Sleeping is not an option. If you go cold turkey, it’s quicker. But harder. If you taper, you have to “slowly deal with all the demons.” Travis went slowly.

He only does shit now when he goes home. He says it’s like spring break in that you know it’s not real life so you can leave it behind. “It’s still fuckin’ fun,” he says.

So does he think there’s a Vermont epidemic? Nah. “I’ve travelled pretty far throughout this country overall and I never had an issue, when I was doing it, finding something there.” If you’re on drugs, he tells us, you will find a way. “It doesn’t matter where you are; sometimes it’s just a little more obvious.”

3. Flood


“The explosion of drugs like OxyContin has given way to a heroin epidemic ravaging the least likely corners of America -- like bucolic Vermont, which has just woken up to a full-blown crisis.”

Rolling Stone, “The New Face of Heroin, April 3, 2014

 

“The speech seemed to shock the world, sparking national and international headlines. And when the actor Phillip Seymour Hoffman’s death in New York earlier this week brought a new wave of attention to the national epidemic, Vermont’s heroin problem was again noted almost as a curiosity: Who knew pristine Vermont had such a nasty drug problem?”

Politico, “How Did Idyllic Vermont Become America’s Heroin Capital?” February 7, 2014.


“A flood of cheap heroin has thrust Vermont, land of green hills and sweet vistas, into an addiction crisis, a grave threat to younger residents and to a way of life.” The Boston Globe, “Heroin gains a deadly foothold in Vermont,” January 12, 2014   “Hidden from view among Vermont's world-famous ski resorts and picturesque villages is one of the deadliest slopes.”

Al Jazeera, “New England town ripped apart by heroin,” March 12, 2014

4. Staircase

We leave Travis and go to look for heroin. Two men stand on a corner. The larger one has blonde dreads and a kilt; a black tank top shows off thick arms. Bullhorns pierce his septum. The other is scrawny with a beard and a beanie, dark clothes. We walk up and introduce ourselves because they look like they know where we could get drugs. We tell them we’re journalism students and they look at each other and smirk. We ask what they do. The big one is a personal trainer who also does delivery and the skinny one says he’s in the Navy reserves. They list two different hometowns and say they went to high school together, just happened to run into each other today. We ask them if they’re here for the Montbeerlier festival that’s going on and they say no. The skinny one hesitates and then smirks again and says, “clothes shopping.”

“Okay, have a nice day,” says Sarah. And we leave.

After being rejected by Bullhorns and Scrawny, we sit on a curb and watch them. There is a guy sitting on a bench across from us who has been there since we first walked down this street; he was wearing a Packers jersey but now he has taken it off, exposing a mat of dark chest hair.

He’s much more receptive. He’s super happy that we came and talked to him because everything sucks. And because we’re “super hot.” What sucks? Anti-Semitism, he gives as an example, that sucks. His name is Isaac and he’s 24. He says he used to sell drugs in college. We ask him what he does with his life now.

“Right now?”

“Yeah.”

"It's top secret."[4]

We tell him we’re looking for texture. “I got mad texture, yo, I got like miles of texture.” He says he’s a rich person disguised as a homeless person. He has a gold chain around his neck and a gold watch on one wrist, a FitBit on the other. This kind of confuses me because he doesn’t seem like the health-conscious type. Green and blue plaid boxers poke out the back of his khaki pants, and he’s wearing one white sock and one black, with brown shoes. We sit on his bench and he starts telling us about his life.

“I used to talk to this girl. This probably is a shitty story. Or it could be good.” He was talking to this girl on the internet, but then he was doing drugs, and fighting with his parents, and his parents “took away the internet.”

“So then it was like super beautiful and tragic, or like really lame.”

He goes on, “You hear like ‘80s songs about livin’ on a prayer and stuff, and it’s like super dramatic, like livin’ on the street and all that shit. And then it’s like oh maybe one day I’ll marry this girl, but then she’s totally dating some other guy.” Aw, we say, that’s rough.

“So that’s why I went downtown today.” He says he’s constantly on the verge of crying.

“So is that how you ruined your life?” Sarah asks.

“Well, kinda.”

“Was that the first step on a long staircase down?” she prods sarcastically.

“That’s exactly right. That was very poetic, too.”

The day Isaac’s life went the rest of the way down the staircase, he literally fell down a staircase. And out a window. And then the cops showed up. He had taken a bunch of pills and drunk some booze he stole from his parents.

Trying to understand Isaac’s story is like putting together a thousand piece puzzle blindfolded, using only your thumbs. It’s partially because he keeps interrupting himself with things like, “You guys ever do mushrooms?”

He sees one of his friends. “Lulu! Hey, dude, oh come here, come here, you’re a drug addict. Look, they’re trying to talk to drug addicts.” He tells us she’s an alcoholic.

“I am an alcoholic!” she exclaims. “I actually have a bottle of gin in my bag.”

“Lulu’s straight up cool. Lulu doesn’t give a fuck. She doesn’t take any shit.”

“No shit taken,” said Lulu, shaking our hands.

She’s been drinking her gin all day while working at her church’s soup kitchen. She’s kind of adorable. Pointy shoes and leggings with an oversized plaid shirt, an oversized black leather bag, dark eyeliner.

Lulu’s boyfriend used to deal drugs. Isaac says he was kind of a dick. She tells Isaac he needs to put his shirt back on and stop acting creepy. “You’re so hairy!”

Lulu also did black tar heroin back when she lived in Springfield, Massachusetts. At least once, and opium. And she also used to deal. Something. Kind of evades the question of what it was. Concerning heroin, “I think it’s probably one of the fuckin’ worst drugs you can do. It was, you know, it was horrible. It was horrible.” So, we ask Lulu, is it an epidemic?

“Holy fuckin’ hot god damn damn,” says Lulu.        

Lulu has to run but she tells us that there’s an apartment complex down the street where we can find the real drug dealers. We spend some time sitting on the curb across the street from it later, but we don’t see anybody.

Isaac knows the people who live there but won’t give us their names or any information or let us talk to them because that can easily turn to fucking someone over. He says they don’t have anything to fall back on. He says if they were rich people, he would tell us everything he knew.

“People used to call me entitled,” he says, “but then my life got ruined so I don’t have to deal with that anymore.”

“And now you’re happily unentitled?” Sarah asked.

“No, I’m not happy but it’s nice to talk to you guys.”

We can’t get him to actually explain what kind of drugs he was on when his life got ruined, but he says he’s done all the good ones. “Just not crystal meth or heroin.”

“Drugs didn’t get me in trouble, is the thing. My parents got me in trouble.” They were the ones who called the cops, sent him to rehab. He compares this to people in the ghetto who get arrested because they do drugs. Their problem isn’t the drugs, it’s the cops.

He once did ecstasy at a music festival and hooked up with a girl and it was “super hot,” but now that he’s seen more of life he guesses it wasn’t that hot. And then he went to college and did a bunch of drugs and got a girlfriend. Then one night, he says, “I was talking to my mom and she was like, ‘Isaac, you sound insane.’” She sent him to a therapist and he got put on antidepressants which ruined his sex drive which ruined his relationship. Then, at some point, he was arrested for lewd and lascivious conduct, under circumstances which are extremely unclear, and it made the front page of the newspaper. And then he was homeless for a while. “Not like really homeless, but you know, like white person homeless? Like rich person homeless?” His parents gave him $10,000 and took out a restraining order against him. So he went to Hollywood.

“One time I was walking down Hollywood boulevard, drinking peppermint schnapps, listening to Neil Young, and I gave a bunch of homeless people like hundreds of dollars and stuff, so that was great. So that’s one of the ways in which I am not a complete waste.”

We ask what happened next. “I got a lawyer, I got a baseball bat, and now, when people try to intimidate me, it’s like, fuck you.”

He says that he is super paranoid, but he doesn’t think he’s insane anymore. For a long time, he didn’t think common sense existed, but now he’s pretty sure it does. “Everyone is trying to get laid. And do drugs, I think, is what it all boils down to.”

He says we’re going to go places and Sarah laughs and tells him about my complete failure to get a job post-graduation. That’s okay, he tells us, “You guys don’t need life plans because you’re hot and smart. I know that’s like, super douchey, I’m sorry.” I was kind of flattered.

Isaac is baking in the sun, his shoulders getting progressively redder the longer we sit. He’s holding a Styrofoam cup of coffee but never takes a sip. “Vermont really fucking blows, man.” We ask why. “Because there’s nothing to do, you have to do drugs, or, just, do school work, I guess.”

We ask about the guy we’re calling Bullhorns and Isaac says that he hangs out on the bridge. What goes on at the bridge? “Cool stuff. Think of the Red Hot Chili Peppers. Things might be a little scary, just, throwing that out there. Just, in general.” Isaac says that there’s a baseline of terrible things and he has overcome it. “And by 'overcome it,' I mean I’m not dead yet.”

Isaac points us toward Burlington, because that’s where there’s the most stuff happening. “If you’re trying to follow the story, the story will just happen,” says Isaac. We decide to go to Burlington.

5. D.O.C.

We couldn’t score heroin in Burlington but we did meet a man who may or may not have had a little blue package shoved up his ass.

We brought Travis with us so that he could act sketchy as all hell. He does it beautifully. On the way to Burlington, he tells us that in order to help, he might actually have to go off without us and try to buy some drugs. He’s getting excited, a kid playing undercover cop. Or maybe he’s excited because he’s planning on getting high later. I honestly have no idea, but I’m assuming that the knife in his pocket isn’t going to be used on us.

It starts on our first pass up Church Street. “Hey!” yells a kid in a camo vest and a backward white baseball cap, “wanna hear a funny joke for a buck?” I’ve been trained to just walk past things like that but Travis says hey man, sure thing.

“Why couldn’t Ken get Barbie pregnant?”

“Because he came in another box,” says Sarah.

So we’ve ruined his joke but Travis says hey man, I’ll give you a buck anyway. He palms it, shakes, leans in and whispers something in his ear. “Oh yeah, man,” the kid mutters back, “up at the top of Church Street.”

Travis teaches us to look at eyes. Pinpoint pupils means opiates. Or bright sun. Sometimes it’s hard to tell. There is no one of interest up at the top of Church Street.

We get to the park. A line of men on benches falls silent as we walk by. We sit on the edge of the dry fountain with Travis and he decides we should split up. He’ll go be his shady self and try to score some goods. We should talk to people in the park.

The Kid is sitting on a bench. The Kid tells us his real name but asks to remain "anonymous as fuck." "The Kid" is what people call him. He’s the one who might have a little blue package up his ass, which we find out later[5]. His top row of teeth is gone, bottom is half brown with sharp cavities. Meth mouth? He’s wearing a gray denim vest with spikes. Lots of tattoos—on one bicep, half a sun with a raindrop falling from it, and on the other elbow in typewriter font, “not yet.”

He tells us we should ask people about their D.O.C.—drug of choice. Heroin, he says, is like rats. Once it’s out there it will travel. He says people like it because it’s so new here. He’s drinking wine out of a blue water bottle. Sarah tells him that my D.O.C. is booze and he offers me some wine. I decline.

A woman wearing a pink shirt with a big number 19 on it greets The Kid and he tells her about the story we’re doing. She sits down on the bench next to me. Her name is Barbara. Her daughter had a bad problem with heroin, she says, but she got into a methadone clinic and that helped. Her daughter was a traveler. She hopped trains. Barbara’s D.O.C. was crack cocaine. Clean for nine years, but as she speaks she occasionally brings her hand to her nose, sucking first with one nostril and then the other. She became sort of a housemother for travelers. Dirty Kids, she calls them. She had three rules: everyone had to shower, no drugs in the house, and everyone had to pick a chore and do it.

Soon we are joined by a group of travelers who don’t seem to be going anywhere at all. It’s the boy with the cameo vest again. It says “Finn” on the strap of his backward baseball cap and he goes by Huck, but the girl he’s with calls him Junior and he sometimes introduces himself as Eric[6]. The girl is also wearing a baseball cap, dyed red hair sticking out the sides, a short braid poking out the hole in the back. She has a sweet face, skips off to hug a friend she spots on the other side of the park.

At some point in the conversation, I watch Travis swagger back into the park, gray hoodie, one hand in his pocket, the other tapping a cigarette. Looking over his shoulder. He walks out the other side.

An older man with gray hair and crooked sea green eyes[7] brings Eric a paper bag filled with beer. Eric slips him something in exchange and we pass the beer around. At some point Travis joins us. Later he says that he wanted to drink beer with them so they would trust us, and also because he just really wanted a beer. It’s a fluid exchange of open containers, cigarettes, lighters, and a styrofoam takeout box full of sliced turkey that The Kid has procured from somewhere.

The Kid teaches us that “six up” means that a cop is coming—it’s a reference to pallbearers and the number of handles on a casket. Someone mutters “six up” and suddenly a loaf of bread is being passed around in place of the beer, and the girl is muttering, “I’m going to butt fuck this,” in reference to the spliff she’s rolling. Eric yells at the cop as he passes by. “What happened to your nose?” It looks like someone broke it. The cop just laughs. “Top secret.” 

That motherfucker took his dog away from him, Eric tells me. Kira. She was the sweetest thing to ever walk on three legs. That’s the second dog he lost. The first was Sriracha, and he has an anchor tattooed on his forearm in memory of her. She’s with his foster parents now. Kira wasn’t so lucky. He doesn’t know where she is. “I’ve been scaring you haven’t I?” he says. “I’m sorry. I didn’t mean to scare you. I hope I haven’t scared you. I scared you, didn’t I?” I assure him that he hasn’t. Not a lot of things scare me in a public park in broad daylight.

He cracks open a beer with his teeth, hands me the bottle cap and tells me to keep it. For the fourth time that day, he looks me in the eyes and tells me that he thinks he loves me. I tell him I’m flattered. It’s a red Budweiser cap, silver crown logo, “TWIST OFF” printed on the side next to the dent from his canine. He says he only wishes it were from a better beer.

It’s time to bring Travis back to Montpelier so he can babysit his brother’s dog . We decide to return later. Travis encourages me to flirt more with Eric because “he’s already in love with you,”  and “as two good looking young girls you have assets you aren’t utilizing.” 

It takes us about two minutes to find Eric and The Kid loitering on Main Street. [8]

“I’ve been doing this for thirty years,” says The Kid. Traveling, he means.

“I’m not going to make it that long,” says Eric. He says he’s not going to live to thirty.

The Kid laughs. “God’s not gonna let you die,” he says. “Just like he wouldn’t let me die.”

I sit with Eric on the curb in what I'm pretty sure is a small puddle of vomit[9] and he tells me his life story. His birth family was shit and his foster family was wonderful, but here he is. He says he’s been an alcoholic for five years. He’s twenty. He doesn’t know where his sister is and that kills him. He says they got separated for a while, but then he found her. They got breakfast every day, and she always had shaved her head. He never understood why, and that’s what made him the saddest.  He’s got a beer between his legs as we speak, and he keeps interrupting the conversation to yell jokes at people.

“Hey, wanna hear a funny joke for a buck?” Sometimes he asks for a smoke instead.

His jokes:
            
“My boyfriend beats me, I’m not gay but he’s gayer than I am.”

“One time my mom threw a grilled cheese at my face.”

“Hey, will you take my dog away? I’m probably going to beat him later.”

He points at The Kid.

“Hey, my boyfriend beats me. He’s also my dog.”

The Kid mostly ignores him.

I tell him the Barbie and Ken one was the best one he had. He gets a surprising amount of cigarettes; they just keep falling from behind his ear and he keeps smoking them. He also keeps telling me I’m beautiful.

Opiates? I ask. Fuck opiates, he says. They’ll fuck up your life. He once was dating this girl, and he would buy her the best reefer you could get in Vermont and the best whiskey he could afford. What more could she want? One day he turned around for a second and when he turned back there was a needle in her arm. He packed up his reefer and whiskey and left.

Earlier that night, The Kid had patted my back and said, “Don’t you worry, you’re as safe as you’ve ever been in Burlington." He now tries to get us to drive him to someplace in Winooski[10], won’t take no for an answer. “Don’t leave without me,” he says, walking off down the street. He says he’s going to make some money to buy beer. Eric is distracted, petting somebody else’s dog and asking the owner if he can borrow his pet for the night and go to Canada. I stand up to get out of there before The Kid comes back higher and maybe more dangerous. He looks up at me and I tell him we have to go. He doesn’t say anything, just nods. That’s how we leave him.

6. Anesthesia

Dr. Tim Lahey, an HIV specialist, tells us something an addiction psychologist told him once. “He said, ‘You doctors. Think of what you’ve done to be here. You decided not to go to that party, so that you could study that one time for the test, you decided you would defer gratification in multiple ways so that you could achieve a long-term goal. You exhibited self-control on multiple occasions to get where you are, you kind of define yourselves by that discipline. Addiction is oftentimes specifically comprised of the opposite behavior. It’s not about denial or self control; it’s about exactly the opposite. So of course, you have a hard time talking to each other.’”

A woman is brought to a clinic after being found passed out in front of a circle of needles with a “glob” of heroin sitting in the middle. Lahey is surprised that she denies injected drug use to her doctors.

Humans have been cultivating the opium poppy since 3400 BC, in Lower Mesopotamia. The ancient Sumerians called it the “joy plant.” In 1803, German pharmacist’s apprentice Friedrich Sertürner discovered its active ingredient—morphine. In 1874, English chemist C.R. Wright synthesized diacetylmorphine by boiling morphine in the presence of acetic anhydride, but it wasn’t until 1895 that the German pharmaceutical company Bayer would begin marketing the compound as a cough suppressant, coining the name it is known by today—heroin.

The human body has specific neural receptors for opiates—in the brain, spinal cord, digestive tract, elsewhere. Opiates have the same chemically active site as endorphins. Endorphins are released when an organism is stressed or in pain. They make you feel good when things are bad.

The current epidemic gets blamed a lot on over-prescription of narcotic drugs like OxyContin and Percocet over the past twenty years. Doctors get rated based on patient satisfaction, and prescribing pills for pain not only makes patients feel happy but also prevents them from calling them at two a.m. and complaining about how much their knees hurt. “The U.S. is five percent of the world’s population and consumes 80% of the world’s opioids,” Dr. Brian Sites, an anesthesiologist, tells us. “Clearly this has gone crazy, right?” So people got addicted to OxyContin and Percocet and Vicodin. But then the crackdown on prescription opiates began, and doctors got really scared, really fast. Supply plummeted, demand stayed the same, and the price skyrocketed. Heroin is much cheaper than pills.

A man shows up in the ER wailing about a dislocated shoulder, won’t let anyone touch him, claims he is allergic to all inhaled anesthesia. They put him under, realize there was nothing wrong with his shoulder, wake him up. When he realizes they haven’t used any opiates in the anesthetic cocktail, that he is still dope sick, he gets angry. Rips out his IV. Security has to tackle him.

If you take an MRI of someone’s brain before they use opiates and then look at it again after a few weeks of use, it looks different. And the scary part is that if you look at it a year after they’ve stopped using, it doesn’t go back to normal.

Pain is now considered the fifth vital sign. Pulse, breathing rate, temperature, blood pressure. All measurable with instruments that have been fine-tuned over centuries. And then pain. Subjective. You can only really know your own.    

7. Anthropology

Jeff DeFlavio, who graduated from Geisel Medical School in 2014, runs “Recover Together,” a small network of for-profit suboxone clinics. He is giving a talk about heroin addiction in the Upper Valley to a group of Dartmouth College students. With him is an anthropology graduate student whose olive green dress and strawberry blonde pixie cut give me no option but to remember her name as Peter Pan.

They know we’re there because we’re writing about heroin, and she asks us about why we think people end up abusing opiates. We explain that we’ve encountered a lot of different paths into addiction, and say that it cuts across socioeconomic levels, and everyone sort of has his or her own reason.

“So do you think it’s a medical problem?” she asks.

Yes, we reply, it is a medical condition. It changes your brain’s physical and chemical structure.

“Oh,” she says, “so as soon as the drug enters your body, it becomes a medical problem. But what about before that?” We start to chime in again, but her question was apparently rhetorical because she’s off on a rant about oppression manifesting itself in the body and Foucault’s notion of biopower, or something like that.

“Chronic social stress,” she says, triumphantly, is causing the heroin epidemic. She also throws the word “multifactorial” out there, and people sitting around the table nod their heads thoughtfully.

“We collectively haven’t decided whether or not we’re going to blame these people,” says Peter Pan.

Sarah and I, collectively, have decided whether or not we think she’s full of shit, even before she starts talking about the “odd moral space that addiction occupies.” She is asking the room to decide whether it is a medical condition like any other or if it is a question of personal responsibility or if it is our fault as society for putting people in a position where they wanted to do drugs. Neglects to mention that it’s definitely all three and about eight other things as well.

“Anthropology vs. public health vs. journalism,” Sarah writes in my notebook, “the most theoretical framework is manifestly the emptiest.”    

8. Narcan[11]

Anna[12] used to be a heroin dealer. She claims she used to roll with the Latin Kings in Hartford, Connecticut, help them cut heroin with some Spanish cleaning product, and drive it back up to Vermont.

Then she got caught. Four days before she went to jail, she overdosed.  The heroin was laced with fentanyl and she was in her bathroom. Her friend James was outside smoking a cigarette, came back in and thought, “where’s Anna?” He found her on her bathroom floor, blue. On her way down she’d smashed her head on the porcelain toilet. He picked her up and threw her in the bathtub, started running cold water before he realized she was dead. No pulse. He gave her mouth to mouth until the ambulance showed up.

Fentanyl complicates Narcan treatment. They had to do it twice. She woke up.

9. Needles

Laura Byrne runs the syringe exchange program out of the Good Neighbor Clinic in White River Junction. She’s middle-aged, wearing a pastel sweater when I meet her. They’ve doubled their number of clients and quadrupled the number of distributed needles since 2010. She says it’s only because people have found out about them and found out that it’s a safe place. She says Vermont gets a bad rap, but New Hampshire is no different. “Vermont has actually embraced the concept that there’s this kind of drug use in its communities. They’re more open to acknowledge that and then deal with it.”

People who come for needles don’t have to give their names or show identification. Demographics? Forty percent female, mostly eighteen to twenty-five. Some are her age, mid-fifties. Opiate rates are relatively steady, she says, but “the awareness is growing by leaps and bounds.” The syringe exchange gives out clean needles and cottons and cookers and ties. Everything you need.

There’s a whole system, formal and informal. Some people will never come in to the clinic. They’re nervous. Paranoid. So they actively encourage secondary distribution. She’ll give out a thousand syringes at a time to one guy, and she will get a thousand back a month later. She gives them eight-gallon biohazard sharps containers, and they come back full.

She’s able to give out Narcan as well. They’ve had fifteen reported overdose reversals since January 2013. Reported, she emphasizes, because not everyone who overdoses runs back in and tells her about it.

“They’re trying,” she says of people who relapse.

I ask her what people miss when they talk about the “Vermont heroin epidemic.” She says that for one, it’s not just Vermont. It’s everywhere. And two, that it’s really important to see drug dependence and addiction as a disease. And that drug use knows no socioeconomic bounds.

“And also just how people are really struggling.”

Depression. “I think some people just bottom out and they just are beyond caring. And that, to each individual, that feeling sort of ebbs and flows. It’s hard to help those people.” Heroin is a disappointing drug. “Within the first year, really, that excitement is no longer exciting,” she says. Every level of tolerance sets you back to where you were before, but worse.

 “I had a client who I think just had lost all hope and he walked into traffic and got hit by a car. So it wasn’t like he overdosed. But to me it was very much a drug-related death.” She clears her throat.

“A lot of the articles, it’s like heroin: the scourge of the community, and I guess it’s like I would want to show that people who use those drugs they didn’t know, when they started, what was gonna happen. Like unfortunately, they made a really bad choice. They all made a really bad choice, in the beginning, and now they’re stuck. I mean there are so many people and they’re so ashamed of how stuck they are and I think that if we as a community can be understanding of that struggle it would go a long way to helping them.”

“One can only hope,” she adds.

Psychological experiments carried out in the 1970s showed that if you put a rat in a cage and give it the opportunity to inject itself with morphine, it will do so, increasingly often, until it overdoses and dies. This finding has been extrapolated to humans, leading to claims that 1) morphine is irresistibly addictive and 2) addiction is caused primarily by exposure to the drug.

In 1980, Bruce K. Alexander published results from a study that in theory should have rocked the very foundations of how we think about addiction, but was in fact mostly ignored. In what are now known as the Rat Park experiments, he took a group of rats and put them in a large enclosure with wheels and balls and colorful tunnels, where they could mate and run and climb on things. Rat Park. A control group was put in traditional cages. Each group had access to two water bottles—one pure and one laced with morphine. The caged rats replicated the earlier experiments, becoming reliant on the morphine water. The Rat Park rats didn’t, even if they had previously been made addicted to it.

Addiction, Alexander argued, is a result of being caged.

10. The Tenth Thing

Laura said, “Once they stop using the drugs, it’s not like everything is suddenly better. It’s like all those problems that they had, which is probably why they started using in the first place, come back at them and then they have to deal with that and I just, it’s so hard for people to do that.”

Heroin is never alone. It’s not the only thing ruining someone’s life, but one of ten. One of twenty. That’s what Peter Pan meant by chronic social stress. All that stress gets cloudy when they’re high. But it’s not gone. And once someone becomes dependent on opiates, those changes to the brain, those changes in how they think and feel—some never go away.

There is no narrative of the Vermont heroin epidemic. There can’t be. It’s not being bored in a bucolic setting. It’s not broken homes. It’s not a work accident. Travis did pills because he was in love, and Isaac because he’s crazy and life is terrible, and Anna because her mother had a bad boyfriend when she was eleven.

Pain is so personal.

[1]See Sarah Khatry, "Montage of Heck," for all annotations that follow.

[2]: "For many, a one-month detox program, no matter how expensive, will end in relapse. It’s just not enough. The stats are hard to find online. One site tells you a 10-15% relapse post-rehab. Another will give you the same figures for success..."

[3]: "I offered Travis the radio, but he said he didn't know the stations. He never took his discs of Nirvana out the speaker. He referred to himself, perfectly serious, as a Nirvana addict..." 

[4]: A familiar answer. The Kid: "I can't tell you. Secret CIA stuff..."

[5] "Huck Finn in his rambles now makes a comment about blue baggies somewhere up The Kid's ass. The Kid snaps his head and glares, chin out, in a moment so silently observed it almost didn't happen..."

[6] To Lisa, he's Eric. To Sarah, Huck Finn.

[7] "Gord, with his permanently skewed eye..."

[8] "Huck Finn and The Kid were panhandling to the right of Nectar's on Main Street in Burlington at ten one night. The sign, lettered in red neon, rotated above them: LOUNGE Nectar's RESTAURANT..."

[9] "After we greeted them, asked if we could hang with them for the night, Lisa sat down with Huck on a single low step and I was left with The Kid..."

[10] ""I need to go to that bridge in Winooski. Just a ten minute drive from here. You know, I could really use a ride...""

[11] "Narcan, the brand name of naloxone, can be used in the event of overdose to help prevent death and minimize brain damage..."

[12]  "Anna is twenty and lives in Vermont. When we first met her, she was in furlough housing, six weeks out of jail, just off the bracelet..."