In April 2018 House Republicans on the Energy and Commerce Committee convened a roundtable at the Capitol and offered a speaking platform to families who had lost loved ones to overdose deaths. After the roundtable, the GOP posted videos from the open forum on two websites entitled “These Are the Stories of the Opioid Crisis” and the “Crisis Next Door.”Footnote 1
All the family members at the GOP forum were white and middle-class – a not surprising fact given the demographics of the Republican base – but any unpacking of opioid storytelling must begin with this simple, yet consequential, recognition of what Ekow Yankah has called the “new white face of addiction.”Footnote 2 Not only are all the families white at the GOP forum, but the parental testimonials practice an emergent elegiac politics that now circulates as the narrative format in documentaries, news stories, books and television advertisements on the crisis. In all the videos that are part of the GOP's “These Are the Stories of the Opioid Crisis,” mothers and fathers hold aloft photographs of their deceased children, the majority of whom are young white women, as if to witness both a public-health crisis and the loss of white innocence,Footnote 3 although overdose deaths from heroin since 2010 have been impacting whites and communities of color equally and the highest increase in deaths has been among working-class middle-aged white men.Footnote 4 Through this potent photomontage of athletes and prom queens dying young, these staged stories from the opioid crisis tap into white resentment, precarity, and agency panic to induce a melancholic reinvestment in a simulacrum of a lost whiteness. At the same time, these photos also recirculate and induce a broader anxiety about the loss of borders, boundaries, and the walls of whiteness's “immunity nationalism,”Footnote 5 for, as the forum's participants share their brief stories in the edited videos, we hear the insistent refrain that addiction now happens “next door” or that the “opioid crisis” is no longer walled off in “broken homes and in inner cities.”
What, we need to ask, are the particular stories that are being collected to represent the “opioid crisis” and what effect do these stories achieve, not only in terms of policy, but also in terms of identity, consciousness, and power. Although, on one level, the GOP forum's stories created needed sympathy for people with opioid-use disorders and their families, reduced the stigma and shame of addiction, and coincided with fifty-seven pieces of legislation introduced in the summer of 2018, much of this storytelling risks disseminating what I want to call an emerging white disability nationalism. This white disability nationalism seeks less to address a public-health national emergency – one that requires better pain management, criminal-justice reform, medication-assisted treatment solutions, harm reduction, and federal dollars – than to realign its audience with a white collectivity structured around a contrasting antiblack expendability. In recent years it has become widely accepted among critical race scholars that the drug war is a race war, one that, as President Nixon's domestic affairs adviser John Ehrlichman noted, would associate blacks specifically with heroin in order to criminalize and disrupt African American communities.Footnote 6 But the opioid crisis, I want to argue in what follows, is a different kind of race war, one whose outcomes, while perpetuating disparate racial stereotypes about black and white drug users, specifically works to morph and reconsolidate the “machinery of whiteness” around an affectively charged disability politics that recenters whiteness.Footnote 7 As black studies scholars such as Jared Sexton and Roderick Ferguson investigate, new formations of neoliberal whiteness have emerged that embrace a seemingly progressive language, while still retaining whiteness's particularity and its privileged dividends.Footnote 8 Opioid storytelling, even within progressive media outlets, functions to constitute just such a rehabilitated addiction to whiteness through its strategic braiding of disability language, images, and affects tied to a foundational antiblack relationality.
In his book Dying of Whiteness, Jonathan Metzl explores the contradiction that many whites are willing to die to preserve their place in a racial hierarchy rather than participate in a federally funded health-care system that, while it would improve their well-being, would put them on the same plane as immigrants or racial minorities. Rather than making a rational risk assessment about different health policies, these conservative whites invest in an affectively charged, and ultimately self-harming, identity politics.Footnote 9 Metzl's focus group studies of whites in conservative red states demonstrates that a backlash politics of “white rage” has been marshaled to convince whites to sacrifice their own “health,” while at the same time dismantling a larger multiracial community activism.Footnote 10 Opioid storytelling similarly enacts a white identity politics to sideline collective multiracial forms of social and political activism that might advocate for expanded Medicaid, additional government programming, and a turn from racialized law enforcement responses to treatment solutions and harm reduction. Through its framing and affective mobilizations, opioid storytelling reveals that a post-Obama-era politics of white rage is complemented by its sentimental inverse, an addicting politics of mourning and melancholy, which, while it overlaps at times with an overt white nationalist anger embedded in the rhetoric of the drug wars, is distinct from, although it expands out against, a white noise of xenophobia, terrorism, and purity nationalism. As part of opioid storytelling, readers and viewers learn how to feel as white victims, more than to feel a part of an ethnically and racially diverse community with a chronic disease, and in, doing so, are taught to realign themselves with a whitened nation against those from “Baltimore and the Bronx” who threaten to take that nation away.Footnote 11
In using the term “opioid storytelling,” I want to clarify from the beginning, I do not in any way intend to suggest that the suffering due to addiction is less real, or that overdose deaths should not be declared a public-health emergency, as today more people die of opioid/heroin overdoses than by guns or car accidents, and annual fatalities are higher than deaths from the HIV virus at its peak.Footnote 12 The overprescription of opioids has shattered families – irrevocably. But the affective biopower of white disability nationalism's opioid storytelling comes through its check on critical complications, for to question stories of such overwhelming trauma can risk seeming insensitive. Opioid storytelling, moreover, should be understood as a delayed narration of trauma. The emergence of the “opioid crisis” as a media-grabbing, retweeted headline of US national concern did not coincide with a statistical peak of increased white overdose deaths which occurred in the early 2010s. Instead, the white-faced opioid crisis emerged on the national stage during the 2016 presidential primary. Conservative media had seized upon a report at the end of 2015 by Nobel laureate in economics Angus Deaton and his wife, fellow Princeton economist Anne Case, detailing an increase since 1999 in mortality and morbidity among white Americans aged forty-five to fifty-four and among those with only a high-school education or less, especially in rural areas.Footnote 13 This report confirmed the pessimism and vulnerability that many white Americans felt about historical and economic decline, and, for some, their victimization by other groups allowed to “cut in line ahead of them.”Footnote 14 As a consequence, the opioid crisis dominated the 2016 presidential primaries and election, and even traditional conservative law-and-order Republican candidates broke silence and confessed their own family histories with drug abuse to reframe the opioid epidemic as a crisis about white decline and lost family values. Jeb Bush shared his daughter's struggle with addiction and the felony charges she had faced for “illegally possessing prescription drugs”;Footnote 15 Carly Fiorina admitted her daughter's struggle with alcohol and opiate addiction before her death from an overdose; and Ted Cruz tried to make himself “relatable” by disclosing his older half-sister Miriam's similar overdose death, explaining, “These tragedies are happening in human lives all over this country – it's the human journey.”Footnote 16 Then Republican primary candidate Donald Trump, moreover, first called for building the wall along the Mexican border at a drug forum in New HampshireFootnote 17
The delayed narration of this opioid crisis represents a significant policy shift away from an earlier law-and-order zero tolerance of crack users in the 1980s and 1990s toward a contemporary public-health response to sympathetic white opioid users said to be suffering from a disease. Such a shift from crime to disease, however, draws on a seemingly more humane disability language (disease/addiction) within social justice reform to retool a white identity politics as a disability nationalism.Footnote 18 In stating that opioid storytelling is shaping a white disability nationalism, I am drawing upon David Mitchell and Sharon Snyder's conceptualization of what they call “ablenationalism.” In defining ablenationalism, Mitchell and Snyder identify the way nations and multinational corporations use disability as a means for promoting American exceptionalism, often through misleading representational tactics that integrate a privileged and renormalized minority of the disabled at the expense, and further disempowering of, others.Footnote 19 Building on Mitchell and Snyder's theoretical lens, I want to argue that opioid storytelling's white disability nationalism effects this reprivileging of white abled disabled users through a melancholy affective politics rooted in a complementary black disposability.
In the sections to follow, I will first offer a close reading of one of the many documentaries on the opioid crisis that have appeared since the mid-2010s: HBO's 2017 Warning: This Drug May Kill You, directed by Perri Peltz.Footnote 20 In its tactical suspension of the expected overcoming and recovery narrative, Warning's opioid storytelling particularly redeploys a panic about lost agency and increased vulnerabilities into a melancholic reinvestment in a fantasy ideal of white immunity nationalism that cannot be fully mourned. While in the first section, I focus on opioid storytelling's imbrication in a white sentimental nationalism, I then shift to trace out more fully the antiblackness that structures this white disability politics through a close reading of Beth Macy's New York Times best book of 2018, Dopesick: Dealers, Doctors, and the Drug Company That Addicted America. In its in-depth investigation of opioid history, the role of Big Pharma, the tension between law enforcement and medical responses, and the controversy over medication-assisted treatment and harm-reduction strategies, Macy's Dopesick offers a comprehensive overview of the causes behind and potential mitigations of the crisis.
Yet, at the same time, Macy's Dopesick also discloses how opioid storytelling's white identity politics circulates and frames representations of this national emergency even in progressive media. Particularly in her user-centered stories focussed on Roanoke, Virginia's white middle class and in her plotting of the episodic chapters around a true-crime narrative of black criminality, Macy's Dopesick discloses how opioid storytelling's melancholic reinvestment in a lost white innocence relies on a depiction of middle-class whites as abled disableds, or dopesick users, in contrast to an “unredeemable” noncompliant blackness. In the end, Peltz's and Macy's opioid storytelling reveals not only a contemporary morphing of a complex history of race and public health around a neoliberal white identity politics, but how “fragile” white subjects can reinvest in intractable hierarchies of white supremacism, while simultaneously thinking of themselves as liberal antiracists.Footnote 21 For opioid storytelling to end the stigma and shame of opioid abuse disorder – and to ensure a federal response that values all families – it needs to replace the white face of addiction with a more nuanced and complicated set of stories that finds the affinities between inner-city DC and Roanoke, VA rather than rehabilitating white innocence through the recriminalization and disposability of people of color.
DOCUMENTING THE PRECARITY OF WHITENESS IN PUBLIC HEALTH'S MELANCHOLY POLITICS
At the start of Perri Peltz's 2017 HBO documentary Warning: This Drug May Kill You, we see a series of phone-generated videos of white people “nodding out,” as the sedation into inactivity from heroin is generally referred to, on subways, on sidewalks, in parked cars, and in the aisle of a toy store where a distraught child tugs at her mother's arm pleading with her to wake up.Footnote 22 Interspersed amidst these grainy, unprofessional videos with their raw power are the slick marketing videos of Purdue Pharma representative Dr. Alan Spanos of the University of North Carolina, who proclaims the dawn of a new era which will end the historical underprescribing of medication for those in chronic pain. Touting the patented slow-release formula of OxyContin, Dr. Spanos assures consumers that less than 1% of users become addicted. Through this juxtaposition, Peltz's Warning establishes on a powerful visceral level the main “warning” or deterrence narrative that is at the center of its storyline: the crisis results from innocent teens and suburban moms (the sole focus of Peltz's documentary) being turned from pain patients into persons with opioid abuse disorders.Footnote 23
This story of “pain patients turned into users” is true – and tragically so for the 12% of patients who become addicted through prescribed opioid medications. But it is also overly simplified and limiting, while at the same time being a particularly flexible and useful storyline to instrumentalize and ameliorate white fragility. The “calamity” of the late 1990s opioid revolution, as Christopher Caldwell notes,Footnote 24 was not so much the actual conversion of pain patients to people with opioid abuse disorders; it was the release of massive quantities of addictive drugs into the public at large as part of broad regulatory and cultural shifts. As a result, bottles of hydrocodone fell into the hands of suburban teens, who often took them to experiment or self-medicate their boredom, anxiety, or depression. While these pain-patients-to-user stories draw necessary attention to Big Pharma's role in the crisis, they also ignore the preconditions of this overprescribing, which resulted from deregulation and new legal protections for corporate “free speech” that allow over half of the FDA's budget to come from pharmaceuticals – a fact which is rarely mentioned in the public backlash against Johnson and Johnson or Purdue Pharma.Footnote 25 Although political cultures, even progressive or leftist ones, often resort to melodramatic forms to raise awareness, this public-health shorthand undercuts the critical emergence of other alternative understandings of opioid abuse disorders that might better challenge inequalities, injustices, and racialized structures of power.Footnote 26 In its sentimental focus on user-centered stories of victimization by prescription, Peltz's Warning links public-health messaging with the preservation of a white innocence that did not choose addiction, while at the same time feeding a vulnerability panic about the loss of white agency and privileged immunity.Footnote 27
Peltz's opening montage of iPhone videos, moreover, also disseminates another significant feature of the imagery within opioid storytelling: opioids induce inactivity and turn abusers into “nodding” zombies. Although, as Travis Linnemann and Tyler Wall note in their analysis of the “meth wars,” methamphetamines in rural communities (“hillbilly crack”) also seized the cultural imagination in the 2000s and played on fears about declining white status, meth is a stimulant, not a depressant like opioids. Meth raised fears about an undisciplined, criminal-prone, toothless “white trash” breaking the law and violating middle-class norms as society displaced its fears about economic decline, inequality, and dispossession in the new global economy.Footnote 28 The images of the “opioid addict” are not only different from the Reagan-era African American “crackhead,” but also from the working-class white “meth head.” The user with an opioid abuse disorder possessed by synthetic drugs that latch onto the neuroreceptors in the brain figures a specific panic about white precarity and inactivity, or a lost agency, inertia, helplessness, and vulnerability among a middle class that feels it no longer has upward mobility or profits from segregated (or gated) privileges of whiteness.Footnote 29
Although Warning does not invite its viewers to interrogate the origins of these homemade videos, there are also telling signs that many are haunted by what Toni Morrison has called a constituting black shadow.Footnote 30 In a number of the videos focussing on individuals attempting to awaken the passed-out opioid users, we see brown hands, arms, and legs, as well as voices – some even calling out for assistance to help a child left abandoned in the backseat of a car while the parents nod off against the steering wheel. However, this blackness that appears – and yet cannot appear as more than a shadowy fragmented body part, whose perspective and affinity (a caring hand) must finally be erased when the sentimental stories start of the four white families destroyed by a “prescribed” (not chosen) fate – remains as the necessary shadow presence realizing the “warning.” The term “addiction” has always implied, through its Latin roots, the idea of “being rendered a slave or a bonded servant”;Footnote 31 thus the specter held up in Warning's opening montage is that whites will be rendered a slave, or rendered black, reduced to living in and passing out in “black neighborhoods” (as the videos attest), which they in the past avoided or felt immunized against. Whites have lost not only entitlements and status, but a fundamental relationality and immunity that has defined whiteness since its invention in the post-Enlightenment West: a differentiation from the African and the slave.Footnote 32 But if the shock of the opioid crisis is a lost agency knotted with blurred racial boundaries, Warning also reminds us visually that it is also imbricated in a feared loss of humanity, for one is not only “black-like”; one is also no longer “human,” but slave-like, even zombie-like. Although it is not my intention to argue specifically for the true facts about opioid abuse disorders, it is worth noting that some opioid/heroin users do remain active when high, and many use other drugs like meth to offset the numbing effects of opioids, a complicating multiple drug use that Warning, and the majority of the headline-grabbing stories from the opioid crisis, omit from their representation.Footnote 33 Instead Warning focusses singularly on only the inactivity – and not on the fluctuating “manic” behavior – to invoke a specific fear about inertia, lost autonomy, a lost rugged individualism, and lost family values historically associated with whiteness.Footnote 34
Throughout Peltz's Warning, as in its opening video montage, the tragedy of the opioid crisis is as much about its disruption of a presumed racial ordering and boundaries, as it is about the quantitative death toll. All Peltz's opioid stories begin with highly stylized establishing shots that reinforce a geographic as well as corporeal dislocation. As David Amsden noted in one of the earliest long-form journalistic pieces on the “white crisis” for Rolling Stones magazine (2014), the shocking question of the opioid crisis is how “did idyllic Vermont (or Allendale, NJ or Ohio) become America's heroin capital,” thus invoking an invasion from “Baltimore, or the Bronx” (the most commonly referenced metonymic cities standing in for a racialized pathology in opioid storytelling).Footnote 35 Thus Warning's camera pans across open country fields and lurks outside picturesque middle-class suburban streets in Mill Valley, California or Allendale, New Jersey with an almost fetishized lingering over bric-a-brac in the finely appointed homes far removed from the dirt, the grime, the noise, and busy trafficked streets stereotypically associated with a racialized drug problem. As disability scholar Mel Chen traces out in her discussion of the discursive and affective fabric of “immunity nationalism,” a racial order that creates toxic environments and debilitated health for communities of color also implies the complementary premise that whiteness comes with a particular privilege of immunity, even if it is always an immunity under threat. This naturalized logic of white exceptionalism, while intersecting with notions of white purity and decriminalization, included ideas of bodily control as well as segregated risks and susceptibilities. The borders of this racial immunity system, however, as opioid storytelling's sentimentalized settings expose, worked only through a not always fully acknowledged complementary segregated slow violence against communities of color that have been allowed to debilitate and die.Footnote 36
Each of the four stories within Peltz's Warning is organized around a parental elegy that recurs as the structuring through-line within opioid storytelling, whether in documentaries or in public hearings such as the 2018 Republican summit. In three of the four family stories that Warning profiles, the common theme is the parents’ mourning of their lost innocence (as opposed to the daughter's or son's experience), an innocence that is not so much moral as epistemological: a lost worldview that one could secure immunity and a protected life. The stories from the opioid crisis in Warning are as much about the parents as about the actual users, and about the pain the parents feel in losing control over their ability to inoculate their children.Footnote 37 Thus, in the third story on Brendan Cole from Allendale, NJ, who became hooked on opioids after having an operation to remove a cyst, his father Brian voices the anxiety that lies at the center of opioid storytelling: he had “created everything possible to create a perfect family” and had even moved to Allendale because it was like “Mayberry,” while his wife Gail shares her own helplessness and disbelief, musing, “Why would he have done that? What could he be thinking? Is love not enough?” Although it is undeniably tragic for families to be powerless to help a family member with opioid abuse disorders, opioid storytelling as a genre transforms the personal devastation experienced by middle-class white families into a cultural and national loss that encodes the racialized fixations of a post-Obama-era historical moment about lost boundaries, immunities, and personal control in a neoliberal order. Opioid storytelling taps into a long history of articulating white subjects around immunity. As the Coles announce, “Mayberry,” a reference to the setting of The Andy Griffith Show (1960–68) often associated with an earlier white American innocence and greatness, is gone. In its nostalgia for “Mayberry,” opioid storytelling erases any larger context of how a market privatization of health care, decreased federal and state support for higher education, or declining wages in a global economy shifted the burden of a downsized welfare state onto individual families and contributed to their helplessness.Footnote 38
In opioid storytelling, a disability language of addiction's relapse replaces a historical panic about “degeneration” dating back to the post-Reconstruction era as an expression of racial anxieties about status insecurities. At the same time, moreover, the opioid imaginary also recycles long historical motifs about racially imperiled white “fallen women,” that were a key part of these narratives of degeneration to “warn” against deviance from middle-class racial and gender norms.Footnote 39 Peltz's documentary overlaps a warning about the overprescription of opioid painkillers with a panic about the decline of white families. The first chapter of Warning entitled from “Pills to Heroin” introduces us, for example, to the first of its women-centered profiles, Stephany Gay, as well as her mother, and sister Ashley, who died of a heroin overdose. In introducing Stephany, Warning employs the techniques that mark the conventions of the opioid narrative: first is the photomontage of Instagram-able moments of Stephany – smiling, playing, hugging her family – while the parental voice-over narrates the family album, saying that “Stephany did not hang out with the bad kids.” When Stephany, however, at sixteen, goes to the emergency room because of kidney stones, she is sent home with bottles of OxyContin and Vicodin by “trusted doctors.” Soon she is taking a month's supply in two days, and when she complains about the withdraws, or dopesickness, the doctors give her another prescription for Percocet. As Stephany notes, she assumed, as do many of the interviewed teens, that taking pills was not like “sticking needles in her arm,” “that's for real junkies.” But soon to keep that “best feeling in the world” that made her “feel like a superwoman,” she turned to cheaper ten-dollar bags of heroin. In the telescoped melodramatic timeline of the photomontage crosscut with interviews of Stephany and her mother, we soon learn that, although she “had the perfect life” with a husband and young daughter, she lost it all because she was a “slave to it [heroin].” Although Stephany goes into rehab, like the 60 percent of users who relapse within the first sixty days, she returns to using after six weeks. Throughout this telescoped overview visually accompanied by camera shots of the sentimental knickknacks in the family home, it is important to note that Warning does not address how Stephany had the money to buy heroin over the six years of her story, thus avoiding having to acknowledge that many users also sell and deal drugs or do sex work to maintain their habits. Warning presents viewers with a retrofitted family-values fallen woman, someone who was simply a user, thus conferring on her a decriminalized identity separate from an implicitly racialized needle-injecting “junkie” dealer.
As part of its sentimentalized user- (not dealer)-centered storytelling of innocent victims, Warning practices an elegiac cultural politics of sentimental feeling prevalent within the opioid imaginary that induces viewers to renew whiteness's decriminalized innocence. In part, this overlay of deterrence narrative and elegy in Warning reflects that the movement against Big Pharma and opioid activism often began within the community activism of parents’ groups, and these parents offer an understandably hagiographic account of lost loved ones. But the translation of this familial grief into a narrative repetition and fixation in opioid storytelling functions as a politically useful affective politics. In telling its stories of Stephany Gay, of Wynne Doyle, of Brendan Cole, and of Georgia Cayce, Peltz's Warning turns personal remembrance into cultural memory to unfold a specific form of “melancholy history,” one which, as David Eng and Shinhee Han have argued, drawing on Freud's distinction between melancholy and mourning, remains invested in the fantasy of the lost object, refusing to fully mourn and move forward.Footnote 40 The opioid imaginary is about the mobilizing of affective legacies of loss as the flash point for political and racial subjectification in a lost Mayberry-style white immunity nationalism. Throughout Warning there is never any mention of the need for better pain management, medically assisted treatment solutions, harm reduction, or federal dollars. There is only a fixation on loss as part of the documentary's arrested mourning for a white American innocence.
In his work on loss, Freud distinguishes between two psychic states in relation to individuals’ ability to successfully work through their loss, whether of a beloved person or of an ideal. While as part of a successful mourning process individuals are able gradually to let go and withdraw their affective investment in the lost object so that they can have once again an openness to the world and discover new objects and alternative becomings, in contrast, melancholy is mourning without end, as individuals cannot resolve the conflicts and ambivalences caused by the loss of the beloved object and remain attached to the object of sorrowful loss. Although I borrow Freud's distinction between melancholy and mourning, I do not want to suggest that opioid storytelling's emotions connect with inherent psychological states; rather, this melancholy enacts a cultural practice that taps into the ressentiments of wounded white attachment.Footnote 41 In its focus on female user-centered stories of mothers and daughters, Warning taps into the historical way the vulnerability of the white female body has often stood in for the vulnerability of the nation that has allowed itself to become too soft, porous, and susceptible to the invasion of others.Footnote 42 As Stephanie and her mother lament, a privileged white rural and suburban version of the American dream that promised immunity from a racialized world of junkies is now in “crisis.” In its repetition of grief without any serious investigation into the complexity of drug addiction or its treatments, Peltz's documentary may “warn” of the dangers of opioid use, but this vague public-health deterrence narrative slips into melancholy repetitions of the lost innocence, immunity, and difference of an aggrieved whiteness, which is invoked, if never quite fully named.
In recent years political commentators have focussed on white conservatives’ self-fashioning within a victimization narrative under the threat of a US “Third-World-ing.” Such a victimization narrative, it has been argued, fueled President Donald Trump's appeal.Footnote 43 But in highlighting a white identity politics within a supposedly liberal anti-racist public-health narrative, I want to distinguish white disability nationalism from this obvious racist discourse, despite at times the family (values) resemblance. In this neoliberal white disability nationalism, white Americans are less victimized by people of color than are said to share a color-blind fate, or disability, here a drug addiction, previously associated with blacks or heroin-using countercultural white bohemians. In part, these white addiction/disability narratives resemble a liberal “post-identity” discourse of a supposed shared precarity in a gig economy in the wake of post-industrialization. However, such supposed “post-identity” universalisms around a shared fate in the new global marketplace economy ignore the disproportionately higher risks and vulnerabilities that poor people of color face and are scaffolded upon false equivalencies.Footnote 44 To see heroin addiction as a disease that brings white people down to a level of black suffering depends on a number of reductive fallacies, particularly that blackness remains a sign of dysfunctionality and crime. But despite claims of a shared color-blind vulnerability, opioid storytelling leaves in place the long historical duration of an antiblackness that uses contrastingly disposable black “slaves” (now needle-using “junkies”), as Stephany notes, as a humanizing contrast for whites said to be worthy of greater rights, or at least the right to rehabilitation.
In his study of pain, sociologist and health historian Keith Wailoo notes that pain is always political.Footnote 45 Not only has who is said to be in pain been perceived through a racialized lens, but pain has performed historically ideological work within political movements. Thus it is important to note whose pain counts – and whose stories can be told (and how) in the documenting of the tragic increase in heroin overdose deaths. In its sentimentalized populist appeal around teens and moms with opioid abuse disorders, Warning does not just omit diverse representation. It channels the increased precarity of white families in a global capitalist economy into the “siren song” of an affectively charged white identity politics.Footnote 46 Opioid storytelling's siren song, like an earlier white working-class identity politics that David Roediger describes in his groundbreaking book in whiteness studies The Wages of Whiteness, is designed to erase class differences amidst growing economic inequality, while implementing a divide-and-conquer strategy that would foreclose the development of multicultural working-class solidarity that might work together to expand health care and government programming for desperate families.Footnote 47 Although a user-centered focus on teens and moms underscores the loss of an imagined family-values past, it is important to note that in states with the highest overdose death rates, such as Ohio, it is manual laborers, particularly construction workers, who are seven times more likely to die than middle-class workers in white-collar jobs.Footnote 48
Opioid addiction has not just impacted suburban middle-class family members – the focus of opioid storytelling – but the employed and underpaid and overworked in a deregulated economy.Footnote 49 These are the stories not heard as part of opioid storytelling's public-health warning. Such stories, indeed, must not be heard, for white voters in the Republican base must not be reminded of class-based disparities in health and disease. Given the high percentage of minorities in construction, such an unsentimentalized working-class focus would, furthermore, complicate the white-faced, family-friendly image of an “opiate” (definitely not a needle-using heroin) crisis. To take the construction site rather than the family home (and its troubled teens like Stephany) as the point of reference in the opioid narrative would disrupt the restoration within opioid storytelling of a melancholy investment in a relapsed, but still recoverable, disabled white nationalism. To set Peltz's Warning and the GOP's “These Are the Stories of the Opioid Crisis,” with their panic-inducing stories of teens monsterized from pain patients to users, against contemporaneous increases in overdose deaths among older and supposedly less sympathetic working-class and multiracial users with opioid abuse disorders exposes that opioid storytelling mystifies class and racial inequalities implemented through a biopolitics of health. In opioid storytelling, thus, not only does the innocent white – largely feminized – body more than others represent the nation in its mourning, and the loss of white families count more than the loss of other families, but also opioid storytelling attaches white viewers to the conditions of their own subordination as they learn to reinvest in a privatized and fetishized immunity rather than align themselves with more collective and multiracial forms of state and federal harm-reduction programs that dispense with distinctions about “innocent” or “worthy” users. Warning's opioid storytelling does not only discriminate against people of color. It harms the white users it profiles. Despite its “warning,” Peltz's documentary feeds an emotional addiction that would have viewers, to modify Jonathan Metzl's assessment, “overdose by whiteness” rather than imagine multiracial treatment solutions or a transformative justice system that would secure their economic and physical health as well as those of an “undeserving” minority.
ANTIBLACK RELATIONALITY AND THE WHITE DOPESICK ABLED DISABLED
In describing the spread of opioid abuse disorders and overdose deaths from a “handful of mostly African-American heroin users and dealers in Roanoke” to white youths and families in the middle-class suburb of Hidden Valley, Macy's Dopesick repeats the phrase that addiction researcher Warren Bickel borrowed from one of his white patients: “‘Herr-on is my girlfriend,’ one of his patients told him, adopting the street pronunciation for the drug popular among African American users” (108).Footnote 50 This phrase “herr-on is my girlfriend” recurs as a citational motif throughout Dopesick to underscore one of the book's key themes: opioid addiction is a disease, a chronic disability that shuts down individual willpower and requires medication-assisted treatment and harm-reduction strategies, not simply law and order or abstinence-based, “just say no,” messaging and therapy: “Not love. Not family. Not sex. Not shelter. The only relationship that matters is between you and the drug” (108). In Dopesick a key impediment to addressing the crisis in opiate overdose deaths arises from the clash of law enforcement strategies with medical and public-health science. Yet what does it mean that the refrain that diagnoses Hidden Valley's youth with an addiction rather than a crime borrows the language of racialized criminality from the same police officers and prosecutors whose lock-’em-up solutions it finds insufficient?Footnote 51 Although Dopesick makes its readers aware of the problematic racially biased law-and-order responses that often stand at cross-purposes with medically informed public-health strategies, it challenges implicit racial biases only to recirculate antiblackness as the necessary shadow presence for the reinvention of a white disability nationalism. In using Dopesick as a case study in what follows, I want to trace out how even the well-intended, New York Times-endorsed, progressive media often remains embedded in opioid storytelling's unmarked white identity politics. Dopesick's user-centered stories of sympathetic white, mostly young, middle-class users, in particular, depends on a constitutive othering of an invading black criminalized “herr-on” echoed within and shaping its supposedly antiracist color-blind reporting.
At the heart of Macy's Dopesick, despite its in-depth analysis of the history of opioids, its dissecting of legal and public-health responses, and its evaluation of treatments for opioid abuse disorders, is, as we saw in Warning, a focus on destigmatizing profiles. These profiles are provided largely through maternal narration that aligns innocent young white users with “family values” to establish an exculpatory, if not completely blameless, addiction etiology. Safely shutting the door on “grim” or “disturbing” depictions of heroin use by these young adults with opioid abuse disorders, Dopesick highlights once again the parental anxieties more than the users’ experience, for we hear mainly from mothers and listen in on their parental insecurities and guilt about being unable to create an “immunized” white life for their children. Although Dopesick also extends its reporting on the crisis to the rural and working-class communities of Martinsville, Woodstock, and particularly the western Virginia towns of Laurel Fork, Big Stone Gap and St Charles, it tellingly omits any extended user profiles in these communities, shifting its focus instead to the heroic doctors and community organizers who fought against Big Pharma. The book's few profiles of rural users, moreover, highlight how these less respectable displaced and unemployed workers (in Martinsville) turn welfare cheats, trying deliberately to stay sick with mental illness and chronic pain to “make them eligible for Social Security disability” (125). In contrast to these “draw-ers,” who want only to draw disability benefits (125), Dopesick opens with the extended portrait of Hidden Valley high-schooler Jesse Bostridge and highlights his innocence and invocation of a lost suburban “all Americanness.” Jesse is described as a “robust high school football player barely old enough to grow a patchy beard on his chin” (14), who in high school “once summoned the crowd to its feet simply by running onto the field and pumping his arms” (15). Like the other young men granted a profile in Dopesick, he is “handsome” and has a gentle caring nature that loved sunflowers and that ended phone conversations with his mother by telling her he “loved her [you] more.”
Throughout its moving and intimate maternally narrated user stories, Macy's Dopesick enacts, in many ways, the familiar strategy of opioid storytelling's elegiac politics. The crisis involves the loss not only of young (white middle-class) lives but also of an innocent way of life. This sentimental nationalism is highlighted once again in the constant references to a Mayberry-like “idyllic” American landscape before the epidemic (25): thus Macy describes Roanoke (or her suburban section of white Roanoke that stands in for Roanoke) as retaining before the opioid epidemic a “safe, small-town feel with an almost Mayberry level of friendliness” where locking one's doors is viewed as an amusing eccentricity (107). Although Dopesick often assumes a detached reportorial tone connotating objectivity – transcribing rather than commenting on the viewpoints of police officers, prosecutors, social workers, and doctors – Macy positions herself as a native informant who identifies with, and was motivated to write the book on behalf of, the grieving middle-class white mothers of Roanoke. Interjecting her own personal history amidst the stories of the four Virginia moms who are at the center of the book, Macy writes,
I spent the summer of 2012 trying to make sense of how two young men with educated, caring mothers and movie star good looks could keep the severity of their drug habits hidden for so long. I wanted to alert readers to the growing scourge of heroin in our community, and with two teenage sons still at home, I hoped to inoculate my own family too. (111, added emphasis)
Although Macy concludes her book by noting that solutions to the opioid crisis often logjam due to distinctions between “good addicts” and “bad users” (272), her reserving of user profiles for only those with “movie star good looks” and “caring mothers” works against the book's repudiation of a language of “worthy/unworthy” victims. In situating the viewpoint of her book, moreover, Macy invokes a language of inoculation, calling attention, as we have seen, to a fantasy of white immunity, which is also in crisis in the border-blurring spread of opioid overdose deaths. Such a personal identification with middle-class moms is certainly, on one level, understandable and implies a commendable empathy. Yet, at the same time, it divulges the more deeply rooted racialization of opioid storytelling. The increase of opioid overdose death in Hidden Valley has not just created a public-health crisis: it has created, as Macy notes, a crisis of meaning, a traumatic shattering of an “inoculated” worldview. In contrast, the death among black, Latinx, and other people of color in Roanoke for several decades was not just underreported. It was normalized, for black herr-on death creates no shattering of a worldview, even if it might demand some legal, political, or public-health responses. Black herr-on death stands only as a marker of that from which white families used to be and need to be protected.
Tellingly in this identification of her ally standpoint, Macy switches from the singular “I” to the plural first-person pronoun, “our communities,” which underscores the particular rhetorical framing and targeted audience of her investigative report: our communities signals once again the exception granted by the opioid crisis language to focus exclusively on the “white face of addiction,” or the fate of deserving middle-class white families such as those in the Hidden Valley suburb of Roanoke, Virginia. The implications of this framing around an unmarked racialized language of “our communities” has significant resonances. As Macy acknowledges elsewhere, Roanoke's African American community suffered from problems with heroin even before the late 1990s, but no one cared until it spread to the white suburbs or until it made local headlines in 2010 with the sentencing of Spencer Mumpower, the son of a prominent businesswoman, for providing the drugs that killed one of his former high-school classmates (Scott Roth). Although Roanoke's population is 28.2 percent African American, the fate of those families is not included as part of this imagining of a shared “our” community built around maternal anxieties. Such a white framing of the problem, moreover, is not simply a marker of deficient representational diversity, although that in itself is not an inconsequential omission, occluding, as it does, cross-racial alliances that might work to ensure the harm-reduction community-based programming that Macy's Dopesick tries to convince white families to embrace. Instead, this segregated white maternal sentimentalism functions to maintain an antiblack relationality central to the opioid storytelling's rehabilitation of white (but not black) disability.
The shadowing constitutive resonance of “black herr-on” on Dopesick's imagining of a white disability nationalism can be most clearly seen in the book's overarching “true-crime” narrative centered on Ronnie Jones. Dopesick opens with Macy's visit to the Hazelton Federal Correctional Institution on the outskirts of Bruceton Mills, West Virginia to visit Ronnie Jones, “the monster” black man (255), who, according to federal prosecutors, “transform[ed] a handful of users into hundreds” (13). This true-crime plot convention of the felon behind bars whose backstory will slowly unfold between the informational chapters and user-centered stories adds narrative suspense and marketability, especially given this genre's ubiquity in contemporary podcasts and documentaries. But it also discloses an inherent narrative contradiction and cognitive dissonance that makes sense only in the service of a white disability nationalism. Macy begins her book with, and makes its climax, her visit to Ronnie Jones in the federal penitentiary because, she says, for five years, she had been trying to understand Jesse's death – all the addictions, imprisonments, and overdose deaths among Hidden Valley's young adults – and “now I had someone I could ask” (14).
Although Macy later breaks down the answers she wants to learn from her interview with Ronnie to include illuminating the “ruts in … a criminal justice system that pursues a punishment-fits-all plan when the truth is much more complicated” (243), we need to ask, especially if we are to move beyond the white identity politics of opioid storytelling, why Ronnie would be designated the person to ask. Why does Macy, in response to her own desire to “make sense” of the opioid crisis among Hidden Valley's white young adults – and on behalf of all the white mothers of Hidden Valley driven “crazy” because “the story doesn't add up” (16) – think the answer (the blame?) lies with Ronnie? Such a need to interrogate the black supplier really only has coherence within the logic of opioid storytelling's white elegiac politics. Ronnie cannot answer the two questions that supposedly motivate Macy's visit to the federal penitentiary on behalf of the mothers: what is the cause behind their sons’ and daughters’ opioid abuse disorders and what are the best approaches to treat addiction and prevent opioid-related overdose deaths? The answers to those questions certainly do not require Macy to bring the picture of nineteen-year-old Jesse Bostridge, the “robust high school football player” in his number 55 jersey – the picture of innocent white youth – as part of a confrontation with the black “dealer.” In contrast, Macy does not feel a similar need to confront the white youths who traveled up Highway 81 to Baltimore to buy, sell, and “evangelize” (her word) opioids (190). To make meaning out of the tragedy that Dopesick's narrative implies, however, requires a visit to Ronnie Jones, or the restoring of categorical and ontological distinctions between white innocence and black criminality.
That visiting Ronnie Jones would somehow “answer” and provide closure on Jesse Bostridge's death seems all the more illogical since Jesse had been using (and dealing) long before Ronnie Jones become a key heroin supplier for the Roanoke area, and although Ronnie may have provided the heroin – the police could never trace the source – which Jesse's buddies shared with him the night he died, Ronnie, a distant middleman, could not have offered more “answers” or insights about the circumstances of his death for the story to “add up.” The “answer” (Ronnie) functions only to provide a scapegoat, and, as importantly, a demonized blackness necessary as the oppositional figure on the other side of the plexiglass to rehabilitate a white innocence that might have too many troubling resemblances to its mirror image on the prisoner's side. As Steve Mertinot has argued, it becomes difficult to separate whiteness, even more progressive versions of antiracist whiteness, from white supremacy, since white identity invented – and understands itself – as a race through a dissociation from, and through the racialization of, others.Footnote 52
It is that separation between black criminality and white family-values innocence that Dopesick rehabilitates even as it indicts the racial biases of the police and the courts. Although Ronnie is exonerated as the sole cause of the opioid crisis, as some law enforcement officers believe, it is significant that, when Macy relates Ronnie's story, she insists he cannot be “redeemed,” even though the “innocent” white youth whose picture stares back at him across the visitor's glass at the penitentiary also dealt drugs. As Macy announces at the beginning of her final investigative report on Jones, “Ronnie Jones’ story was tough to fit into a neat arc of redemption” (248). Yet what is it that finally makes Ronnie so unredeemable, while the “handsome and tan” high-school linebacker in the number 55 jersey – whose picture Macy pastes against the glass to make Ronnie Jones aware of the harm he has caused – is redeemable? That answer lies in the logic of opioid storytelling's white disability nationalism. Dopesick's white storytelling upholds a constitutive belief in a difference between the black dealer and the white users who go to Baltimore to buy and sell heroin only because they are “dopesick,” or because they have a disorder/disability.
Although Ronnie's criminality is only broader in scope than the buying and selling engaged in by most of the white youths, the white youths have a disability, or an addiction, that makes them “slaves” unable to make proper choices. As Macy elaborates, unlike the white user, the black dealer Ronnie Jones's crime was that he did not care about his victims. He was driven (supposedly) by “the two things he craved most: money and respect” (250). On the drive back from the penitentiary, Macy muses, “I was too tired to stop in Woodstock, where I'd arranged to meet with Kristi. She was eager to learn what light Ronnie had shed on Jesse's death, but I dreaded telling her just how little he seemed to think or care about the victims of his crimes” (257). This distinction between the heartless profit-oriented “all about the Benjamins” black dealer – a stereotype within US cinema and television – and the disabled dopesick white user driven by an agency-robbing brain disease is one that is repeated throughout Dopesick by both law enforcement officers and the sympathetically treated white users. When Macy interviews, for example, Tess Henry, one of the young women who worked as a “middle manner” for a “cartel,” buying, selling, and recruiting new users to support her habit, Tess clearly distinguishes what she does from what African Americans like Ronnie and her dealer do: “He [her supplier] was a serious dealer, she said, an African American who sold the stuff but was strict about never using himself. ‘Not to sound racist or anything, but typically black opiate dealers do not use heroin’” (193). For Tess, “serious dealers” are black, while white sellers are dopesick users, thus restoring, albeit in the language of disability, a long historical distinction between unworthy and disposable black dealers/criminals and white victims, who have an opioid abuse disorder. Although Dopesick notes that Baltimore had the “highest per capita rate of heroin use in the country” and that the city's residents were “six times more likely to die from an opioid overdose than the national average” (152), none of the black residents included in this cursory statistic are recognized (or profiled) as dealing to fend off dopesickness.
Now in arguing that Dopesick recirculates an antiblackness that is central to opioid storytelling's white identity politics, I need to clarify a distinction that black studies scholars make between racism (especially liberal notions of racism) and antiblackness. In her account of the opioid crisis, and in particular in her chapter on Ronnie Jones, Macy calls attention to the implicit biases of police officers, legal prosecutors, and community leaders. The problem from an antiracist equity perspective, as Jonathan Kahn notes in Race on the Brain: What Implicit Bias Gets Wrong about the Struggle for Racial Justice, is that this language of implicit bias tends to see racism as a problem of attitudes, and the goal is to end disparate treatment by becoming color-blind or race-neutral.Footnote 53 Yet, at the same time, an attention to antiblackness requires more than an awareness of a systematic racism in health disparities, segregated housing, educational resources, employment, and food sustainability, which Macy only briefly hints at in noting that Ronnie grew up in Section 8 housing and lived with a father who had substance abuse disorders. These attentions to social conditions are, moreover, repeatedly undermined by selective comments from Ronnie's moneymaking music promoter younger brother Thomas, implying that Ronnie could have made better choices and similarly overcome adversity. More than prejudice, or systematic racism, though it includes them, antiblackness refers to a foundational structuring differentiation and devaluation of black lives that has served to constitute, since the Enlightenment, notions of whiteness and of citizenship, and, importantly here, those having a full and deserving rehabilitate-able humanity. As Frank Wilderson notes, slavery was – despite popular conceptions – not simply about forced or bounded labor, but about a distinctive alienation of black life as worthless, rightless, and disposable – against which a free white citizenship could be oppositionally defined and its entitlements legitimated.Footnote 54 The “white face” of the opioid crisis is not only about increased overdose deaths, but a shattering of this foundational meaning-making racial order, even among those “good white folks” who felt “inoculated” from having to consider how antiblackness structures their identity, privileges, and worldview.
Such a reimagined antiblackness within opioid storytelling's white disability nationalism, moreover, Dopesick veils behind a neoliberal color-blindness of false equivalency. Appealing to the vulnerability and agency panic of white parents/readers, a panic that, as we have seen, serves as the affective heartbeat of opioid storytelling, Macy writes,
Our culture seems to excuse drug- and other risk-taking in white middle and upper-middle-class kids, especially young men. These same liberties, when taken by rural poor whites or people of color – wherever they live – come across as more desperate, born of fundamental wants or needs that can't be satisfied. But as I've come to learn, gauged strictly by drug use, there is no less urgency and desperation in America's middle and upper classes today. (128)
Once more, as we saw in the 2018 GOP forum over the opioid crisis, Dopesick asserts a shared precarity, but this time one reimagined as a “shared desperation” among teens across race and class hierarchies. However, the urgency and desperation of the middle-class white child hardly seem the same as the “fundamental wants and needs” of the Appalachian SNAP recipient or black kid in Section 8 housing like Ronnie. While no one's pain and suffering ought to be trivialized, it is a stretch – and a politically strategic stretch at that – to compare the crisis of what Macy calls the “under-challenged” white suburban youths lacking direction (128), and a desperation about safety, basic housing, education, employment, police violence, access to insurance, and food insecurity that poor or minority children might face. Yet it is precisely this failure to make/hear differences about risk, vulnerability, and insecurities that preserves blackness as that immorality, criminality, irresponsibility, and now emotionless psychopathological “unredeemable” hardness against which white users can be considered as chronically disabled, or dopesick, but never degenerate. While Ronnie is a delinquent whose “fundamental want” for dignity, respect, and self-worth has no redeeming quality, Hidden Valley's high-schoolers have a basic goodness and potentiality (as athletes, as poets, as lovers of sunflowers) that has been lost to the disease of addiction. Such spectacles of the idealized white deceased, set against a noncompliant blackness, are a fundamental part of Dopesick's elegiac politics in which elegy becomes retrospective fantasy taken as cultural affect, memory, and truth and as the “answer” to the opioid crisis's “crisis” in meaning-making in the face of shattered racialized social orders.
In describing the incomprehensibility of Jesse Bostridge's death, Dopesick cites statistics from the CDC to point out that “in 2013, Jesse's was one of 8,257 heroin-related deaths in the nation, by far the majority of them young men, an increase of a staggering 39 percent over the previous year” (182). In citing these CDC statistics, Macy fails to point out, and thus obscures in her narrative of “white death,” that African Americans and Latinos were also part of this huge 39 percent statistical increase in heroin-related deaths among young men. Although the highest increase in this 2013 CDC report was among white men between eighteen and twenty-four, the second-largest increase was among non-Hispanic black men aged between forty-five and sixty-four. Such an exclusion reflects more than an omission signaling racial biases in reporting. It is an absence central to and constitutive of opioid storytelling's white elegiac politics. Although, as Peter Jamison notes in his series of stories for the Washington Post in December 2018, the nation's capital had the highest increase in opioid overdose deaths of any major US city – and a death rate higher than most rural and suburban Virginia communities – these deaths prompted little notice, and only a delayed municipal response, because the deaths were among older black men who had been addicted for decades but were now dying from fentanyl-laced heroin. Unlike sympathetic white users, these black men could not be portrayed as victims of drug companies, or unscrupulous pill mill doctors, who gatewayed them into a dopesick chronic disease. In the public imagination, they could not be mourned as the victims of dealers since their blackness marks them already as dealers. As Jamison's coverage of these men's lives indicates, this underreporting reveals not just a lack of diversity in opioid storytelling, but also the normalization of black death as not a crisis of meaning that needs “answers,” or a confrontation with a guilty mastermind. The normalization of black death appears only, as in Macy's story, as the black “herr-on” that helps elucidate the horror of white addiction. When Macy recounts Ronnie Jones's confession at the federal penitentiary, her transcription tellingly omits any of his possible vernacular pronunciation of words except to disclose that he pronounces heroin “herr-on,” thus turning this carceral interview into an echo chamber of law enforcement policing of criminalized blackness (255).
For a new and better witnessing of “These … stories from the opioid crisis” in a less partisan way, either intentionally or indirectly through an unmarked whiteness, we need then to move beyond a white elegiac politics of user-centered stories concerned with preserving white innocence and a lost idyllic white America. In turn, we need to dispense with the minstrel show of some “white-faced” opioid crisis that segregates diverse representation. Yet, in this increased black – and Latinx, indigenous, Asian American – visibility, we need to root out a foundational antiblack relationality that associates blackness more with criminality than with disease and disability. We can see the emergence of this alternative opioid storytelling in documentaries such as the 23 February 2016 PBS Frontline episode “Chasing Heroin” that offered a different young white female user-centered story, one more conducive to addressing the need for medication-assisted treatment and harm reduction than appealing to a melancholy white identity politics.Footnote 55 In its profile of Christina Block, “Chasing Heroin” witnesses heartbreaking parental grief, but it also does not gloss over Christina's experience on the streets: injecting needles into her neck to shoot up heroin, using multiple drugs including meth to stay functional, hanging out with a multiracial groups of friends, dealing drugs and engaging in sex work to pocket money to stave off dopesickness. Christina's unsentimentalized, yet compassionate, story is a powerful argument for prioritizing harm-reduction programs that dispense with moral judgments. Her story is not, as Tess Hardy's similar story at the end of Dopesick, fitted into a rebooted “fallen woman's” tragic demise symbolizing a lost suburban dream.
We can also see the emergence of a different opioid storytelling as well in Washington Post writer Peter Jamison's December 2018 series on a “generation of African American heroin users” who are ignored in the debates over the opioid epidemic.Footnote 56 In one of his user-centered stories entitled “Falling Out,” Jamison profiles Sam Rogers, an older user (aged fifty-three) who has been addicted to heroin since the 1980s. Although the national death rate from heroin among African Americans since 2014 has increased at twice the rate as for whites, and in Washington, DC is seven times the rate for other groups due to the lethal mixing of fentanyl with street heroin, Rogers, as Jamison reports, cannot (supposedly) be a poster child for the opiate crisis. Rogers was not gatewayed into heroin use as a result of the overprescription of OxyContin; nor was he the son of a “good” middle-class family who only turned to opioids because of a personal trauma (“desperation”) that invites easy sympathy. His depression at growing up in Section 8 housing is not a disease, but a sign of a pattern of “noncompliant reckless behavior.” Yet he is no less a “disabled” dopesick user than Hidden Valley's teens. At the beginning of his profile, Jamison portrays how Rogers plays every day a game of Russian roulette. Each time Rogers buys heroin to stave off sickness, Jamison writes, he thinks, “Palliative or poison. He would know soon enough.” In Jamison's account, Rogers is not mocked as someone who needs “herr-on”: he is a middle-aged black man who, no less than white suburban teens, needs a “palliative” for his disease. He may not have a mother who has the time and resources to demand an answer to how addiction can happen to a son from a good family. Nevertheless, he does have a girlfriend who prays every day that he does not overdose because she is afraid to call the police since these law enforcement officers will arrest him because of his prior record. In most states, moreover, Rogers would not be eligible for drug court or treatment instead of incarceration because of these prior convictions. In addition, as Nancy Nicosia, John M. MacDonald, and Jeremy Arkes note, there is a persistent disparity in the diversion of blacks and Hispanics relative to whites to drug courts due to racial biases and due to much lower graduation rates since the treatment programs fail to address the major obstacles preventing blacks from successfully completing rehabilitation: poverty and a lack of employment, support networks, and access to education.Footnote 57 This intersection of antiblack policing, structural inequalities, and opioid overdose deaths is rarely reported in opioid storytelling's white identity politics.
In her study of the AIDS crisis, Paula Treichler argues that AIDS was not just a lethal disease, but an “epidemic of signification” as activists, patients and public-health officials struggled, and fought over, the meanings to attach to the illness and the deaths it caused.Footnote 58 Throughout this essay I have tried to bring attention to the “epidemic of signification” that now surrounds another public health emergency – overdose deaths from heroin and fentanyl and other opioids. While this drug crisis has prompted a public-health response that differs from an earlier law-and-order response to the crack and meth epidemic in the 1990s and early 2000s, this shift toward addiction as a disease, or a disability of dopesickness, not only still perpetuates disparities in treatment, referrals to drug court, and incarceration. It also works to foster a reinvestment in the simulacrum of a white innocence and to recover an antiblack relationality that serves to rehabilitate a white identity that is also seen as in crisis. This epidemic lack of new meanings testifies not just to the challenges that illnesses cause to the stories we tell about our self and our relation to the world, but also to the dangers within even a more seemingly progressive reframing of a public-health emergency around disabilities. Opioid storytelling has the potential to cause an epidemic level of harm if it mobilizes and taps into a white supremacism disguised as a white disability nationalism that doesn't even acknowledge itself as racism, and that recovers and rehabilitates historic racial differences around a language of disability in order to preclude more multiracial outreach and community organizing at a time when they are even more urgently needed in the face of growing economic inequalities. In the 2016 election, pollsters found the strongest predictor of which US counties shifted traditional party allegiances to support Donald Trump for President was the white “death rate.”Footnote 59 Health, more than income, education, or ideology, shaped citizens’ political imagination. The power of opioid storytelling to constitute contemporary consciousness and identity lies precisely, then, in this blurring of the desire “to restore life” and “to restore life to the way that it supposedly used to be” within elegiac histories of heroin overdoses. In an austerity economy of state retrenchment where economic support is often only for the most deserving subjects, opioid storytelling's unmarked white biopolitics literally becomes a matter of life and death.
