Chasing the Scream

the start of my journey, I set out to find an answer to a contradiction within myself, and within our culture—between the impulse to be compassionate to addicts, and the impulse to crush and destroy our addictive impulses. Now, at last, I see—and really feel—that it is not a contradiction at all. A compassionate approach leads to less addiction. The conflict within me—the one I found so disturbing—is not a conflict at all. It’s not a question of one impulse winning over the other. They can both win—if we just do it right

the chemical is to blame, and if only we could eradicate the chemical, we could eradicate the problem

That’s when coca tea was replaced by powder cocaine, and Mrs. Winslow’s Soothing Syrup was replaced by injectable heroin

The war on drugs makes it almost impossible for drug users to get milder forms of their drug—and it pushes them inexorably toward harder drugs

The answer doesn’t lie in access. It lies in agony. Outbreaks of drug addiction have always taken place, he proved, when there was a sudden rise is isolation and distress—from the gin-soaked slums of London in the eighteenth century to the terrified troops in Vietnam

toxic drinks like Billie Holiday’s favorite, White Lightning, a booze so strong that even hard-core alcoholics would turn it down today

But that’s only the first step: it’s the bandage that stops the hemorrhaging. Then

If you can prescribe opiates for back pain, why can’t you prescribe them for psychological pain

Nobody, she explained to me, swallows 80 mg of Oxycontin prescribed by their doctor and goes out to commit a crime, or dies of an overdose. No: it’s when the doctor realizes the patient is an addict and cuts them off that all the trouble begins

Meghan Ralston, one of the leading experts on this crisis, explained to me: They don’t begin when the drugs are prescribed. They begin when the prescriptions are cut off.