A dear fried of mine named Adam died last week. I had known him since I was about 12 and we were close until I moved away to go to school. I would even say that until that time, we had a lot in common. I still talked to and emailed him after I left for school, but things seem to change when people see each other less.
I do not like to return to my hometown because it is so boring. I do not know how Adam tolerated it. Actually, I do, he tolerated it because he never left it; I think if he had gone elsewhere he would have come to see Orange, Texas the way that I see it. Orange must be one of the wealthiest places on earth, but the poverty there is terrible. There are many chemical plants there – DuPont, Fina, Firestone; I am not sure what others. They process the by-products of refining fuel from petroleum, making them into tar, plastics, and whatever else. Someone gets a lot of money for this, but not the local community and not the local workers. Besides that, Orange is on a major highway (Interstate 10) which runs from California to Florida. Also it is on an inlet of the Gulf of Mexico, so it is a port by means of which shipped goods enter America.
Adam worked at Wal-Mart for several years when I was in college. I told him he was wasting his time, but he saved his money and made good when he used his savings to make a down-payment on a five-bedroom, three-bathroom house on four acres of land in a place that was less rural than most other real estate in Orange. I was pleased to find that he did this; I was even more impressed when he rented the rooms out, thus covering his house payments and financing his lifestyle. He did this at about age 23.
Somewhere along the way he started taking prescription opiates and muscle relaxers. I did not piece this together until I personally had a small problem due to his behavior, but looking back, I can see that relatively quickly after starting to take pills he became habitual for the process and started neglecting other aspects of his life that did not directly involve pills. By other aspects, I mean time with friends, his wife, his child, maintaining his home, maintaining his own health, keeping a job, socializing, and eventually – and this is unthinkable to me – he got to the point where having internet was no longer important, and that’s where I lost regular contact with him. I cannot imagine keeping a job or scheduling and organizing my life without net access; somewhere along the way he and I really parted ways.
When I heard that I died I assumed that he died from a drug overdose. His mother called and said that he had recently gotten a new job, and that the only medical problem he had recently was that he had was a toothache, and that he died on his stomach. I talked to her again after the autopsy and she said they reported no particular cause of death; I asked if he had vomited and she said no. She told me that he died of a blood infection related to his tooth. I presume that what must have happened was that he increased his use of hydrocodone (Vicodin) and carisoprodol (Soma) as he recently came into money. Tooth pain is hardly relieved from general anesthetic, so I suspect he took extra pills to try to relieve this local discomfort. In the past he had been accustomed to taking 2 week’s dosage of these in one sitting; I can only guess that in the time he had gone without his drug because of lack of income, his body lost some tolerance for it, and the familiar dosages slowed his breathing to a level that could not sustain life.
So, some people die this way. Adam refused heroin because he said it was too dangerous. He took prescription pills that he got from fake doctors, and they dimmed his consciousness as years of his life progressed. He told me that he had become proficient at securing pills. His method was to visit every doctor in a 100 mile radius and ask them for pain pills. He would find doctors who were in the business of only proscribing pain pills; these doctors only advertise by word of mouth, and as he described them, they were all the same. They would rent some shabby office as a private practice, and they would prescribe pain pills to people who asked for them. These doctors took no kind of insurance and frequently only took cash. Adam described them the same way that Burroughs described his pain pill doctors- they would give pills for any sad story, and any reasonable person could have seen that all the patients where total addicts, but the doctors play the part as if and on some level truly believe that all their clients were the sick in need of pain pills for medical purposes. Adam regularly told me stories about his doctors suddenly leaving town, or getting raided, and he was even in a waiting room when a SWAT team came and arrested one of his doctors and hauled out all the computers and files. There is a subculture of people like Adam who continually troll for private practice doctors and small pharmacies with no computer records, and they meet each other in waiting rooms, and then they travel around the countryside in vans collecting prescriptions from a region’s doctors’ offices during their day trips. Adam, being something of an organizer, would drive a set of these people around to all these doctors’ offices, he would pay their doctors’ bills and pay for the prescriptions to be filled, and then he would take a percentage of the pills and resell them or eat them. I think he got addicted to the money to be made before he got addicted to the pills, but even at his most financially profitable, the time and effort expended in doing this – leaving out the fact he eventually got addicted and that this “work” entails committing many federal felonies in an afternoon – is not enough to finance a middle-class lifestyle.
I am of the opinion that Adam’s life was not made better by his drug use; I am not stating an opinion as to whether he ever got short-term benefits from his use, or whether other people might be able to use as he did and be better for it. I form my opinion based on his statements that he was not happy, that he was suicidal, that he was anxious that some series of unlikely things which were all out of his control would come into his life and grant him money, which would then make him happy. I would like to present his death as an opportunity for other people to see a modern lifestyle that has a demonstrable problem (self-destructive drug use) that probably could have a solution (somehow quitting the drug use). So how did this happen to him, to what extent is this a common occurrence, and how can society prevent this from happening to others?
After leaving my home town, I told Adam to leave also. For different reasons, he wanted to live his entire life in Orange. I am almost sure that he was never outside of a 20 mile radius from his place of birth for more than 3 weeks. Life has a lot to offer, and there are some stimulating places that make good permanent homes, but the things he was getting from the small town were hardly irreplaceable elsewhere. One of the major disadvantages of living in a small town is the inherent poverty; not only were job opportunities grim, but community services (recreation opportunities or chemical dependency treatment, for example) are not present for a majority of the people. After he recognized that he had a chemical use problem, I think that it is likely that Adam would not have been able to sustain his lifestyle had he moved elsewhere; that is not to say that there are not other addictive lifestyles available to those who want them, but he would at least have had to go through a culture shock and consciously make some novel choices to carry on as he had. I recommended that he go to India; life is cheap there in two senses: one, that he could afford to live there without working for an extended period of time, and two, people die everywhere for reasons considered trivial by Western standards, thus confronting foreign visitors with the concept of mortality. Opium and heroin is plentiful and cheap there, but taking pills is not an option because they are illegal there. I really do not think he would have taken to using opium or heroin, and I think a vacation there would have detoxed him.
I know other people get into Adam’s situation because he told me about the people with whom he associated. It seems that no one in these social groups holds anyone else with much regard; these drug-user co-ops are surrogates but not replacements for meaningful human interaction. Adam’s dear wife left him after he became increasingly secluded from her; she told me she was scared a few times and the only bad thing I can say about her was that she was not smart enough to leave sooner than she did. She had a child and must have been confused. The child must be about 4 now; there was a period of close to a year when Adam did not see or talk to his child at all. This time was not consumed by his sitting alone; no one gets to this point without being either radically crazy or inducted into the lifestyle by someone who is already there. Adam is gone from this world and I do not worry about him, but I regret that other people still alive are living the lifestyle that Adam lived, both those who supported him as he became a user and who became users because of his influence.
I think that society should do something to prevent this from happening to people, but at the same time I think that it would be a bigger problem if society prevented people from using massive amounts of drugs should they truly desire to do so. For example, some people are really in pain, and drug-abuse laws in many cases prevent people from getting the relief that they honestly need. One small thing that I would like done is reform of the medical system to prevent it from having so much financial motivation to give people unnecessary treatment. I really dislike the idea of the government denying medications – even medications that a person intends to use improperly to support an addiction – to citizens. However, the middle ground is probably to draw a line somewhere. Adam could take a year’s supply of painkillers in a month; perhaps if there were an nationwide database with sufficient privacy protection, the fact that he went to many doctors could have been detected. I would not advocate for a direct government intervention at this point – like prohibiting him from continuing to take 10 times the allowed dosages, or arresting him, or forcing him into treatment – but I would like to see some kind of control.
I am not sure what would work and be fair; I have no ideas for solving this problem. Adam did not want to quit using. I had been talking to him less since about mid 2007 because I was bored with hearing him talk about his habit. I told him to clean up, and gave suggestions about how to clean up, and he always said that he had to keep using for financial, social, and health reasons. I got angry at him one time, really angry, and when I expressed this to him, he told me it was not my concern. I wonder if he was right; as a Westerner, we really put a lot of value on people’s ability to choose their own lifestyle. But do we own our own lives? Adam is leaving behind his poor mother, an 18-year-old nephew who is at risk for entering the same kind of lifestyle, his young daughter, and his ex-wife who he told me many times drove him to using drugs (she did not use herself; he was referring to her alleged nagging behavior). The United States spends a tremendous amount of money on every citizen preparing them to contribute to society; Adam probably had not served his country long enough. I miss him terribly, although I only felt sad at the time when I realized he had become a drug zombie. Expecting his death made it easier for me to accept. I knew his use habits were reckless and that he was proud of them.
Adam was a magnanimous person who deeply cared for those around him. He was enthusiastic about improving the lives of all who associated with him. He was clever and often demonstrated his unusual ability to quickly make sincere emotional connections with strangers, which was an ability he used to influence a lot of people in positive ways with minimal effort on his part. He was ambitious and I wish he had had more time to enact his plans, and that I could have had time to work with him. I considered him to be family.
I hope that anyone reading this will be able to recognize addiction better in the world; as spun out as he was, I am sure that most of the people around Adam never knew that he used at all, or if they knew that, I doubt they knew that he used irresponsibly. I hope that anyone reading this will think about what they will do if they recognize that a friend or coworker has an addiction problem. I respected his personal decision to be left alone; someone else may think it is appropriate to compromise a person’s right to decide to use and force another lifestyle upon them. This whole post seems a little condescending, I am not sure that I do not right now regret writing it. Such as they are, these are my thoughts right now. Bye, Adam.