“The Opioid Epidemic and US Culture” Aims to Expand the Conversation

In The Opioid Epidemic and US Culture: Expression, Art, and Politics in an Age of Addiction, Travis D. Stimeling, Ph.D., associate professor of musicology at West Virginia University, presents a collection of essays with the intention of expanding the conversation surrounding opioid addiction to include the perspectives of those amidst this crisis — not just looking in — thereby bringing awareness to damaging stereotypes and further victimization of those caught in the opioid epidemic.

While the opioid epidemic ravages communities across America, it’s the Appalachian region — West Virginia specifically — which has become the nation’s reluctant poster child of addiction, overdose, and decline. Appalachia has a long history of being portrayed not as part of America, but rather, “a place within a place.” And, in the last decade, documentaries such as “Oxyana,” “Heroin(e),” and “Recovery Boys” have invited mainstream culture to peek behind the curtain, at this “other” America. Here, in former coal towns, up lonely gravel roads and down shuttered-up Main Streets, heroin, oxycodone, and their sinister synthetic cousin, fentanyl, are portrayed as the only ways residents can keep the inevitable boredom and despair at bay — for a little while, anyway.

Bringing much-needed attention and differing perspectives to social issues has long been a driver of many documentary artists. However well-intentioned, storytellers cannot help but season the narrative with their own points of view. Since society’s most vulnerable are not empowered to use their own voices — to construct their own narratives — they are at risk of becoming further victimized as unwilling participants in so-called “poverty porn” and the more recent trend of “opioid-addiction porn.”

Stimeling explains that while the opioid crisis is killing “tens of thousands of people, many of them under the age of forty, and contributing to the first decline in life expectancy in the United States since World War I,” what is often lost in these statistics are the “individual human impacts of opioid abuse.”

Through this collection of essays, Stimeling seeks to go beyond the gritty (and some argue exploitive) cultural representations of a region in crisis by focusing “on the ways that creative people have engaged with opioid addiction, recovery, and loss in a variety of media, from music to memes, to everything in between.”

Organized in three acts, these essays explore opioid addiction from the perspectives of the outside looking in, from those that live amongst it, and conclude with a discussion of what a post-opioid future could bring.

On the Outside Looking In

In five essays, “Part 1: One the Outside Looking In: The Opioid Crisis from Without” evolves the conversation on opioid addiction and its current portrayal in American culture. Stimeling explains, “These essays engage with narratives surrounding opioid use, addiction, and recovery that are generated and propagated by people looking in, narratives, that, these authors suggest, sometimes exert a negative influence on the short- and long-term recovery of individuals.”

In “Something Too Pure / Is Killing Us: Opioid-Addiction Porn, Endurance, and the Neoliberal Appropriation of Resilience,” Jordan Lovejoy may give casual viewers of opioid epidemic documentaries, like “Oxyana,” an uncomfortable pause as they recognize themselves as the empathetic viewer consuming opioid-addiction porn with an “uncritical passivity.” Academics and advocates are also unspared, called out for celebrating “resilience despite such continuing trauma” occurring in the “on-the-ground lives of people enduring everything our neoliberal system throws at them.” Lovejoy argues that neoliberalism “benefits from poverty and opioid-addiction porn, allowing viewers to feel momentary sadness for those affected without having to act or think beyond an individual’s resilience (and our own) despite the wider systemic issues they continue to endure.” Sure, documentaries created by privileged outsiders about the under-privileged, such as “those poor people in West Virgina” create empathy, but they are also often laced with themes of “otherness,” which only preserve the division between the privileged and those less so.

If You Lived Here

In “Part II: If You Lived Here: Representing the Opioid Epidemic from Within,” authors share perspectives of those living amidst the opioid epidemic through a collection ranging from poetry to essays on mumble rap and comic books. These authors consider the ways that artists create work that humanizes addiction and loss, while highlighting local efforts to support recovery.

Here is Stimeling’s opportunity to finally provide that platform for first-person narratives challenging the stereotype of “the poor people in West Virginia.” However, with the exception of the first two excerpts, the approaches are largely academic, and no authors identify as an addict themselves — a missed opportunity. Their absence implies that articulate (and even academic) addicts are so exceptional, one could not be tracked down to include (yet, Jesse Thistle, Chris Hart, Dr. Judith Grisel, and Brian Pennie, all university-affiliated published authors and addiction experts, come to mind). This oversight perpetuates the stereotype that addicts must be spoken for, as they are unable to speak for themselves.

Two pieces written by residents and advocates of the region serve as a proxy for the perspectives of addicts and their families: “Pretty Lil Azzie,” by Affrilachian poet Crystal Good (who does identify as a member of a recovery fellowship) and “The Way the World Is,” an excerpt from Maggie Boylan, by Michael Henson (also a substance abuse counselor). As Appalachian scholars with personal connections to addiction, Good and Henson’s inclusion in this volume are obvious, yet without an introduction to the authors themselves nor their specific works, the impact is lessened. The reader is left to wonder why were these specific pieces selected to the exclusion of others? If the intended audience are, in fact, the “people working on the front lines of the opioid crisis… social workers, addiction counselors, halfway house managers, and people with opioid use disorder,” then connecting the dots for the non-academic audiences is essential.

Piggy-backing on “The Way the World Is” (the excerpt from Maggie Boylan) is an essay by the same author, Michael Henson. “Finding Maggie Boylan” serves as a straight-talking cultural antidote to the “addict as other” common narrative, and the strongest component of “Part II.” Hensen poses the question: What gives him the right to write (and “strike gold”) using the stories and suffering of others? Both a writer and substance abuse counselor, Henson explains:

I wanted to write narratives that humanized my subjects, that told hard truths but left their essential dignities intact. And I wanted to show that healing, if healing is possible, takes place within a community, a potentially regenerative amalgam of awed but essentially compassionate human beings. And I wanted — badly — to excoriate the greedy bastards who caused the whole thing.

A New Day Dawning

In the final section, “Part III: New Day Dawning: Recovery, Sobriety, and Post-Opioid Futures,” offers creative solutions regarding recovery while connecting the opioid epidemic to themes beyond poverty and West Virginia. In “Healing Open Wounds,” author Chelsea Jack introduces hemp farmer Chris Yeager, who began lobbying for cannabis reform in West Virginia following the death of his brother from an opioid-related overdose. In “Pain Is One Dance Partner: Move with It,” by Anne Lloyd Willett, the heartbreak of losing a child to addiction is presented alongside a discussion of what is “pain” and why is the world in so much of it? Paige Zalman discusses how privilege impacts recovery — even when addiction takes hold among the mainstream hip-hop elite, in her essay “Images of Opioid Addiction, Recovery, and Privilege in Mainstream Hip Hop.”

“It’s easy to go wrong in writing about people on the margins,” reflects Michael Henson. Indeed, the residents of Appalachia have endured a long history of negative portrayals from mainstream media. The opioid epidemic is merely a recent chapter of a region that remains largely ignored by the rest of the country, until we need an “elsewhere” for its problems. But Appalachian artists are taking back control of their narrative, from the 100 Days in Appalachia project to Elizabeth Catte’s published rebuttal of J.D. Vance’s bestseller, Hillbilly Elegy, to the perspectives shared within this collection. Overall, the takeaway is hopeful, but also complex, muddy even, ranging from discussions of privilege issues in hip-hop to the motivations of farming hemp — indeed, one clear message would be woefully inadequate for such a deeply nuanced social issue in a culturally rich and diverse region that deserves much better than it gets. And Stimeling never promises a “unified theory of opioid aesthetics.” Instead, he argues, it’s the aesthetics themselves that are essential to understand the toll that opioids have had on communities as well as in the development of strategies for recovery.” Stimeling continues, “As long as policy makers blame opioid users for their struggles… it is possible to recast people with opioid use disorder as dehumanized problems. Aesthetic experiences challenge that dehumanization.”