What Our Addictions Say About Us

Mar 15, 2018

According to the National Institute on Drug Abuse (NIDA), “every day, more than 115 Americans die after overdosing on opioids.” NIDA calls the misuse of and addiction to opioids "a serious national crisis that affects public health as well as social and economic welfare.” What do these additions say about us? This week on Thinking Out Loud, Nathan Rittenhouse and Cameron McAllister discuss some of the implications of the national opioid crisis.

Follow the Thinking Out Loud hosts on Twitter:

Cameron McAllister - @CamMcAllister7
Nathan Rittenhouse - @N_Rittenhouse1

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Please Note: Thinking Out Loud is produced to be heard, not read. We strongly encourage you to listen to the audio. Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors. Please check the corresponding audio before quoting in print.

Cameron McAllister.: Hello and welcome to Thinking Out Loud. This is a podcast where we think out loud about current events and Christian hope. I'm your co-host, Cameron McAllister.

Nathan Rittenhouse.: And I'm your co-host, Nathan Rittenhouse.

Cameron M.: So today we want to talk about a fairly sobering topic. It's come to increasing media attention that we've got a real crisis on our hands in the United States. We've known for a long time that we struggle as a nation with addiction, but the opioid crisis is really helping us to see this in a whole new practical and extremely down to earth way. When you look at the numbers they're staggering, the amount of people who are affected by this crisis, so there's a very...It's very likely that many of our listeners have direct experience with this.

So I think what's really interesting about this crisis is that it's starting to shed a lot of light on some of our tendencies toward seeking quick solutions to pain, but also I think it actually sheds some really interesting light on the nature of scientific research, and we'll talk about that a little bit more as we go on here.

But just suffice it to say we tend to have this really mystical view of science as this sort of be all, end all authority and that when we hear the declarations of scientists or when we see articles in scientific journals there's a level of objective purity there, and really what happens is you see something like this and it shows us some of the ways in which scientific research is abused and also where flagrant misinformation is spread as well.

So I think it's worth interacting on this subject. I mean, Nathan, one of the ways I thought about you as I was doing some of the research here is that I mean you make your home in West Virginia, and West Virginia is one of the states that is the most affected by this opioid crisis.

Nathan R.: Yeah. So I think you're bringing out some interesting things there as far as how we think about the scientific evidence and whatnot, but on a practical level another question that we should probably wrestle with the way I hear this topic or conversation is generated is for people to say whose fault is this?

You hear that both through the news articles that are written, you hear it in response to the pharmaceutical companies and their response to it, so it's a multi-variable thing, but kind of moral agency responsibility, and of course all of that is woven in with what you already mentioned.

So yeah, I'm looking forward to kind of picking your brain about this, because there are a lot of different angles that we can think about this that highlight sort of where we are as a country and as a culture.

Cameron M.: Well I think one particular angle that really stuck out to me initially is the way we handle pain in the United States, and I'm talking about physical pain and also actually psychic pain as well.

So the general sense if you look at this very broadly as a nation our response to pain I would say is usually that we try to eliminate it. So we don't often think about the fact that our instant access to even aspirin in our medicine cabinets, the ways in which that affects our thinking.

But then you think about the facts you can go to a doctor and if you have some sort of pain, and the mindset generally seems to be that pain should be eliminated, and very, very quickly, so just find some way to deal with it. Most of us have a general sense that we often are overly-reliant on medication and that it is over-prescribed, but when you look at the habits of the nation we still seem to be voting with our wallets that pain should go away completely.

I think it's an interesting contradiction, because if you look at life it doesn't really make sense to expect a life of relative...Well, a relatively pain-free life. After all, we're bundles of nerves and if you're in relationships with people you're going to experience emotional pain. I mean just because your physical body... The nature of your physical body is such that it's going to break down as well, so you're going to experience physical pain.

So in some ways this just doesn't...This points to I think a little bit of a contradiction in the way that we approach life, but then you also see there's a very...If you really want to spend some time on the issue of the opioid crisis there's a long form journalism article in the New Yorker, it's pretty lengthy, and it's called The Family That Built An Empire of Pain. That'll give you some deeper insights into how this whole crisis was really perpetrated and where the fault lies. It's an extremely sobering piece of writing.

Nathan R.: Yeah, but I would say like it's not just the New Yorker. Almost every news agency that you could go to within the last day or two has run something on this. You hear on the radio on NPR all sorts of angles. So it's interesting just in the sense that everybody agrees there's a problem. Nobody really seems to be agreeing on what the cause of that problem is.

But I think your idea about pain and our perception of pain is interesting. In particular, I was speaking to a physical therapist who said, "You know what?" He said, "My favorite category of patient are old ladies." He said, "If you have a 40 year old athletic guy who comes in for a knee replacement," he said, "You're going to be seeing him for weeks. There's going to be complaining, a desire for more medication." He said, "You get like an 80 year old lady who gets a knee replacement and three days later they're up mopping their floor and baking dinner for their next door neighbor. Life is pain. This is how it goes."

So we were laughing about that and just thinking like is there a cultural shift? This points back to what you were asking about our perception of pain, of saying what the role of physical pain is perceived to be and what it means to be human.

Then also is there a sub-category there? I took a bioethics class once that made the distinction between pain is physical and suffering is psychological. The point was that you can be in physical pain but not be psychologically suffering, and vice versa, that you can be psychologically suffering and not be in physical pain.

I think as you read some of the responses to maybe some of the articles I would push back and say this isn't just a mafia-esque scheme by the pharmaceutical companies to...You know, it's rampant capitalism that's taking of the world and this is where it leads kind of thing.

You get some of those lines in there where they're saying you can see what types of places are going to be the most vulnerable for this, specifically places of unemployment, of poverty, of family dysfunction and different pre-existing psychological issues. Obviously the use of other drugs beforehand are a factor in this.

So in some of the kind of on the ground conversations that I've been part of, a lot of it is trying to look past this as a cause and say is this not a byproduct of deeper social and structural maybe relational brokenness. So anyway, yeah, it's a...But the new part of this conversation, like you're saying, is how we perceive pain as something that at all costs must be done away with.

Cameron M.: Yeah. And I think that's a really fascinating sort of distinction that you got from your bioethics class, because I don't know that many people would recognize a meaningful distinction nowadays. I guess I don't think most people would recognize a distinction between pain and psychological suffering.

I don't think that people think in these terms, usually at least I don't. Your average person on the street, I think it's just the natural default setting nowadays, and this points to a deeper shift in mindset, but I think is partly what you were alluding to here, is that pain is basically just synonymous with suffering, so we tend to conflate those two, but they're not necessarily the same thing.

But another interesting factor here is...And I think you're right to push back against the narrative that evil pharmaceutical companies and these wicked corporations have foisted this on an unsuspecting and innocent population. There's clearly blame to go around in many ways and we always look for scapegoats when we hear these kinds of national narratives.

But I think it is interesting if you just take a step back and you look at the fact that how much trust that we place in our doctors. You know, a lot of philosophers nowadays have pointed to the fact that your medical doctor nowadays in many ways fulfills the function that a priest used to fill. This is sort of a...These are the people we entrust our lives to, we confess all of the intimate details of our lives to them, and we receive their directions and their prescriptions as gospel in a way.

Nathan R.: But let me push into that a second though, because I was speaking to some doctors who were complaining about this also, saying that yes, we do take their directives when we like it, but when we don't then everybody comes in with the Google solution, well I looked this up, you know. I'm like I have an MD here and you're looking on a Google search for information.

So you're totally right in that we live in an age of so much information, but it comes back to whose information...That there's a huge bias on our part of what we want to hear, and therefore that's true.

Cameron M.: Yeah. There's friction there too, because yeah, you have at your fingertips a diagnosis that could...I don't know, could conform a little bit more to your own wishes of course.

But I think part of what I'm getting at though is the level...It's not just the level of authority that these guys have, but it's just public perception in general if, say, you have a certain drug...Let's take Oxycontin. If the medical industry says that this is overwhelmingly a non-addictive drug, that it releases very slowly in your system, and that it offers you pain relief for up to 12 hours, we know now that none of that is accurate, but this is the information that was widely disseminated and it was widely accepted and it has had some-

Nathan R.: And people were paid to say that.

Cameron M.: Right. It's had some fairly catastrophic consequences. I think that brings into the conversation, Nathan, another interesting factor, and that's that the nature of scientific research is not quite as pristine as we might think, and you actually...You had some thoughts here because...And you came at it from a...I think an even more practical level. This one involves our consumption of sugar. I'm wondering if you could bring that into the discussion here a little bit?

Nathan R.: Yeah. So I mean basically...And I kind of do this jokingly when I speak on faith and science, saying hey, let's just remember we're purely rational creatures. So maybe I'll say to the audience, "How many of you think that an over-consumption of processed sugar is bad for you?"

Everybody's hand goes up, and I say, "How many of you think you've eaten too much processed sugar today," and everybody's hand goes up. Then you start considering that probably the caffeinated beverage you had for breakfast had more sugar than you probably should have in a whole day.

So we live in that sense of...I think maybe many of our listeners don't have somebody pop into their mind when they think about the opioid crisis, but all of us can do that when we think about sugar. You can read the news articles about big sugar...Actually the New York Times just a few days ago running more stuff on that, of saying it's the same sort of thing. You have these huge marketing firms pushing an agenda behind things to convince the American people that this really isn't as big of a problem as it is and it shows up.

So I was just using...When you sent some of the links you were reading about the big pharmaceutical companies, and then to see the New York Times using the word big sugar, it just makes you think is big bad I guess is a question we should be asking ourselves. When there's this amount of money involved in it do we inherently develop some type of skepticism of saying oh, they're out to get us?

But the situation is that with the opioid crisis you see, what, 64,000 deaths a year from overdose? I'm not exactly sure that we'd publish statistics in saying this many people in the United States died of diabetes because of sugar. So there's an immediacy to the opioid crisis that though it maybe isn't even the leading killing factors of humans, it's maybe one of the faster ones, and so its statistics are counted in a different way.

But, again, just to be fair and to mutually and equally offend everybody at the same time, it's good to loop in some of these other things as saying this isn't a structural way of thinking just within one specific item in our culture, but maybe there are parallels to this in other areas as well.

Cameron M.: Yeah. Absolutely. I think in some ways what...I think that this can act as sort of a nice countering to our notion that scientific research, for one, is always pure and disinterested. Clearly that's not always the case. I don't think that... And this is not...This shouldn't be heard as me railing against the scientific community any more than what we've said previously should be countered as us railing against the free market necessarily, but this is just a call for a little perspective on it.

I mean clearly money plays a huge factor for many of these studies, and because of that I think we can sort of temper some of our views about how research works and also...I mean when we see the way many of these corporations, they do play...But they're also playing to our habits. We're also voting with our wallets.

So there's a reciprocal relationship going on here, and I think what links both sort of this sugar crisis and the opioid crisis is the fact that as a nation addiction has been rampant for a long time, but we seem to really be so focused on not just quick solutions, but feeling good all the time.

This is a conversation I think that we've had before, Nathan, you and I, but the understanding of really a person's wellbeing and happiness nowadays seems to be centered more on feeling good, and feeling good in a more superficial sense. And I'm not using that word pejoratively, I'm using it descriptively, just feeling good, enjoying what you taste, enjoying what you watch. Our entertainment habits reflect this. Just generally a life of ease and comfort, and a life lived without pain.

I think what looks like often something very understandable and fairly commonplace can actually have an underlying insidious nature to it, because let's go back to something that you said at the beginning of the show, Nathan. You were talking about how...What you were hinting at was that there's a distinction between physical pain and psychological suffering and distress, but another factor that gets overlooked here is that pain can play a very...Can be a good thing.

Pain can be instructive. Pain can...And suffering even can deepen our understanding of life, and suffering can give us wisdom as well. I think that's a really under-explored topic these days. I'm kind of wondering what you think a little bit about the role of suffering shaping our understanding.

Nathan R.: Well it's interesting to me. I was looking at some kind of transhumanism manifestos because sometimes this is... Ultimately where this is going is the justification is we can get rid of all pain, but what's interesting in a lot of that writing it also says there's going to be a day when we're beyond pain, sex, race, ethnicity, death.

And when you start throwing in things like do we want to get to a point where we're past ethnicity and race? Like do we want to get to a point where we're past death? They all get lumped in together of saying...You see what I'm saying? Sort of that these are deeply formative, beautiful things about what it means to be human and can corruption happen within them? I mean we can say yes, there is racism, while at the same time saying that ethnicity is a wonderfully beautiful thing and cultural diversity is great.

So it just starts to blur categories when we start categorically saying that this is something that's been part and formative of human experience in the past, and now whatever it takes we need to stamp that out of our existence leads to some interesting consequences.

Cameron M.: Well yeah, because I mean what you're taking about right now with some of these transhumanist aspirations is you're talking about the elimination of all distinctions.

Nathan R.: Right. Yeah.

Cameron M.: Yeah. And so you have this sort of very...I mean sort of generic humanoid post-human form, I don't even know if you could use the word form, that emerges, sexless, raceless, without any struggles, without any scars.

Nathan R.: Right. But the point being our happiness.

Cameron M.: Right. And supposedly...And this is...And what's interesting about that is in many ways I think that's the logical outcome of the happiness is feeling good kind of mindset. I think if you look at it like that... And this is played up in some of our entertainment, by the way. Black Mirror plays a lot with this theme. It ends up looking like a nightmare to many people because it's not recognizably human.

Nathan R.: Yeah. Yeah. Can I shift gears here just a second and say that I've been hospitalized over some traumatic injuries and I tell you what, opioids are great, Fentanyl and then all kinds of...Percocet and whatnot. It was a long extended process of a lot of days of intensive care, and I was so thankful for them. But as I was making a conscious choice to stop taking those I could definitely feel the physiological tug in my body to desire to have them more.

I was talking to a group of people just recently about this and they said but you had such a stable social support group around you and you've grown up in a way that has a fairly strong will about some of these things that we can't immediately transfer our experience onto everybody else.

But what I'm saying is that when we're in intense pain we do seek crazy alternatives to get out of that. So whether or not the pain is real or not, if the pain is perceived people are going to go to extreme measures to get over that. And to be clear, only like 1% of the deaths in our country are from people that are prescribed these medications. A lot of the opioid stuff has to do with Fentanyl laced heroin and a bunch of other different stuff, so we can't categorically put all...What I'm saying is that people that are in pain seeking a solution will go to desperate measures.

I think we even have a Biblical example of this. I was thinking about the woman who had suffered chronically from bleeding for 12 years who goes out on a crazy limb, saying I'm going to go up and just try to touch this guy's garment and see if that'll do it. I think it will. That by any standard is a ridiculously odd thing to do, but if she had been chronically suffering for 12 years anything that promises a bit of hope is worth trying.

So I think there's a tenderness and compassion that we want to have here also in recognizing the real brokenness of the world. But then as a Christian, and I'd love to hear you comment on this topic specifically as a Christian and think what Jesus offered her was a bit of a foretaste and a snapshot of what it is that his program was here in the world.

So he talks about the thief comes to steal, kill and destroy and I've come that they may have life and have it to the fullest. So he does give us these little glimmers of kind of the pre-end of all things when he says, "Behold I make all things new." Though we have this foretastes of what is yet to come, that somehow doesn't eliminate the pain now, but situates us in a perception and a perspective of peace while we wait for that.

So maybe that's some of what the Christian faith offers in this, is that Christ offers us a peace in the presence of our pain, not peace just from the absence of it. What are your thoughts? How do you think being a Christian helps you reflect on this differently?

Cameron M.: Well, peace in the presence of Christ is massive for me, knowing I'm not alone. I think often about...When I've been in times of extreme pain, whether it's physical or emotional, knowing that there's a bigger picture, knowing that there is a future relief of which I am confident, that gives me the necessary perspective to endure it.

So in that sense those verses from Revelation mean a great deal to me, making all things new, wiping away every tear, but also knowing that Jesus suffered and really went through life and experienced the degree of pain that I can never imagine, but also that he knows intimately...He's on intimate terms with what it means to be human and what pain is like.

And I think you were mentioning this earlier, we often...We underestimate, we greatly underestimate the need for healthy communities around us. I'm just reminded as you were...I was reminded as you were speaking and as we look at some of these articles that are very sociological and throw a lot of numbers and data our way, I was reminded just how many people are so desperately lonely in this country and don't feel like they have a support system so if they do sustain an injury...And like you, I had an injury. My wrist was shattered and I was prescribed Oxycontin and I was also very grateful for the relief.

But I had also...Like you, I had strong willed supportive people surrounding me, I had a good church. So many people don't have that. I think this for me...As you were speaking actually, it was a convicting moment because it was...Basically I need to be much more...My eyes need to be open to see those around me who are suffering.

Often people suffer silently. I mean it's not...It's generally not socially acceptable to talk about how you're not doing well and how you're in a lot of pain nowadays. So I mean in some ways you have to go seeking this out a little bit with people. But as a Christian, not only do I want a good perspective on my own pain, but I want a good perspective on other people's pain.

So part of that I think will involve me asking the Lord to show me who I can help in the people in my immediate surroundings, the people in my office, the people at my church, the people at my grocery store who are hurting. It's true, the more you talk to people and the more you get to know them, it's amazing the trauma and the struggles of people.

So I think for me pain is a communal experience as well, and I need to be reminded of that, because I get swept into sort of the individualistic mindset so often, and that's a hard spell to break.

Nathan R.: You know I was for a while just for fun...I don't know if this is really fun, but asking people would you rather feel perfect in isolation or suffer in community? I don't know that there's a right or wrong answer to that. Maybe it makes naïve assumptions and different things, but oftentimes people would come around and say, "I would rather live in community broken than in perfection and isolation."

So I mention that only to say that when we think about our response to this topic, for us to see it as a very multi-variable problem, therefore put some of the burden back on me because I can't say oh, it's just these pharmaceutical companies that are doing that, but when I recognize that it does have to do with the personal and the social and the economic and the local cultural community aspect of it, then that puts me back in a position where I can say actually maybe I can't perfect legislation for this, but I can be a good neighbor to this person. So it binds us back into the reality and the responsibility of it that I think is helpful for me to remember.

Cameron M.: That's well said. Well, I think we've covered so much ground that we could have easily turned this into four podcasts-

Nathan R.: Undoubtedly.

Cameron M.: ...but that's how we do it here. Any final thoughts Nathan?

Nathan R.: So I think the takeaway for me, and hopefully for all of us, is that as we hear about this issue in the news that we reflect on the ways in which Christ may be calling us to respond in our local context and settings.

Cameron M.: You've been listening to Thinking Out Loud, a conversation between Cameron McAllister and Nathan Rittenhouse, exploring current events and Christian hope.

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