More on Isolation and Addiction

More on Isolation and Addiction

I previously wrote about pain medicine ideas that Sam Quinones presents in his book Dreamland. He is critical of the idea that we can take a pill to alleviate chronic pain without making substantial changes in our lives to address the root cause of our pain. Even if we can’t completely stop chronic pain by changing our habits, our environment, and our lifestyles, Quinones shares information which suggests that our experience of pain is connected to many parts of our lives, and that we can change how we think about and relate to pain, even if we cannot eliminate it completely. This is a holistic approach to pain and pain management that Quinones thinks is a crucial piece for understanding our nation’s current opioid epidemic.

 

Chronic pain and its mismanagement is a common route to opioid addiction. Quinones views opioid addictions similarly to how he views chronic pain. In his book he writes, “Chronic pain was probably best treated not by one pill but holistically. In the same way, the antidote to heroin wasn’t so much Naloxone; it was community.”

 

Naloxone is a drug that helps prevent opioid overdoses by binding to opioid receptors in the body to block the effect of opioids like heroin. This drug has helped save thousands of lives, but on its own it won’t stop addiction. Quinones argues that a big problem with addiction is the way in which we hide it from others, whether it is addiction to drugs, gambling, or something else, we don’t allow anyone to know about our addiction. Without talking about addiction, without acknowledging that it has had impacts on our families and lives, and without having meaningful connections with others, we languish in our isolation and addiction.

 

The argument that Quinones makes in his book is that we need more community. We need more things in our lives where we interact meaningfully with others. We need to find more ways to be in service to other people, to work together for meaningful causes, and to have greater social connections with the people around us. By developing meaningful relationships with others, we provide community for everyone, and that helps push back against the forces that drive toward isolation and drive many of us toward substance addiction. Community provides us the space to discuss our challenges, our addictions, and our discontents, and hopefully gives us the chance to build constructive spaces in which we can connect and find solutions to problems that we cannot find in isolation.
Making People Feel Valuable

Making People Feel Valuable

Toward the end of his book Dreamland, Sam Quinones quotes a the VP of sales from a shoelace factory in Portsmouth Ohio named Bryan Davis. Speaking of the company that Davis helps run, and discussing how Davis and a few others took over a failing shoelace company and reinvented it, Davis says, “It’s all been about money, the mighty dollar. The true entrepreneurial spirit of  the U.S. has to be about more than that. It has to be about people, relationships, about building communities.”

 

Quinones writes about how the decline of manufacturing has harmed cities across the United States. He understands why companies have relocated oversees, and in some ways accepts that businesses move and that economies change, but he sees the abandonment of American workers and the lack of supports for those workers when opportunities disappear as a major contributing factor to the Nation’s current opioid epidemic. When people suddenly lose the job they have held for years, when there is no clear alternative for them to turn to in order to feel useful, valuable, and like a contributing member of society, an alternative to ease the pain of their new reality is often pain killing opioid medications. It is an easy recipe for widespread addiction.

 

I don’t understand economics well enough to place criticism on businesses and factories that move operations to different cities, different states, or different countries altogether. I won’t criticize or praise these companies, but what is clear to me, is that we need to find ways to be more respectful of the people who work for and with us. We need to find real ways to make people feel valuable in their jobs, whether they are call center staff, healthcare workers, or a VP of a successful company. We can’t set out with a goal to make money and then withdraw ourselves from the lives of our fellow Americans and communities. We have to develop real relationships with people across the political, economic, and cultural spectrum of the communities where we live, otherwise we turn toward isolation, which isn’t helpful or healthy for ourselves or others in the long run.

 

This is the idea that Bryan Davis expressed. We can be inventive, creative, and push for economic success, but we should do so in a way that supports our community and values relationships with those around us and in our lives. If we only drive toward our own wealth and bottom line, we risk exploiting people, and that ultimately leaves them in a vulnerable position where isolation, depression, and isolation are all the more possible.
Isolation and Addiction

Isolation and Addiction

American’s are isolated, and it’s not just because we have all been asked to work from home, stay inside, and intentionally distance ourselves from others to prevent the exponential transmission of COVID-19. We have been isolated for a while, so much so that former Surgeon General of the United States, Vivek Murthy, recently published a book about loneliness and the importance of human connection. Loneliness and isolation are new problems that we are starting to look at in new ways. In his book Dreamland, Sam Quinones connects isolation and addiction in ways that change the discussion we have about addiction and our values as Americans.

 

Quinones is critical of how our society interacts today, or rather how our society doesn’t interact. He writes, “the most selfish drug [opioids] fed on atomized communities. Isolation was now as endemic to wealthy suburbs as to the Rust Belt, and had been building for years. It was true about much of a country where the streets were barren on summer evenings and kids no longer played Kick the Can as parents watched from porches. That dreamland has been lost and replaced, all too often, finally, by empty streets of bigger, nicer houses hiding addiction that each family kept secret.”

 

To atomize means to convert into very fine particles or droplets, and is used by Quinones to show that we have separated our communities into individual, isolated nuclear units. We hide inside our houses, rarely venturing outside to just be outside. We drive to our suburbs, stop at the mailbox from our car, park in our garages, and rarely spend any time outside. If we do get out, we are in our private backyard where we cannot be seen. We have cut out everyone else, leaving us with just ourselves in our ever larger houses filled with ever more things for our individual enjoyment.

 

Quinones argues that this lifestyle has been brought on by our own selfishness. We want our own stuff, we want to show it off, and it holds more value today than it did in the past. Consequently, we are also more jealous of those who have more than us, and more guarded of our things. We lock out other to protect our stuff, but in the process we locked out a crucial part of our humanity: our connections and community.

 

Community shows us that there is more to life than just our desires. Isolation and addiction are linked because when we withdraw from community, when we focus only inward on what we want, our purpose of helping others and interacting with others disappears. Quinones believes that a lack of interaction with others fueled the opioid crisis. We hid addiction in our homes, withdrew from community, and and took away the joys and connections that made us human. We left ourselves vulnerable to pain killing addictions, and took away the best tools to cure the epidemic we now face.
Excesses and Externalities

The Problem with our Excesses

My previous post was about our desires to live a life that never involves any pain or suffering. We try to build a life for ourselves and our loved ones where every moment is happy, and where we never have to engage in drudgery, never experience physical discomfort, and never face any obstacles. Today’s post looks at another related aspect of our lives and mindsets that Sam Quinones highlights in his book Dreamland as part of our current opioid crisis: excesses.

 

Quinones is critical of our capitalistic culture that creates a message of buying things to find happiness, fulfillment, and meaning. The marketing departments of everything from soap companies, life insurance companies, to take-out restaurants suggests that happiness is right around the corner, as long as we are willing and able to buy more of what they offer. It is owning something bigger, having more, and expanding our consumption that is branded as a good life. But as Quinones sees it, “Excess contaminated the best of America.”

 

I studied public policy and I spend a lot of time listening to podcasts with economists. A common idea in the world of public policy and the mind of economists is the idea of externalities, secondary consequences of policies and peoples actions. Some externalities are positive, such as people developing a sense of civic pride after participating in an election, but many externalities are negative, such as green house gasses polluting the planet as we drive to and from work. What Quinones describes with the quote above, is the reality that our drive for excesses produces negative externalities that damage our planet and ultimately ruin the lifestyle that we chase.

 

By always wanting more, wanting it faster, and wanting it more tailored to our specific desires to make us feel like royalty, we have put ourselves in a place that is unsustainable. Our single use plastic bags have trashed our cities and open spaces. Having our individual cars to drive to everyplace we want to go emits more pollution than a well developed public transportation infrastructure. Over-purchasing consumer goods produces more garbage that has to go someplace.

 

This post has simply highlighted the reality that we live with negative externalities, and that our consumer driven culture is creating externalities which poison the planet. Quinones throughout his book focuses on the idea that our culture’s excesses have fueled the opioid epidemic by turning us inward toward our own wants versus encouraging us to think of others and how we can work together as part of a community. I think he is correct, and I think the space to start in making a change is by getting people to truly reflect on their lives, their purchases, and what they pursue. As Ryan Holiday put it in Stillness is the Key, “Eventually one has to say the e-word, enough. or the world says it for you.”

 

The way out of our opioid crisis, and indeed the way out of so many of our problems today, is to say enough to our own selfish desires. We need to stop the negative externalities that we produce when we purely pursue our own selfish ends, and instead we need to embrace our communities and put others first, to create more positive externalities which can heal our communities and fill the empty holes that consumerism leaves inside of us.
Our Efforts to Avoid Pain

Our Efforts to Avoid Pain

I had an amazing track coach at Reno High School. His name was Mark Smith (everyone called him Smitty) and like all great coaches, he knew what high school students needed in their workouts and in their heads in order to be successful both in sports and in life.

 

Some of the neighborhoods that Reno High School draws from are among the nicest and most expensive in all of Reno. Many students have very dedicated parents who will do anything to help their children succeed, be happy, and avoid pain and suffering. However, these parents often miss an important point, a point that Coach Smitty would always remind parents and athletes, “you can never eliminate suffering, and you can’t protect your child [or yourself] from all pain.”

 

Sam Quinones, author of Dreamland would certainly agree. In his book he writes, “In heroin addicts, I had seen the debasement that comes from the loss of free will and enslavement to what amounts to an idea: permanent pleasure, numbness, and the avoidance of pain.”

 

Our society, in TV shows and commercials, continually pushes a narrative that we should be happy and have lots of consumer goods in our lives. We seem to believe that every moment of our lives should be nothing but entertainment and enjoyment, and we pursue that, continuously trying to buy our happiness and avoid any possible pain or suffering. As Coach Smitty said, however, this is not possible, and as Quinones shows throughout Dreamland, this can lead to dangerous consequences. Part of the opioid problem in our country, Quinones argues, is that we place too high a value on never feeling pain and suffering, and we under-invest in the real things that would help us actually overcome and reasonably manage and respond to pain and suffering.

 

Our mental health, counseling, and therapy services are under-developed and costly. Our economic system doesn’t provide people the support they need in difficult times, and we don’t do a good job of helping get people into jobs that actually feel meaningful. We have built suburbs and isolated ourselves from community, and when we face hard times, we are afraid to admit it and don’t have many close people to turn to. We seek avoidance from these challenges with chemicals like alcohol, opioids, marijuana, or worse. We try to blunt the pain and reduce the suffering artificially, which doesn’t work, and doesn’t help us feel happy or fulfilled.

 

We have a myth that we can eliminate all the suffering in our lives and in the lives of our loved ones. However, the reality is that we must work to overcome that suffering together. As a team, we can support each other, train each other to be strong during adversity, and learn how to put in hard work and lean into the uncomfortable reality of the world to find a place where we can accept and appropriately respond to suffering and pain.

 

Coach Smitty passed away on October 12th, 2018. He was a truly great influence in my life and in the life of others. I hope everyone has a Coach Smitty in their lives, and please reach out to say hi and thanks if you do.

Where You Live (& Are Born) Matters

Raj Chetty, a Harvard researcher, has done some pretty interesting work that shows that the zip code you are born into can have a huge impact on how much money you earn over the course of your life. Down to the neighborhood level, where you live, the people around you, and the connections you happen to make in life can be major determining factors in what job you take, what college your children attend, and how well off you end up financially speaking. We don’t like to address this very often, but we recognize that it is true, and we have seen increased segregation as we try to separate ourselves from living next to undesirable people and places.

 

In his book The Complacent Class: The Self-Defeating Quest for the American Dream, Tyler Cowen writes, “in 1970, only about 15 percent of families lived in neighborhoods that were unambiguously affluent or poor. By 2007, 31 percent of American families were living in such neighborhoods.” We are moving in directions where we separate ourselves from people who are not like us in terms of socioeconomic status (SES). Today, relative to 30 to 50 years ago, we are less likely to interact with someone who is very poor if we are rich. We are less likely to know anyone who does not share a generally similar SES, and we are far less likely to have any meaningful interactions with someone from a different SES. Cowen continues, “for where you live, income matters more than ever before, as can be shown by a simple perusal of the apartment ads for most of America’s leading cities.” 

 

This segregation by home value and SES has some obvious consequences, such as schools becoming more segregated by income and race and skyrocketing home prices in some regions of town coupled with deterioration and disinvestment of other regions. However, as the research from Chetty shows, there are other, less obvious consequences from our SES segregation. Where you live influences the opportunities available to you and your children.

 

We like to think that it is our own effort, talent, and hard work which determines how much money we make and where we end up financially and in terms of the home we are able to buy. Since talent, intelligence, and work ethic are evenly distributed on a genetic level, we would expect that everyone could achieve the same ends regardless of where they happened to be born. Instead, we see huge disparities by zip codes and neighborhoods in terms of ultimate SES. Our segregation is leading to situations where those who are born in wealthy areas are able to make valuable connections, learn the unwritten rules of networking to getting ahead, and receive visible reminders of what can be achieved through hard work and perseverance. Certainly people from the lowest SES background can still network and can still see the benefits of hard work, but research also suggest that when people from the lowest SES don’t have any interactions with people who are economically well off and successful in their careers, they do worse.

 

Cowen argues that our segregation by SES is making us a less robust society. Partially because we are leaving other people out, but also because it narrows the world for all of us (not just those in low SES neighborhoods) and stymies innovation, development, and progress. We are comfortable in neighborhoods with people who have a similar background and SES to our own, but this does not help us better understand the world, does not help us advocate for and support policy which might help us and others, and does not help us identify and encourage the top talent born in our country. Our complacency as we all search for our own individual American dream is crippling the American dream that we share as a nation by segregating us into complacent bubbles.

Problem Solving Locally

“As politics has become nationalized, problem solving has become localized,” write Jeremy Nowak and Bruce Katz in The New Localism. National politics is all about identity. It is all about the question of whether people like me are favored and socially rewarded on a nationwide scale. People like me might be men, intellectuals, Ford truck drivers, snowboarders, retail workers, stockbrokers, veterans, or evangelicals (note: I am not all of these things). We constantly have debates and shift our discussion of what identities are valuable and best reflect the America we desire to be, and at a national level, there is no real answer to these questions. Political decisions and policies become tied up in these identity questions, and it is hard to avoid having an opinion or becoming consumed with the values questions that these identity debates spark.

 

Meanwhile, daily life continues and human societies rely on systems and structures to guide our interactions and facilitate a peaceful flourishing for all individuals (ideally but maybe not what we always see). We rely on government to avoid tragedies of our commons, to ensure the products we use and depend on for our ways of life are safe, and to protect our individual and group rights from being infringed by others.

 

Problems will always exist in the organization and interaction of human beings, and when our national government is subsumed by questions of identity and debates that can never be fully settled, solving the daily challenges of human existence moves downward toward the locality where life is actually lived. Our states, our metropolitan areas, and especially our individual communities are the places where we can make changes and improve our situation.

 

These localities are innovating and connecting with new groups in unique ways. The interactions between private businesses, charitable foundations, and public agencies are being reinvented based on local situations and opportunities to drive forward new solutions to wicked problems. Challenges that cannot be introduced on a national level, where issues of identity fracture alliances and coordinated effort, are evaded at the local level where we all have a stake and a greater voice in addressing the challenges we face. Communities can produce a groundswell of support for innovative approaches to challenges new and old, and can dynamically adapt by creating new connections and structures between the stakeholders and organizations with the power to enact change. This is one way which governance can adapt in the future, and one way that we can overcome division to continue to make the world a more cohesive and better place.

To See Our Own Face

Fernando Pessoa’s The Book of Disquiet is exactly what the title suggests. It is a disquieting look at the world around us, making us think, question the every-day, and second guess what it is we believe and accept. Pessoa dealt with sever depression, and writes about his challenges with depression in stark and honest terms. He pulls apart experience in a way that is unique to him, and makes us question the experiential sums of the filaments of reality that we perceive.

 

Included in the book’s translation by Margaret Jull Costa, is a short piece about seeing ourselves in the mirror: “Man should not be able to see his own face. Nothing is more terrible than that. Nature gave him the gift of being unable to see either his face or into his own eyes. 
    He could only see his own face in the waters of rivers and lakes. Even the posture he had to adopt to do so was symbolic. He had to bend down, to lower himself, in order to suffer the ignominy of seeing his own face.
    The creator of the mirror poisoned the human soul.”

 

We easily become self-obsessed in our world today. We can spend hours looking at just pictures of ourselves if we wanted to. We have so many ways to capture our image and post it where we want. We can place mirrors and reflective surfaces throughout our world, to constantly look at ourselves and dress up the outside answer to the question, “Who am I?”

 

In Pessoa’s mind, we were never supposed to look at ourselves from the outside to try to answer and define that question. His quote shows that he believes we ourselves cannot provide an answer to the outside question of who we are, and that it should be publicly shameful to try. To turn inward, to become self-obsessed is a curse. To remain ignorant of the self, to be focused outside oneself and to exist as part of the social group of others to which we belong is where the human mind was supposed to be. The mirror split us and our definition of self from that collection, and poisoned the mind by forcing us to always consider ourselves first. Our ancestors from whom we evolved could not look back at themselves with a clear view of who they were and wanted to be as an individual. It is only with human created technology that we can focus the light back at ourselves, and take control to define ourselves as the outward image that is presented to the rest of the world.

Evaluating What Really Matters

I really wish that the work week was not 40 hours long. I really believe we could be just as productive working 6 hour days rather than 8 hour days, and I think that we could use our extra time to build meaningful social capital in our societies and lives. (As an aside, I do recognize that a shorter work day would really just mean our cities would sprawl more and we would live further from work and spend more time commuting for work). Where we are right now, is in a weird position where we have allowed our work to consume almost all of what we do for reasons we don’t like. We work 8 hours a day and 40 hours a week because we want more and we want things that don’t really matter so that we can impress people we don’t really care about. We are focusing on things that are not that important and giving up large amounts of our lives to pursue these meaningless things.

 

In Letters From a Stoic, Seneca writes, “it is easy to escape, if only you will despise the rearwards of business. We are held back and kept from escaping by thoughts like these: What then? Shall I leave behind me these great prospects? Shall I depart at the very time of harvest? Shall I have no slaves at my side? No retinue for my litter? No crowd in my reception room?” It is hard to look at the opportunity for material gain and turn it down in favor of enjoying time. It is hard to draw back when we see an avenue for promotion, a way to work more to earn more, or a chance to gain more status and prestige. Often however, we hate the time we spend working and we put ourselves in situations that are dangerous to our health (even if you are not going into a mine, going into an office that spikes your blood pressure every day is unhealthy).

 

“Hence men leave such advantages as these with reluctance,” Seneca writes, “they love the reward of their hardships, but curse the hardships themselves.”

 

I recognize how important hard work is. I understand that without everyone working together to get stuff done, society does not advance, we don’t grow and prosper, and we don’t have any way to enjoy our leisure time. But I think we may be at a point where we are no longer working to enjoy our leisure time. We are not seeing our levels of work decline as we become more prosperous, we see the opposite. Productivity growth is slow, but the hours we spend working are increasing. This suggests we are putting ourselves in places we don’t want to be, not really working that hard when we are there (because we hate it) and then getting rewards we don’t even have time to be happy with.

 

I think we should step back and reconsider the things that really matter. We should find ways to pull back from work we hate and dislike. We should find ways to give people time and should encourage people to use that new time in a way that brings communities together with shared purposes and prospects. Rather than selfishly working for ourselves, we should spend more time engaged in a community and working together for others.

A Harmful Sentiment

I am fascinated with tribalism. We all have a part of us that looks around at the world and recognizes who is like us, who is different from us, what people are part of our family, and how people in our group behave. Everyone in our in-group stands above the people in our out-groups. Those “others” seem to take on any negative qualities that we want to assign to them. People who are less wealthy than the people in our tribe are less intelligent or lazy, and that is why they are not as well off. People who are doing better than our tribe financially are greedy or privileged elites and don’t really understand what it is like to be a true American. Our tribe, however, is full of hard working, smart, and all around good people.

 

We all seem to share these tribal tendencies, and they can be harmful when we start to pull into our own group and ascribe negative qualities to all the other groups out there. Colin Wright addresses our tribal behaviors in his book Becoming Who We Need To Be by looking at “America First” from a tribal perspective. Wright describes the benefits of a globalized community and population. Using the insights, developments, and tools created around the world to raise the standard of living for everyone, and not just to use discoveries in one part of the world to improve that part of the world. He writes, “People in the US should be taken care of, certainly, but to paint our relationships in those terms [America First] implies that we have to be utterly selfish and introverted in our dealings with others, when in fact, being more open and generous will bear much greater fruit. That sharing our strengths and celebrating the strengths of others is somehow detrimental to our well-being is an ignorant idea easily sold to a mistrustful populace.”

 

Wright argues that America First trumps up some of the worst aspects of our tribal nature. It highlights who is in our tribe and who is outside of our tribe and focuses solely on increasing the status of those in our tribe. The sentiment abandons the idea that improving the lives of everyone will improve our own lives, and seeks only to expand the economy, fortunes, and standards of living within our own tribe. This may work and we may have great prosperity for the few who are part of our tribe, but putting ourselves ahead of others so openly and blatantly while also denigrating those outside our tribe may create extreme mistrust and anger. Stability, fairness, and long-term well-being may be sacrificed in our selfish quest to primarily enrich ourselves.