It’s a small gas station nestled onto a mountain road, fluorescent lights buzz overhead. Rows of dusty candy and other road trip essentials arranged in neat lines on beige metal racks. Lottery tickets and cigarettes, a cacophony of color and plastic wrapping, create a wall behind then worn red counter. I ask for the key to the bathroom.
The bathroom is small, worn cream tile speckled with grey streaks. I wonder about the manufacturer of this tile, how they’ve managed to create a stronghold in convenience stores and gas stations nationwide. Was it an unspoken agreement? Or is it simply a coincidence?
Washing my hands, my eyes flicker to my reflection in the mirror. My face is warm from a day of sun, freckles popping off my skin and bridging across my nose, down my arms, over my hands. The desert winds have blown my hair through a day of driving with the windows down, it sticks up in all directions, defiant from any attempts of flattening. I smile tightlipped at my reflection and my eyes catch a dash of orange in the corner of the mirror.
Wait, what? My head turns left, back to the mirror, and left again. There’s no way I read that right. But sure enough, in big block letters, neon orange: Naloxone saves lives. And then, in smaller white letters across the bottom corner of the framed poster: Have it. Use it. A public health directive shouts across the dingy room.
I shake my hands over the sink and wipe them on my shorts, no paper towels in sight. My eyes stay affixed to the poster, a hand pulling up out of the bottom edge, white Naloxone spray bottle in its grasp. I leave the room, key dangling in my palm.
“Thanks so much,” I say to the cashier, a man with tanned skin, deep wrinkles rippling from around his eyes.
“Why thank me,” he says, laughing. “You did all the work.”
I laugh — true — and push open the glass door, back into the fading colors of a mountain town at dusk. My mind turns over the poster again, neon orange against a beige wall, as I stand on the gravel parking lot, hand on the door of my CRV. I gotta ask, I think. I’ll regret it if I don’t.
I push in, a bell overhead chiming to announce my entrance.
“Hello again,” he says, words amiable in the empty room.
“Hi,” I say, palms pressing against the faded vinyl of the red counter. “I just have to ask — there’s a poster in the bathroom. One for Naloxone?”
He nods. I continue on.
“Is that a big deal around here?” I ask. “Like, obviously I know that it’s a big deal everywhere but I’ve never seen a poster like that before.”
He sighs, leaning back against the wall of cigarettes and dip cans.
“Oh yeah,” he says. “It’s a big thing around here.”
“Is it mostly heroin, or is it black market pills?” I ask. “Meth, even?”
“Not meth, really,” he says, shaking his head. “Surprising actually, there’s a big market for black tar and everything like that up here in the mountains.”
I nod: it is really. How long have you been up here?
“Since 2012,” he says, arms crossed casually across his chest.
“Do you think it’s getting better, worse, or staying the same?” I ask.
He pauses. A sigh as he stares off beyond me, weighing the question. Then, he shifts, turning to look me in the eye.
“Don’t know if I’m getting used to it,” he says, “or it’s getting better.”
The bell chimes. Another customer. I make my exit.
The opioid epidemic has been one of the few true constants during my travels around the United States. From the first time drugs came up in casual bar talk in rural Indiana to witnessing the aftermath of an opioid overdose in Ohio, the scope of the epidemic knows seemingly no bounds.
I’ve held the hands of people who told me stories of their loved ones who had died from overdoses and listened as mothers told me about their children who struggled with addiction. I’ve seen how communities band together in the face of the problem — and how others threaten to fall apart under the stress.
According to the Centers for Disease Control (CDC), the rise in opioid overdose deaths has been noted in three waves: an increase due to prescription pills in 1999, due to heroin in 2010, and synthetic opioids (particularly fentanyl) in 2013. Nearly six times as many people died from opioid overdoses in 2018 than in 1999; according to the U.S. Department of Health and Human Services (HHS), approximately 128 people die every day.
The people I talk to on the road appear to be exhausted — much like the gas station clerk I spoke with off that winding mountain road. The general sentiment seems to edge on frustration: what will it take to stop the epidemic’s rise? Is there anything that can truly solve this problem once and for all?
Nationwide, efforts appear to be starting to work.
Data from the CDC suggests that overdose death rates have dropped for the first time since 1990: nationally, we saw a 5.1% decline in the 12-month period between 2017 and 2018. While a decline may be in motion, that is still nearly 70,000 people who died much too young in 2018. As one CDC official noted: it’s too soon to declare victory.
This indicates that many of the questions: the pangs of regret, the frustration, the exhaustion and begging for answers that I’ve heard on the road will likely continue. Because while the numbers may be decreasing overall, many communities are still wrecked with the reality of the crisis daily. They are struggling with how to help their neighbors who struggle with addiction and piece back their communities once one of their own has fallen.
It’s not just a headline, it’s their reality. It’s our reality, in communities all across the United States.
Opioids are not mired by the lines we draw to distinguish ourselves from our neighbors; instead, they’re found nearly everywhere — across every geographical, racial, socioeconomic, and other boundaries we can find.
