Heroin has arrived in Shepherdstown, West Virginia. I never thought I would say that when I moved to this bucolic little town 29 years ago. I grew up in Baltimore, which has been known as a heroin capital of the country for as long as I can remember. And there it stayed until just a few short years ago. And now, heroin has moved into every corner of the country in just the last 15 years. What happened?

As any economist will tell you, it’s all about supply and demand. Understanding the supply side of heroin is pretty straightforward. Over 92 percent of the world’s opium comes from Afghanistan. The Taliban effectively eliminated opium production by the end of 2000. And then two planes were flown into the World Trade Center, the U.S. went to war with the Taliban, and opium production skyrocketed to help the Taliban pay for their war effort.

But how did the opium get refined into heroin, transported halfway across the world, and distributed with the same efficiency as a book ordered through Amazon? I will leave that answer to your wildest imaginations. Take your pick: drug cartels, extensive tunnels from Mexico, Mafia, corporate jets, CIA, and even military transport. I’ve heard all the rumors, and so have you.

The real mystery lies in the demand side of the equation. Absent demand for one of the most powerful, addictive, debilitating substances, there would be no market for heroin beyond its historical pattern of distribution and usage. But something else is going on here when we see hundreds of thousands of teens, twenty-somethings, and thirty-somethings turning to heroin, and an estimated 2.1 million Americans using some form of opioid painkiller.

There are some very interesting theories emerging about addictions, and some of them will make your head spin. One novel theory comes from a physician named Gabor Mate. In 40 years of working with addicts, he sees one overriding trait among his addicted patients: they all suffered physical or emotional abandonment at a very early age. These patients, the theory goes, did not develop an attachment to human-produced oxytocin (which is that feeling you get when you first fall in love or a mom hugs her baby). These patients were stunted until they were introduced to synthetic oxytocin through drugs. Call it a crazy theory if you will, but it resonates with all of the young addicts I have met and talked to over the years.

We live in a society where half the marriages end in divorce. Most “intact” families have both adults working away from home. Children are shuttled from school to childcare to soccer practice to band to homework to TV to bed—or they’re latchkey kids. Emotional abandonment. Not by choice, and not for nefarious reasons—but abandonment nonetheless. Now mix in an economy that has also abandoned our young people, where 30-year-olds have moved back home in droves, and brilliant people with master’s degrees are asking if you want whole milk or skim with your latte—if they’re lucky enough to have a job. And now you have a young adult tired of abandonment and rejection, who will do whatever it takes to make the pain go away.

And that, in my humble opinion, is how we created the town of Heroin, USA.

(Photo: A soldier from the Afghan National Army steps through a poppy field during a foot patrol, Thursday, June 4, 2009, in Settlement Two outside of Camp Bastion in Helmand Province, Afghanistan.)


Noteworthy: According to the American Society of Addiction Medicine, 1.9 million Americans had a substance abuse disorder in 2014, and 586,000 had a substance disorder involving heroin …


— Tony is a retired social worker and government employee, and has lived in Jefferson County with his family since 1987. He can be contacted at trussowv@gmail.com.

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