An addiction crisis along ‘the backbone of America’

An addiction crisis along ‘the backbone of America’
By Joel Achenbach
Dec 30 2016
https://www.washingtonpost.com/news/to-your-health/wp/2016/12/30/an-addiction-crisis-along-the-backbone-of-america/

The young woman sat on a city bench in Athens, Ohio, smoking a Marlboro. She told me her name is Keri, she’s 29, and she has a 10-year-old daughter and a history of drug addiction and mood disorders. She’d just been to a court hearing to get custody of her child. Bad as things are for her, they used to be worse, she said.

“I’d want 10 Percocets to get through the day,” she said. At first she could buy a 5-milligram pill for just $5 on the street, but the price rose to $7 and she soon switched to heroin, which cost only about a third as much.

But she managed to overcome the addiction and now wanted to put her life back together and be with her child again.

“I feel optimistic,” she said. “And that’s a feeling I’m not really familiar with.”

This brief interview came during a road trip in June that ultimately led to a story published online Thursday by The Post about another community: Chillicothe, Ohio, about an hour’s drive west of Athens, via U.S. Route 50.

The Post this year published a series of stories in a project called Unnatural Causes: Sick and Dying in Small-Town America. It focused largely on the opioid epidemic and the rise in the death rate among midlife white Americans. I worked on a broad overview of the trend for a story that ran in April. After sorting through lots of data, I wanted to hit the road and talk to people trying to survive this epidemic of self-destruction.

This was a challenging story to report and write, because it’s a national phenomenon without a single, simple explanation. A study by Princeton economists Anne Case and Angus Deaton published in late 2015 brought national attention to the spike in the white death rate. Our data analysis showed that this was driven largely by increased mortality in white women, and we also found a geographical gradient: The death rates had jumped most significantly outside big cities.

I decided to drive west from Washington on Route 50, a historic road once labeled “the Backbone of America” by Time magazine. It goes more or less straight across the country’s mid-section from Ocean City, Md., to Sacramento. In D.C. it’s known as New York Avenue in one stretch. West of the Washington suburbs, beyond Winchester, Va., it finds its true self as an antiquated cross-country road that links towns so small they never quite rated a stoplight. The drive across the Alleghenies is particularly serpentine; this is hardly an interstate highway.

The lack of demographic diversity along Route 50 is striking. Many counties are more than 95 percent white — and experiencing rising death rates. For example, in Athens County, home to Ohio University, the death rate for white women ages 35 to 54 rose 24 percent in the first decade and a half of this century, according to The Post’s analysis of CDC records. To the southeast, about an hour away on Route 50, Parkersburg, W.Va., sits on the bank of the Ohio River in Wood County, where the death rate for that same group of white women has spiked 51 percent.

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