You walk into your teenage child’s bedroom expecting them to be puttering away on their iPad only to discover them slumped over in their chair, turning blue. As you look around, you see an empty bottle of prescription opioids, or maybe a needle and a spoon. How did things get to this point? Where did this junk come from? In the latter case, it may have come from someone like this:
As a boy, Esteban Avila had only a skinny old horse and two pairs of pants, and he lived in a swampy neighborhood called The Toad. He felt stranded across a river from the rest of the world and wondered about life on the other side.
He saw merchants pay bands to serenade them in the village plaza and dreamed of doing the same.
He had a girlfriend but no hope of marrying her because her father was the village butcher and expected a good life for his daughter.
Then Avila found an elixir and took it with him when, at 19, he went to the United States. It was black-tar heroin, and selling it turned his nightmare into a fairy tale.
That’s an excerpt from an article Sam Quinones wrote six years ago for the Los Angeles Times. He turned his investigation of the Xalisco drug gang into a book that was published in 2015: Dreamland: The True Tale of America’s Opiate Epidemic.
Of course, most kids these days are looking for something a little better than black tar heroin, but the Xalisco crew is still very active. Apparently, they made a move into the Cleveland area and Northern Ohio sometime last year.
But heroin deaths are concentrated most heavily in New England, and second most in the Midwest. The epidemic has, so far, bypassed demographically similar spots: Upstate New York, the Plains states. In individual stories you often see the line through the cases—a pain prescription, an addiction, a switch to heroin, a death—but the picture of the epidemic generally is not so clear.
One theory, advanced by the author and former Los Angeles Times reporter Sam Quinones, is that the shape of the epidemic may largely be the result of choices made by drug traffickers. Quinones focuses on a network of distributors from the Mexican state of Xalisco, who, at least in his account, are largely responsible for distributing a cheaper and less pure version of the drug, called black tar heroin, around the country. Quinones suggests that this network is low-profile and nonviolent (its members decline to carry guns). For this reason, he argues, it has targeted those regions where there are fewer drug dealers already operating—places like rural New Hampshire, and Ohio. The Xalisco network has largely avoided African American neighborhoods. The story of the Xalisco boys, in which a whole region is said to be co-opted into a drug operation, echoes the case of Marietta, Arkansas, during the crack epidemic, in which much of the population of this Delta town moved to Detroit in the employ of a drug supply chain led by four local brothers (Larry, Billy Joe, Otis, and Willie Chambers).
Quinones’s account is compelling. It could explain, for instance, the uneven spread of heroin through the country.
Explaining the uneven distribution of the opioid epidemic is an interesting exercise, but so is making an effort to understand the motivations of the Mexican kids who brought this deadly drug into your community.
There are no pat answers for how to roll back the opioid epidemic, and certainly the pharmaceutical industry and prescribing doctors are huge parts of the problem. But, people like Esteban Avila are part of the problem, too, and what’s the answer for that?
Building a wall?