Where have you been, my blue-eyed son?
Where have you been, my darling young one?
—Bob Dylan, “A Hard Rain’s A-Gonna Fall”
April 2021
If you follow the line of the hills with solely your eyes, you can see where the altitude of red rock crumbles to dirt and the colors of the sunset pile one atop another like water against a dam. My parents and I are driving west from Colorado to the ocean — across sprawling, arid reservation land — on the day before my brother’s birthday. The land enclosing the freeway is desolate, one would think uninhabitable (of course, this was the point) if it weren’t for the abandoned wooden rooms and gas stations, windows barred and obscured by a thin film of clouds. My parents’ profiles carve into the light of the windshield; I slouch alone across the backseat.
When I say that the land is “desolate,” I do not mean forsaken so much as I do barren, or in mourning for those who have felt the hollow of loss that transcends words. The road is only two lanes, scarred, lacking a shoulder or guard rail because it needs neither — the land on each side is flat as the road. Still, the car trembles down the lane, the asphalt uneasy under the wheels. This is the slice of the country where the wind moves with the kind of force that you worry would lift the paint from the sides of the car given the will, and horses wobble wild behind thin barbed wire fences. If you look away or blink, you won’t know whether the silhouette glanced through the glass was even a horse at all or a saguaro cactus taken to its side by the air, thin and dry, or else, regardless of the silhouette’s physical essence — cactus or horse, horse or cactus — with the twitch of an eyelid it might whip into dust and disintegrate into the silt on the horizon or crash into the sun that takes too long to split. Where plastic bags will whirl through the hot air before a raven can rise, and nothing is where it is supposed to be. Here the abandoned buildings are inscribed with labels scrubbed by the dirt, letters forming words not often found in the front of people’s minds today, such as “oil” and “trading post.” Where time crumbles against the sky that leaks everywhere, you can look and look, and then some more. And there rolls the tumbleweed.
I was raised in this part of the country, where the dirt is dry, and people speak about drought and drugs and death in the same breath. My mother was born here to generations born south; to women with calloused hands, skin creased and sun-shaded, worn from decades spent in the harsh light of the high desert sun. My brother was born in this part of the country, too. And he died here.
One afternoon a decade-and-a-half or so ago, my family stopped at one of the scarce buildings now visible through the window, my brother in his spot in the backseat next to me, tears making his eyes glint even bluer in the harsh, unending light of the horizon — light like this is found rarely and only in places where there are no trees tall enough to cut the sun, nor clouds to dim. My parents and I all have eyes the color of mud, my brother’s were an anomaly even among our extended family — passed down to him by the Irish, German grandfather we never met, himself moving up to this part of the country from Texas to work on an oil rig. When my brother cried, his irises turned an artificial blue, the hues exaggerated against the pink of the tears. While his eyes spilled, a river kicked around in the heat across the road. I couldn’t have been more than eight, my brother six, his dark hair wild behind his ears and his mind already earnest and quick.
Once inside the building and hidden from the warmth outside, he wanted to buy a stone. My brother possessed a singular relationship with the earth — rocks and water, birds and lizards. He loved anything that came from the ground: fossils, geodes, remnants of a past our country cares little to preserve. I don’t remember the reason for his crying that day, only his small, dirty fingers clasped around the stone, his tears disintegrating into the air. Today I cannot close my eyes and remember the way his hair was cut the last time I saw him, but I can see him in that moment, his small, dirty fingers clasped around the stone, his tears disintegrating into the air. I cannot remember the exact span of the gap between his front teeth, but I know exactly how feeling that cool desert stone in his hand calmed him. I can picture the way his cheeks creased when next to a crawling river, and the way his knees looked in motion, the same at age thirteen as they would at age eighteen. Our parents knew aching, and they taught us to turn outside ourselves when in pain — to go outside and move our bodies, to see others’ suffering and direct our energy there. But when my brother was young a shift occurred, producing a pain inside him too searing to access, let alone share or quell as a young man within our failing mental health system. Drugs washed that pain away in a manner nothing else could, and when the high wore off, the fragments of sorrow crashed around him, only a teenage kid. After my brother started using benzodiazepines, then opioids, he returned to calm only when he was outside or in sleep. One of the final things he taught me, caught up in my own darkness, was to hold my forearms to the sun to absorb the light. But when the clouds close in, brother? Those, like everything, will roll in and then leave again.
Now I blink and the building has been pulled across the window, filled again with the lines of the dirt against blue. Across the other window, the river has run dry, its bed swept with dust. I am twenty-two. My brother would be turning twenty tomorrow.
This is the first birthday of my brother’s that will pass since he died of a fentanyl overdose in May 2020. He was born in the spring, on April 15th, and he died in the spring, on May 22nd. He was nineteen, short-sighted and rash in the way that nineteen-year-old kids inescapably are, the horizon still unknowable. But this didn’t change that he was also the smartest person I knew, wickedly funny, and too kind for his own good. The moment I began to speak ill of anyone, he would cut off my words; if a friend’s car broke down or they needed money, he was the first person they would call; he told people that he loved them freely and often. And he was also addicted to drugs and alcohol.
The night of May 22nd, 2020, he relapsed on opioids after two brutal weeks of detoxing, leaving a sober friend’s house in the middle of the night to buy pills that he may or may not have known were laced with fentanyl. After swallowing one of the pills that he had bought less than an hour prior, he went to bed on the friend’s couch expecting to roll out again in the morning. The fentanyl slowed his breath until it stopped completely. He died in his sleep. His friend found his body in the morning. They didn’t call the hospital; they called the morgue.
Out the window of the car, now, there are trees round like pregnant sparrows stuck to the ground. Farther off, an oil rig pumps smoke into the horizon, searing the clouds pink even in the early afternoon. What might the land look like if the people here were not too bone-tired to bother with the fact that they have been hung out to dry? The reservation has long passed now, the Sonoran Desert stretching out on either side of the windows, one side the United States, the other Mexico. My mother’s index finger points toward a plane flying low to the ground, dusting the crops beyond the guard rail with a thin film of chemicals. Men try to stave off the dry heat burning off the asphalt, their wide hats meant to halt the sun only from above, while a dead coyote on the side of the freeway looks like it is sleeping. My brother feels both very far away from and very close to all of this now, his death only a harsh fluctuation in something that will continue to sprawl, continue to sprawl. Nicole Krauss writes that “though love can be mutual and shared, pain only ever happens in a place of radical aloneness.” My parents’ profiles carve into the light of the windshield. My mom’s eyes fall closed while my dad watches her.
I see my brother everywhere. That won’t change on this birthday or all those waiting for us, when I will try to celebrate the nineteen years that I was fortunate to spend with him, rather than mourning the years that will pass without him. I will remember him with a slice of almond cake in a place where the air is damp with salt, hot with anger, and heavy with the joy of a life cut far too short. I will hold my parents. Then, I will think of the other 100,000 families blown hollow by preventable overdose deaths this year alone.
My brother’s voice sounded the same over the telephone as it did in person. When he spoke, he was sincere and monotonous, awkward and thoughtfully self-conscious, and overwhelmingly polite to those he didn’t know. Upon meeting him for the first time, adults never failed to compliment our parents on his manners: he never let a request begin or end without please, he thanked people for things that he did not need to; he refused to speak poorly about anyone; he was generous with his descriptions of those he met and those he loved; and he was forthcoming with his stories. When I spoke with him, I heard my voice in his. I still hear his voice in mine, his intonation and his cadence, his sarcasm and his pain and his fear and his laughter. It is the way our father speaks—considerate and quiet. It is the voice of my mother—quick and fluid. Often, it startles me when I say something and my voice and my words are those of my brother.
I hadn’t heard my brother’s voice for several weeks when my mother texted to tell me to call him in January of 2020, followed by the hospital that he was in and his patient ID number. It was the beginning of my semester, and I was sitting in a library, reading, a senior in college in New York, while my brother was a freshman in college in Denver, where the winter had descended dry and unforgiving, nearly unbearable in its loneliness, he said. A gifted writer, he had been granted a merit scholarship at a competitive business school. We were beyond proud of him, and he was so proud of himself. I had visited him twice in the recent months, though — once in December and once in January — and, without snow, the city he lived in was barren and dead. My mom had to force me there to see him. When she texted me, his third quarter had just begun and he was withdrawing from classes to go to treatment.
I had stood and walked down the hall of the library, already dialing the treatment center’s number. My brother’s voice sounded different when he was high or when he was drunk, and it varied depending on what drugs he was using. When he was using stimulants, his words were shaky and angry and unsure, and he sounded older than his actual age. When he was using benzos, he spoke slowly and I could hear how tired he was, and could discern the synthetic smile on his mouth. When he was sober, I could hear the pain in his voice, but I could also hear him. When the nurse transferred my call to his room, he had already been in detox for at least two days. His voice was his.
My brother and I spoke frequently during that period in which he was in treatment. We both always kept our phones on “do not disturb,” but had changed our settings so that one another’s calls and messages would always come through regardless. He was not allowed his phone in the hospital where he was detoxing (this detox was routine, if he had gone off drugs cold turkey, he would have died), so I had changed my phone settings so that the hospital number could filter through at all times. I was worried when I saw the number on my screen, and picked up anxiously. “Hanny?” he had said, his voice sounding younger than eighteen, “what was the card game that we used to play? I want to teach it to my roommate.” As kids we spent long winter evenings laying on our living room carpet, making up card games for solely the two of us. I had explained the game we used to play to him in vivid detail — one that we had killed hours playing, our fingers flitting by one another’s to grab the cards as our mother watched us tiredly.
My brother called me the following morning to tell me that his roommate had died in his sleep. “Heart failure,” he had explained, awkwardly. I had asked him if he was okay. If we had been together in person, he would have shrugged. I know his mannerisms like I know no one else’s, and there is no doubt in my mind that that is what he would have done, raised his shoulders and looked away. But over the phone he just said, “Yeah.” We never spoke about it again. Years later I discovered that he never told my parents that he woke up to find the man who slept across from him dead.
Another time he called, he was haggling with the nurse who distributed his medication for more nicotine gum. The treatment center had put him on a mixture of antidepressants and sleep medications, but also gum for withdrawals. My brother was charmingly sheepish and charismatic, and it was nearly impossible to say no to him — he got the extra nicotine gum.
My parents and I often hoped my brother would go to treatment because it meant it would prolong his life. But it didn’t. I believe that some of the darkest moments of his life occurred while he was in treatment, and it has little to do with the fact that he was sober or in withdrawal. Our system is broken — the last time he was in treatment was less than half a year before he died.
My brother did not want to die. That he did was a mistake, but his death should not be depicted as an accident. To claim that drug overdose deaths are at all “unexpected,” as they are currently labeled, in a way mirroring those from car accidents or gun violence is a fallacy. Half of the U.S. population has a family member or close friend who is addicted or has been addicted to drugs. In 2015 more than 23 million Americans reported struggling with substance use disorder — the COVID-19 pandemic, spike in overdose deaths, and proliferation of fentanyl suggest this number is likely much higher. Among those who reported using, 75 percent had never received any form of treatment. And not only are rehabs expensive, often filled to capacity, and frequently uncovered by health insurance, our current treatment for addiction doesn’t work.
In what alternate reality can overdose deaths carry the label “unexpected” or “accidental?”
I used to have nightmares about my brother dying. When I was eighteen, I wrote a short fiction story in which he died from a heroin overdose — when I shared it with my mom, she wouldn’t speak to me about the plot. The story depicted our greatest fear. My brother never used heroin. The rest of the plot of that story could have been written as a non-fiction essay after his death. Often, I wonder if I wrote the future into being. “Unexpected.”
We grieved my brother for many years before he died. I would stay up late at night, afraid to receive a phone call from my parents. I became obsessed with my brother and his addiction, overwhelmed by my love and my anger and my inability to help him. Loving someone who is addicted to drugs is terrifying. Loving someone who is addicted to drugs, deeply and unconditionally and over a long period of time, is petrifying. There were months and years when I did not sleep, not yet twenty years old, frigid with the fear that my mother or father would call me to tell me that he had died. I was inexplicably anxious and inexplicably distracted and inexplicably angry. At the darkest points of his life and of mine, I had wondered if my brother’s death would offer reprieve. Now I cannot look at another person without thinking that I would trade their life, anyone’s life, to bring him back.
There was sorrow inside of my brother that isn’t mine to disclose. The moment that sorrow began to manifest in his behavior, psychiatrists began medicating him. The first and only solution to his pain that our society gave him was prescription medication — adderall for likely misdiagnosed ADHD. Our country does this with both psychological and physical pain, then blames people when they continue using medications to navigate suffering. Nearly one-third of my brother’s life was spent trying to repress the pain of wanting to use substances — starting with weed in early middle school — and then ease the subsequent shame of not being able to stop himself from using them. One of the last times I saw him, he quoted a Vice article to me about how he felt when he was trying to quit opioids, “Everything hurts and there is only one thing in the world that will make it okay. . . . Opioid withdrawal is, I am going to fucking die right now. I actually really want to die right now.” In rehab, going through withdrawal from benzos, my brother was promptly put on antidepressants.
When he was using, my brother bought drugs from different sources. There was a thirty-year-old man who sold him benzos in our hometown. My mom would see him at the grocery store, tall and awkward, and he would cast down his eyes, the same color as my brother’s. I don’t blame him. He sold drugs so he could afford to buy his own. I don’t know if my brother was buying from a person in the city he died in, but he was receiving pills in the mail. There is a good chance he knew these pills were “pressies,” laced pills designed to look like xanax or oxycodone. The pills could have been coming from China, or from a local dealer. None of this matters. What matters is that the moment my brother tried fentanyl, he was addicted because he stood no chance against it — fentanyl is fifty times stronger than heroin, and one hundred times stronger than morphine. A close friends’ younger brother, two years older, died of a fentanyl overdose in the same city eight days prior. We often wonder if they knew each other, and if they were buying from the same person.
My brother had Narcan — naloxone, a medication that can reverse opioid overdoses — in his backpack, one foot away from him, when he died. He knew that the drugs he was taking could kill him, and he did not want to die. But Narcan cannot save someone’s life if they are using alone. If my brother had told the friend he was with that night that he had bought and taken the pills, there is a good chance that he would be alive today — but he was ashamed.
The perception of and conversation around substance use disorder and recreational drug use in the United States has slowly begun to shift, largely thanks to harm reduction campaigns, but harm reduction only works if someone is willing to disclose that they are using drugs. Meanwhile, external forgiveness of drug use comes at a time when drug experimentation itself is frighteningly unforgiving. None of my friends that are able to use drugs recreationally will touch synthetics that have not been tested for fentanyl.
Drug overdose deaths in this country reached a record high in 2020 — 93,000, nearly a 30 percent increase from the year prior. Then new data came out in 2021 about the wave of drug overdose deaths spawned by the COVID-19 pandemic — the ensuing lockdown and isolation, and their effects on mental health — and the pervasive spread of fentanyl in the United States. More than 100,000 people died from drug overdoses in the twelve-month span between April 2020 and April 2021. My brother was just one.
To ground that number — 100,000 — it is more than thirteen times greater than the number of U.S. soldiers who have died in the two decades since 9/11, and over three times greater than the number of suicides among U.S. service members and veterans of the post-9/11 wars. The number of drug overdose deaths in that single twelve-month span ended more lives than gun violence and car accidents combined. Indeed, they lead as the number one cause of unexpected death in the United States. “Unexpected.”
I work as an editor for a cultural and political magazine. When I suggested to my manager that we commission a piece about the unfathomable spike in overdose deaths during the pandemic, he ignored my Slack message. When I pressed, he proposed that we connect it to a larger piece about public health in the United States. To be sure, my magazine has published excellent pieces on harm reduction, but my manager’s reaction was not an anomaly. If you scroll through leftist, political cultural magazines that publish long-form critical essays, pieces on the new data on overdose deaths are few and far between. Take a look at more mainstream publications, you’ll find reporting that suggests curbing overdose deaths is a task for law enforcement — stricter crime lab testing and cracking down on fentanyl — or more money toward failing treatment programs. The Times has very recently begun publishing responsible, empathetic journalism about the opioid crisis, but the vast majority of media outlets do not care to talk about people with substance use disorder — “drug addicts” — and the profound way that our country has let them die and continues to let them die, now by the hundreds of thousands.
We know, of course, that the fifty-year-long War on Drugs failed; it did not stop the opioid crisis, nor did it intend to. The Sackler family and the doctors who over-prescribed were never prosecuted like other drug dealers were. Continuing to criminalize those who use and sell drugs or attempting to limit the supply of fentanyl without thinking about where drug users will turn when that supply is hard to come by will not stop the fentanyl crisis now. No one wants to ask the question that unsettles many in the United States every day as our country’s infrastructure continues to fail poor people and people of color, the question that has been in the mouths of so many that this country has never cared about, and still doesn’t today: how does neglecting people — knowingly and passively letting them die — differ from actively killing them? It is a question that has grown salient over the course of the pandemic, but is also worth asking in relation to drug use and overdoses — especially as Black men and Native American men die at unspeakably higher rates. We have now classified substance use disorder as both a mental disorder and a disease. I am skeptical of this language, but if we do choose to classify it as an illness — my brother would have — then it is one bred by trauma, poverty, and a failing health system. It is excruciating loving someone in a world deliberately structured to cause harm. Whose responsibility is it to protect people? To keep ill people alive?
It is by now well-known that our country opted to wage a losing drug war, stigmatize addiction, and let our broken incarceration system handle those afflicted by addiction rather than investing in the resources that could save people’s lives. In this world we have chosen, a nineteen-year-old boy wanting more than anything to get sober can relapse, buy unregulated, fentanyl-laced pills, and die less than twenty-four hours later — and we will call it an “accidental overdose” without blinking an eye at the circumstances precipitating it or the events in history we opt to deem “accidental.” It’s not lost on me that my brother died three days before George Floyd was murdered; that those nearby on the Navajo Nation died at exponentially higher rates than any other population during the COVID-19 pandemic. When does this sprawl end? Where does this sprawl end?
May 2020
I was lucky to spend a week with my brother in early May of 2020 — ten days before he died. He flew home for Mother’s Day, just several weeks after he turned nineteen. His eighteenth year had been defined by struggling and striving to get sober, and he had changed because of it — he was more prudent and mature, and, somehow, he was even kinder. I was taken aback by my younger brother’s wisdom, and sincerity, and goodness. He radiated goodness.
When my mother and I picked my brother up at the airport on that last trip home he had scratched his face to the point of obscurity and his body was gashed with claw marks. He was candid: it was because he was using fentanyl. I did not recognize him coming out of the airport, tall and swaying, thin. Later, my mother told me that he had overdosed a few days prior. During that last trip home, he was trying to detox, spending long days with me outside. He still smoked weed, trying to dull the pain of wanting to use opioids, but he was lucid, himself. Our parents house sits just beyond a slow-moving river, and we drove there with the windows down, the sunlight spilling everywhere, me in the driver’s seat, he beside me. Neither of us knew anything about birds, and once by the water, we let our feet cool in the mud and took turns making up names for the ones that passed over the water. Yellow-breasted tree bird, red-footed just-above-the-water bird, flitting-floating leaf bird. We sat in the sunshine. We laughed as the light from the sun pulled the moisture from the scabs on his back. When we returned home, our dirt-caked feet leaving behind prints through our parents’ mudroom, he asked me to put Vitamin E oil on his back so that the marks on his skin would not leave scars. When he was using, he didn’t like to be touched, and physical affection often was a sign that he was sober. I put the oil on each scratch slowly, his pale skin pink from the day’s warmth. Then I patted him on the back, and he hugged me. “Thank you.”
Moments of light cut through that week, but there is no hiding that he spent that time in excruciating pain while the opioids left his body. I remember walking into his room to find him under the blankets, curled into his side. He was crying. When I asked him what was wrong, he responded, “I don’t want it to be like this.” I sat down beside him and held his hand. I reminded him how young he was, how kind and funny and smart and young he was. Then I laid down beside him and held him against my chest. “Life is very long,” I had said, only a kid myself, “you still have a long future ahead of you.” We had both believed those words. I now understand how short our time is.
In the last week he was home, in the last week of his life, we talked about his substance use more than we ever had before. After withdrawing from his classes at the Business School at the University of Denver to try to get sober, he was planning to return to his merit scholarship the following fall. The sky at dusk made his eyes look almost gray, and he wrapped his arm around my shoulders as we walked, playing a song that he was working on from the speaker of his phone. He told me that he had not expected to live long enough to plan a future through and after college, but something had shifted that trip — he had begun to visualize a future, hope for one.
Walking outside our parents’ home in the light air of the early spring, my brother told me that he wanted to switch to studying pre-med, so that he could go to medical school, so that he could learn alternative approaches to addiction, so that he could start a different kind of treatment facility. Excitedly, with a smile in his words, he described the one he imagined. Each patient would tend to her own garden. She would plant organic food and herbs to care for and to eat. My brother had a green thumb. He spent that week in the trees above our house, helping my mother dig holes in the warm soil for new rose bushes and shrubs. He has three small grapefruit trees, not meant to grow at our harsh altitude, that still stretch toward the sun along my parents’ windowsill.
In this world we have created, a nineteen-year-old boy can hold the density of this hope, relapse and buy fentanyl-laced pills days later, and die within a week — and we will call it “accidental.”