America’s Approach to Addiction Has Gone Off the Rails
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In Louisville, Kentucky, not long ago, I heard the story of a woman named Mary. She grew up middle-class, cheerful at times, though she struggled with depression. She took antidepressants. After her marriage broke up in 2006, Mary switched to pain pills, and her life spiraled.
She had a son in 2016. A couple of years later, methamphetamine from Mexico flooded Louisville, and she began using meth too. After that, her mother, Carole, told me, Mary heard voices coming from a ceiling vent, saw a phantom hand reaching from the back seat of her car. She abandoned her son and lived on the street. Her teeth withered. “She became a person I didn’t recognize,” said Carole, who is now raising Mary’s son. (Carole asked that their last name not be used, because she’s concerned that the late father’s family might seek custody.)
Mary would show up on rare occasions, then head back to the street. In late 2021, she detoxed and came to her mother’s house sober, the daughter Carole remembered. Only two days later, at a playground with her son, who was then 4, Mary announced that she had to go see a friend. “I said, ‘Please don’t leave us,’” Carole told me. “‘You haven’t seen him for a year.’ We had an argument. She kissed [her son] goodbye and said, ‘I’ll see you tomorrow.’”
Three days after that, a woman called saying that Mary was pale, hungry, and in need of insulin for her diabetes. She was living in a tent encampment in Jeffersonville, Indiana, across the Ohio River from Louisville. Carole delivered money and clothes and then called the police. “I wanted them to arrest her, to get her off the streets. I wanted to save her life.” But the police could do nothing, she said, and even in midwinter, Mary refused to leave the encampment.
Early one morning in 2022, she froze to death in a tent.
A week later, I met Eric Yazel, a Jeffersonville emergency-room doctor and the county’s health officer. Yazel told me that cases of frostbite had surged as fentanyl, meth, and the ensuing tent encampments spread throughout the area. Countywide, he said, people were dying
