W. Azul La Luz
Please picture this: you walk into a cancer ward in a hospital; with you is a knowledgeable oncologist. He looks around at the terminally ill patients, many of whom are in various stages of dying from their respective cancers in what would be horrific pain were it not for the large dosages of pain medication. The oncologist turns to you and says, “We really need to cure these people of their drug addiction.”
The essence of that statement is exactly what the “accidental drug overdose” deaths are about. An epidemic of drug overdose deaths has been plaguing North Central New Mexico (the Valley) for more than a decade now. And all the institutions that should be looking at the problem as a public health Issue are looking at is as only an issue of addiction and poor self-control.
New Mexico has had the highest per capita drug overdose death rate in the United States, about 18 per 100,000, for more than 10 years. The USA’s rates for the same period are about five per 100,000. North Central New Mexico (the Valley) has the highest per capita “accidental drug overdose” death rate in all of New Mexico, ranging from 42 to 72 per 100,000 over the course of the 11 years examined, from 1995 to 2006.
What are the differences and similarities between victims of “accidental drug overdoses” and suicide victims in the Valley (as subjectively designated by the Office of the Medical Investigator)? How can we understand these high rates of suicide among the Valley residents? What are the race, class and gender structures that set the backdrop for the high rates of overdose and suicide? My research examined the social forces that may contribute to the overdose epidemic among the predominantly Hispanic population in North Central New Mexico. My analysis of 34 interviews of active illicit drug users and 10 interviews of family members and professionals in the Española Valley was anchored in sociological analysis, concepts and literature—Anomic Suicide (brought about by a loss of social and personal norms and values), post-Marxism (unequal distribution of wealth with a small number of people owning most of the wealth and the means of producing wealth), current sociological drug-addiction theory (the belief that addiction may be a physical illness that may be also brought about through social means), colonialism (colonization of a people by another more powerful group), historical/cultural trauma (the pain and suffering brought about through the destruction of cultural norms over a long period of time), and racial and ethnic inequality.
The research design employed both qualitative and quantitative data, including data from the New Mexico Office of the Medical Investigator (1995-2006), historical analysis, participant observation, in-depth interviews, and autoethnography and positionality. This mixed method approach allowed for the three-sided analysis of unlike data. I found that there was an overlap between the demographic—age, sex, race, socioeconomic status, etc.—profiles of suicide and overdose victims. I argued that the effects of colonization and “street-level trauma” (SLT), shocks of repeated strong emotional, psychological, physical blows, weaken and distort a person or even a group’s perception of the world around them. When untreated, SLT often leads to deathly personal action such as “accidental drug overdoses” and suicide. SLT leads to a condition I call “cultural-post traumatic stress disorder” (C-PTSD). C-PTSD may be shaped by the loss of arable land (despite high home ownership), loss of traditional and cultural norms, the whole-cloth invention of a mythological and superficial ethnic consciousness and loss of meaningful social bonds to community. When C-PTSD and SLT are coupled with a substance-abuse career, the combination of all three often proves lethal in Valley women and men over the age of 35. They learned “pharmacology” in their teens when they first began using; those illicit substance-users that didn’t learn quickly don’t grow much beyond their teens. Contrary to the prevailing wisdom, rarely do they make an accidental mistake in dosage or combining substances when they are older. They know better.
Further, treating drug overdose and suicide as a “personal trouble,” an individual-level problem in the Valley, is a major limitation of current health policy. Public health programs must be implemented that do more than attempt to treat substance abuse. My findings strongly suggest that a community-level approach that includes an analysis of the intersecting structural, disciplinary, powerfully historic, and interpersonal oppressions and resistance would shed light on the social forces that shape community health and viability.
W. Azul La Luz Báez, PhD, MA, MA, CCHt is a medical sociologist, executive director of NuevaLight Enterprises and executive director of Silver Horizons New Mexico, Inc., based in Albuquerque. 505.795.5166, firstname.lastname@example.org