Faces of an Epidemic

Philip Montgomery

2017 - Ongoing

United States

What is it like to live in a place that’s been gutted by an epidemic? In the United States, opioid overdoses are now the leading cause of death for Americans under the age of fifty, killing more people each year than gun homicides and motor vehicle accidents. The response—from both the federal government and the public—has been strangely muted. Maybe something about the nature of this epidemic muffles the sense of crisis.

It’s a “mass- casualty event” as the coroner of Montgomery County, Ohio, has said, but one played out in slow-motion: first the mounting overdose deaths from prescription drugs in the 1990’s, then from heroin, starting around 2000, and increasingly in the last few years, from the potent synthetic, fentanyl. Heroin used to seem like somebody else’s problem. Yet, in places hit hardest by this epidemic, throughout the Rust Belt and New England, it’s impossible to ignore.

In Montgomery County, overdose deaths now punctuate everyday life. The grim statistics have climbed steadily, from 127 deaths in 2010 to 349 in 2016. And that trend shows no sign of abating, not least because the opioid found most commonly in post-mortems now is fentanyl, which can be up to 40 times more potent than heroin. At times, there is no room for all the bodies at the morgue, and the county coroner, Kent Harshbarger, has been obliged to rent space from local funeral homes.

Brian Malmsbury’s was one of the quiet deaths. He was 33 and had been living at home in Miamisburg, Ohio, trying to get clean after years of addiction. His mother, Patty Neff, said he liked the idea of becoming a long-distance truck driver, out on the road, just him and his dog, but his history with drugs made that unlikely. He’d had depression for many years—“he’d always just been a sad kid,” Patty said. On the day Brian died, he had been helping his mother with some errands. She and his stepfather thought he’d gone out for the evening, but he’d actually headed down to the basement where he overdosed and died. His stepfather, Damian Neff, found him there a day and a half later. Perhaps something about opioids themselves is relevant: people hooked on them numb their pain, whatever its causes, rather than raging against it.

In the last couple of years, Brian’s girlfriend had died of an overdose, and so had his younger sister’s boyfriend. “I didn’t think it could get any closer to our family after it took those two,” Patty Neff said. “And it does get closer. The boys would tell me every day about somebody they went to high school with that died that day. That whole generation’s getting wiped out.”

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