The White Working Class Will Still Suffer, Trump or Not

Supporters of Donald Trump at a campaign rally in Las Vegas, Nevada. Flickr/Gage Skidmore

The GOP nominee is a howl of rage on behalf of a desperate people.

As a child, I spent my share of time in my father’s hometown, the northwestern Massachusetts hamlet of Greenfield. A patchwork of rolling pastures with a main street that seems sprung from those light-up Christmas figurines, Greenfield is dozens of miles removed from the Boston hubbub and, it seemed as a kid, outside the jurisdiction of civilization itself. It still calls to mind the creak of my grandfather’s rocking chair, glimpses of the dairy farmer across the road, checks of my watch after an hour had seemingly transpired only to find it had been fifteen minutes. Serenity reigned there; a white church steeple peeked over the treetops.

Today, Greenfield is one of the epicenters of the heroin epidemic that originated in . . . is it New England? Baltimore? Appalachia? No one knows for sure, but it metastasized outwards from all those places until it reached the capacity of national crisis. One of its main smuggling routes is I-91, known as the “Heroin Highway,” which runs right through Greenfield. The town’s dope addiction has gotten so bad that travel journalist Anthony Bourdain recently profiled it on his CNN show Parts Unknown. Asked by Bourdain who these heroin buyers are, one anonymous former dealer sighed, “Practically all of Greenfield.” “There’s going to be more robberies,” she warned. “There’s going to be more killings.”

America’s last heroin flare-up began in the late 1960s, but it was confined mostly to the inner cities and had largely come to an end by the 1980s, when it crashed into the crack epidemic. Still, heroin lingered. In her brilliant investigative series “Heroin in America,” my Rare colleague Yasmeen Alamiri chronicled the dope problem in Baltimore, which dates back to the end of World War II, yet for decades received little attention outside of the HBO show The Wire. It wasn’t until heroin starting appearing in middle-class New England neighborhoods like Greenfield that the national headlines blared. Alamiri talked to a number of families in New Hampshire affected by heroin, all of them white, relatively well-to-do and wondering how a drug they’d previously heard about only in the papers had invaded their Main Street USA.

The origins of the heroin outbreak lie with the pharmaceutical companies, which compelled doctors to write promiscuous prescriptions for opioid drugs starting in the 1980s. The revolutionary breakthrough came with Oxycontin, debuted in 1996 by Purdue Pharmaceuticals. Oxycontin could relieve pain for up to twelve hours per dose. It was also chemically similar to heroin. Users addicted to heroin found that snorted or injected Oxycontin was a seamless transition, and vice versa. Doctors began overprescribing, especially in communities that were dependent on mining and physical labor, which yield more cases of chronic pain. That meant Appalachia, where abuse of Oxycontin, locally dubbed “hillbilly heroin,” exploded. “There’s no doubt it’s very much a plague,” one native of Gilbert, West Virginia, told the Associated Press in 2001.

One of the many Appalachians who developed an addiction to opioids was the mother of J.D. Vance, author of the new book Hillbilly Elegy, a memoir-cum-crash-course in white working-class culture for us Acela Corridor softies. Vance portrays a people whose kindnesses are larger than life—his grandmother, or “Mamaw,” saved him from neglect by raising him—but whose shortcomings are equally grandiose: addiction, marital dysfunction, random acts of violence. In Tom Wolfe’s novel I Am Charlotte Simmons, little ingenue Charlotte departs Appalachian North Carolina for a state school where she’s gradually corrupted; in Hillbilly Elegy, Vance has seen more before he turns eighteen than most of us ever will.

This was the white working-class crisis in its Precambrian period. What sent it creeping into sleepy hollows like Greenfield isn’t clear. What is known is that heroin isn’t its only symptom. The suicide rate among whites has also skyrocketed, up 80 percent among white middle-aged women between 1999 and 2014, per the National Center for Health Statistics, even as the same figure for black men ticked downwards. Mortality rates for whites have overall been falling, but so-called “deaths of despair”—suicide, drug and alcohol overdose, chronic liver disease—still shaved six months off average white life expectancy. According to Pew, 52 percent of white voters believe life has gotten worse for them over the past fifty years.