Opioids – America’s Killer

An epidemic of opioids, opiates, prescription drugs and illegal narcotics, is killing record numbers of Americans. This isn’t news – it is a massive public health problem that has been getting worse for several years. The statistics are staggering. A New York Times article highlights that overdoses are the leading cause of death for Americans under the age of 50. Nearly 100 Americans die every day from these drugs, prescribed or purchased illegally. It is having a disastrous effect on hundreds of thousands of families, communities across the country, and our economy.

We are getting a better sense of the how of why of this crisis. I count myself among those who did not comprehend its scope or causes. I knew that drug addiction was a continuing issue. But I had little sense to the pervasiveness and devastation stemming from opioid addictions and heroin use. A host of new reports and government actions has informed and awakened broad attention across the country. Even with the attention experts predict that numbers of deaths will continue to rise for the next few years.

Several factors have led this disastrous state of affairs. Pain management became a focus within healthcare, and cost concerns have led to more and more “pill” solutions to chronic pain. The economics of healthcare, in other words, propelled certain kinds of prescriptions and certain kinds of business to profit from these changes. An increase in cheap heroin – coupled with new drug selling techniques – provided more fuel, as did a host of new synthetic opioids. Knowing the root causes is important if we are to effect long-term, meaningful change. We need to address this as a nation and in our communities: opiates are ending and ruining lives.

One of the best accounts of how this crisis came to pass is Sam Quinones’s Dreamland: The True Tale of America’s Opiate Epidemic. Quinones is a journalist who has researched in the US and Mexico. Familiar with both cultures, he brings an on-the-ground feel to his reporting as well as a love of story-telling. He is a relentless journalist and a captivating writer. Dreamland won a well-deserved National Book Critics Award and is on many “best book of 2015” lists.

Quinones weaves together many narratives to make sense of this complicated epidemic. His perspective is through the eyes and words of people connected to the issue: doctors, addicts, parents, children, dealers, community leaders, and police. One thread is about how middle, rust belt America became the ground zero for black tar heroin. “Dreamland” was a swimming pool in Youngstown, Ohio. Long-ago it was a place of joy, family leisure, and a representational shared good among the town’s many residents. Gone for many years, its memory hovers as a far away time when life was better and more optimistic. Changes in the economy and culture, marked by job loss, fewer prospects, and the proliferation of prescription painkillers, highlight the Youngstown of the 2000s.

Quinones explains how our more recent world set the stage for increased drug use. The massive increase in the how and why of prescription pain-killers – in particular Oxycontin – is another thread. He takes us to medical conferences, doctor’s offices, and the pain clinics that sprung up in middle America. The development, marketing and distribution of heroin from the “Xalisco Boys” of Mexico. These young men, born in poverty in a small Mexican town, sought a better life. Often relatives or neighbors, many came to the United States to take part in the lucrative drug trade. Organized into small cells, they first sold heroin in the smaller towns and cities away from the established organized drug trade. The Xalisco Boys model was different. They only carried small amounts of the narcotics, never used the drugs, and were drilled into customer (addict) service. They had a growing market, an increased number of Americans who had an opioid addiction.

The American communities’ responses to the crisis forms another narration. Many parents never admitted that their sons or daughters were addicted. Deaths from a drug overdose was rarely reported and not often studied. Only when the numbers began to add up did families, communities, and public health officials begin understand the scope and massive spread of the problem. The journey of analysis and comprehension is another thread, as is the work of police in figuring out what was happening to their towns and cities. Fighting this spread of heroin called for different kinds of policing and prosecution.

Dreamland offers much to digest. It is wonderfully written but it is hard to read: so much sorrow, so much sadness, and so many tragedies. We learn who is profiting and who has avoided responsibility for the crisis, but the aim here is not blame. Quinones does not moralize. He explains with sympathy and patience. The better understanding he gives us is a window into the powerful forces that reshape lives. He also writes about compassion, cooperation and the many ways that people have worked to fight addiction and this crisis. Dreamland is also about everyday heroes who save lives and give us hope.

We need more books like Dreamland.

David Potash

Junctions of Memory, Identity and Loss

Slavkov u Brna is a small town in the Czech Republic. Centuries ago, it was known as Austerlitz. In 1805, one of the most important battles of modern Europe took place there, with Napoleon’s Army defeating the Prussians and the Russians. To commemorate this historic victory, the French named one of its large Parisian railroad stations Gare D’Austerlitz. It’s a stop on the Parisian metro today. Austerlitz is a place, a station, a stop, and a battle. It is freighted with meaning, which is probably one of the reasons that it is also the title and lead character is W.B. Sebald’s haunting novel, Austerlitz

Published in 2001, Austerlitz was immediately recognized as a significant work. Garnering several awards and prizes, it was also an inspiration for a movie. Sebald died shortly after the book’s publication. He was considered an important writer at the time of his untimely death. Sebald’s reputation has not waned and he remains popular today. He writes literature worthy of time, consideration and reflection.

The story of Austerlitz is recounted through a narrator who talks with the title character over many years. Their friendship serves as a vehicle for Austerlitz to recount his search for his identity. Raised by a cold Welsh family, Austerlitz was a child refugee from Czechoslovakia during the early years of World War II. Austerlitz gradually learns of his parents, his history, and himself. The themes are of loss and identity, but much more happens. We think about meaning, empathy, and the consequences of choice and contingency. It is a magically layered work, with streams of knowing and not-knowing strung together in an evocative web. Photos are sprinkled through the text. It has enough authenticity to read like non-fiction; I wondered, while reading it, where Sebald did his research. There is tremendous integrity in the work.

I found reading an overwhelming experience, emotional and intellectual. The details are compelling. The prose – often strung together at lengthy, building on itself and creating a cloud of observation, memory and questions, is mesmerizing. Sebald’s book offers a way to think about the Holocaust that is both global and individual, judgmental and compassionate. I was moved by the book in unexpected ways; it haunts me. Austerlitz is an extraordinary novel.

David Potash


My apartment opens to a busy Chicago Avenue. At night, the street is loud with hipsters, tourists, buskers and custom car stereos. Young men and women Whoo and Whoop and the bars clink with bottles and glasses. Sounds are continuous, a constant roar punctuated by thumps and yells, with engines rumblings and street musicians jamming.

Mornings are different. Sound is episodic. Single cars and trucks, conversations, the barking of a dog. I hear people, not crowds.

The bike lane is full. More and more people are cycling downtown to their jobs. Some take their bicycle commute seriously, kitted with panniers, reflective tape and extra mirrors. Others are more spontaneous. They pass by in a steady stream.

A difficult intersection is up the street, a hundred feet or so from my door. When halted by a red light, the they start together as a mass, a morning peloton.

I like to linger – not watching but listening. I want to hear shifting, the sounds of gears changing. The sound of a well-tuned bicycle is extremely satisfying: silent with perhaps the quietest of hums, depending upon pavement, save for the changing of gears.

A gear change announces itself with a small but purposeful rattle. It is a hiccup, a deep breath before starting something strenuous, a machine readying itself before picking up a piece of work. The pause is brief, less than a second. And then, with a decisive click, the gear engages.


David Potash

Lines in the Permafrost

Some changes are irreversible.

When I entered my local public New Jersey high school, expectations for science learning were high: earth science freshman year, biology in the sophomore year, chemistry as a junior, and physics your senior year. Everyone in my cohort took those subjects in that sequence. I am sure that some kids questioned it, some kids dropped it, and some were never placed into it. Not me. For science, at least, I went where I was told.

A teacher gave us the outline when we were in junior school. I looked forward to physics, biology and chemistry. Earth science, though, did not excite me. It sounded a bit fake. I had no idea what it was. Today, I think about it and its lessons often.

Our earth science teacher was Mr. Caprio, a pleasant, non-intimidating man who seemed old to me. He was not, but when you are fourteen, everyone seemed old. He had a gentle manner. The word around school was that he was “nice.” In my high school, that was faint praise. Mr. Caprio was methodical and patient. I decided that he was OK.

We read about the formation of the earth. Geology figured prominently in the fall semester and we handled samples of igneous, metamorphic and sedimentary rocks. We had sections on earthquakes and even a bit on plate tectonics, which was cutting edge back in the day. We identified types of clouds and learned about the atmosphere, which also meant sections on the oceans and currents. It was a good class. I can’t say that it made me excited, but it was solid.

A little more than half way through the year, when working on climate, things changed.

Mr. Caprio had spent years in Alaska. It might have been research – I don’t remember – but he was passionate about the Arctic. The first day he showed us slides from his time in northern Alaska, his voice was different – and that I remember distinctly. He brought passion and immediacy to the lecture. We saw images of him in a Snow Cat (this was before The Shining), pictures of glaciers and icebergs, and of endless horizons of snow and ice. Mr. Caprio had traveled to Alaska regularly. The place, its people and nature, mattered to him – and this came through the lecture. He showed slides of the areas he had traveled and where he lived, clicking through the carousel.

A series of slides, taken over the years of the same area, stood out. They were tracks of a Snow Cat carved in the permafrost. Not exciting. Simply two lines of dark moving away from the viewer on a flat terrain. Mr. Caprio explained that when the vehicle traveled over the permafrost, the frozen cover would be broken. The grooves become deeper and deeper over time. The permafrost was broken. There was no “fixing” it. The tracks were indelible and had spread over the years.

Mr. Caprio emphasized the fragility of the permafrost and told us that human action in the Arctic had real consequences, things that could not be changed. He forecast problems for the future.

Mr. Caprio did not preach any idealized conservation. He did not portray the Arctic as romantic or glamorous. His method was rational. Actions have consequences. He stressed that figuring out science was one problem and that figuring out human behavior was a different problem. The science of the permafrost presented one set of issues. The science of how and why people did what they did – like driving around in the Arctic – was a different set of issues. He could not tell people what to do or not to do in Alaska. What he could do is make certain that we understood the impact of what they did.

Thank you, Mr. Caprio, for the lesson. You taught a good class. You were right then and right today.

David Potash

Another Look at the Data

Steve Lohr, a journalist for the New York Times, knows how to explain. He has written about technology for decades and his book, written with Joel Brinkley, on the federal antitrust lawsuit against Microsoft is outstanding. Lohr is not a “gee-whiz” technology enthusiast. He is also not a Luddite, crying for the return to a simpler, earlier age. Instead, he brings solid technical knowledge to the table and explains how technological change and innovation impacts business, society, and culture.

Data-ism: The Revolution Transforming Decision Making, Consumer Behavior, and Almost Everything Else is Lohr’s account of the rise of data science and analytics. He started the project in 2012, finished it three years later – and I would expect that the field has changed since. Change in technology, and especially this kind of work with its endless applications, is constant. I would still recommend Lohr’s book. It mixes theoretical and real-word information, painting a picture of how things are being transformed as well as the thinking and rules that will lead to more change. It is accessible, memorable, and very interesting.

A host of different technologies contribute to “big data,” Lohr explains. The amount of data from various points is increasing exponentially. New and better systems are making better sense out of it – especially on the artificial intelligence front. The book wisely focuses on people leading in their fields. Lohr has written a narrative, not an abstract. He profiles Jeffrey Hammerbacher, whose journey from Harvard to Facebook to Mt. Sinai hospital and entrepreneur captures the many possibilities of data science. From the business side, Lohr gives a quick history of how developments in data analytics changed IBM from within. He visits McKesson, a company in Memphis that is responsible for a third of the pharmaceutical products in the United States. Sensors, analytics, and smart computing – along with help from IBM – have radically changed its operations. From hotels to vineyards to hospitals (the work of Dr. Timothy Buchman, who heads Emory University Hospital’s critical care unit, is very instructive), smarter and better use of data is leading to small changes and big reworks of organizational structure, processes and decision-making.

Concerns are woven through the book. Lohr asks hard questions about context, about how data is used, and about privacy – and its erosion. His curiosity leads him to businesses, government officials, scientists and business leaders. He has worries about discrimination and the potential loss of agency of any one individual. People are much more than a collection of data points. Technology is not waiting for us to sort out the rules. The future, Lohr opines, will increasingly be shaped by those who have access to more and better data and the ability to analyze and act on it.

David Potash

A Look Ahead – Several Years Back

Robert Gilpin wrote The Challenge of Global Capitalism: The World Economy in the 21st Century in 2000. Gilpin was widely recognized as one of the wise men of global economics and the book won notice and awards. If you were to take a college class on global trade or economics, chances were good that you would be assigned this book or one of his earlier efforts. In 2002, Gilpin penned a new preface to the paperback edition, commenting on the 2001 technology slowdown. He wrote that “this situation of Americans living beyond their means cannot last.” He explained his concerns that slowing economic growth, an American trade deficit, and high unemployment might “trigger a protectionist reaction in the United States, and that such a development would seriously damage the global economy.”

After reading that preface, I decided that giving time to Gilpin’s prophetic work would be well worth the effort. I was correct. We are seeing signs of a protectionist backlash today. Gilpin’s analysis – particularly of the interplay of global politics and global trade – seems spot on. The heart of Gilpin’s argument is that a healthy international economy based on free markets is highly dependent upon safe and solid political leadership. It needs cooperation, stable currencies, and the recognition that multilaterism is better for all concerned. Gilpin stresses further that there should be an ongoing campaign to educate the public on the benefits of free trade and a global economy. Without leadership and popular support, the global economy is surprisingly fragile.

Gilpin highlights America’s drift toward unilateralism and the poor recognition among leaders and the public of the benefits of the global economic system. Noting the rise of international trade, technology, and services to the global economy, he makes clear that these shifts are painful. Markets are amoral, he stresses, and their impacts have to be managed. Contrasting the Cold War economy from after the fall of the Berlin Wall, Gilpin examines the structural weaknesses in the global economy: insecure trading, unstable monetary systems, and unreliable financial markets. He notes the clustering of regional economics. He also gives attention to the many critics of the global economy. They fear exploitation, loss of sovereignty, lower wages, and diffusion of culture. The answer, Gilpin writes, is better leadership and cooperation from America. He is well aware, though, that this is no easy task – and a specter of fatalism haunts Gilpin’s conclusion.

In a culture awash with bad information and fake news, I do not anticipate much interest in attempting to educate and convince the public on macroeconomic principles or facts. Nevertheless, we have to try. We need a better informed polity to navigate through these challenges. Reading Robert Gilpin is one small step in that effort.

David Potash

When Were The Good Old Days?

Above and beyond explaining the past, history can give us perspective and helpful doses of humility. Are our experiences or abilities all that different from those in the past? It is comforting to believe that we have made great gains. Confidence in our collective abilities aside, questions remain about causality and broad trends. For example, what should we define as “normal” in terms of the macro-economy? It is critical question, particularly when voters go to the polls. Managing public expectations is at the very center of our democratic institutions.

Many Americans believe that strong economic growth and rising standards of living is how life was and should always be. Economic historian and journalist Marc Levinson explains otherwise in his well-argued book, An Extraordinary Time: The End of the Postwar Boom and the Return of the Ordinary Economy. Levinson focuses on 1973 as a pivot point in economic and political history. It marked the end of an extraordinary post-World War II boom, a period of steadily rising wages, multiple employment opportunities (regardless of income), and great expansion. The decades since, which have witnessed slower growth, balloons and busts, greater economic instability, are a return to “traditional” American economic history.

Levinson weaves together broad macroeconomic trends and global politics in the 1970s, making sure that we appreciate the complexities of the OPEC oil embargo, the abandonment of the gold standard, increased global trade, and currency speculation. There are always disruptions and shocks to economic systems. What Levinson underscores is that political leaders had assumed that they could control and manage these forces. After all, they had successfully done so since the late 1940s – the “extraordinary times” of his title. But by the Nixon and Ford administrations, there were no magic bullets. A range of policies were tried without success. Growth slowed, times got harder, and they have mostly remained so since.

Forgotten leaders, questionable theories, and difficult decisions dot An Extraordinary Time. Levinson takes a hard look at Arthur Burns, an economist who was named chairman of the Federal Reserve in 1969. Under Burns’ leadership, the Fed waged a losing battle to inflation. Broad faith in the Phillips Curve, which was supposed to explain the relationship between inflation and employment, muddied policy decisions. Gordon Richardson, head of the Bank of England, tried with limited success to bring greater stability to international banking. The most important underlying fact, Levinson argues, is the slowdown in productivity spelled the end of a post-war extraordinary time. Inequality increased and that trend that has accelerated since 1973. Social unrest followed, leading to the broad turn to the right by the late 1970s. Levinson locates the elections of Thatcher and Reagan within these broad currents of economic unrest.

An Extraordinary Time is closely researched, accessible, and a vitally important corrective to assumptions that there should always be tremendous economic growth. It makes clear that interventions in global market forces may or may not result in planned consequences. Levinson gives us a clear-eyed perspective on our recent history and the currents of forces that brought us here. It would be comforting to think that we are smarter today, but . . . .

David Potash

Chicago’s Block Clubs

Chicago is often described as “a city of neighborhoods” and there is much to that claim. When meeting someone from Chicago, more often than not they will immediately volunteer their neighborhood. “Oh, I’m a South Sider” or “Wrigleyville” or “Bronzeville.” It seems to be especially true for life-long residents of the city.

Historically, local Chicago communities have carried a host of associations along with their geographical boundaries. Neighborhoods were known for certain industries or employment (steel, meatpacking, transportation), with a particular race or ethnicity, or for a parish or organization. Neighbors were invested in their local community. Figuring out the nature and meaning of that local attachment is the focus of Amanda I. Seligman’s Chicago’s Block Clubs: How Neighbors Shape the City. A professor at the University of Wisconsin, Milwaukee, Seligman is interested in urban history and questions of community.

The book is closely researched hyper-local history about activities for which there is often little by way of written record. Seligman overcame the research challenges by working, in her words, where there was archive material – in the light. Block clubs are informal neighborhood groups. Totally voluntary, they became a fixture of Chicago in the early half of the 1900s initially through the efforts of the Chicago Urban League to help African-Americans in the great migration north. They were not just for African-Americans, though. Many other groups organized and supported block clubs. Clubs sprouted throughout the city during World War II. The numbers of block clubs have declined – bearing in mind that there is no official “count” – but they still are an important part of the Chicago landscape.

Anchoring the book are the records of the Hyde Park Kenwood Community Conference, a block club with a robust archive. Herbert Thelen, a long-time professor of education at the University of Chicago, was HPKCC’s driving force. Seligman’s book, interestingly, does not study block clubs through chronology and the shifting priorities of Chicago’s history. Instead, she organized her observations into clusters: why block clubs matter, how they were developed, and their primary functions – beautification, local improvements, sanitation and regulation. We gain a strong sense of on-the-ground dynamics and activities, but missing are the clubs’ roles in the larger context of Chicago politics, economics, and change.

David Potash


Financialization’s Bamboozle

Could it possibly be true that the emperor of finance has no clothes? John Kay, one of the most important and influential economists of the past forty years, argues that the world’s financial sector needs a major rethink. In fact, he goes so far as to argue that the rise of the finance industry has probably done more harm than good.

Kay is no radical Marxist. He is a professor of economics, a consultant, and a public intellectual. He believes in markets and the value of finance. But as he explains in Other People’s Money: the Real Business of Finance, the real aim of the colossal finance industry is to aid the people who work in the colossal finance industry. What we have now, he claims, is a sector with tremendous wealth that operates untethered from its original and central four functions: payments (wages, salaries, buying goods); matching lenders with borrowers; management of personal finances; and management of risks for individuals and businesses. Instead, Kay argues, we have confusion, complication, deception and a system of fictions being swapped with fictions for the benefit of the few.

It is a damning and troubling book.

Kay covers the historical rise of finance. He is British and his perspective is shaped by the empire and Britain’s long history in risk management. Finance today, he makes clear, is less and less about raising capital or making matches.

The books not aimed at the uninformed or those unfamiliar with our current financial sector. Kay packs every page or two with an aside, an insight, and a criticism. It is well-written but slow going simply because there is so much to it. It highlighted to me the inadequacy of just staying on top of the business and financial news. Reading the Economist and newspapers regularly gives a solid account of the action. Missing is an understanding of the how and why of the financial industry. Kay offers that and a clear message about the dangers of unchecked financial activity.

Kay proposes a series of reforms. One wonders, though, if they will fall on deaf ears. Those in the industry are far too focused on amassing more wealth. Those outside of the industry lack the technical skills to push through the necessary changes. It most likely will require another financial crisis – and Kay makes it most clear that without reforms crisis is due – in order to put the house of finance in order.

David Potash

Borders and Education

Global Migration, Diversity, and Civic Education: Improving Policy and Practice is a fascinating collection of essays in the National Academy of Education and Teacher’s College, Columbia University’s work on multicultural education. The focus is on multicultural education in the United States and Israel. The essays look at a range of practices, problems, and policies.

The foundation of this work takes for granted that we live in a time of unprecedented migration, free and forced. Nation-states have obligations and needs to address mobile populations of children. The authors look at education, socialization, and issues of integration from a variety of perspectives. The volume provides an overview of current scholarship and interest. It is inherently interdisciplinary work that is informed from different perspectives. Essays look at national issues and what happens at the school level. There are essays on religion, language teaching and acquisition, teacher education, and civic education. What emerges is an overview of a highly dynamic and contested field – in policy, practice, and theory.

If you were to enroll in graduate seminar on nation-building and education in the 21st century, this would be a required text. Considering the rapidly changing political environment, I think that it is a course that many of us will have to think about taking.

David Potash