I hail from western Ohio, not far from JD Vance’s hometown, Middletown. Like him, I grew up in a family marred by addiction, with a grandmother who was also my rock.
In the small city of Urbana, many of the mills and factories closed not long after I left for college in the 1980s, the same hollowing out Mr. Vance later witnessed in Middletown, as detailed in his memoir, “Hillbilly Elegy.” The work my mom did building airplane navigation lights was shipped overseas or replaced by automation, our flagship factory sold to a Cleveland corporation in 1977 and, two mergers later, bought by an international conglomerate. Such moves were cheered by economists and pushed by Democrats and Republicans alike.
Mr. Vance’s mother, fortunately, made her way into treatment and out of addiction’s morass. I am always impressed by a fellow Ohioan who finds a way to a productive life beyond the limitations of home. My dad tried but could never manage it, dying at 57 of late-stage alcoholism and lung cancer.
You shouldn’t have to be exceptional to muscle your way into a healthy, productive life. Instead of peddling outrage in this week’s vice-presidential debate with Gov. Tim Walz, Mr. Vance should focus on extending the ladder to those coming up behind him.
But I fear all we will hear is a replay of Mr. Vance’s public playbook — about how Americans in distressed communities simply need to bootstrap better, pray harder, have kids and blame their woes and work concerns on immigrants supposedly coming for their jobs. He has lectured that they should be wary of colleges, which, despite the life-changing impact of his higher education, he deemed the enemy. “Universities do not pursue knowledge and truth. They pursue deceit and lies,” he insisted in a 2021 speech at the National Conservatism Conference. (He has since sounded less strident.)
Public education — and then college — were my tickets out of poverty, just as they were for Mr. Vance. I became a first-generation college student courtesy of federally funded Pell Grants, which covered the entirety of my four-year state-college degree. Today the same grant would pay roughly 30 percent. Mr. Vance went to Ohio State on the federally funded G.I. Bill, then on to Yale Law School.
I have paid back the government’s investment in me many times over through my taxes, and Mr. Vance has, too. This was once a crucial piece of an American social contract that valued educating poor kids as an investment in a collective future. With the right leadership, it can be again. In a rapidly globalizing world, access to higher education would make our nation stronger, smarter and more competitive.
Forty years after leaving Urbana, I’ve been trying to figure out exactly how the hometown that helped raise me morphed into a poorer, sicker and much angrier place. Mr. Vance channels such rage in his stump speeches, from promoting unfounded rumors about Haitian immigrants eating pets in Springfield, Ohio, to railing against immigration itself. Such anger seeks to rally people by making them vulnerable to half-truths and distortions.
My first clues to the changes taking place in my hometown were the many Confederate flags I spotted flying in a region that was once an important stop on the Underground Railroad and encounters with former classmates who now openly embrace QAnon. In my hometown, I learned, mental-health emergency calls have soared by a factor of nine.
In his memoir Mr. Vance blames his mother’s addiction for the violence and abandonment he suffered. I’ll never forget the gripping scene of him riding in the car as his mother drove erratically and threatened to crash and kill them both. I get how much that must hurt. I had my share of near-death experiences, too, along with utility cutoff notices and a slurry dad who fell into the Christmas tree.
Though he witnessed the opioid crisis up close, Mr. Vance would have you think that what most thwarts struggling communities is laziness or a lack of thrift or the absence of Christian values. But having reported on the crisis for a decade, I believe it’s our institutions, more than individuals, that deserve the blame for our nation’s inability to help the staggering 48 million Americans with substance-use disorders.
The subjects of our debates should be how to address the fallout from the ill-gotten OxyContin gains of some of the members of the Sackler family and the initial lax regulations that allowed the Food and Drug Administration and politicians to turn a blind eye to the dangers of wildly overprescribed painkillers — not more fearmongering about trans kids, immigrants or women seeking dominion over their reproductive organs. Until addiction treatment becomes easier to access than dope, tens of thousands of Americans could keep dying of opioid overdoses every year.
Jan Rader, a former fire chief of Huntington, W.V., who now directs that city’s opioid response, tells me she now administers Narcan to the fentanyl-overdosed children and grandchildren of people she revived from OxyContin years ago. These days, it’s the trauma caused by growing up in dysfunctional homes that leads them to the comfort of opioids, rather than a doctor’s prescription.
Mr. Vance rightly claims that fentanyl coming in across the border with Mexico is a scourge, and stemming that supply is a worthy goal. But I want to hear him talk more about what’s driving an estimated two million opioid-addicted Americans to seek the drugs as they self-treat the physical and emotional urge to avoid withdrawal, of becoming dopesick. (Currently, only one-fifth of addicted Americans get any form of treatment at all.)
I wish I heard Mr. Vance turn a greater focus to solutions such as walk-in clinics for treatment, needle exchange services and other harm-reduction strategies and efforts to treat the estimated 65 percent of incarcerated Americans who are addicted to drugs. He might also become a more vocal advocate of the placement of additional mental-health counselors and remediation coaches in all schools, with an eye toward the children he is well aware have been orphaned by the crisis, many of whom struggle with truancy, poverty and appalling living situations that are ill addressed by our overtaxed foster-care system.
Scattershot though these initiatives may be, I have seen them work to stem the onslaught of opioid-related poverty and deaths. But Mr. Vance introduced no legislation for treatment that would help opioid-ravaged communities during his time in the Senate, continuing instead to amp up partisan fears about the border rather than present comprehensive solutions that would stem both the supply and the demand.
The barriers to mobility that Mr. Vance and I faced as we came of age weren’t only about money; they were also about class. In his memoir, when he recalls spitting out seltzer during a fancy dinner, having mistaken it for tap, I could relate.
In college, I had my own fish-out-of-Perrier faux pas, like when I was bewildered by the presence of a second fork for salad and had to get used to saying “isn’t” instead of “ain’t.”
Like Mr. Vance, I made my way eventually to an Ivy League school — in my case after winning a midcareer journalism fellowship at Harvard, where, despite having had some success as a newspaper reporter, I still felt like a food-stamp recipient in the checkout line at Whole Foods.
Perhaps, on the debate stage, Mr. Walz can push Mr. Vance to commit to legislation geared toward treating people with substance use disorders. Mr. Walz can also expose how Mr. Vance turned his back on the things that helped make him who he is — public schools, public college and Ivy League opportunities — and catapulted him onto the very stage from which he will speak this week.
Beth Macy is a Virginia journalist and the author of “Dopesick” and the forthcoming memoir “Paper Girl.” This article originally appeared in The New York Times.
