Heartland America Struggles for Hope Amid the Opioid Epidemic

The crisis may not be a political priority, but in Sedalia, Missouri, its effects continue to be profound

Heartland America Struggles for Hope Amid the Opioid Epidemic
A sign on a bus stop in Edmonton, Alberta, Canada. (Artur Widak/NurPhoto via Getty Images)

Cherri Bridges says that the first time she used meth was an accident. Although it didn’t take long for her to become addicted to alcohol and marijuana as a young teen in rural Missouri, hard drugs were still a novelty to her at age 14. She was out with her cousins at a party when someone told her to stick out her tongue, sprinkling on a line of meth before she realized what was happening. Thus began more than a decade of addiction that forced her away from home and led to her living in trap houses.

Along with many other small towns across America, Sedalia, Missouri, has been battling substance abuse on a vast scale. Known as a “flyover” state in the Midwest, Missouri has a poverty rate of about 13%, slightly over the national average of 11.5% as of 2022, and although representative of many of the ills of “Middle America” it is largely absent from the national discourse. The Missouri Department of Health and Senior Services has identified drug overdoses as the leading cause of death for adults aged 18-44, with prescription opioids, heroin and synthetic opioids like fentanyl the main culprits.

In October 2017, the U.S. government declared the opioid epidemic a public health emergency. (Missouri’s state health care system, overcome by the opioid crisis and later the COVID-19 pandemic, was ranked the fourth worst in America in 2021, according to the Commonwealth Fund.)

As the 2024 presidential election looms, the country at large continues to suffer the worst drug crisis in its history. Fentanyl and other opioids are the leading cause of overdoses, which result in a staggering rate of over 1,500 fatalities per week. The opioid epidemic started in the 1990s, with the overprescription of legal pain medication, then developed in recent years to include street drugs like cheap heroin, fentanyl and synthetic opioids.

This is especially telling because, according to a recent study by two economists titled “Democracy and the Opioid Epidemic,” opioid use appears to rank among the most important political forces in recent American history.

Carolina Arteaga at the University of Toronto and Victoria Barone at the University of Notre Dame examined voting trends in congressional districts since opioids hit the market and became heavily prescribed in the 1990s. The authors identified areas of high exposure to opioids using cancer mortality statistics (drug companies’ marketing strategies for opioids focused on areas with high incidences of cancer, even after they expanded beyond cancer-related pain relief) and found a correlation between the areas where opioids were heavily marketed and voters shifting to the right.

Yet both major presidential candidates seem to address the crisis with little more than symbolic rhetoric, leaving voters who have lost loved ones due to addiction feeling marginalized. (Republican candidate Donald Trump, for example, promised Iowans he would launch the “largest deportation operation” in U.S. history, accusing undocumented immigrants of fueling the opioid crisis and promising nothing to Americans who continue to suffer.)

Drugs keep police busy and hospitals full, says Michael Elwood, a sergeant with the Sedalia police. His wife, Megan, a nurse at the regional Bothwell health clinic, nods in agreement. “It seems like the majority of run-ins with the law revolve around drugs or people committing crimes to get money for their habit.” Data from the Centers for Disease Control (CDC) and the Substance Abuse and Mental Health Services Administration estimate that 15% of people in the state use illicit drugs each month — and that’s just what’s reported.

Sedalia, in central-western Missouri, is home to 22,000 people. Rooted in a strong farming tradition and boasting a booming automobile parts industry, the town has also been facing a spike in violent crime — more than twice the national average, according to the FBI.

Bridges doesn’t have the statistics for how many people in high school were using drugs, but “it felt like most people” were, she tells me. She was also born a methamphetamine baby — dependent on the drug. For 27 years her mother, Candy Meyers, battled a drug addiction that nearly destroyed her relationship with her own parents. Meyers went through four marriages and lost her teeth. She and her third ex-husband, Bridges’ father, were respectively arrested for drug possession and meth manufacturing on Valentine’s Day in 2005.

At the time of their arrests, Bridges was 9 years old. A few years later, in the seventh grade, she wrote a letter to herself — one that her mother somehow saved in a plastic sleeve, which resurfaced amid the clutter of her house all these years later. In the deepening Missouri dusk, Bridges reads the words out loud to me, about how she never wanted to become a drug user. It seemed like witnessing the violence and pain it brought to both her parents would have been deterrence enough, but just a year later she started using drugs herself.

At age 20, in 2016, she left home and moved to New Mexico, where she stayed for nearly a year. It was her first time on her own, outside of Missouri. “At first I felt free,” Bridges told me. “But when I became homeless, I felt lost — like I didn’t belong anywhere, and that nobody cared about me.” She describes how, at the height of her addiction, she saw employment as getting in the way of her using habits. She returned to Missouri but kept taking drugs.

The turning point was when Bridges spent a week in the Sedalia jail in August 2020, when she was 24 years old. “It took having to tell my mom that I’m going to jail for meth possession to realize what I’m doing with my life,” she says. Meyers refused to bail her daughter out. In 2005, Meyers herself had been in jail for 81 days for meth possession. “She needed to hit her rock bottom, like I did, to really change,” recalls Meyers. “It broke my heart but I had to let her learn the hard way.” Tears start pooling at the corners of Meyers’ eyes, behind her tough, charismatic bravado. “When my daughter went to jail for drugs, I finally had an idea of what I’d put my parents through over all these years.”

Candy Meyers looks into a bail bond agent’s shop where she made bail after being arrested for drug possession on Valentine’s Day in 2005. (Kang-Chun Cheng)

Companies that manufactured and marketed opioid painkillers (like OxyContin and Vicodin) will pay out a combined $50 billion across the country to settle claims that their drugs led thousands of Americans down the path to drug addiction. Missouri expects to receive $900 million, and political debate continues over how much of this money should go toward health services like drug rehabilitation and counseling versus law enforcement and the “war on drugs,” a dichotomy very much felt by the people most affected by opioids.

Bridges finally wanted to get clean, from somewhere deep inside. “The hardest part about getting clean is trying to find your new people,” she explains. “You have to change your friends, the places you go, all of that. Finding a new group of people to connect to that is safe is difficult.” It feels almost like betrayal, she continues — turning away from people who have seen you at your worst and didn’t judge you, but knowing you can’t do anything to help them because of their ongoing addictions. “You have to find new people who don’t judge you, who you can trust.”

Last year, she started working as a certified peer specialist at one of the places that had been so critical to her recovery — Recovery Lighthouse, an outpatient organization that helps individuals and families find and sustain recovery from substance use disorders through a secure and supportive environment.

Here, peer specialists with personal histories of substance abuse work not only to counsel outpatients in their active addiction but also to rebuild the trust of their families and their trust in themselves. “We’re big on countering stigma here,” says Tracy, a recovering addict herself and certified peer specialist at Recovery Lighthouse. “It can be really surprising for people to learn that someone like me knows what addiction is like — that it’s not just the guy living under the bridge.”

When you’re in active addiction, anything can be a reason to use, Tracy continues. “If you had a good day, or if you had a bad day. Here, we’re really protective of each other. We’ll check in if something seems off, if someone has been particularly stressed. We have to go through this together.”

Now, at 28, Bridges has been clean and sober for three years. A year ago, she encouraged her mother to join her as a certified peer specialist at Recovery Lighthouse.

“We do everything together,” the two chime in on a phone call. “We work in the same office and then spend time at each other’s place.” Although it’s not always easy, the mother and daughter are working to rebuild their relationship.

It’s Thursday evening, and Bridges is at her mom’s house, ironing motivational words onto T-shirts and tank tops for a community-centered “Recovery Day” in downtown Sedalia. Meyers is in the living room, helping her with cutting out the appliques. The tops are all purple, the national color for substance abuse recovery. “I never know what my daughter is going to get me into,” Meyers guffaws. “She always has so many ideas.”

“You’re only as sick as your secrets,” she says. “Healing starts when you get rid of the pain and stigma and guilt.”

A study by the Recovery Research Institute found that 1 in 10 (or 22.35 million) American adults report having resolved “a significant substance use problem” (of these 22.35 million adults, 1,117,500 individuals identify opioids as their primary substance of choice). Just over half of sober individuals identify as using assisted recovery — with nearly one-third receiving formal treatment. The rest find their way to the light without formal assistance. The CDC and the National Institute on Drug Abuse found that three-quarters of people who experience addiction eventually recover. As of 2021, the Pew Trust found that there are 1,816 opioid treatment programs in the U.S. providing care for over 400,000 Americans. While the cultural perception may be that many people never get better, many do go on to rebuild full and vibrant lives.

Despite being estranged from her parents for decades, Candy is now extremely close to them, visiting them with Cherri at their home. (Kang-Chun Cheng)

Earlier, Cherri and Candy brought me to the house in downtown Sedalia where they had lived for a couple of years with Bridges’ biological father. “I got beaten up [by her dad] here so many times,” says Meyers. “It’s a place that brings back horrible memories.” She shows me a hole in the backyard, covered by some old piping, where she was instructed to drop the drugs should the police ever come. The house has been abandoned for years; Meyers is trying to rent it out now, but her motivation is low since it’s so hard for her to spend time here.

Meyers drives us to the home where she now lives, on land adjacent to her folks’ land, which she describes as her “own slice of paradise.” Dozens of stray cats have found their way here over the years; she estimates that she goes through a 40-pound bag of cat food every few weeks. She shakes her head, in something akin to disbelief, at how much things can change over the course of a lifetime. “I was addicted for 27 years,” she says. “There were times when my folks wouldn’t acknowledge me as their daughter, avoided me in the grocery store. But now, I’m helping my dad sort his medicines. Sometimes, I can’t believe we’ve gotten here.”

This essay was reported from Sedalia with the support of the 75th Missouri Photo Workshop.

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