In mid December, I wrote about “The Least of Us,” a book by the journalist Sam Quinones about the continuing opioid and meth crises in America. In the book, from which The Atlantic adapted an article, Quinones argues that a resurgent form of meth called phenyl-2-propanone meth, or P2P, arriving in large quantities from Mexico, could be responsible for a surge in homelessness in California and other parts of the country.
Using P2P meth, according to Quinones and his sources in “The Least of Us,” can bring about a quick descent into a state of psychosis with symptoms including the hoarding of junk and the complete abandonment of financial and filial responsibilities. If Quinones is right about its link to homelessness, the implications could be enormous in terms of how the government, nonprofit organizations and law enforcement deal with both drugs and those living on the street.
My criticism centered on the lack of scientific study on the specific effects of P2P meth, something Quinones himself states in his book. This is particularly concerning given the long, troubling history of panics over so-called superdrugs, which are responsible, at least in part, for things like crack-cocaine sentencing disparities that put hundreds of thousands of Black people in prisons for lengthy terms.
Over the holiday, Quinones reached out to me with a response. I want this to be a space where readers can follow a thread of thought or argumentation over a period of time, especially when there’s a truly compelling debate over substantive issues.
What follows is our exchange, edited for clarity and length.
Jay Caspian Kang: OK, Sam, let’s get into this. I want to thank you for reaching out.
Sam Quinones: Thanks for talking about my book, “The Least of Us,” and the issue regarding P2P meth that it raises.
A few things:
I don’t know what is causing this very quick descent into psychosis, symptoms of schizophrenia, etc., among people using the meth that’s now on the street nationwide. I said this in the book.
It could indeed be the staggering quantities of the drug nationwide — certainly a byproduct of how P2P meth is made — that leads in turn to far greater consumption. It could indeed be its alarming potency. As I state in the book, there’s no neuroscience on this — no studies of the effects of today’s street meth on rats or mice. I hope the National Institute on Drug Abuse or the Substance Abuse and Mental Health Services Administration will fund those studies, using authentic street meth from around the country.
In my book, I’m giving street reporting — just talking with folks who work or have lived in this world — because there are no studies. If there were any, I’d have cited them.
Also, people end up homeless for many reasons. A shredded safety net, release from prison without any family support, registered sex offenders who can’t find housing in the limited areas they’re allowed to live in, massive childhood trauma, etc. The list is probably as long and complex as the people who are homeless. I’m quite sure the high cost of housing is among the reasons for many people.
But people whose problem is a lost job or an expensive surgery with no health insurance forcing them out of housing do not collapse into a tent on the street. They usually have family support, friends on whose couch they can sleep. Not so with folks for whom using meth is the issue.
What’s more, meth’s prevalence is now so complete that once someone is homeless (for whatever reason) it’s quite easy to fall into using the drug. Meth-induced psychosis allows a user to escape the reality of living on the street. Getting out of homelessness then becomes a much more difficult task. My reporting shows that often users do not return to their former state of mental acuity once they stop using this meth. Recovery of brain faculties can take months.
Despite all this, on the list of causes of homelessness, this meth surge and meth-induced psychosis seems to me, after a lot of reporting on it, is the only topic that appears taboo to discuss in many activist/advocate circles. The issue’s narrative is almost entirely about the high cost of housing. Nothing else seems permitted. There’s almost a prohibition, a woke censorship, that prevents meth from being discussed.
When I was speaking with treatment providers in Los Angeles’s Skid Row, two of them lowered their voices almost to a whisper over the phone, as if they were afraid someone was listening outside their offices, when they spoke of meth’s impact on homelessness, psychosis and the encampments.
This enforced conformity regarding what can be discussed is stifling and not how we get to real-world solutions.
Jay: The tension you’re identifying here may very well be real. A fear of stigmatizing homelessness may have led some portion of advocates to avoid talking too much about drug abuse and meth in particular. The media, who mostly source their work to these same activists and service providers, will likely just report what’s been said to them.
But even if we grant this is true, isn’t there some part of this wariness that seems prudent? Helping the homeless requires a great deal of public support, as you’ve pointed out in both “The Least of Us” and “Dreamland.” Both books, at least in my reading, are compelling and deeply reported warnings on what happens when everyone decides to turn a blind eye. A whole lot of people die, not only on the streets, but in suburban bedrooms, in high-priced treatment centers, in abandoned houses in the Midwest.
I agree journalists should tell the truth about these things. We shouldn’t simply be the mouthpieces of advocates and activists whom we think more or less reflect the progressive leanings of our readership. (Or the opposite for that matter.) But I also think we should be careful about how we use both anecdotal evidence and scientific studies, and exercise some restraint when it comes to potentially explosive provocations. As I wrote in my last piece, I just don’t think there’s enough proof right now that P2P meth leads to far worse outcomes than ephedrine meth or other forms of amphetamines. The problem seems more to be that there’s so much meth, period, which is still a pressing issue, of course, but not quite the same as a mysterious drug that immediately takes away people’s sanity.
You are an immensely gifted storyteller and reporter. My worry is that because the stories you tell about P2P meth in “The Least of Us” roughly match up with the observations of people who live in cities with homeless encampments and who may encounter unhoused people experiencing a mental health crisis, these residents will be primed to accept nearly any explanation, especially one that places the burden of responsibility on the moral failings of that population.
So I have two questions for you:
1) Do you think there’s enough evidence right now to really advance this theory around P2P meth?
2) Do you think the sort of wide-scale response you prescribe in the end of your book, which involves what you called a “Marshall Plan of American recovery” that would get at the roots of the societal degradation you see at the heart of the drug crises and require a great deal of public good will and compassion, will be possible in a country that has accepted that some significant portion of the homeless have fallen under the spell of P2P meth?
Sam: I’m not attempting to advance a theory. This is basic reporting.
And yes, there’s absolutely the evidence of this connection — that this meth is leading very quickly to mental illness and that leads then to homelessness, particularly tent encampments.
The evidence is not in the form of scientific studies. But that doesn’t mean it’s not there. It can be had by doing what I did — basic journalism: talking to people who work or live this every day.
Furthermore, the questions misunderstand the role of the reporter. The job is to tell the story, based on evidence you gather from talking with people who are expert — in this case, people who are on the ground. They’re the experts in so many ways.
If journalists went around trying to predict the future impact of their stories, then tiptoe away at the first sign of anything that might one day prove controversial or offensive, we’d never write anything and would be rightfully condemned. The point is this: If you have the story nailed with solid reporting, then run it.
That’s what I did.
Perhaps the question then really ought to be why all the people I’ve spoken to are wrong. I’ve spoken to drug counselors, Skid Row cops, homeless shelter managers and workers, E.R. docs, addicts and recovering addicts, on and on — people all across the country, all saying the same thing, recounting the same story. Why are they wrong?
They’re seeing the impact of this meth in eastern Tennessee, rural and urban Oregon and New Mexico and in many places in Kentucky; in Houston, rural Northern California, southern Virginia, Columbus, Boston, Phoenix, Louisville and Nashville. They’re seeing it in areas of very high-priced housing like Los Angeles and Portland and in areas where housing prices are low — Bernalillo, N.M., Clarksburg, W.Va., southern Indiana.
“We don’t see a guy who lost his job, lost his place and ended up on the street,” a homeless shelter director in Clarksburg wrote to me. “We see folks afflicted with methamphetamine. And housing costs are lower here than the rest of the country.”
Why should their analyses, opinions and comments not be taken seriously? These are people with profound personal and/or professional experience in the issues of drugs, mental illness and homelessness. I’m happy to catalog in later responses, if you wish, what they had to say.
I’d add that one reason I was able to see this story, break this story, is because of long years reporting on drugs and drug trafficking in the United States, combined with a knowledge of Mexico that came from 10 years and two books, living in that country as a freelance journalist.
So my reporting in “The Least of Us” adds the Mexico trafficking story, which is essential to the discussion of local homelessness, yet which few across America involved in that discussion — advocates, policymakers or even many journalists — really understand. But the last few years should make clear to anyone who may have had doubts that changes in the Mexican trafficking world have had monumental impacts here in the U.S. Fentanyl is one example. Meth is another.
Given our national silence on this crucial topic that I referred to above, to not report it would be journalistic malpractice, a betrayal of my trade. My book shows what people are seeing every day around the country.
Rather than stigmatize, this reporting does, I believe, what reporting should do. It raises the proper questions.
How do we deal with the mentally ill — and treat mental illness and addiction together, for they are inseparable often, though we treat them as separate and distinct? It pushes us to discuss whether we need various gradations of housing for the mentally ill — to keep folks off the street where the drugs now are more dangerous and plentiful than we’ve ever seen.
The reporting also pushes us to question how we as a country, together with Mexico and Canada, might address, as we have with free trade, the issue of catastrophic synthetic drug supplies (meth and fentanyl).
These are some of the questions; there are many others. But the point is that we get nowhere as a society when our reporters and advocates avoid uncomfortable truths. This allows politicians to do the same. And it leads to expensive, fruitless solutions.
Meanwhile, we do nothing good for anyone who’s homeless by avoiding this kind of discussion. On the contrary, it’s “compassion” of the most misguided and harmful kind.
Sunshine is always the best medicine.
Have feedback? Send a note to kang-newsletter@nytimes.com.
Jay Caspian Kang (@jaycaspiankang), a writer for Opinion and The New York Times Magazine, is the author of “The Loneliest Americans.”
