CHAPTER 1

ANGELA GARCIA

THE ELEGIAC ADDICT

Eternal Return

On the cusp of her thirtieth birthday, Alma Gallegos was discoveredlying in the parking lot near the emergency-room entranceat Española Hospital. Like many patients who present atthis particular ER, Alma was anonymously dumped by acquaintanceswho likely feared she might die or was already dead. Infact, Alma was close to death: her breath was shallow; her heartrate barely discernible at six beats per minute; and, despite theintense summer heat, her skin cold to the touch. Upon quick inspectionof her swollen limbs, the attending physician determinedthat Alma had overdosed on heroin, and she was treatedwith naloxone, an opioid antidote that, if administered in time,revives the body's central nervous and respiratory systems. Alma'svital signs were soon stabilized, and she remained in thehospital until the local drug court mandated that she be transferredto the very drug treatment facility from which she had recentlydischarged herself.

Four days after her overdose, Alma emerged from the facility'swomen's dormitory. With one hand against the wall for support,she shuffled unsteadily down a narrow hallway and entered herdrug counselor's office with a groan. Having privately sufferedthrough the initial torments of heroin withdrawal, it was now expectedthat she begin putting addictive experience into a socialand linguistic frame—an exercise central to the clinic's therapeuticprocess. Alma pulled at her hair uncomfortably; her body twitched,and pebbles of sweat collected on her brow. For several minutes, she lookedaround the small, windowless office and stared blankly at the counselor.Finally, she asked in the Hispano manner (i.e., more statement than question):"Yo estuve aquí una vez, no?" (I've been here before, haven't I?)

Indeed, it was Alma's second admission to the detoxification clinic in ayear and her sixth admission to a drug recovery program in just five years.Addicted to heroin for half of her life, Alma's affective world—from herembodied pains to her cravings and the quietude she experiences during aheroin high—were as familiar to her as the institutions intermittentlycharged with apprehending or caring for her. It was a familiarity achievedthrough certain recurring personal and institutional fractures, indexed bylong stretches of heroin use, arrest, mandatory treatment, and an eventualand ongoing return to heroin use, arrest, and treatment.

In clinical parlance, Alma's return to detox was a "relapse." Such adetermination was in accordance with the logic of contemporary publichealth and addiction medicine, which understands and treats drug addictionprimarily as a "chronic health problem, not a moral failing or a socialproblem" (McLellan et al. 2000). But Alma understood her presence at theclinic less as a "relapse," which connotes a period of remission, than as a"return"—a return to living "once more and innumerable times more"(Nietzsche 1974: 274) this particular aspect of Hispano life; these wearylimbs, this room, this familiar and anticipated question now posed to herby the drug counselor: What happened?

For several moments, Alma pulled at her hair and let the questionlinger. Then she told the counselor that nothing had happened. "Es que loque tengo no termina" (It's just that what I have has no end), she said. Yetalmost two years later, Alma was rushed to the same hospital ER, whereshe was pronounced dead after overdosing on heroin.

This chapter considers heroin addiction and overdose in northern NewMexico's Española Valley as a vexing condition marked by the impossibilityand the inevitability of an end. It reflects on observations and interviewsI conducted with Alma between 2004 and 2006 and gives a sense ofher struggle to reconcile this condition's inherent contradictions. Amongits primary concerns are how recurring forms of personal and institutionalexperience configure the struggle—as well as the ways Alma wouldcome to apprehend her world, her addiction, and, ultimately, the horizonof her future. The stress here is on the political and psychoanalytic, and Ilink local modalities of emotion, perception, and subjectivity—writ largeas heroin addiction—to certain historical refrains. My goal is to explorehow ongoing political, economic, cultural, and biological forces constitutedAlma's life—and her determination that it was not worth living.

The Melancholic Subject

The Española Valley is a rural network of poor, Spanish-speaking villagesat the center of a triangle whose points are the tourist meccas of Santa Feand Taos and the scientific center of Los Alamos. It encompasses the site ofthe first Spanish colonial settlement in the U.S. Southwest (where presentdayEspañola resides) and is the site of centuries of colonial exploitation,resistance, and change. Since the 1990s, the region has had the highest rateof heroin overdose and heroin-induced death in the country. In a...