Home Is Where the Bodies Are

One of the central characters in Home Is Where the Bodies Are is Nicole Thomas, who develops an addiction to prescription pain medication after being involved in a car accident. Nicole struggles for seven years before finally overcoming dependency on drugs. She says:

In my twenties, it was weed, alcohol, and cocaine, whenever I could get my hands on it. But I was functioning, until I got a taste for something stronger—much stronger than myself. It was the oxy the doctors prescribed. They kept me on it for far too long, and then they cut me off cold turkey without a plan in place. So, I made a plan of my own. Get high or die trying. And I almost did many times (121).

Nicole’s plight mirrors the very real experiences of millions of Americans who are dealing with opioid addiction. The opioid crisis began in the 1990s when doctors routinely prescribed opiates to their patients for pain management. An aggressive push by pharmaceutical companies lobbied doctors to prescribe their powerful drugs to patients. Marketing reps assured prescribing physicians that these products were non-addictive. However, drugs like oxycodone and fentanyl affect the brain in the same way as heroin or morphine and create a chemical dependency. Overprescription was aggravated by the policies of American insurance companies, which tend to reimburse patients for pharmaceutical prescriptions but not for alternative methods of pain management. This is especially true for economically disadvantaged patients who can’t afford better insurance. Since 1999, more than 500,000 people have died from opioid overdose. The rate was 10 times higher in 2021 than it had been in 1999. (“Drug Overdose Death Rates.” National Institute on Drug Abuse, 2024).

The problem disproportionately affects female patients, who are far more likely to visit a doctor for chronic pain issues. These patients may be victims of domestic violence, rape, or suffering pain related to childbirth or postpartum symptoms. Aside from the special needs of female patients, it also seems that opioid overuse is a rural problem. Recent studies indicate that states with the largest rural populations are the places where opioids are routinely overprescribed. In the novel, Nicole is a rural woman, fitting the unique demographic of those most at risk for developing opioid dependency.

In recent years, the Surgeon General brought attention to the opioid problem by calling it a national health crisis. The Center for Disease Control (CDC) stepped in to create better standards for the use of opioids. In 2016, it published the CDC Guideline for Prescribing Opioids for Chronic Pain. While this policy statement was intended to offer uniform standards for prescribing pain medication, the opioid crisis is far from over. Since the demand for opioids has risen and restrictions have increased on prescribing them, many people buy the pills from drug dealers, who sometimes sell counterfeit pills. In recent years, there has been widespread use of fentanyl, which is more potent than other opioids and is normally administered in a supervised hospital setting. Fentanyl-laced drugs include not only pressed pills but also other recreational drugs like marijuana and cocaine. The spread of fentanyl resulted in 70,000 overdose deaths in 2023 alone (“What is National Fentanyl Awareness Day?” FentanylAwarenessDay.org).