The Opioid crisis has been turned into an opera

Jet-lagged and disorientated, I headed downtown for my first taste of midwest America. Night was about to hand the baton over to day. Cafes were still shuttered and the sky was dimly blinking. Certain that there must be a coffee shop open somewhere, I wandered vaguely across blocks, studiously following bossy instructions from pedestrian crossings; the disembodied countdown booming into the silence.

Around me, people stirred in the shadows. Some dragged holdalls, others clutched plastic bags. I was trespassing into streets that some people called home. A man paused on the corner, bent at the waist, head bowed, arms limp. I would learn later that this was probably the ‘fentanyl fold’, a response to synthetic opioids. Homelessness is ubiquitous in most cities – but in the US, it is linked to an ongoing drug crisis.

When I returned to the same spot some hours later, refreshed and caffeinated, there was no sign of suffering. Diners were open, office workers bustled. My food bill arrived with a moment of alarming clarity: a hit of fentanyl now costs less than a snack.

Read more:

• Nitazenes: Use of life-saving overdose drug surges by 50% amid synthetic opioid crisis
• Warning as new synthetic opioid 200 times stronger than heroin kills three users in days
• UK organisations still taking millions from Sackler family as museums rush to cut ties over opioid crisis

The Lancet describes the opioid epidemic as “one of the worst public health disasters affecting the USA and Canada”, and estimates that 1.2 million people could die from an opioid overdose by 2029. Semi-synthetic opioids like heroin have been replaced with purely synthetic alternatives, often illegally made and mixed into other drugs without the user’s knowledge. The synthetic opioids are more potent, precipitating enormous numbers of accidental overdoses.

As with more innocuous trends, there is concern the UK is set to follow this fashion, as addiction shifts to different substances. These issues are at the heart of The Galloping Cure, described as ‘a bold new opera for the opioid age’, which premieres at Edinburgh International Festival (EIF) this summer (9, 11 and 12 August). Composed by Missy Mazzoli with a libretto by Royce Vavrek, the piece is a co-commission by the EIF, Scottish Opera and San Francisco Opera, among others.

Drawing on Kafka’s 1918 short story A Country Doctor – a surreal tale about a dark house call – and Grimms’ fairytales, The Galloping Cure story was developed by Karen Russell. It follows the arrival into town of a strange man called Lucky Mack who is peddling a cure for pain – a ride on a carousel.

The community is swept up with the excitement, and the local doctor Theresa Hart endorses this miracle treatment. Then, Mack sells stick horses that people can ride at home and things spiral; Hart discovers her daughter has had an accident while riding one. 

“There are some obvious parallels with the crisis and the rollout of OxyContin [a popular brand of semi-
synthetic opioid],” explains Mazzoli. “The opera is set in a small town that could be anywhere in the world. I think of it as being my home town in Pennsylvania, but it could easily be in the UK.”

The carousel aspect of the allegory was a gift to a curious composer like Mazzoli. “I’ve always found fairground sounds creepy,” she says.

“I’ve incorporated merry-go-round music into the score. There’s a section where teenagers transform an abandoned movie theatre into a rave; for that part I worked with two DJs to create an electronic part that the orchestra will play along with.” 

Other unusual sounds come from an autoharp, a strummed string instrument, which adds an otherworldly hum.

Although The Galloping Cure traces the specifics of the opioid crisis, the opera is “about addiction more broadly”, concludes Mazzoli. “It could be to alcohol, food – these things we struggle to shake that are all essentially cures for pain.”

The Galloping Cure is performed by Scottish Opera on 9, 11, 12 August at Festival Theatre, Edinburgh

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