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Over the course of their career, journalist P.E. Moskowitz has written about everything from Curb Your Enthusiasm to trans hype houses. But their latest and most ambitious project—the book Breaking Awake: A Reporter’s Search for a New Life, and a New World, Through Drugs, which is out now from Simon Schuster—shares the most DNA with their popular newsletter, Mental Hellth, an examination of the limitations of current medical and self-help modalities. Its tagline? “You’re not crazy, the world is.”
The same thesis undergirds much of Breaking Awake, which moves seamlessly from Moskowitz’s own experience with drugs of various sorts to their traumatic experience living through the 2017 attack on Charlottesville and their reporting on how people around the United States and beyond form and maintain relationships with a kaleidoscope of prescription and illicit drugs in their day-to-day lives. This week, Vogue spoke to Moskowitz about rebuilding in the wake of a breakdown, critically evaluating America’s drug culture without veering MAHA, and what they feel is most commonly misunderstood about their work.
Vogue: How are you feeling ahead of pub day?
P.E. Moskowitz: I’m excited for it to be out, but I’m nervous. It feels like pre-party jitters, where you’re convinced nobody will show up to your birthday party, even though you know they will.
What’s the most significant preconception you had about drugs that shifted while reporting for this book?
I think that I was very caught in the moralizing nature of how we talk about drugs for a long time. I’ve spent a lot of my life doing drugs. I did way too much cocaine when I was 15, and I have been on various mental health drugs, like SSRIs and Adderall, but I always had this feeling of, Well, XYZ drug is bad because it’s illegal, and XYZ drug is good because it’s prescribed to me, and I always felt guilt about my drug use. I think the thing that’s changed with this book is just realizing that drugs are tools like anything else, at the end of the day, and like pretty much any tool, they can be used for good or bad. That means that prescription drugs can be very good for people or they can harm people, and it means that illegal drugs can, in some ways, be good for people or helpful. I think the TLDR is that I still have many complicated feelings about various drugs, but I’ve started to unlearn the moralizing lens through which society looks at drugs.
Your writing about the breakdown you experienced after Charlottesville is so vivid. What do you wish more people understood about putting yourself together in the aftermath of an event like that?
I think we’re all kind of breaking down right now, in various ways [laughs], but I think the reason I wanted to write this book is that the kind of terror I experienced in Charlottesville—almost dying and having this trauma in such a direct way—is such an obvious version of the kind of violence of the world right now, and the violence of white supremacy and capitalism and all the rest. But I think there’s so many less obvious ways in which people are kind of infected by the violent energy of our society. The inability to take space for mental health; the fact that we don’t have sufficient health care, so most people can’t really afford a good therapist or are isolated from our community—all that causes a kind of despondency among so many people.
I think the first step for rebuilding yourself after a breakdown is to realize that you’ve had a breakdown, because you might not even realize it, right? I think a lot of people are are discouraged from even recognizing that they’re struggling, or that the material world around them is the reason they’re struggling. It’s not just something in their brains. It’s not just like, Oh, you’re prone to depression or anxiety or whatever because of your genetics. It’s like, we’re all fish swimming in the same polluted pond, and I think often what we do is we remove the fish from the pond and give it medicine and then throw it back into the polluted pond. I feel like that’s why we all treat mental health in this very individualistic way, without realizing that even if we all have varying stories and varying traumas and whatever, that the root problem is the same for all of us.
And so I think one of the kind of beautiful things about healing, if it’s done in the right way, is that it helps you realize that you’re not alone. If you realize that your problems aren’t individual, or that they are caused by the same thing as so many other people’s problems, I think that gives you—or at least it has given me—this much more tight relationship to my friends, my community, my family, and it has given me much more hope about the world, because I realize that we’re all in the same boat together.
Are there any advancements in drug policy you discovered during the research process that made you genuinely hopeful?
Not really. [Laughs.] There’s been lots of really good moves towards that kind of stuff, like I report in the book about activists in Vancouver who were doing this study called the Compassion Club, where they would sell the drugs that people were were using on the streets of Vancouver, like heroin and meth, but they would sell them in very regulated ways, where they were keeping track of people’s health, testing the drugs to make sure they were 100% pure and not contaminated with things like fentanyl, and it was working. It was keeping people from overdosing. It was keeping people alive. That, combined with lots of other things we’ve seen across the US and the world in terms of drug-testing and safe injection sites, all these things are really good signs, but to start off with, they were never enough, you know? They don’t really address the root problem of why people use so many drugs and use drugs so dangerously. And that’s because people are in an immense amount of physical and emotional pain, right? So no matter how safe you make the drugs, that’s not going to solve that original problem.
And what happens with the harm-reduction movement is the same thing that happens with everything, which is the government giving it temporary support and not enough funding, and then it doesn’t work as well as people want it to, and then they declare it a failure, and then they break it all up. So I think, unfortunately, that’s the era we’re in now—the same as with education and science. You underfund it, you undercut it, and then you declare it a failure, so that you can then destroy it. So I think, unfortunately, we’re in this kind of reactionary backlash to the very simple idea of seeing drug users as people who deserve to live.
How do you toe the line of talking about the very real dangers of overprescription and cultural drug reliance without veering MAHA?
I mean, that’s something I constantly think about, because unfortunately, MAHA has taken over the discourse about all this stuff. I’m old enough to remember the ’90s, when being skeptical of the motivations of prescription drug companies and being skeptical of our corporate-controlled food system was a very left-wing-coded thing, right? And I think unfortunately, because RFK Jr. and the MaHA crowd have taken up that mantle, they’ve kind of poisoned the well for everyone else. [People] see the truth. They know the food we’re eating is laden with chemicals. They know that the drugs we’re being given, while they can be helpful frequently, aren’t enough, or they have side effects, or whatever; those are all just factual things that anyone can see. But then when you Google around asking about that stuff, it’s now just completely been captured by the right. So that’s part of the reason I write about what I write about. I want there to be a perspective and information from the left, or whatever you want to call it. I’m not anti-medication and I’m definitely not anti-vaccine, but I’m anti-the corporate control of our scientific medical-industrial complex that gives us not enough options, that gives people bad information, that hides negative information about any of their products. I think it’s just important to be out there speaking about these things, so that it’s not just all these crazy people doing it.
What do you think will get people the most mad about your book?
Well, I think the antidepressants and prescription drugs sections in general. People sometimes see my take as this very black-and-white, “never get on a prescription drug, psychopharmaceuticals are evil” idea, and I’ve never said that. I think my point has always been that these things are tools that can help most or many people, and they’ve also harmed many people. Even if they help people, it’s not enough; to go back to the polluted-fish thing, which I know is a bad metaphor, sorry, but it’s like, giving someone an SSRI might help them, but it’s not addressing the root cause of the problem, which is that we’re in this world that constantly traumatizes us and isolates us and makes us sick and sad and anxious all the time. And so that’s the danger, I think, of an overreliance on these things, is that it kind of distracts from the larger problem. If there’s a plant down the street in your neighborhood causing cancer, the solution is not to just individually treat everyone’s cancers, it’s to shut down the factory that’s doing that, right?
Also, I think the general thesis of the book might be a tough pill to swallow, because the thesis is kind of that we’re all in the same boat. The heroin user on the streets of Vancouver and the suburban mom taking a litany of prescription medications are obviously in different circumstances; one is more privileged than the other. But the use of drugs of any kind for your brain is to ameliorate the pain that you’re feeling, whether that pain is physical or psychological. And so I think to me, it’s really important to show these connections between these things where we often think we’re in these very unique situations. We like to see ourselves as all separate, because we don’t want to think of the world’s issues as all kind of applicable to us. We’d rather just see it as something we can manage within our own personal lives.
Is there a main thing you hope readers take away from your book?
I think, in addition to the “we’re all in this together” thing, I want people to know that there’s no one right answer for dealing with any of this. I write in the introduction about this narrative that’s forced upon all of us in our healing journeys, where you feel depressed or you feel sick or traumatized or whatever, and then you find the right therapy or the right medication, and then you’re better and you’re healed. And I think that’s a very limiting narrative, because sometimes you just have to get weird with it and throw shit at the wall and see what sticks. Try various medications, you know, try different forms of therapy. Don’t assume there is one solution to your problems.
The last section of my book is about rave culture, and while I don’t think raves are inherently radical or something, I think the potential of being on ketamine at a club next to a bunch of other people is that you kind of realize how important being with other people is, and how ecstatic that can make you, and how much the world prevents us from having experiences like that. And I think if you can just experience for a moment the kind of joy of that kind of situation, it gives you something to fight for in the future—like your community, your friends, your family—instead of just fighting against things all the time. These are legitimate things to fight against—you know, police brutality, imperialism, et cetera—but there will only be a sustainable way forward if we have other people that we love deeply to fight for.
This conversation has been edited and condensed.
