‘Dopesick’ examines denial and America’s opioid crisis

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Beth Macy’s DOPESICK: Dealers, Doctors, and the Drug Company that Addicted America

Editor’s note: Make sure to check out Steve Mitchell’s interview with ‘Dopesick’ author Beth Macy here.

There are always those who can see the storm coming. No one listens to them. The classic Cassandra, they walk the battlements bemoaning the impending future. People like rural Virginia doctor Art Van Zee, and Sister Beth Davies, a five-foot-tall activist nun, were sounding the alarm as early as the mid 1990’s. They were working in Appalachia, where mills and mines were closing down and many doctors had been notoriously loose with their prescription of opioids for pain. Van Zee and Sister Beth were seeing the birth of an epidemic and they knew it.

There are a number of ill-conceived cultural perceptions at the heart of America’s delusions about its own drug problems. Some are ideological: the belief that only ‘the wrong kind of people’ get involved with drugs, the belief that addicts could quit if they really wanted to, the belief that punishment will somehow deter drug use. As a nation, we conflate morality with health care, making judgments about how people get sick, then often deciding on that basis whether or how to treat them. As a nation, we cling to the myth that everyone has an infinite array of choices, that anyone can change their life by making the right decisions.

Beth Macy’s bracing DOPESICK: Dealers, Doctors, and the Drug Company that Addicted America plunges us into a world where even ‘the right people’—teenage white students from upper class homes in Roanoke, Virginia—quickly lose any ability to choose as they become locked in a cycle of addiction.

Beth Macy

Macy traces the advertising and sale of opioids from the 1880s to the mid ‘90s when Purdue Pharma began hawking OxyContin as a safe, nearly addiction free treatment for pain. Purdue Pharma marketed Oxy relentlessly to doctors for years, at all times both denying its potential for abuse and laying responsibility for that abuse on the addicts themselves. In a 1996 company training session, Dr. J. David Haddox, Purdue Pharma spokesman stated that physician caused addiction was ‘exquisitely rare.’

Dr. Van Zee and Sister Beth knew they were wrong.

They knew about people like Debbie Honaker. In the early 2000’s, Debbie was released after routine gall bladder surgery with a 30-day prescription for OxyContin. At the end of that 30 days, taking the drug as prescribed, she was addicted. Within weeks of using, addicts are no longer taking the drug for the euphoria, Macy explains, but simply for relief from dopesickness, the body’s physiological response to going without the drug. Debbie Honaker found she would do anything to stave off dopesickness.

Meanwhile, sales representatives from Purdue Pharma sponsored free trips for doctors and their families to Florida and Arizona, gifting them with blue OxyContin ball caps and visors. Big Pharma shipped over nine million hydrocodone pills to a single pharmacy in Kermit West Virginia, a town of just 392 people.

“Sales Rep bonuses were growing exponentially, from $1 million in 1996, the year OxyContin hit the market, to $40 million in 2001. New patients were given OxyContin ‘starter coupons’ for free prescriptions—redeemable for a thirty-day supply.”

Macy traces the spread of Oxy from the Big Pharma boardroom to the plowed fields of a Virginia community where a 75-year-old retired miner is found dead in a truck, having sold everything he owned, and stolen from his family, to support his recently acquired habit. She talks with law enforcement, judges, doctors, lawyers, nurses, and rehab workers, but the epicenter of DOPESICK is Hidden Valley, an upper-middle-class subdivision in Roanoke. It’s here that she finds a new kind of community impacted by prescription drug use. These are the stories of parents, mostly mothers, whose children are lost to the drug epidemic; lost because they are addicted or in jail or lost because they are dead.

Many of the students at Hidden Valley High—the children of surgeons, lawyers, community leaders—were already acclimated to the use of prescription drugs. They were taking, and trading, pills for ADHD, depression, even pain from sports injuries. Tess Henry was a high school track and basketball star, an honor roll kid, the daughter of a surgeon and hospital nurse and, by high school, she was addicted to prescription drugs. One day, someone tells her: ‘Try this—it’s cheaper and a lot easier to get’ and she snorts heroin for the first time.

For years, Beth Macy doggedly follows the story of Tess, who drifts in and out of rehab and the courts, and her mother Patricia Mehrmann, who walks the shifting line, day to day, that separates caring from enabling. We meet other students and their parents: Jesse Bolstridge, a high school athlete who dies from an overdose at 19, and his mother Kristi Fernandez. Scott Roth, who dies from an overdose sold by Spencer Mumpower, the son of a Roanoke business woman and community leader, Ginger Mumpower. We follow Spencer as he goes to prison.

DOPESICK is a high wire act, balancing the stories of families ravaged by drugs, desperately struggling to pull a loved one free of addiction, with a nuanced exploration of how opioids are legally marketed and sold and the transition, by economic necessity, from prescription drugs to illegal ones. Macy doesn’t turn away from the moments of heartbreak nor the heartbreaking moments of hope, displaying a dogged empathy for every person working or living on the front lines of the epidemic. She brings a clear eye for journalistic detail and a searching humanity to her account of the people who turn to crime to avoid dopesickness, their families, the doctors, police officers, court officials, all locked in their own way within the cycle of addiction.

“One of the reasons people stay so hopeless about the epidemic is that, in any given episode, they only see a small proportion of people get into remission,’ Harvard researcher John Kelly told me. ‘What happens is, it takes about eight years on average, after people start treatment, to get one year of sobriety…and four or five different episodes of treatment’ for that sobriety to stick.”

DOPESICK details, in horrifying fashion, the manner in which drugs, both legal and illegal, are a business, addiction is a business, rehabilitation is a business; businesses which sometimes help those they are meant to, but more often than not abandon or punish them once they run out of money. It explores the complex crisis Dr. Van Zee and Sister Beth envisioned in the mid-90’s. It engages crucial national questions around healthcare, social support, and political will and it does so with the stories of real people who might be our neighbors.

Tess Henry, addicted for many years, in and out of private rehab facilities like Carilion paid for by the dwindling savings of her parents, returns home to Hidden Valley to stay with her mom for a recent Thanksgiving. She has a two-year-old son who has been removed from her care by the courts. She might be living on the streets, it’s hard to know. Patricia often looses track of her for months at a time.

Patricia and Tess talk about Christmas and make plans to visit her son. A week after Thanksgiving, Tess disappears again, leaving a note for her mother on the kitchen counter.

“Gone to Carilion. Mental Breakdown. I LOVE you so much mom. You are my everything. I want to get better & I won’t stop trying.”

DOPESICK will enrage you and bring you to tears, often on the same page.

About Beth Macy: Beth Macy was a journalist for the Roanoke (Va.) Times and is the author of two best-selling non-fiction books. Factory Man is the story of the havoc caused by globalization in the American Furniture industry and the efforts of John Bassett III to resist the outsourcing trend and save jobs in his community. Truevine: Two Brothers, a Kidnapping, and a Mother’s Quest: A True Story of the Jim Crow South tells the remarkable true story of George and Willie Muse, two African-American brothers kidnapped from a field near Roanoke, Virginia and forced to work in a sideshow because they were albinos.

—Steve Mitchell is the author of Cloud Diary, a novel, and The Naming of Ghosts, a collection of short stories. He is co-owner of Scuppernong Books in Greensboro, NC. You can find him at www.authorstevemitchell.com