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In “Dopesick,” journalist and author Beth Macy takes readers to the front lines of the opioid epidemic in Roanoke, Virginia, and other nearby communities, telling the story of grieving families, exhausted medical workers and convicted heroin dealers. Jeffrey Brown reports as part of our ongoing series, America Addicted.
In her new book, "Dopesick," journalist and author Beth Macy takes readers to the front lines of the opioid epidemic.
As Jeffrey Brown reports, she outlines what's fueling a growing public health crisis that has killed more than 350,000 Americans in the last 15 years. It's part of our ongoing series, "America Addicted".
Tess Henry grew up in well-off surroundings in Roanoke, Virginia. Her mother, Patricia Mehrmann, remembers her as an honor roll student who wrote poetry at her Catholic school.
My Tess was the one who would worry every day, every day if her uniform — was this right? She was very delicate, very sensitive. She was very quiet, but yet very kind, very gentle.
In 2012, Tess first became addicted to opioids, after a prescription for bronchitis-related pain. Over the next six years, her life would spin out of control, to heroin addiction, homelessness and prostitution.
I liken it to someone you were watching just slowly drown.
Las Vegas detectives are working to find Tess Henry's killer.
Last Christmas Eve, Tess Henry's murdered body was found in a dumpster in a Las Vegas apartment complex. She was 28 years old.
People are so uncomfortable about talking about addiction, still. I know people still to this day who have shared with me that their loved one is struggling. Thank you for saying something.
But they don't want to say it out loud.
But they don't want to say it out loud. And I cannot tell you how often this happens, at least a couple of times a week.
Two years ago, journalist and author Beth Macy, a fellow Roanoke resident, met Patricia and Tess. Macy tells their story, and that of many others, in a harrowing account that traces two decades of one of the worst drug crises in American history. It's called "Dopesick."
I heard it over and over from people who were struggling with opioid addiction.
You heard that phrase?
That is the word they used. Man, I'm dope-sick, or, man, I was dopesick when that happened.
What does it mean? That means, like, excruciating withdrawal. They have sweats, diarrhea, chills, vomiting. And as somebody early on in the book says, at the end of your journey, you're not doing it to get high. You're just doing it to keep from being dopesick.
Why did you take this on?
It was just so hard, it was just so much pain to process, what these families are going through. But this was a story I started following back when I was a newspaper reporter in 2012, and heroin had landed in Roanoke, Virginia, here where I live, in a big way.
In "Dopesick," Macy focuses her reporting on communities along Interstate 81 in the Blue Ridge Mountains.
This book is really a microcosm of America told through three Virginia communities.
It begins here in the economically distressed heart of Appalachia, some four hours from Roanoke in southwestern Virginia's coal country, where Macy went to meet Dr. Art Van Zee, who in the 1990s, began to see an explosion of people becoming addicted to the painkilling drug OxyContin.
Dr. Art Van Zee:
It really was a tsunami of opioid addiction for us in our region. And it became such a huge problem because, one, it was a very high-potency opioid. And it was very easily abusable.
By 2000, Van Zee, an internist at a community health center in tiny St. Charles, Virginia, was writing desperate letters like this to OxyContin's maker, Purdue Pharmaceutical, and to the FDA, urging them to recall the drug.
Instead, Purdue continued to push it both as a beneficial painkiller, and one that could be prescribed without fear of addiction, as in this testimonial video.
We doctors were wrong in thinking that opioids can't be used long-term. They can be, and they should be.
The way that this was being marketed really was fueling the whole problem. You know, we had young people becoming addicted, going into jail, going to prison, overdosing, dying, families being torn apart. And, Purdue is giving out beach hats, OxyContin beach hats to physicians.
And, writes Macy, physicians were over-prescribing the highly addictive OxyContin. In 2007, federal prosecutors brought and won a case against Purdue's parent company at this courthouse in Abingdon, Virginia, forcing an admission that they had fraudulently marketed the drug for years.
The important thing to the families who had lost children to OxyContin overdose was they got to be here. They got to look them in the eye. And Federal Judge James Jones, who still presides over this court, got to hear their testimony.
The company paid 600 million dollars in fines, that were eventually divvied up between Virginia's law enforcement, and state and federal Medicaid programs. No company executives were jailed.
In 2010, Purdue agreed to reformulate OxyCotin, making it tougher to crush for illicit use.
They didn't recall it, they didn't do many things that would meaningfully change the trajectory of the problem until it was you know much too late.
Around this time the epidemic had already spread into more affluent communities, including in Macy's adopted home of Roanoke, where prescriptions and recreational drug use were leading dope sick teens and others to relatively cheap and easy to get heroin and synthetic opiods like fentanyl.
In middle class, upper middle class America, people had the money to hide it for longer. And so it took it longer to bubble up, and because of the stigma against it, even the parents who were in on the dirty little secret, didn't want to tell their neighbors. And so that allowed it to fester and grow for two decades before we as a society looked around and said "holy crap this is everywhere."
Patricia Mehrmann told Macy of her own daughter going in and out of rehab, of her family being torn apart by the wrenching decisions on when to offer help and when to push Tess away, for her own good and the sake of others.
I didn't know if, when, or ever, she would be able to come through this, walk through this. You never get to the other side, because there is no other side. Once you struggle with substance use disorder, you always have substance use disorder.
You do have to learn coping skills and you got to employ them so you can function.
Beth Macy devotes much of the last section of her book to the treatment of opioid addiction. In Roanoke, we watched a weekly session run by Vinnie Dabney.
You know you still got to deal with life. You still got to deal with things that pop up.
A former heroin addict himself, who's now a mental health and substance abuse counselor helping men and women in so-called MAT, medication- assisted treatment.
Dabney's program uses the prescription drug Suboxone to reduce the painful symptoms of opioid withdrawal.
I feel like you know getting on Suboxone was good for me because my cravings are so severe all the time.
It's a necessary, but extremely difficult, process, says Dabney. And many here are on their second, third, or fourth tries in the program.
All kinds of things will happen to cause a percentage of them to drop out. It's a numbers game. You know, the more that try, the more that will make it. The fewer that try, the fewer that will.
And Macy writes of the continuing national divide over treatment approaches.
Well, you have a lot of rehab centers that don't believe in medication-assisted treatment. They believe in abstinence only. So, you have — you have a lot of gaps in care, in general, and then you have a lot of ideological divides at work as well.
Beth Macy's "Dopesick" is a haunting, unfinished story of over-treatment for pain, and under-treatment for the addictions that follow.
Epidemiologists don't even think we're anywhere near the peak of it yet. You know, sometime after 2020 is when it's predicted to be. So, we're not even close.
So, if we're still so early on in this, what were you trying to do in your book?
Well, I'm trying to tell people how we got here, and where the holes in this treatment tapestry. What do we need to do? I mean, I'd love to mobilize people just to care.
As the epidemic continues, Tess Henry's murder remains unsolved. Her mother hopes telling her story will help others.
I hope the legacy of my daughter's life will be that people will be able to comfortably sit down and talk about this.
For the PBS NewsHour, I'm Jeffrey Brown in Virginia's Blue Ridge Mountains.
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In his more than 30-year career with the NewsHour, Brown has served as co-anchor, studio moderator, and field reporter on a wide range of national and international issues, with work taking him around the country and to many parts of the globe. As arts correspondent he has profiled many of the world's leading writers, musicians, actors and other artists. Among his signature works at the NewsHour: a multi-year series, “Culture at Risk,” about threatened cultural heritage in the United States and abroad; the creation of the NewsHour’s online “Art Beat”; and hosting the monthly book club, “Now Read This,” a collaboration with The New York Times.
Mike Fritz is a video journalist and producer for the PBS NewsHour.
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