Former Roanoke Times reporter Beth Macy chronicled the spread of the U.S. opioid epidemic in her 2018 bestselling book “Dopesick: Dealers, Doctors and the Drug Company that Addicted America.” Macy also helped write a Hulu series based on the book; it recently received nominations in 14 Emmy categories.
The awards ceremony is slated for Sept. 12.
Macy’s new book, “Raising Lazarus: Hope, Justice, and the Future of America's Overdose Crisis,” follows people working to combat opioid addiction. The author will discuss her latest work at 6 p.m. Tuesday at the Library of Virginia in downtown Richmond. Admission is free, but online registration is required. The event will also be streamed live on Facebook and YouTube.
The following has been edited for length and clarity.
Scribner: In “Dopesick,” you wrote about how opioid addiction has been stigmatized and criminalized in the U.S., as well as the effects that has on people struggling with addiction. Could you talk a bit about how that stigma operates?
Beth Macy: At the end of “Dopesick,” a young woman, whose story I've been following for over two and a half years, is brutally murdered on Christmas Eve. Her body’s found in a dumpster. Her name was Tess Henry.
Everybody says stigma is the number one cause of the fact that this crisis isn't getting better, and you hear it so much, you almost don't even pay attention to it. But when you look back on her story, you saw her hitting barrier after barrier. And those barriers are caused by stigma. Stigma is why we have these rules that doctors have to have special training to prescribe the treatment for opioid use disorder, when they don't have to have special training to prescribe the drugs that got her addicted to begin with.
What she said to me the first time I interviewed her back in 2015 was we need urgent care for the addicted. And she didn't know what that looked like. I didn't know what that looked like. But the new book, “Raising Lazarus,” really gives you stories about what that might be on the ground.
Honestly, I was so bereft at the end of “Dopesick,” I didn't want to write about it again. I was so kind of ticked off at the lack of urgency that our leaders had around this issue that I really wanted to write about something else. And then as I started to see what really could be urgent care for the addicted, I was like, I want to get back in. I want to write about this because I want to show that if we could only scale up what these people were doing on the ground, we could actually have a chance at turning this back.
What are people doing to combat opioid addiction as it continues to spread through American communities?
The people that I see who are doing the most to reach out to the addicted population are the ones that are meeting them where they are. Many of them now are relegated to living in tents and living unhoused, doing sex work in order to buy the dope … . It's not a fun way to be, nobody's choosing it. But that's all that rules their day.
You have this group of harm-reduction workers who are going out and meeting them and trying to help them by triaging their needs, whether that be getting them help with housing, getting them food or getting them on medication-assisted treatment. That includes giving them clean needles to stay safe and to stop the spread of HIV and hepatitis C until they stop using.
Law enforcement can play a big role, too. I have a story [in the book] about a jail that offers medication-assisted treatment, which is still very rare in America. But a lot of rules and procedures had to be changed in order to do that. And I see these people, mainly women, who are willing to kind of rewrite some of the rules. And so you have a sheriff in Fairfax County, Virginia, who has figured out that people will stop coming back to jail over and over and over if she actually helps rehabilitate them while they're in the jail.
Do you think the stigma around opioid addiction is beginning to fade?
I think it is some, but I think we're so inculcated in drug-war thinking. These things are still a crime, possession is still a crime. And so, I think we need to shift the way we see people who use drugs as people with a treatable medical condition. And too often, when people propose jail as a way to start to do that, they're seen as coddling inmates, rather than doing innovative things.
I have an example in the book from Mount Airy, North Carolina, where one good cop makes a huge difference. He decides to start diverting people from jail and into treatment, not everyone, but those who are really desperate to give it a try.
I was able to watch a woman go from operating a trap house, she gets arrested with dope. And instead of putting her away again — she's been in and out of jail and prison her whole adult life — they actually get her treatment. She just celebrated 14 months clean the other day.
