Dopesick - Beth Macy Page 0,122
with a dozen or more blooms. They are not just memorials to Scott Roth but also to the epidemic’s intractability. The young woman who bought Robin’s house had not only been addicted to heroin herself (she’s been sober now for more than four years), but her sister, twenty-seven-year-old Joey Gilbert, is the one who relapsed and died in March 2017, despite the Hope Initiative angels’ herculean efforts to help her. Had Joey had access to Medicaid health insurance and a clear path forward for continuing her MAT, her family firmly believes, she’d be alive today.
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In the early fall of 2017, I sat down again with the Hope Initiative director, Janine Underwood, Bobby’s mom, who grew more despairing by the day. All the overdoses and all the deaths—none of it seemed to inspire more awareness of the tragedy or its toll on families, many of whom were still cowering in shame.
Bobby’s old friends continued showing up to Hope every week. Some had been using for almost a decade, and “they are so, so very tired of the way they’re living,” Janine said, and yet they were so equally afraid to give it up.
One friend, a thirty-year-old man, had broken down when he realized Janine was Bobby’s mom. Though his mother had driven him to the Hope clinic from the suburban ranch-house-turned-meth-lab where he now lived, she was so ashamed that she waited outside in her car.
Betsy (not her real name), a young woman who had once babysat for Bobby’s sister, showed up recently at Hope, too, determined to get sober. But by the time Janine and Hope volunteer Nancy Hans went to her home to help arrange a transfer to detox, Betsy was nodding out. During a brief coherent moment, she pulled out her Hidden Valley High yearbook, pointing to a homecoming-dance picture of herself and her friends: Three of the five were now active heroin users, she said, her voice slurring as she spoke.
Then, abruptly, she pointed to the window. “Look, it’s raining,” she said. “That’s Bobby looking down on us.”
Nancy and Janine made dozens of phone calls to get Betsy into the community services board-run detox. Janine even drove her to the facility, but it wasn’t yet providing buprenorphine for detox, and Betsy left after just twelve hours, saying she couldn’t take the pain of being dopesick.
By the time the women lined up a facility that would allow her to be on MAT, Betsy had fled to New York, partly to avoid an upcoming court date for drug charges. A few days later, she overdosed on fentanyl-laced heroin in Central Park, where EMS workers revived her and let her go. The last Janine heard from Betsy, she had taken off for New Jersey, where she was now presumably trading sex for drugs.
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Unlike the Tennessee Tri-Cities collaboration that had birthed Overmountain, Roanoke had not created a working group to transcend bureaucratic logjams, but perhaps in time it would. Nonfatal overdoses in 2017 had more than doubled the previous year’s count, and fatal overdoses had nearly tripled (and those figures were likely an undercount).
At a sparsely attended public forum at Tess’s alma mater, police recounted the August 2017 seizure of 4.4 pounds of fentanyl along I-81—enough for 1 million fatal overdoses. They’d also recently arrested a Cave Spring High graduate attempting to sell 700 “Xanax bars” at the local community college that contained fentanyl he’d mail-ordered via the dark web from Hong Kong.
Ronnie Jones was right again: Shit had not stopped at all, but with continued regional-media cutbacks—the Roanoke Times was down to just a single Roanoke Valley police reporter, and there were now sprawling heroin-ring prosecutions that received zero media attention—the public was left to believe that it had.
Warren Bickel, the world-class addiction researcher, had just nabbed a $1 million grant for his Virginia Tech Carilion Research Institute to pilot new MAT protocols for the streamlining of ER-to-outpatient transfers: Patients who overdosed would be directly connected to outpatient buprenorphine via a newly FDA-approved once-monthly injection called Sublocade. Bickel had recently lost a family friend to overdose. The young man had been taking Suboxone, but when he tested positive for additional opioids during a follow-up visit, his doctor cut his Suboxone dosage back as punishment. “What he needed was an increased dose, not less,” Bickel said. When I told Bickel that Tess was still living homeless on the streets of Las Vegas, paying for illicit drugs with sex work, he called up a study he’d coauthored in 1988, showing that buprenorphine