of Heroin,” American Journal on Addictions, April 2, 2010.
“I won New Hampshire because”: Donald Trump explaining why he won the Republican primary in New Hampshire (though he did not win the state’s general election), from Liam Stack, “Trump Called New Hampshire a ‘Drug-Infested Den,’ Drawing the Ire of Its Politicians,” New York Times, Aug. 3, 2017.
most Americans support federal financing: “Public Ranks Children’s Health Insurance, Marketplace Stabilization Higher Priorities Than ACA Repeal,” Kaiser Family Foundation poll, Sept. 22, 2017. The poll found that Medicaid and Medicare buy-in ideas are more popular than single-payer, which was affirmed by 54 percent of those polled. Data analysis from Eric Levitz, “America Is Not a ‘Center-Right Nation,’” New York Times, Nov. 1, 2017.
to court nonwhite voters, including Hispanics: U.S. Census Bureau, “Voting and Registration in the Election of November 2016,” released in May 2017.
“You’ve got too many leaders just not responding”: Author interview, Bryan Stevenson, July 12, 2017.
“really bad for you”: Aubrey Whelan and Don Sapatkin, “Advisers: Trump Won’t Declare Opioid Crisis a National Emergency,” Philadelphia Inquirer, Aug. 9, 2017.
A few days later, he seemed to change his mind: Brianna Ehley, “Trump Says He Will Declare Opioid Crisis a ‘National Emergency,’” Politico, Aug. 10, 2017.
the so-called emergency was retrumpeted: In ninety-day increments, federal agencies could more freely use existing money to mitigate the crisis, and Trump’s aides pledged that eventually Trump would release more money for treatment: Julie Hirschfeld Davis, “Trump Declares Opioid Crisis a ‘Health Emergency’ But Requests No Funds,” New York Times, Oct. 26, 2017.
seven Americans were dying of overdose: Zachary Siegel, “Where Are the Opioid Recovery Activists?,” Slate, Oct. 29, 2017.
The Obama administration had also been slow: Author interview, Acker.
One-third of children in central Appalachia: Lori Gates-Addison, area prevention council director, quoting Kids Count data, presentation for Taking Our Communities Back, Big Stone Gap, VA, May 23, 2017; and author interview, Gates-Addison, May 23, 2017.
96 percent of the adopted kids: Author interview, Welch.
“Repeats”: Author interview, Giles Sartin, May 24, 2017.
DEA recommended that first responders wear: iaclea/visitors/PDFs/Fentanyl_BriefingGuide_June2017.pdf.
“already happened here to us”: Gates-Addison, presentation for Taking Our Communities Back.
study forecasting the epidemic’s spread: Jeanine M. Buchanich, Lauren C. Balmert, and Donald C. Burke, “Exponential Growth of the USA Overdose Epidemic,” doi/10.1101/134403. The study is critically lauded though not yet peer-reviewed, as outlined in Jeremy Berg, “Modeling the Growth of Opioid Overdose Deaths,” Science, June 5, 2017.
“more disturbing is the pattern”: Author interview, Don Burke, May 30, 2017.
predicting the toll would spike to 250 a day: Max Blau, “STAT Forecast: Opioids Could Kill Nearly 500,000 Americans in the Next Decade,” STAT, June 27, 2017.
“Don’t mess with this shit”: Author interview, Robert Pack, Aug. 25, 2017.
2.6 million Americans who are already addicted: Of the 20.5 million Americans with a substance use disorder in 2015, 2 million had prescription opioid-use disorder, and 591,000 were addicted to heroin: Results from 2015 National Survey on Drug Use and Health at samhsa.gov/data/.
residents of two rural Virginia towns: CDC statistics ranked Martinsville, VA, first for opioid prescribing and Norton, VA, second, using 2015 statistics. Andrew Joseph, “More Opioids Were Prescribed Here Per Person Than Anywhere Else in the U.S.,” STAT, July 7, 2017, using data from this CDC report: cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm?s_cid=mm6626a4_w.
It was in their Highpower clinic: Among the patients who explained the practice to me were Crystal Street and Debbie Honaker; author interviews, March 16, 2016, and in follow-up phone calls.
“Our wacky culture can’t seem to do”: Author interview, Dr. Marc Fishman, May 9, 2017.
a slim minority of opioid addicts: Ibid. Half of buprenorphine patients drop out within six months of beginning MAT, and poor outcomes often follow dropout, according to Kathleen M. Carroll and Roger D. Weiss, “The Role of Behavioral Interventions in Buprenorphine Maintenance Treatment: A Review,” American Journal of Psychiatry, Dec. 16, 2016.
only three had managed not to become: Author interview, Susan (real name withheld to protect job prospects), May 22, 2017.
“The loss is tremendous”: Email to author from Sister Beth Davies, Oct. 13, 2017.
Van Zee told me his greatest fear: Author interview, Van Zee, June 25, 2016.
I stood in the low light: Author interviews, maintenance director Tim Allen and Dr. Jessie Gaeta, Boston Health Care for the Homeless Program medical director, who designed SPOT over the objections of several community groups; June 23, 2017.
Judge Michael Moore’s hair had turned: Author interviews, drug court judge Michael Moore, March 16 and April 1, 2016, and June 20, 2017.
studies showed kids were more likely to use: Multiple studies showed that DARE was ineffective, including a GAO report: Christopher Ingraham, “A Brief History of DARE, the Anti-Drug Program Jeff Sessions Wants to Revive,” Washington Post, July 12, 2017.
Neil Smith thought they were the grandchildren: Author interview, Russell County bailiff Neil Smith, June 20, 2017.
“The more we talk about the epidemic”: Author interview, David Avruch, Nov. 1, 2017.
“The answer is always community”: Author interview, Sue Ella Kobak, March 13, 2017.
former nursing home into a rehab: Author interview, Bob Garrett, July 5, 2017.
treatment clinic called Overmountain Recovery: Author interviews, Pack, Dec. 16, 2016, and July 5, 2017, and follow-ups via email and phone.
a mighty resistance on its march: Dr. Stephen Loyd, as featured in the documentary The Gray Area, by David Floyd, available at youtube/watch?v=qGQy0NcnK2Q&feature=youtu.be.
Loyd knew exactly how to explain himself: Author interview, Loyd, Aug. 25, 2017.
via an app on his cellphone: The app prompts Loyd to check in daily for the possibility of a random drug screen. He is drug-tested at least four times a year.
repeated overdose reversals were: Corky Siemaszko, “Ohio Sheriff Says His Officers Won’t Carry Narcan,” NBC News, July 7, 2017.