Friends of overdosing users commonly chuck them into the bathtub and try to revive them with ice or cold water, to avoid having to call 911, which could draw police to the scene, along with criminal charges. One police officer I know showed up to an overdose call to find an unconscious man on the floor, a frozen fish on his neck, a frozen bottle of soda shoved into his pants, ice all over the floor—and the user’s friends long gone from the scene.
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In a region of just over a quarter-million people, a blue-dot Democratic stronghold in the center of a hilly rural red, Roanoke is a smallish city, transformed in the mid-1880s into a gritty railroad town and now, more than a century later, striving to become a health care, neuroscience, and medical-research hub. “We’re really going from Train City to Brain City,” a city manager recently enthused.
But Roanoke retains its safe, small-town feel with an almost Mayberry level of friendliness. Shortly after I moved here in 1989, a grocery store clerk picked up my bag of shiitakes and cheerfully wanted to know, “Lordy, what are you fixing with these?” A neighbor and journalist friend who spent the bulk of her career in Philadelphia still chuckles when I lock my doors. She used to lock her doors in Philly, but here in Roanoke she travels for days at a time and leaves her house wide open.
“The opioid epidemic is an urban story, a suburban story, and a rural story,” said Dr. Jennifer Wells, a Roanoke addiction specialist who has patients from each of these demographics, including one mom with five kids in a countryside trailer and no running water who somehow manages to make it to her group therapy meetings every week.
“Roanoke is just big enough where all the stories meet.”
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The skin-popping weathermen represented Roanoke’s first wake-up call. But it was wrongly viewed, by myself and other area journalists, as an anomaly. The story was so tawdry that the Roanoke Times assigned two beat reporters to track it, one from courts and the other from media and entertainment. It received much more attention, for instance, than the national story that broke in our backyard when Purdue Pharma settled with the feds a year later.
Before the weathermen incident, heroin had been the domain of police and court reporters in Roanoke, widely believed to be an inner-city (read: black) drug. “In the ’80s and ’90s, maybe a few dozen people were doing heroin here,” said Don Wolthuis, the assistant U.S. attorney who became one of the federal government’s top heroin prosecutors in the state’s western half. “Because heroin is a depressant, people kind of withdraw; they go in a corner, shoot up, and sit there in the dark, in a fetal position. They weren’t out there committing crimes like with crack or meth. It was a largely invisible and isolated group.”
It was common knowledge back then, among the handful of mostly African-American heroin users and dealers in Roanoke, “that you don’t sell heroin to white people because they’ll turn you in,” as Wolthuis put it. In the mid-2000s, it was also common knowledge that the stronger and more dangerous the heroin, the more users yearned to have it, as Roanoke addiction researcher Warren Bickel, then working in Baltimore, described it.
“Herr-on is my girlfriend,” one of his patients told him, adopting the street pronunciation for the drug popular among African-American users. He’d come to Bickel’s lab with track marks on his neck—all his other veins were spent.
And what this patient wanted Bickel to know was no different than what the Lee County farmer meant when he told his doctor how OxyContin had stolen everything from him: Nothing’s more powerful than the morphine molecule, and once it has its hooks in you, nothing matters more.
Not love. Not family. Not sex. Not shelter. The only relationship that matters is between you and the drug.
Bickel went on to scientifically quantify the indifference of the typical opioid user, comparing the average nonaddicted person’s perception of the future—calculated to be 4.7 years—against an addicted user’s idea of the future, which is just nine days.
The first time I interviewed him, in 2016, Bickel said he hoped to design treatment methods that would not only predict future addictive behavior among children but might also help those at risk of becoming addicted improve and extend their temporal views, therefore arming themselves against the scourge.
Though he’d won prestigious grants and awards for his groundbreaking work—he was often touted as