Dopesick - Beth Macy Page 0,95
sweaty brow, rubbed his back when he writhed in pain, and comforted him when nurses could not find a vein receptive to a medication IV. His parents sat nearby, paralyzed in their fear and unable to help. “I want to get this out of me,” John told Janine, between screams. “It’s like a demon, and I want to get it out.”
Janine had pulled strings to have John directly admitted from the hospital into detox, a rare handoff with no waiting—only to be slammed by the emotional wallop of visiting John the next day and walking the same corridor where she’d once delivered clothes to her son. “Because of his connection with Bobby, I feel like he’s listening to me, but the truth is, he could walk out any time,” Janine said. By day three of detox, John was already calling his parents and pleading over the phone, “Dad, come pick me up.”
A Hidden Valley couple, his parents were unable to direct his care or even process what was happening to him. They’d been enabling John’s addiction for ten years, supporting him and allowing him to live in their home. “They were completely frozen,” Janine said.
John’s dad, a retired law enforcement officer, told Janine he’d given many tough-love lectures to parents on the job, but when it came to his own son he was helpless, even denying that the constellation of scars on his son’s arms were track marks.
“They couldn’t even call the detox center from the hospital; they needed someone to do it for them,” Janine said.
And: “They have the disease, too.”
When it came time to discharge John from detox, a Hope volunteer working with John’s father arranged for him to fly to an out-of-state treatment center, but it was up to Janine to make the transfer work. To do that, she coaxed the detox center to keep John an extra day, then arranged for an intervention between John and his family members off-site. (Detox managers would not allow the meeting to take place there, not even in their parking lot.) “I was starting to panic; I had that sick feeling in my stomach again,” Janine said. The liminal window was beginning to close.
John’s father hired an “interventionist,” a retired cop whose job was escorting, by force if necessary, reluctant patients into treatment. Another local agency offered a conference room, and everyone involved lied to John to get him there, saying it was outpatient counseling he was signing up for on his way home, not residential care.
“I played the Bobby card,” Janine admitted the next day on the phone.
And yet it had still taken four hours to persuade John to go, the volunteer angels sighing, finally, when he got on the plane.
*
As soon as one bureaucratic gap was stitched up—and that could take days—another rip appeared. Government help was on the way in many states, but the national treatment tapestry remained a hodgepodge, divided not only along geographical but also firm ideological lines.
In late 2016, Virginia State Health Commissioner Marissa J. Levine declared the state’s opioid crisis a public health emergency, noting that three Virginians were dying every day from drug overdose and that emergency departments across the state were seeing more than two dozen overdose cases a day. Levine also issued a standing order, or blanket prescription, allowing any resident to buy the opioid antagonist naloxone (brand name Narcan), the overdose-reversing drug.
Public health officials in Vancouver were miles ahead of most of America in so-called harm reduction, a social justice movement aimed at reducing the negative consequences of drug use—without necessarily ending the use—and, more broadly, treating users with dignity and respect. The basic theory being: Users can’t get sober if they’re dead, and it’s cheaper and more humane to give them clean syringes, say, than it is to pay for HIV and/or hepatitis C treatment. Vancouver officials launched supervised injection sites where nurses stood by to revive overdosed users, fostered the free exchange of used needles for clean ones, and distributed naloxone. Sites in Toronto and Ottawa were also approved.
Several liberal-leaning American states and cities have used Vancouver as a model, including Seattle, where officials in 2017 approved the nation’s first safe-injection program for users of heroin and other illegal drugs, even though it was still illegal under federal law. In Massachusetts, where the opioid death toll now claimed five lives a day, some Bostonians carried naloxone kits, signaling their ability to administer it by placing a purple ally patch on their backpacks. Prevention workers were piloting fentanyl