Dopesick - Beth Macy Page 0,126

the streets: “This feller up here’s got this new stuff he’s selling. It’s called Oxy, and he says it’s great.”

“We enabled her,” said Ashlyn Kessler’s grandmother, Lee Miller, who is raising Ashlyn’s young son while Ashlyn finishes a federal prison sentence for heroin distribution. A paralegal with a degree from Jerry Falwell’s university, Ashlyn was one of the region’s top drug mules, making the trek from Roanoke to New Jersey three, sometimes four, times a week.

Jamie Waldrop, a surgeon’s wife and a recovery coach, had two children who became addicted, first to pills, then to heroin. “Until they go off to rehab, you don’t realize just how dysfunctional your life has become.”

When her twenty-eight-year-old daughter, Tess, checked herself out of a Nevada treatment program, Roanoke nurse Patricia Mehrmann tried desperately to track her movements, including via Facebook Messenger, to prostitution websites featuring her daughter. “There is no love you can throw on them, no hug big enough that will change the power of that drug.”

Still raw in her grief—her son Bobby had been dead only six months—Janine Underwood could draw a detailed mental map of the treatment landscape, from health care privacy hurdles to instructions on what to do the moment you realize your twenty-one-year-old is injecting heroin. “I’m in health care, and there were just so many things I didn’t know,” said Underwood, the administrator of a free clinic for the working poor.

In 2016, psychologist Cheri Hartman teamed up with Jamie Waldrop and Janine Underwood as well as local police officers to try to divert Roanoke users from jail into treat-ment. Hartman and her husband, psychiatrist Dr. David Hartman, battled bureaucratic logjams, political indifference, and stigma concerning the use of buprenorphine to treat opioid-use disorder.

After her son Spencer’s conviction for heroin distribution made front-page news in 2012, prominent Roanoke jewelry store owner Ginger Mumpower became a de facto counselor to worried parents, some of whom drove two hours just to talk to someone about their children’s addiction to heroin and pills. (Photograph by Josh Meltzer)

Substance-abuse counselor Vinnie Dabney had been a mostly functioning heroin user for three decades before court-ordered treatment in the late 1990s put him on the path to sobriety. “The moment [heroin] crossed those boundary lines from the inner city into the suburbs, it became an ‘epidemic.’ But nobody paid any attention to it until their cars were getting robbed, and their kids were stealing their credit cards.”

Sergeant Brent Lutz spent nights, holidays, and weekends surveil-ling a heroin ring that was operating out of a poultry plant on the outskirts of Woodstock, Virginia. “How it transformed from a pill problem to a heroin problem here, it was like cutting off and on a light switch.”

ATF agent Bill Metcalf spent the bulk of 2013 relentlessly investigating members of what was then one of Virginia’s largest heroin rings, a conspiracy that federal agents informally named “FUBI.” “Man, this reminds me of The Wire,” he told Lutz late one night during a surveillance operation.

Wise County, Virginia, EMT Giles Sartin made the deci-sion to train for emergency medicine the day he was sit-ting in a freshman English class and heard the double thump of two classmates seated behind him hitting the floor. “Last week I Narcanned the same person for the fourth time. There’s communities where we’re like the ice cream truck.”

In her mobile Health Wagon, nurse practitioner Teresa Gardner Tyson and her grant-funded staff of twenty are largely left to tend to the health needs of the uninsured in Virginia’s coalfields. During repeated attempts to gut the Afford-able Care Act in 2017, Tyson grieved for her patients who were dying due to untreated hepatitis C caused by IV injection of opioids and Virginia’s repeated failures to expand access to Medicaid.

Of his 1993 Lee County (Va.) High graduate class of two hundred students, A. J. McQueen said more than half were either in prison or battling addiction. “We have to wear rubber gloves now when we make arrests,” the drug detective said.

In 2017, public health professor Robert Pack and Dr. Steve Loyd led a coalition to open Overmountain Recovery, a center offering methadone and other treat-ments in the conservative rural community of Gray, Tennessee, where opposition was fierce. This collaboration among a university, a regional nonprofit hospital, and the state’s mental health agency represented one of the strongest models I witnessed for thwarting governmental rigidity and indifference to turning back the crisis.

Acknowledgments

This book stands on the shoulders of several important works about the opioid crisis that came before it: Barry

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