Dopesick - Beth Macy Page 0,59
proof that borders were impotent in the face of the drug. The weed-killer Roundup may cure your front yard of crabgrass, but if your next-door neighbor’s lawn is infested with it, those weeds will eventually creep back into your turf.
During the six months Lutz was away from his usual drug beat, heroin exploded in his tiny, bucolic community—three people died of overdose, and the hospital would soon report its first opioid-dependent baby. “How it transformed from a pill problem to a heroin problem here, it was like cutting off and on a light switch,” Lutz recalled.
Local deputies had yet to identify the supplier of the dope. But an informant helped them zero in on people close to the dealer, including Smith and Butler, who were the eyes and ears of a major heroin supplier Lutz knew only by his nickname: D.C.
In late 2012, D.C. was more rumor than reality, a malignant but murky force. A few counties to the east, an associate of D.C.’s selling heroin in Stafford County went by the nicknames Sunny and New York. In between the new heroin hot spots, local police were also noticing a spike in drug arrests and shoplifting.
Lutz called in federal reinforcements when he heard that D.C., whoever he was, was in the habit of demanding sex from female addicts before he’d sell them their dope. Informants said at least one was a teenager. Lutz was also beginning to see former classmates hijacked by the drug—farmer’s kids, football stars, many of them still managing, somehow, to get up and go to work. One woman he knew was in the habit of kissing her husband goodbye in the morning, putting her kids on the school bus, then driving to Baltimore to buy enough to last the day before returning to Woodstock just as the school bus brought her kids home.
Though Lutz had made his first undercover heroin buy in 2010—at a price twice the current going rate—Woodstock was now, three years later, beginning to fall prey to what economists would label the diseases of despair. Whereas central Appalachian communities like Lee County—victims of factory and coal-mine shutdowns, followed by skyrocketing disability claims that made them prime sales targets for Big Pharma—had been battling opioid addiction since OxyContin’s 1996 release, Woodstock and similar small towns were slower to experience deaths related to opioid addiction, alcohol-related liver disease, and suicide. They seemed to be somewhat shielded because their economies, while not exactly robust, had maintained a centuries-old agricultural base and were never dominated by a single industry or two like so many smaller Appalachian counties where pill abuse first took root.
“The places with the lowest overdose mortality rates tend to be in farming-dependent counties” with a more diversified economy, said Shannon Monnat, a Syracuse University professor. She likened Woodstock to her hometown of Lowville, New York, a village near the Adirondacks that’s economically dependent on dairy farming, wood products, and a wind farm that generates about $3.5 million a year for the local school district.
Compared with Lee County at the western tip of Virginia, Woodstock and other rural communities like it displayed far better indicators of health: Fewer residents smoked, fewer were uninsured, and drug-related mortality rates were much lower than in places where single, labor-heavy industries like coal and furniture once dominated.
More significantly: The opioid-prescribing rate in the Woodstock region was almost half the state’s rate—and less than one-third the rate of opioid prescriptions in the coalfield counties. On average, every person enrolled in Medicare Part D in Lee County had been handed a whopping 10.23 opioid prescriptions in 2013, compared with just 2.96 in Shenandoah County.
As the epidemic spread from rural enclaves to cities and suburbs in the early aughts, police in Monnat’s upstate New York hometown began seeing the same trends as Sergeant Lutz: “They were saying, ‘It’s coming, we see traces, but it isn’t yet here,’” she said. “That doesn’t mean people weren’t self-medicating in other ways. It’s just that alcohol doesn’t kill you instantly like heroin and fentanyl can.”
As journalist Sam Quinones theorized in his 2015 book, Dreamland, maybe the addiction-prone people who would have succumbed to alcohol addiction in late middle age—had opiates not appeared—were the same people who were now prematurely dying of heroin in their early adulthood.
Monnat’s deep dive into rural wellness data underscored that hunch: Binge-drinking rates in the northern Shenandoah Valley were roughly the same, even a little higher, than rates for rural dwellers living in the nation’s most distressed counties and towns. But people