Ralph Berrier Jr. Special to The Roanoke Times
Beth Macy will never forget what Tess Henry told her the first time they met.
Henry at the time was a 26-year-old Cave Spring graduate, former basketball player and mother of a young son. She had become addicted to opioids following a routine trip in 2012 to an urgent care center, where she was prescribed 30 days of codeine-laced cough syrup and a pain killer to treat bronchitis and a sore throat. After the prescription ran out, Henry was unable to shake her addiction, and she later turned to heroin, methamphetamine and other drugs.
Rehab and treatment centers could not help her shake addiction.
“What we really need,” Henry told Macy, “is an urgent care center for the addicted.”
Macy, a Roanoke author and former newspaper reporter, met Henry in 2015 while working on her book “Dopesick: Dealers, Doctors, and the Drug Company that Addicted America,” a 2018 bestseller that chronicled the evolution of America’s opioid crisis. Henry died in 2017, just a few months before the book was published. After another unsuccessful rehab stint in Las Vegas, Henry ended up on the streets, still fighting addiction. She was murdered and her body was discovered in a dumpster on Christmas Eve.
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Henry never received the urgent care for addiction she desired.
Now, nearly five years after Henry’s death, Macy has prescribed what that kind of urgent care for drug users would look like in her new book “Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis” (Little, Brown and Company ). The book comes out Tuesday and reads as a follow-up to “Dopesick.”
The care centers around “harm reduction,” a concept that seeks to help addicted people not through 12-step programs, 30-day in-house treatment, cold-turkey abstinence or jail, but by keeping them alive with different medications, providing clean needles to lessen disease transmission among addicted people and by removing the chronic stigma associated with addiction. Those methods, Macy writes, have reduced overdose deaths in localities where they’ve been implemented.
By following a cast of real people whom she calls “warriors,” Macy gives frontline reports from the battle to keep addicted people alive. In “Raising Lazarus” — a phrase based on the Gospel story of Jesus raising Lazarus from the dead, a story favored by one of Macy’s warriors — readers are introduced to activists who provide clean needles to addicts in fast-food parking lots, operate clinics that administer buprenorphine to treat people with heroin addiction and work zealously and often off the grid to change people’s minds about how to cure America’s addiction crisis.
Their methods have been successful, but also controversial and not completely accepted in communities where drug addiction and overdoses are high.
“What I have learned in 10 years writing about this topic is that you have to meet people where they are and not be judgmental,” Macy said in a recent interview with The Roanoke Times. “You have to make the treatments easier to access than the dope.”
“Dopesick” chronicled the underpinnings of what started as a nationwide opioid crisis that evolved to include fentanyl (a synthetic opioid nearly 100 times stronger than other painkillers) and heroin, which became increasingly easier to get when opioids prescriptions and availability were cut. The book also detailed the marketing practices of Purdue Pharma, the drug manufacturer that introduced the powerful painkiller OxyContin, knowing that it was highly addictive but choosing to hide that fact from the public.
Television and film producer Danny Strong adapted “Dopesick” into a Golden Globe-winning miniseries on the streaming platform Hulu in 2021. The series is up for 14 Emmy Awards, which will be announced Sept. 12 on NBC (WSLS-TV, Channel 10). Macy served as executive producer and co-writer for the series.
“Raising Lazarus” is Macy’s effort to provide solutions to the addiction crisis, which has claimed the lives of 1 million Americans in the past two decades. The story, though, is still bleak at times, as the helpers and activists, some of whom are called “peers” because they, too, had been addicted, work with people whose lives have been wrecked by addiction.
She chronicles the work of the Rev. Michelle Mathis, who runs a faith-based harm reduction ministry with her wife in North Carolina; Mark Willis, an opioid response director challenged by resistance to his work in Surry County, North Carolina; nurse practitioner Tim Nolan; Nikki King, who established programs to help people in Appalachia, where she was born and raised (King now works in Roanoke); and others who work with addicted people.
“They are the real warriors who are innovative and working at the ragged edge of capacity and need a lot of help,” Macy said. “But if you’re a community that really wants to deal with this problem, then look at things to avoid and things to do and things to maybe get your head around. You also might have a little stigma [toward addicted people] you need to check, too.”
Stigmatization of drugs and drug users abounds, though, which is also reflected in “Raising Lazarus.” Reluctant police departments deem humane treatment of addicted users as the “hug-a-thug” approach. Political and community leaders in Mount Airy, North Carolina, are featured prominently, some of whom openly resist efforts to help those with addictions beyond packing them into an overcrowded jail. Macy witnessed a scene that she has written about previously when a Mount Airy citizen announced during a public forum that the community should let drug users die and then harvest their organs.
But the activists have had some successes in the battle against addiction. Macy credits people such as Rev. Mathis for being able to work with diverse people who include drug users, physicians, law enforcement and community members. Just as some police leaders resist working with harm-reduction specialists, some addiction activists are just as reluctant to work with law enforcement. Not Mathis, Macy writes.
“She meets the naysayers where they are, too,” Macy said.
The book includes a glossary of terms and acronyms that appear throughout, from SUD (substance abuse disorder) to OUD (opioid use disorder) to FQHC (federally qualified health center). Macy, a prize-winning reporter at The Roanoke Times for more than 20 years, ends with 55 pages of notes that describe her research.
“Raising Lazarus” also follows the ongoing legal battles, lawsuits, settlements and bankruptcies involving the Sackler family, operators of Purdue Pharma.
“The Sacklers still have a lot of their wealth,” Macy said. “There is no jeopardy of them going to jail, unlike the people I’ve written about who have been ensnared in this drug crisis. Jail still the No. 1 way we treat people with this disease. If we spent more money diverting people from jail into treatment, giving them a place to go, providing life-saving medicine, we’d all be better off. We know these methods work. I knew that this story was not over and that there was still much to tell. That’s why I believe that this is the positive book, the hopeful book.”