Loose Leaf Notes

-The following first appeared in The Floyd Press on October 28, 2021.

Roanoke-based best-selling author Beth Macy recently attended a public screening at the Floyd Country Store of the first episode of Hulu’s new series, Dopesick, which is based on her 2018 book Dopesick: Dealers, Doctors and the Drug Company that Addicted America.

The drama miniseries, starring Michael Keaton and created by Emmy-winner Danny Strong, was described in the event press release as “an examination of how one company triggered the worst drug epidemic in American history. The series takes viewers to the epicenter of America’s struggle with opioid addiction, from the boardrooms of Big Pharma, to a distressed Virginia mining community, to the hallways of the DEA.”

Following an announcement by Country Store co-owner Dylan Locke that event ticket sales will go to benefit New River Valley Community Services and Floyd County Multi-Disciplinary Team, Locke introduced Macy, who explained the genesis of the Dopesick story at the Country Store on Oct. 20, which began for her when she was a reporter for The Roanoke Times (1989 – 2014).

“The story everyone was talking about in the summer of 2012 in Roanoke – because it made front page news – was about two wealthy families that were being upended by heroin,” said Macy, whose other books include Factory Man and Truevine.

“One young kid passed away from an overdose, and the other was about to go to federal prison for his role in selling that young man the heroin that led to his death,” she continued.

Those events prompted Macy to write a three-part story on the heroin crisis in Roanoke county, which was published as a three-part series on the paper’s front page for three days. “People were really shocked,” she said.

She knew it was a bigger story than a newspaper feature, so she began researching, making contacts and talking with the young man facing prison time. “We didn’t know then how heroin and OxyContin were connected the way we know now. The way we would learn they were.”

Central to Macy’s Dopesick story is the Sackler family who own Purdue Pharma, the company that created OxyContin, which went to market in 1996 with a campaign that suggested the drug was virtually non-addictive and could be used for moderate pain as well as severe pain.

As the story unfolded, it revealed that the FDA shared some culpability in OxyContin becoming one of the most abused pharmaceutical drugs in U.S. history. They approved OxyContin’s original label, which read “Delayed absorption as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug,” even though Purdue Pharma did not hold clinical trials to show that OxyContin was less likely to be addictive or abused.

In 2010, after it was apparent that OxyContin was as addictive as other opioids and was being abused, Purdue Pharma reformulated OxyContin, but by then people with opioid use disorder were switching to heroin because it was cheaper and easier to get, Macy said. She reported that Perdue is in bankruptcy court right now. The bankruptcy plan calls for the Sackler family to give up Perdue – the company that made them more than 13 billion dollars – and to pay out 4.5 billion in settlement. Unfortunately, it’s been predicted that with good investments, the family will end up richer in the end, she reported.

Macy commented that it was important to her that Appalachia was not stereotyped in the series. Rural communities, including those in Maine, with labor intensive jobs where injuries are common were also targeted by Perdue’s OxyContin aggressive sales campaign, which included sales reps grooming doctors with gifts to prescribe the drug freely.

“It’s a terrible problem that has gotten worse with the pandemic. If we put even ¼ of the money we spend on incarceration into treating people, we’d begin to turn it around,” said Macy.

She is an advocate for the increased availability of medication-assisted treatment to curb drug cravings and stave off the physical illness of withdrawal (dopesickness), and of Harm Reduction principles, which include meeting those who are addicted where they are, making personal connections that can lead to them seeking treatment and providing them with clean needles. She noted that drug addiction impacts the community at large with increased crime, prostitution and child neglect.

“I have a new book coming out next year. It’s about solutions. Dopesick is about a problem. “Raising Lazarus” is about solutions,” she said. “One of the threads is how to hold big Pharma accountable. I tell all sides of the story from the people fighting back.”

Primarily filmed in Richmond and Clifton Forge, VA, the Hulu series has five different story lines that go back and forth in time and use composite characters, as well as real people represented by actors, Macy explained.  She is one of the series’ executive producers, wrote two episodes, appeared briefly in one and was in the writing room in Hollywood for five months. “It would have been longer if not for the pandemic,” she said.

Macy’s hope is that “we don’t just see people who are addicted as criminals, but we see them as people with medical conditions worthy of our care and love.”

“I think it’s very moving,” she said about the series. “We’re hoping it changes hearts and minds.”  ___________Colleen Redman