Dopesick

by Beth Macy

  Asked nearly a decade later about the aftermath of the Purdue Pharma settlement on the communities his court covers, Judge Jones told me: “Opioid addiction continues to be, frankly, a terrible concern.…It’s rare that I don’t have a case today involving substance abuse.”

  He declined to divulge the details of the executives’ probation, citing privacy concerns, other than to say they completed it, to his satisfaction, in their home state of Connecticut.

  When Howard Udell died unexpectedly of a stroke, in 2013, at the age of seventy-two, a local newspaper heralded him for having turned his community service into a redemptive experience. After counseling veterans at a Veterans Administration hospital on job skills, Udell went on to found the Connecticut Veterans Legal Center, helping hundreds of veterans navigate problems including evictions, dishonorable discharges, and substance-abuse-related crimes. Even after his community service hours were completed, Udell stayed on to assist the legal center. “It was very unpleasant for Howard, who was scrupulously honest and careful, but we endeavored to make the most out of it,” said Friedman, who also performed his community service at the site, according to the newspaper, which described the executives’ initial service there, euphemistically, as “volunteer.”

  A lesser person would have crawled into the basement, said Udell’s son, Jeffrey, himself a former federal prosecutor. His dad’s fingerprinting at the guilty plea, his three years of supervised release, the fact that Udell had to check in with his probation officer before he visited his grandchildren across state lines—the younger Udell was still incensed that his late father had been forced to endure such indignities. He pointed out repeatedly in an hour-long phone call that the government presented zero proof of his father’s wrongdoing.

  “The idea that someone of his caliber and his integrity could have the ignominy of a federal crime is so outrageous and unjust,” said Jeffrey Udell, describing his dad as a humanitarian and a law-and-order saint, the kind of restaurant patron who would correct a waiter when presented with a mistakenly small bill.

  “I know there are unfortunately some very sad and unfortunate people who are parents of kids who abused drugs and overdosed. I feel horrible for those people, as my father did, and for the loss they’ve suffered.”

  But again, he insisted, Team Brownlee presented no evidence that Howard Udell had any knowledge of what was happening in the company “some twenty-five levels below him amid a [sales] hierarchy that was not remotely within his purview.”

  Jones said the case was not only the largest he’d ever presided over, in terms of the fine, but also the most dramatic. There was a hard rain that day, he recalled, and yet there were so many people in attendance that the court set up a separate overflow room for observers to watch via video.

  Nor would he ever forget the most heart-wrenching portion of the parent testimony—that of Fishtown native Lee Nuss, who described how her only son, Randy, died as he was getting ready to leave for culinary school in 2003. “His prepaid college ended up paying for his funeral,” Nuss said.

  Nuss had begged the judge to reject the terms of the plea agreement, imploring him, “Money means nothing to them. Let the punishment fit the crime.”

  Then she brandished the tiny brass urn she carried whenever she traveled, the one Purdue lawyers had gotten ejected from Karen White’s whistle-blower trial. Randy had begun as dust, in her belief, and unto dust he had prematurely returned. She clutched his ashes as she stepped down from the stand.

  “This is from your drug, OxyContin, and here he is in this courtroom,” Nuss said, staring steely-eyed at Udell, Friedman, and Goldenheim.

  A reporter sitting in the courtroom thought for a moment she was going to throw the urn at the men. But Nuss waved it instead and returned to her seat.

  She had wanted the men to apologize, to admit that they had understood all along that OxyContin wasn’t a novel way of fighting pain but simply a different and more potent way of dispensing nature’s oldest drug.

  If the Sacklers’ lieutenants had legitimately not known about the flood of pills unleashed by sales reps toting around bad data and free shrubbery twenty-five rungs down the corporate ladder from them, maybe it was because they had not cared to look.

  Part Two

  Objects in Mirror Are Closer Than They Appear

  Hidden Valley, Roanoke County, Virginia

  Strasburg High School, Strasburg, Virginia

  Chapter Five

  Suburban Sprawl

  Awareness of the opioid crisis has typically come in waves, often celebrity-studded and well covered by the media: the death by overdose of Philip Seymour Hoffman, in 2014, then two years later the death of Prince. But for ordinary citizens, the news that opioids had crossed over from Not me and not anyone I know to mainstream traveled more slowly, in dribs and drabs, maybe when the Cincinnati Enquirer became the first newspaper in the country to dedicate a reporter solely to the heroin beat.

  Four hours east of Lee County, in a southern city that counts the local TV weathermen among its biggest celebrities, the February 2006 news that meteorologists Jamey Singleton and Marc Lamarre had been shooting up heroin stunned viewers of the NBC affiliate station in Roanoke, where I live. The story broke after Lamarre suffered a near-fatal overdose at a party, an event that drew local police and, eventually, the attention of federal authorities.

  Viewers loved watching them both, especially the stylish, tanned Lamarre, poised and confident, his hands gesturing fluidly in front of the weather map’s green screen. Back then, it was still hard to picture a thirty-six-year-old collapsed on an apartment floor in an affluent Roanoke suburb, harder still to imagine a world where educated, well-paid white guys felt the need to disappear into bathrooms at parties or, worse, as in Lamarre’s case, end up being tossed into a bathtub and doused with cold water and ice in the hope of waking him up.

  “The weathermen were skin popping,” recalled police chief Chris Perkins, then an undercover Roanoke detective. The term referred to the practice of injecting the heroin under the skin, rather than directly into a vein, for a milder high—the idea being that skin popping gave you a better high than snorting heroin but wasn’t as potent or dangerous as intravenously injecting it.

  But the weathermen were soon outed, as most users are, the sweat circles under the guys’ sport coats the first in a progressively sad series of giveaways.

  “They’d been running around in eighty-degree weather in long sleeves,” Perkins said. “Young people were already starting to snort heroin, but then when the weathermen made the news, it started to become almost vogue, this notion that you could inject heroin and somehow still be functional.”

  Perkins was working the city’s drug unit when the overdose call came in. He remembered finding Lamarre unconscious in the bathroom of his well-appointed apartment, before rescue squad workers arrived. Lamarre survived, barely, moving away from the region soon after.

  Friends of overdosing users commonly chuck them into the bathtub and try to revive them with ice or cold water, to avoid having to call 911, which could draw police to the scene, along with criminal charges. One police officer I know showed up to an overdose call to find an unconscious man on the floor, a frozen fish on his neck, a frozen bottle of soda shoved into his pants, ice all over the floor—and the user’s friends long gone from the scene.

  In a region of just over a quarter-million people, a blue-dot Democratic stronghold in the center of a hilly rural red, Roanoke is a smallish city, transformed in the mid-1880s into a gritty railroad town and now, more than a century later, striving to become a health care, neuroscience, and medical-research hub. “We’re really going from Train City to Brain City,” a city manager recently enthused.

  But Roanoke retains its safe, small-town feel with an almost Mayberry level of friendliness. Shortly after I moved here in 1989, a grocery store clerk picked up my bag of shiitakes and cheerfully wanted to know, “Lordy, what are you fixing with these?” A neighbor and journalist frie
nd who spent the bulk of her career in Philadelphia still chuckles when I lock my doors. She used to lock her doors in Philly, but here in Roanoke she travels for days at a time and leaves her house wide open.

  “The opioid epidemic is an urban story, a suburban story, and a rural story,” said Dr. Jennifer Wells, a Roanoke addiction specialist who has patients from each of these demographics, including one mom with five kids in a countryside trailer and no running water who somehow manages to make it to her group therapy meetings every week.

  “Roanoke is just big enough where all the stories meet.”

  The skin-popping weathermen represented Roanoke’s first wake-up call. But it was wrongly viewed, by myself and other area journalists, as an anomaly. The story was so tawdry that the Roanoke Times assigned two beat reporters to track it, one from courts and the other from media and entertainment. It received much more attention, for instance, than the national story that broke in our backyard when Purdue Pharma settled with the feds a year later.

  Before the weathermen incident, heroin had been the domain of police and court reporters in Roanoke, widely believed to be an inner-city (read: black) drug. “In the ’80s and ’90s, maybe a few dozen people were doing heroin here,” said Don Wolthuis, the assistant U.S. attorney who became one of the federal government’s top heroin prosecutors in the state’s western half. “Because heroin is a depressant, people kind of withdraw; they go in a corner, shoot up, and sit there in the dark, in a fetal position. They weren’t out there committing crimes like with crack or meth. It was a largely invisible and isolated group.”

  It was common knowledge back then, among the handful of mostly African-American heroin users and dealers in Roanoke, “that you don’t sell heroin to white people because they’ll turn you in,” as Wolthuis put it. In the mid-2000s, it was also common knowledge that the stronger and more dangerous the heroin, the more users yearned to have it, as Roanoke addiction researcher Warren Bickel, then working in Baltimore, described it.

  “Herr-on is my girlfriend,” one of his patients told him, adopting the street pronunciation for the drug popular among African-American users. He’d come to Bickel’s lab with track marks on his neck—all his other veins were spent.

  And what this patient wanted Bickel to know was no different than what the Lee County farmer meant when he told his doctor how OxyContin had stolen everything from him: Nothing’s more powerful than the morphine molecule, and once it has its hooks in you, nothing matters more.

  Not love. Not family. Not sex. Not shelter. The only relationship that matters is between you and the drug.

  Bickel went on to scientifically quantify the indifference of the typical opioid user, comparing the average nonaddicted person’s perception of the future—calculated to be 4.7 years—against an addicted user’s idea of the future, which is just nine days.

  The first time I interviewed him, in 2016, Bickel said he hoped to design treatment methods that would not only predict future addictive behavior among children but might also help those at risk of becoming addicted improve and extend their temporal views, therefore arming themselves against the scourge.

  Though he’d won prestigious grants and awards for his groundbreaking work—he was often touted as a star of the growing Brain City constellation—I struggled to understand how Bickel’s research applied to the real-life heroin users I knew, some of whom were now trading sex for drug money a few blocks from his office.

  Could a Bickel-designed app have prevented Jesse Bolstridge’s death? Where was the hope? When I asked him those questions, he pointed to a framed Chinese proverb that he takes inspiration from: “It is better to light one candle than to curse the darkness.”

  But the larger question about hope continued to reverberate wherever I went. I heard a version of it from an overwhelmed family friend, who pulled me aside at a wedding party to tell me about her thirty-four-year-old addicted daughter and pleaded with me through tears: “Just tell me one thing, what can your book do to help me keep my daughter alive?”

  My friend was discovering the same thing through experience that I was through my interviews: that the legal and medical structures meant to combat America’s heroin epidemic were woefully disconnected, often at odds with one another, and full of unintended consequences.

  A crack-turned-heroin-dealer with Philadelphia roots landed in Roanoke in 2006, the same time the weathermen began sweating through their long-sleeved shirts. Clifton “Lite” Lee made heroin an equal-opportunity drug, connecting with drug users, black and white, and figuring—correctly—that he could easily double his profit margin if he imported the drug to comparatively staid Roanoke rather than continue selling it solely in New Jersey and New York. When police caught two suburban teenagers middlemanning for Lee—selling heroin to their friends and keeping some for their own use—they were stunned by what their cellphones revealed: evidence implicating fifty other kids they’d been selling heroin to. Most attended Hidden Valley High School, in outlying Roanoke County’s wealthiest neighborhood, home to insurance agents and doctors and lawyers.

  “Lee was the guy willing to get the kids involved,” Wolthuis said, pulling out a handwritten organizational chart he’d put together to help him keep visual track. At the top of the pyramid were the nonusers like Lee, who were in it just for the money, and at the bottom were the addicted, including some whose names were crossed out—dead of overdose.

  By the time Lee was sentenced to eleven years in prison, in 2008, prosecutors had pinned him with bringing a thousand bags of heroin into the region two to three times a week, paying $5,000 for twenty bricks of heroin that his network then sold for $30,000.

  The growth in heroin users was as exponential as its 600 percent profit margin. The first bags sold in Roanoke were stamped with the names Funeral and Green Frog, and some had a purity of 90 percent, a concentration that addicted users quickly and made the dosages deadlier.

  “I can remember lying in bed awake at night, thinking, how far is this thing gonna go?” Wolthuis said. “If you have a guy doing a chain of bank robberies, you catch him and the robberies stop.” But the problem with heroin is the lure of the morphine molecule. Herr-on is my girlfriend. Even as Wolthuis locked up the perpetrators, he suspected that the demand for heroin was already too entrenched. There were still plenty of user-sellers eager to get on the nearest heroin highway to fetch a new batch from Baltimore or Richmond or Paterson, New Jersey. Unlike Ronnie Jones and Clifton Lee, they didn’t aspire to get rich dealing dope. They just wanted to keep from getting dopesick.

  The story of Clifton Lee and the addicts he serviced and created didn’t trickle down to me at the newspaper, where I wrote about family issues, until 2010. That year, the region’s only heroin-overdose death made headlines, not because it was unique but because it involved the twenty-one-year-old son of a prominent white businesswoman.

  No one was paying attention to heroin arrests when they only concerned the children of inner-city black families. A 2009 Roanoke Times story suggesting that heroin was now closing in on the illicit use of OxyContin and prescribed fentanyl patches in popularity seemed to draw shrugs, even as one prosecutor publicly warned, “They’re skipping over pot and going straight to heroin.”

  Wolthuis may have been lying in bed worrying about Spencer Mumpower’s role in his classmate Scott Roth’s death, but no one, not even the do-gooders giving drug-prevention lectures in local high schools, talked about the kids left behind who were still using. It was as if heroin had settled peaceably into Hidden Valley, with its manicured lawns and attached multiple-car garages, and Scott and Spencer were the only two exposed. Hidden Valley was the perfect name.

  Scott Roth bought the heroin that ended his life in an apartment in Roanoke’s Grandin Village, a retail hub fifteen minutes from the Hidden Valley split-level where he was raised. A neighborhood where locals dine on regionally sourced produce, take yoga classes, watch subtitled movies, spend thousands on Stickley sofas, and crowd the weekly farmer’
s market, the village is full of tree-lined streets and solid 1920s-era brick homes with expansive carports.

  As Spencer Mumpower prepared for prison for handing Scott Roth the heroin that resulted in his life-ending overdose, I spent the summer of 2012 trying to make sense of how two young men with educated, caring mothers and movie-star good looks could keep the severity of their drug habits hidden for so long. I wanted to alert readers to the growing scourge of heroin in our community, and with two teenage sons still at home, I hoped to inoculate my own family, too.

  After all, information is power, I told myself. I talked to my older son about heroin so much that one of the last things he said to me when we dropped him off at college that fall was “I know! Don’t do heroin!” He rolled his eyes with an annoyance reserved for the exceedingly daft.

  In the photo Robin Roth chose for her only child’s obituary, Scott Roth looked like one of the Backstreet Boys. Blond and breezy, he called his mom Rob and wore madras shorts and Izod shirts. He went by the nickname Vanilla Rice, from a cooking job he had at a Japanese steakhouse where he stunt-cooked tableside, juggling knives and shrimp, rapping as he chopped.

  He was a likable young man, polite to strangers, nice to his single mom. He loved the sunflowers she grew on their spacious lawn. She was only mildly annoyed when he invited his friends home to cook for them, using up all the food she’d bought to last them the week.

  He’d been using drugs off and on roughly since the age of seventeen, in 2006. The first time he came home clearly impaired, his mom decided to respond boldly. A registered nurse, she wanted to scare him a little, so rather than give him a take-home drug test from CVS, she took him to the emergency room.