Dopesick

by Beth Macy

  “I’m sorry,” he said.

  “I know,” she said.

  With his mom’s help, he drafted a letter of apology to Robin Roth and mailed it to her therapist, who would decide when she was strong enough to read it. In it, Spencer offered, when he got out of prison, to mow her grass. From his prison cell, he would even donate to her the inheritance he received following his grandmother’s death.

  All told, Spencer had already lost twelve friends from Hidden Valley to drug-involved deaths, and every dealer he knew was either dead now or in jail. And he would soon lose several more.

  He was hale and hearty by the time his mother drove him to a minimum-security federal prison in Petersburg, Virginia, in August 2012. Drug-free for more than two years, Spencer admitted that he’d replaced his opioid addiction with kenpo karate, taking classes almost daily and learning breathing techniques to deal with the anxiety of going to prison. His karate instructor, Rikk Perez, had become a father figure to him; Spencer was estranged, off and on, from his own dad. Perez taught Spencer exercises he could practice in his cell, like slow foot taps that progress up a cinder-block wall.

  Being fit brought Spencer a feeling of confidence as he left for prison, where he hoped to finish his bachelor’s degree. After his release, he planned to dedicate himself to helping young people with addiction, in memory of Scott Roth.

  I called Robin the day Spencer’s mom helped him report to prison. She said knowing that Spencer was behind bars again brought her no comfort.

  “I hurt as much today as the day my son died,” she said, choking up. “I pray for Spencer every day, that he’ll be strong. My heart’s breaking for that kid. But it’s the only shot he has at a normal life—to get some accountability.”

  As the months wore on, Robin began to soften toward Spencer. That fall, she started spending her Friday nights with troubled teenagers and their worried parents in a setting similar to the court-ordered Saturday sessions where Spencer had spoken.

  She was learning that in her loss, she was far from alone. She and Ginger both were beginning to see that all the sunflowers and speeches in the world would not slow the epidemic’s spread. Ginger, a minor celebrity in town from her own ads for her business as well as from a failed campaign for state delegate, was recognized as a friendly face. At her new Ginger’s Jewelry store, a day rarely passed when someone didn’t show up at her counter wanting advice on something other than gold. Distraught parents might pretend to shop for a few minutes, but before long they’d mention the newspaper articles, and the tear-filled stories would tumble out.

  A pastor’s wife with two addicted sons drove from two hours away to search her out. A sixty-three-year-old nurse was struggling to take care of her infant grandson because her twenty-five-year-old heroin-addicted daughter could not.

  While Ronnie Jones was establishing his clientele in the northern Shenandoah Valley, young people in Roanoke were driving right past Woodstock on their way to Baltimore, Philadelphia, or Newark, or taking the Chinatown bus to New York, where they could pay $100 for fifty bags of heroin, stamped with names like Blue Magic or Gucci, then resell them in Roanoke for six to eight times their investment.

  A drug-use survey of Roanoke-area high school students bore out the trend. In the fall of 2012, 6.4 percent reported using heroin one or more times, and almost 10 percent said they’d tried illicit prescription drugs. A local prevention counselor warned that the two percentages were in the process of flipping because heroin was becoming so much cheaper and easier to get.

  The Families Anonymous meetings in town were filling up. Six years had passed since the weathermen’s final forecast, and the storm had settled in.

  While Robin Roth searched for solace in sunflowers and Ginger Mumpower relaxed for the first time in years—knowing that in prison, at least, her son would likely not die of a drug overdose—parents up and down America’s heroin highways struggled to find the right culprit, or set of culprits, to blame.

  But mostly they kept quiet about it, shut down in their grief and their shame.

  Hidden Valley High School, Roanoke County, Virginia

  Chapter Six

  “Like Shooting Jesus”

  An hour south of Roanoke, in a part of the state once dominated by unfettered industry, Martinsville, Virginia, was stuck in an economic morass. In 2012 the small city of thirteen thousand laid claim to having the highest unemployment rate in Virginia for twelve years. For most of the twentieth century, it had been the state’s industrial powerhouse, packed with textile and furniture factories, home to more millionaires per capita than any other city in the nation. But nearly half its jobs went away when the millionaires sent the textile work to Honduras and Mexico in the wake of NAFTA in 1994, and the furniture jobs to China after that.

  Bill Clinton had predicted that China’s 2001 entry into the World Trade Organization would eventually create a “win-win” for workers. American companies would theoretically be able to export products to China’s growing consumer class, an argument Wall Street championed when stock prices climbed with every new plant-closing announcement. Corporate shareholders and CEOs ate up Clinton’s prediction, a cheery best-case version of Adam Smith’s eighteenth-century “invisible hand.” As the economists described it, Chinese peasants would better their lot by making chairs in factories, while dislocated American workers would retrain for more fulfilling, advanced jobs.

  But with ill-designed training for displaced Americans based on a lumbering federal program created in the 1960s, the second part of that equation very rarely came to pass. Only a third of workers who qualified for Trade Adjustment Assistance even went back to school, and the majority of those who did found themselves with new certifications and associate’s degrees yet earning much less than they had in the factories, if they were working at all. The ones I met who were coping the best worked part-time at Walmart, supplementing their pay with food stamps, food pantry donations, and small vegetable gardens.

  Consumers all got cheaper jeans, yes, but what did that matter to the people who had once stitched them if they were now out of work and couldn’t afford new clothes? The global economy created winners and losers, Bassett Furniture CEO Rob Spilman told me, explaining the dismissal of some eight thousand furniture workers from his payroll. “It was that or perish,” he said. “At the end of the day, we are not a social experiment.”

  In rural counties decimated by globalization, automation, and the decline of coal, the invisible hand manifested in soaring crime, food insecurity, and disability claims. In Martinsville and surrounding Henry County, unemployment rates rose to above 20 percent, food stamp claims more than tripled, and disability rates went up 60.4 percent.

  What those numbers looked like on the ground, as I began reporting on the recession in 2008 for the Roanoke Times and later for my first book, Factory Man (published in 2014), could be distilled in two images I observed but did not fully, at the time, comprehend:

  The first was of adults—black and white, old and young—arriving at area food pantries two hours before the doors opened, the older among them clutching canes or leaning on walkers. The second was the smoldering remains of an abandoned furniture factory in the town of Bassett, near Martinsville. An unemployed thirty-four-year-old was attempting to rip out copper electrical wires to resell on the black market when he inadvertently sparked a fire that burned the shuttered factory down. In his police mug shot, you could see the burns on his face.

  It was easy to understand the connection between joblessness and hunger, to get that hunger fueled some of the crime. It was growing clearer, too, that the federal disability program was becoming a de facto safety net for the formerly employed, a well-intentioned but ultimately disastrous way of incentivizing poor people to stay sick, with mental illness and chronic pain—conditions that are hard to prove and frequently associated with mental health and substance use disorders—prompting the majority of disability awards.

  That same pattern was playing out in the
Lee County coalfields, where some parents coaxed their children’s doctors toward ADHD diagnoses, knowing that such behavioral problems could help make them eligible for Social Security disability when they became adults. “Ritalin is a pipeline to disability here,” one Lee County health care manager told me, describing the federal program as a coping mechanism for poverty and workplace uncertainties.

  A hospital administrator I know from nearby eastern Kentucky recalled a Drug Abuse Resistance Education officer asking her high school classmates what they wanted to be when they grew up.

  “A drawer,” one young man said.

  “You mean an artist?”

  “No, a draw-er.”

  Someone who draws disability checks. It was the only avenue he could imagine for himself, the only way to get himself and his family fed. Well over half of Lee County’s working-age men—a staggering 57.26 percent—didn’t work. (The trend line was somewhat better among women, around 44 percent.)

  If OxyContin was the new moonshine in rural America, disability was the new factory work. By 2016, for every unemployed American man between the ages of twenty-two and fifty-five, an additional three were neither working nor looking for work. Having dropped out of the workforce entirely, they had numerically vanished from the kind of monthly jobs reports touted by politicians and reporters.

  Many turned up instead in disability statistics, which were largely ignored in headline-grabbing economic reports. Disability claims nearly doubled from 1996 to 2015. The federal government spent an estimated $192 billion on disability payments in 2017 alone, more than the combined total for food stamps, welfare, housing subsidies, and unemployment assistance.

  For people who have not ventured recently into rural America, the jaw-dropping and visible decline of work comes as a shocker, an outgrowth of the nation’s widening political and cultural divide. Before the 2016 election of Donald Trump, that disconnect was maintained by a national media that paid little attention to rural, predominantly white places like St. Charles or Bassett, where the country’s much-hailed economic recovery had definitely not trickled down.

  At the same time, it had never been within the purview of local papers like the Martinsville Bulletin to investigate what was happening with international trade in Washington or New York, much less the latest push by Big Pharma or global drug cartels. And regional newspapers like my own Roanoke Times had drastically shrunk their coverage to a mainly urban and suburban core, ignoring the increasingly distressed communities in our hinterlands just when reporting on those places was needed the most.

  Those of us living highly curated and time-strapped lives in cities across America—predominantly mixing virtually and physically with people whose views echoed our own—had no idea how politically and economically splintered our nation had become. And also how much poorer and sicker and work-starved the already struggling parts of the nation truly were—because we didn’t follow that story.

  We may feel more connected by our cellphones and computers, but in reality we are more divided than ever before.

  In the midsized city where I live, OxyContin continued to be viewed as a rural problem into the early 2010s—a problem in the coalfields, some four hours to the west. While the Roanoke Times covered the 2007 sentencing hearing of Purdue Pharma executives, it rarely mentioned OxyContin after that. We in Roanoke had heard opioid abuse was seeping into distressed factory towns like those in Henry County, but very rarely did our newspaper report on it.

  We were safe in our ignorance, or so we thought—content to stereotype drug addiction as the affliction of jobless hillbillies, a small group of inner-city blacks, and a few misguided suburban kids.

  But another invisible hand was upon us.

  Heinrich Dreser’s drug moved seamlessly across city and county lines, with zero regard for politics, race, neighborhood, or class.

  I didn’t understand the connection between rural poverty, disability, and opioid addiction until I learned more about the accidental Bassett Furniture arsonist. Turned out he’d arrived at his copper heist on the outskirts of Bassett on his bicycle—a rare sight in the rolling foothills of the Blue Ridge Mountains.

  “He was one of the unemployed masses; he did not have a paying job,” said the prosecutor (now a judge) in his case. “But his crime actually required work, so he wasn’t lazy so much as he was desperate.” Like so many of the region’s petty thieves, the arsonist was propelled by fear of becoming dopesick, added another local prosecutor, who told me that 75 percent of all police calls in the county now involved heroin or methamphetamine, or, increasingly, a combination of both.

  Not only were rates of unemployment, disability, and opioid addiction soaring, but there was also renewed interested in methamphetamines and the practice of switching between opioids (in the form of either pills or their much cheaper cousin, heroin) and meth. “Crystal meth controls all the dockets now” in rural Virginia, a local drug task force officer told me. “If you’re addicted to painkillers, you become so lethargic you can hardly function. But meth keeps you going if you need to run the streets to go get your next dose of heroin or pills, to keep you from getting sick. It allows you to function. There’s a reason they call it ‘high-speed chicken feed.’”

  I thought immediately of Spencer Mumpower’s 2010 jail mug shot. So much separated Spencer, whose mother had sent him to private school and then paid for fifteen different rehabs, from the young man who stripped copper wire out of the abandoned furniture factory. A scrawny junkie with sunken eyes and sticky-out collarbones, as Spencer described himself to me in 2012, “I looked ridiculous, like I had chicken pox. Like I’d stuck my head down a groundhog’s lair.”

  But I had failed, just as the police and parents had, to connect young adults like Spencer to the rural addicted, even though Spencer told me he’d come to his heroin addiction the same way they had—through prescription opioid pills.

  Our culture seems to excuse drug- and other risk-taking in white middle- and upper-middle-class kids, especially young men. The same liberties, when taken by rural poor whites or people of color—wherever they live—come across as more desperate, born of fundamental wants or needs that can’t be satisfied. But as I’ve come to learn, gauged strictly by drug use, there is no less urgency and desperation in America’s middle and upper classes today.

  Drug epidemics unfold “like a vector phenomenon, where you have one individual who seeds that community and then the spread begins,” said Dr. Anna Lembke, an addiction-medicine specialist at the Stanford University School of Medicine and the author of Drug Dealer, MD. People whose parents or grandparents were drug- or alcohol-addicted have dramatically increased odds of becoming addicted themselves, with genetics accounting for 50 to 60 percent of that risk, Lembke explained; she noted that the correlation between family history and depression is much lower, 30 percent. Other risk factors for addiction include poverty, unemployment, multigenerational trauma, and access to drugs.

  “It’s important to note, it’s really not just the unemployed and the poor who are vulnerable today; it’s really everybody, especially underchallenged youths or youths who aren’t engaged in school or other meaningful activities,” Lembke said.

  At the age of thirteen, Spencer had stolen five bottles of painkillers more than halfway full—leftovers prescribed to different relatives in the aftermath of routine outpatient surgeries. By fourteen, he was taking pills regularly. Back then he used saved-up lunch money to buy weed, which he then traded for ADHD medications prescribed to his friends, or for OxyContin pilfered from their parents’ medicine chests.

  “I did my first bag of heroin before I drank my first bottle of beer,” Spencer said.

  In his Hidden Valley subdivision, full of sprawling ranches, trim colonial two-stories, and Arts and Crafts bungalows that were new but meant to look old, heroin was easier to get. “When we first started doing it, we didn’t worry about getting caught because cops didn’t know what heroin even looked like.

  “One t
ime I got pulled over, I had ten bags at my feet, and they didn’t know what it was so they didn’t look at it.”

  In rural America, the opioid epidemic aged into a wily adolescence in the aughts. In the hinterlands of Virginia, it had tended to pool in families. “We’d sometimes have one overdose where the son would die, then the next day the father would die, then the next day the mother would die,” the Roanoke-based medical examiner said. “If it had been an infectious disease, there would have been widespread panic.”

  Then–Virginia Tech researcher Martha Wunsch remembered the moment she went from studying overdose deaths in rural counties, funded by a National Institutes of Health grant, to hearing about it from her own teenagers, who went to high school with Spencer and Scott Roth. State health officials in Richmond had originally dismissed her research, telling her the same thing they’d said to Sue Cantrell, the rural health-department director: “This is a regional problem.”

  “The issue is Interstate 81,” Wunsch told me. “The OxyContin epidemic spread from East Nowhere Jesus all up and down the Appalachian chain by way of the interstate, and suddenly my own kids were coming home from parties,” talking about pills being passed around in bowls.

  Opioids infiltrated the toniest suburbs not by way of families but by peer groups. The new suburban users didn’t come to the attention of police until roughly around the time Purdue Pharma launched its 2010 abuse-resistant version of the drug, at the same time Spencer handed Scott Roth the heroin that led to his death—fourteen years after OxyContin was introduced.