by Beth Macy
Arthur pioneered the idea: Jesse Kornbluth, “The Temple of Sackler,” Vanity Fair, September 1987.
put the figure as high as 56 percent: From a systematic review of Bridget A. Martell et al., “Opioid Treatment for Chronic Back Pain: Prevalence, Efficacy, and Association with Addiction,” Annals of Internal Medicine, January 2007: 116–27.
“Arthur built his own temple”: Kornbluth, “The Temple of Sackler.”
Public Citizen, a consumer advocacy group: Laurence Hammack, “OxyContin Settlement a Reversal of Fortune,” Roanoke Times, May 12, 2007.
“The corporation feels no pain”: Author interview, Andrew Bassford, Jan. 16, 2016. He admitted his point of view was in the minority “and maybe even heresy” to his colleagues in the office.
The $634.5 million fine: According to Brownlee’s news release, May 10, 2007, the fine included the following directives: $276.1 million forfeited to the United States; $160 million to federal and state agencies to resolve liability for false claims made to Medicaid and other government health care programs, $130 million to resolve private civil claims; $5.3 million to the Virginia Attorney General’s Medicaid Fraud Control Unit to fund future fraud investigations; $20 million to Virginia’s prescription monitoring program. “In addition, Purdue will pay the maximum statutory criminal fine of $500,000.” The executive fines were assessed at $19 million for Friedman, $8 million for Udell, and $7.5 million for Goldenheim, and each executive was also fined an additional $5,000.
“independent, associated companies”: Corporate Crime Reporter, “Corporate Drug Pushers,” Counterpunch, May 16, 2007, http://www.counterpunch.org/2007/05/16/corporate-drug-pushers/.
a decision they repeatedly appealed: Barry Meier, “Restrictions Are Upheld for Executives in OxyContin Case,” New York Times, Jan. 23, 2009.
“Plaintiffs appear to misunderstand”: Federal judge Segal Huvelle wrote in rejecting the executives’ arguments that their disbarment from doing business with taxpayer-financed health care programs should be overturned; the executives did get their initial disbarment reduced from twenty to twelve years, Meier, “Ruling Is Upheld Against Executives Tied to OxyContin,” New York Times, Dec. 15, 2010. Ramseyer said they were ultimately excluded for eight years.
But the Abingdon federal judge’s hands were tied: U.S. District Judge James Jones testimony, from the transcript of The Purdue Frederick Company, Inc., et al., 110–21.
“Opioid addiction continues to be”: Author interview, Judge James Jones, Feb. 3, 2017.
Udell went on to found the Connecticut Veterans Legal Center: Anne M. Hamilton, “Helping Veterans with Legal Problems,” Hartford Courant, Sept. 1, 2013.
the government presented zero proof: Author interview, Jeffrey Udell, April 5, 2017.
she brandished the tiny brass urn: Lee Nuss testimony, from the transcript of The Purdue Frederick Company, Inc., et al., 21–22, and author interview, Nuss, Jan. 31, 2017. Laurence Hammack is the reporter who told me he thought Nuss was going to throw the urn.
Chapter Five. Suburban Sprawl
Interviews: Chief Chris Perkins, Dr. Steve Huff, Sgt. Chad Seeberg, Dr. Jennifer Wells, Don Wolthuis, Warren Bickel, Robin Roth, Kristi Fernandez, Lt. Chuck Mason, Spencer Mumpower, Ginger Mumpower, Tony Anderson, Vinnie Dabney
the Cincinnati Enquirer became the first newspaper: Kristen Hare, “The Cincinnati Enquirer Now Has a Heroin Beat,” Poynter Institute, Feb. 15, 2016.
Viewers loved watching them: Lindsey Nair and Marques G. Harper, “Another WSLS Weatherman Admits Struggle with Heroin,” Roanoke Times, Feb. 18, 2006. Gilbert Dennis Hadden, a twenty-one-year-old dealer from Detroit, was sentenced to two years in prison later that year.
“The weathermen were skin popping”: Author interview, Chief Chris Perkins, Dec. 29, 2015 (since retired). Some users skin pop when their veins are too scarred to inject, according to Dr. Steve Huff, author interview, Oct. 2, 2017.
an unconscious man on the floor: Author interview, Sgt. Chad Seeberg of Marysville, Ohio, Aug. 8, 2016.
“Train City to Brain City”: Colin Woodard, “Trains Built Roanoke. Science Saved It,” Politico Magazine, Sept. 15, 2016. The quote was from Chris Morrill, Roanoke’s city manager from 2010 to 2017.
“Roanoke is just big enough where all the stories meet”: Author interview, Dr. Jennifer Wells, May 1, 2017.
“maybe a few dozen people were doing heroin here”: Author interview, Don Wolthuis, Jan. 7, 2016.
an addicted user’s idea of the future: Author interview, Warren Bickel, July 25, 2016.
The first bags sold in Roanoke: Mike Gangloff and Mike Allen, “Rise in Heroin Use Among Youth Alarms Officials,” Roanoke Times, Feb. 24, 2009.
“They’re skipping over pot and going straight to heroin”: Julia Dudley, U.S. attorney for the Western District of Virginia, quoted in Gangloff and Allen, “Rise in Heroin Use.”
“You think of heroin as seedy street slums”: Author interviews, Robin Roth, 2012–2017. Interviews in 2012 and 2013 were research for my Roanoke Times series “The Damage Done,” Aug. 20–22, 2012, and follow-up articles.
Kristi defended her son: Author interview, Kristi Fernandez, May 23, 2016.
Brandon Perullo had become so desperate: Preston Knight, “Robber to Serve 3½ Years in Heist,” Northern Virginia Daily, Feb. 9, 2011.
Brandon’s mother, Laura Hadden, begged: Author interview, Laura Hadden, May 18, 2017.
At Spencer Mumpower’s 2012 federal court sentencing: Transcript of sentencing hearing, United States v. Spencer Cruise Mumpower, U.S. District Court for the Western District of Virginia, Roanoke, March 1, 2012.
But Robin declined, saying she wasn’t ready: Beth Macy, “The Damage Done.”
oversimplification that police only partially confirmed: Author interview, Chuck Mason (then Roanoke County police lieutenant), May 5, 2012: “Catch-and-release implies we’re not going to charge them, but we are. They’re to be out on the road so they can work for us, but they are going to be charged at some point so they can face what they’ve done.…If we take the guy dealing fifty bags and put him in jail, then we don’t have a shot at the guy dealing five hundred bags.”
His lawyer, Tony Anderson, recalled: Ibid.
Vinnie Dabney remembered it: Ibid.
Spencer was alternately immature and wise: Ibid.
stamped with names like Blue Magic or Gucci: Author interviews, Roanoke County native Ashlyn Kessler, conducted via CorrLinks, federal prison monitored email, multiple times beginning May 26, 2016.
Chapter Six. “Like Shooting Jesus”
Interviews: Sgt. Joe Crowder, Dr. Anna Lembke, Cheri Hartman, Tony Lawson, Judge Bob Bushnell, Andrew Nester, Shannon Monnat, Nikki King, Spencer Mumpower, Dr. William Massello, Dr. Martha Wunsch, Vinnie Dabney, Nancy Hans, Dr. Hughes Melton, Andrew Bassford, Dr. John Burton, Ron Salzbach, Jamie Waldrop, Drenna Banks, Christopher Waldrop
ill-designed training for displaced Americans: Trade Adjustment Assistance is outdated, with poor participation and efficacy, according to Beth Macy, “The Reality of Retraining,” Roanoke Times, April 22, 2012.
“not a social experiment”: Bassett Furniture CEO Rob Spilman, as relayed in Macy, Factory Man (New York: Little, Brown, 2014), 300.
soaring crime, food insecurity, and disability claims: America’s overall work rate for Americans age twenty and older dropped 5 percentage points between early 2000 and late 2016, as analyzed in Nicholas N. Eberstadt, “Our Miserable 21st Century,” Commentary, Feb. 15, 2017.
unemployment rates rose to above 20 percent: Food stamp increase courtesy of Supplemental Nutrition Assistance Program data from Martinsville and Henry County social services; disability hike factored from statistics, compiled here: http://www.ssa.gov/policy/docs/statcomps/oasdi_sc/2008/va.html.
mental health and substance use disorders: Anna Lembke, Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop (Baltimore, MD: Johns Hopkins University Press, 2016), 92, based on the work of
economists David Autor and Mark Duggan, “The Growth in the Social Security Disability Rolls: A Fiscal Crisis Unfolding,” National Bureau of Economic Research, Working Paper No. 12436, August 2006. Mental illness is the reason cited in 25 percent of disability awards, and chronic pain is cited in 26 percent.
“Ritalin is a pipeline to disability here”: Author interview, Tony Lawson, Jan. 30, 2017.
“a draw-er”: Author interview, Nikki King, July 20, 2017.
Well over half of Lee County’s working-age men: U.S. Census data collated by Syracuse University sociologist Shannon Monnat.
for every unemployed American man: Eberstadt, “Our Miserable 21st Century.”
Disability claims nearly doubled: From a Washington Post analysis of Social Security Administration statistics, as reported in Terrence McCoy, “Disabled or Just Desperate? Rural Americans Turn to Disability as Jobs Dry Up,” March 30, 2017.
“one of the unemployed masses”: Author interviews, Henry County judge and former prosecutor Bob Bushnell and commonwealth attorney Andrew Nester, June 23, 2015.
“Crystal meth controls all the dockets now”: Author interview, Virginia state police special agent Joe Crowder, March 24, 2017. Methamphetamine was the most common drug involved in federal drug-trafficking offenses in 2015 (31.5 percent of all cases), followed by powder cocaine (20.5 percent), marijuana (17.1 percent), and heroin (13.3 percent), according to the U.S. Sentencing Commission, “Drug Trafficking Offenses: Quick Facts,” 2005–2015 Datafiles.
Drug epidemics unfold “like a vector”: Lembke, Drug Dealer, MD, 16, and author interviews, Lembke, via email, April 15 and Oct. 26, 2017.
“One time I got pulled over, I had ten bags”: Author interview, Spencer Mumpower, April 19, 2012.
“one overdose where the son would die”: Author interview, Dr. William Massello, March 21, 2017. By the time he left the position in 2007, accidental drug overdose deaths in western Virginia had quadrupled, rising from about 65 a year in the early 1990s to 250.
“The issue is Interstate 81”: Author interview, Dr. Martha Wunsch, now an addiction medicine doctor in Northern California, Jan. 27, 2017.
Opioids infiltrated the toniest suburbs: OxyContin was the first drug to receive an “abuse-deterrent” designation from the FDA, according to Christopher Ingraham, “How an ‘Abuse-Deterrent’ Drug Created the Heroin Epidemic,” Washington Post, Jan. 10, 2017.
One of the most segregated cities in the South: Matt Chittum and Sara Gregory, “Decades of Inequality and Lack of Opportunity Have Generational Cost in Roanoke,” Roanoke Times, May 6, 2017.
beginning to migrate to the more affluent: Author interview, Crowder, March 24, 2017.
“nobody paid any attention to it until their cars”: Author interviews, Vinnie Dabney, Dec. 29, 2015, and Dec. 31, 2016. Dabney also told his story in a talk to at-risk kids at the Roanoke Higher Education Center, May 11, 2017.
“The early suburban wave mostly stayed hidden”: Author interview, Dr. Hughes Melton, April 2, 2017.
“We didn’t understand the connection”: Author interview, Nancy Hans, April 4, 2017.
Vice magazine swooped into Roanoke: Rob Fischer, “Bath Salts in the Wound,” Vice.com, Dec. 30, 2012. Bath-salt ban: Matthew Perrone, “Many Drugs Remain Legal After ‘Bath Salts’ Ban,” Associated Press, July 25, 2012.
“How dare you tell the newspaper these things?”: Author interview, Andrew Bassford, Jan. 6, 2016.
“If you tried to crunch ’em”: Author interview, Victoria (real name withheld, by request, to protect her job), Jan. 19, 2017.
the number of prescribed stimulants increased tenfold: Lembke, Drug Dealer, MD, 45–46.
2014 data review that illustrates the discrepancies: Frances Rudnick Levin and John J. Mariani, “Co-occurring Addictive Disorder and Attention Deficit Hyperactivity Disorder,” published by the American Society of Addiction Medicine, 2014, available at https://basicmedicalkey.com/co-occurring-addictive-disorder-and-attention-deficit-hyperactivity-disorder.
“A lot of us think that doctors”: Author interview, Cheri Hartman, Jan. 14, 2018.
the abuse of prescription drugs increased: Lembke, Drug Dealer, MD, 48.
Dr. John Burton watched the cultural shift: Author interview, Dr. John Burton, March 20, 2017.
two-thirds of college seniors reported: Lembke, Drug Dealer, MD, 48, and author interviews, Lembke; also http://drugfree.org/newsroom/news-item/full-report-and-key-findings-the-2012-partnership-attitude-tracking-study-sponsored-by-metlife-foundation/.
“I’d take just a couple”: Author interviews, Brian, May 1, 2012, and in several follow-up interviews and email exchanges.
“like shooting Jesus up in your arm”: Author interview, counselor and Suboxone support group facilitator Ron Salzbach, Jan. 4, 2106; confirmed by author interviews, Brian, May 1, 2012, Dec. 28, 2015, and April 9, 2017.
“It’s been seven days”: Author interview, Brian, May 1, 2012.
“cellphone is the glue”: Author interview, Brian, Sept. 3, 2012.
their chance meeting have lasting implications: Author interviews, Jamie Waldrop, Dec. 5, 2015, and multiple interviews through 2017.
“I just knew [Jamie] was this cool blond-haired chick”: Author interviews, Drenna Banks, Dec. 15, 2015, and March 23, 2017.
“I was a pretty bad robber”: Author interview, Christopher Waldrop, April 11, 2017.
a painkiller-selling scheme that placed Colton: From the Roanoke police search warrant, filed Nov. 4, 2012, by Detective P. B. Caldwell: “Based on my training and expertise, the currency [$1,350 found on site in cash] and the extreme shortage of oxycodone would indicate the distribution of these pills.”
supposed to be his last hurrah: Author interview, Banks, Dec. 15, 2015, and March 23, 2017.
chucking her prepared remarks in favor of: Remarks by Drenna Banks, Nov. 9, 2012, transcribed from a CD of Colton’s memorial service.
“I wanted to drink again”: Author interview, Christopher Waldrop, April 17, 2017.
Fewer than one-quarter of heroin addicts: Lembke, Drug Dealer, MD, 133; John Strang et al., “Drug Policy and the Public Good: Evidence for Effective Interventions,” Lancet, Jan. 7, 2012: 71–83; author interview, Dr. Hughes Melton, March 31, 2017.
for every one opioid-overdose death, there were 130: 2011 data sets compiled by Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, Treatment Episode Data Set, and Coalition Against Insurance Fraud, “Prescription for Peril: How Insurance Fraud Finances Theft and Abuse of Addictive Prescription Drugs,” December 2007, courtesy of epidemiology mapmaker Jeremiah Lindemann, April 7, 2017.
Chapter Seven. FUBI
Interviews: Sgt. Brent Lutz, James Kendrick, Sheriff Tim Carter, Don Wolthuis, Shannon Monnat, Sgt. Kevin Coffman, Mark O’Brien, Dennis Painter, Courtney Fletcher, Kristi Fernandez, Agent Bill Metcalf, Lauren Cummings, Dana Cormier, Keith Marshall
Lutz was tracking the movements: Author interviews, Sgt. Brent Lutz, Jan. 19, 2016, and subsequent interviews about the FUBI ring, including May 24, 2016, and Oct. 27, 2016.
drug users are arrested four times more often: Human Rights Watch and American Civil Liberties Union, “25 Seconds: The Human Toll of Criminalizing Drug Use in the United States,” 2016: https://www.aclu.org/sites/default/files/field_document/usdrug1016_web.pdf.
$7.6 billion spent nationwide: C. S. Florence et al., “The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013,” National Institutes of Health, Medical Care, October 2016, 901–906, https://www.ncbi.nlm.nih.gov/pubmed/27623005.
“that one that starts with a D”: “Makers of Dilaudid to Officially Change Name to ‘That One That Starts with a D,’” http://gomerblog.com/2017/03/makers-of-dilaudid/.
“You go crazy if you can’t laugh”: Author interview, Health Wagon nurse-practitioner James Kendrick, May 24, 2017.
“but they don’t put the resources to monitor them”: Author interview, Shenandoah
County sheriff Tim Carter, July 10, 2017.
three people died of overdose: Virginia Department of Health statistics, 2012. (Five died that year of prescription opioid overdose.) Two NAS babies were reported for Shenandoah County in 2012.
“it was like cutting off and on a light switch”: Author interviews, Lutz.
demanding sex from female addicts: Ibid.; author interview, Don Wolthuis, Jan. 7, 2016 (and many subsequent interviews with Lutz, Wolthuis, and others).
diseases of despair: Anne Case and Angus Deaton, “Rising Morbidity and Mortality in Midlife Among White Non-Hispanic Americans in the 21st Century,” National Academy of Sciences of the United States of America, at http://www.pnas.org/content/112/49/15078.full.
“The places with the lowest overdose mortality rates”: Author interview, Shannon Monnat, June 6, 2017. Lewis County, NY, schools’ payment in lieu of taxes from Maple Ridge Wind Farm: Joanna Richards, “Wind Farm a Windfall to Lewis County Communities,” North Country Public Radio, May 15, 2013.
opioid-prescribing rate in the Woodstock region: Opioid-prescribing rates comparing Lee County’s (10.23 percent) to Shenandoah County’s (2.96), Virginia’s (5.49), and the nation’s (5.03); data comes from Medicare Part D enrollees, 2013, compiled by Monnat. The statewide figure was 5.49 percent.
journalist Sam Quinones: Sam Quinones, Dreamland: The True Tale of America’s Opiate Epidemic (New York: Bloomsbury, 2015), 327–28.
Declining workforce participation wasn’t just: Author interview, Monnat. Princeton economist Alan B. Krueger’s 2017 study also backs Monnat’s thesis: “The opioid crisis and depressed labor force participation are now intertwined in many parts of the U.S.,” he said, in the Brookings Institution paper “Where Have All the Workers Gone? An Inquiring into the Decline of the U.S. Labor Force Participation Rate,” Sept. 7, 2017, found here: https://www.brookings.edu/bpea-articles/where-have-all-the-workers-gone-an-inquiry-into-the-decline-of-the-u-s-labor-force-participation-rate/. Related: Fred Dews, “How the Opioid Epidemic Has Affected the U.S. Labor Force, County-by-County,” Brookings Institution, Sept. 7, 2017.
