“One kid died [of an overdose] and the other was on his way to federal prison for five and a half years for having furnished him drugs that led to his death. He talked to me about this excruciating withdrawal. I remember, we were driving around and he was showing me all the places he had used, or sold, and people he had robbed, and pharmacy trucks, and whatnot. And he explained, ‘Look, the man [the dealer] doesn’t come until Thursday, and it’s only Monday. So you are gonna just use a little bit so that when you get to Thursday, you still have a little bit left, for when ‘it’ comes. The worst thing in the world is to experience those sicknesses, the excruciating withdrawal that everybody says is like the worst blow. Dopesick.”
That was the opening story from author, reporter, and producer Beth Macy’s talk at the Summer Institute Speakers Series, hosted at the Martha’s Vineyard Hebrew Center.
To say the near-capacity crowd was moved, based on the emotional Q and A that followed the talk, would be an understatement. It was a subject that hit home. As Macy said, there are at least 7 million victims of abuse disorder in the U.S., and the impact spreads to over a third of the entire population, by way of families, friends, neighbors, and co-workers. A great number of those victims are often patients who have been prescribed opioid drugs for pain, only to find it almost impossible to get off the medication.
Macy’s book and streaming show, “Dopesick,” shine a light on the ruthless actions of Purdue Pharma, its owners, drug reps, the FDA, and many doctors in selling and prescribing drugs such as oxycodone (OxyContin) to unknowing patients. The result was a congressional investigation, a series of court cases, financial settlements (per Macy, not nearly enough), the dissolution of the company (per Macy, far too late), some enlightened judges and sheriffs (far too few), the advent of drug courts that treat addiction and drug use more compassionately, and ultimately, at least the beginning of an understanding by society of the unrelenting damage of drug abuse, and the brutal journey to overcome addiction. Dr. John Kelly at Harvard states that it takes the average person with a substance use disorder four to five treatment episodes, over a period of eight years, to get one year of sobriety.
According to Macy, the realities are coming to light; societal attitudes are evolving, the stigma is declining, and treatment is changing. Replacement drugs such as methadone, overdose meds like Narcan, and new kinds of treatment centers are increasingly available. But addiction and its fallout continue, Macy says, in all strata of society, at all ages; and no town or area, no matter how remote, is immune.
And Martha’s Vineyard is no exception. Last year, six Vineyarders died of overdoses, a per capita rate higher than the rest of the U.S. And Island police say many ODs go unreported. Now the battle goes beyond oxycodone to another opioid, fentanyl, and animal sedative xylazine, street name “tranq,” mixed with fentanyl, and tianeptine, called “gas station heroin.” The Island does offer some of the more progressive approaches to the problem with Red House, a peer recovery program, with a detox facility, and the Martha’s Vineyard Hospital’s 24-hour-a-day Substance Use Disorder team.
Beth Macy said when she finished “Dopesick” and began to look for her next project, she didn’t want to do another book on drug issues. She was emotionally exhausted and, in fact, suffering from depression.
But she was drawn back to the problem, a problem she’d brought to light, but one that needed a next step. Now that we know so much, now what? What can we do? What should we do? How do we do it? She wrote “Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis.” This next book is largely about harm reduction, which includes Narcan, the opioid rehearsal process, needle exchanges, and getting people into treatment. Harm reduction is any positive change, as a drug user defines it for him- or herself, to literally reduce the harm. If you can enter treatment, do it. If you can’t and still use, try to use it more safely. Do less harm to yourself and to society.
Macy is the third in this season’s lineup of six speakers in the Summer Institute series, including Congressman Jamie Raskin, international relations expert Susan Eisenhower, and coming up soon, head of the New York Philharmonic Deborah Borda, human rights advocate Rabbi David Sapperstein, and president of Harvard Larry Bacow.
For more than twenty years, the Summer Institute has provided a thought-provoking speaker series. Macy’s talk was the latest, a sobering, moving dose of reality.
As that kid who was on his way to prison and took her on that drug tour said to her, “Dude, I taught you the word dopesick.” She responded, “Dude, you did.” Beth Macy has spread that word — dopesick —- and its devastating impact across the country and world ever since. And she delivered that message firsthand on Martha’s Vineyard.