After the publication of her landmark 2018 book Dopesick, which featured six years of reporting about how the opioid crisis affected families in her adopted hometown of Roanoke, Virginia, Beth Macy vowed to herself, “I’m not writing about this again.” Her physician feared Macy might have PTSD after bearing witness to so many tragic deaths, including that of a 28-year-old mother named Tess Henry, whom Macy had grown close to while reporting Dopesick and whose body was found in a Las Vegas dumpster on Christmas Eve 2017. Macy’s husband suggested that she should write about happy things this time, like food and gardening, while her late mother, who had advancing dementia at the time, advised her about “eight times a day” to “write a love story instead.”
Not surprisingly, Macy didn’t listen. Yet today she is feeling happy and hopeful, chatting by phone about Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis from her mountain cabin an hour outside of Roanoke. Midway through our conversation, she becomes even more ebullient, shouting, “Oh my God. I’m looking at an eagle!”
Macy explains that writing Raising Lazarus was a very different experience from writing Dopesick, and in some ways, it was healing. “I’m not writing about just death,” she says of her most recent book. “I’m mostly writing about helpers, as Mr. Rogers called them. I’m writing about people who are actually making a difference. It feels really good to give them a platform, a voice.”
One of the book’s many fascinating heroes is the Reverend Michelle Mathis of Olive Branch Ministries in western North Carolina, who uses the biblical story of Lazarus to encourage people to extend help rather than judgment to those with substance use disorder (SUD). Mathis “tells the story to get well-meaning Christians to check their blind spots,” Macy says. “Jesus does the miracle, but the people who are following him have to go in there and get their hands dirty. They have to roll the stone and unbind Lazarus.”
Blind spots play an important role in examining issues related to SUD. The opioid crisis is everywhere, but in rural areas it’s often hidden in plain sight—”literally,” Macy says, “right under the bridges you drive across.” She and the helpers she profiles in Raising Lazarus encourage an alternate approach to the war-on-drugs, “just say no,” victim-blaming approach that so many of us grew up with. “The idea that drug users are worthy human beings—that they are, in fact, equals—is harm reduction in a nutshell,” she writes. They need access to things like clean needles, hepatitis tests and buprenorphine, or “bupe,” an FDA-approved medication to treat opioid use disorder.
People with SUD also need simple things, such as casseroles, instead of stigma and reproach. “It doesn’t always smell like flowers, and you might get a little something on you,” Rev. Mathis says in the book. “But the people who are willing to work at the face-to-face level get to see the miracle and look it in the eye.” Many such solutions, Macy points out, “are kind of low-tech and high-touch,” and the good news is that they’re working. “That’s the view that America needs to see,” she says, “not just the dark but the miracles.”
“That’s the view that America needs to see, not just the dark but the miracles.”
The first time Macy visited a needle exchange program in Roanoke, “I just kind of had to take a breath and turn around and get a hold of myself,” she says. She thought of Tess Henry, who had verbalized a need for urgent care for people with SUD before she died. “She didn’t know what that meant, because she had never seen it,” Macy says, “but she knew it needed to be as easy as the urgent care center that first prescribed opioids for her.” Tess, she believes, would have loved this needle exchange and its welcoming, comfortable vibe. It’s run by a “sweetheart of a guy,” Macy says, who brings his two little white dogs with him to work and provides things like deodorant, food, computers and help with housing and job applications to anyone who needs it, in addition to clean needles.
Macy admits that she has at times struggled to forgive those with SUD, especially in the case of her father, whose substance was alcohol. As a result of his addiction, she grew up in poverty; he even failed to attend her high school graduation. Every now and then, she thinks, “Wow, I really didn’t have the experience of having a father.” But she also knows that he had an illness. “So in some ways,” she says, “I’m trying to figure all that out for myself too.”
Macy knows that she could have become addicted, too, if things had played out a little differently in her life. “I was a wild thing,” she says, “but in my small town, it was just marijuana and beer. I’m sure if everybody was doing [opioids], I would’ve wanted to get in on it too.”
“I think when the full truth comes out, it’s going to be even more shocking than it is now.”
At that time, however, the Sackler family had yet to unleash the pain medication that would eventually cause the opioid epidemic: OxyContin. With fascinating detail, Raising Lazarus describes major players in the class-action lawsuit against this “cartel of the opioid crisis,” as Macy describes them. Paul Hanly, a high-profile litigator who led the legal fight against opioid makers and distributors, told Macy, “I’ve taken 500 depositions in my career, and I have never deposed a person whose ability to exhibit empathy is zero. . . . Compared to [Perdue Pharma chairman and president Richard Sackler], Donald Trump looks like Jesus Christ.”
Macy says she would love the chance to question the Sackler family herself, but only if they first took a truth serum. “They hid so much of it for so many years,” she says. “I think when the full truth comes out, it’s going to be even more shocking than it is now.”
Still, Macy wonders whether the Sacklers wish they could have done things differently—even though board member Kathy Sackler has already testified before Congress that they do not. “They started this thing that has hurt roughly a third of American families, and they’ve taken no responsibility for it,” she says. “I just want to hear them say they’re sorry.”
Author photo of Beth Macy by Josh Meltzer