Dopesick: Chapter 6 Summary & Analysis

An hour south of Roanoke, Virginia, is Martinsville, which in 2012 has the highest unemployment rate in the state. It has held that record for the past 12 years, ever since globalization reduced the number of factory jobs in the area. Macy began reporting on areas like Martinsville in 2008 for the Roanoke Times and later for her first book, Factory Man (2014). Because of the recession and because of the disappearing factory jobs, disability checks become a major source of income, which incentivizes people to stay sick. Children are frequently given Ritalin because the ADHD diagnosis will help them draw disability checks in adulthood.

Macy learns about the connections between poverty, disability, and opioid addiction when the Basset Furniture store (in Basset, Virginia) is burned down by an accidental arsonist who was trying to steal copper (to sell for money for opioids). The man who started the fire looks like a poor junkie who is desperate to avoid being dopesick. His circumstances are very different from Spencer Mumpower, who went to private school and several rehabs, but their desperation is the same.

In rural America in the 2000s, the opioid epidemic enters its “wily adolescence.” It spreads like an infectious disease, jumping in particular between family members. The main hub is Interstate 81, where OxyContin spreads up and down the Appalachians.

In 2010, police begin to notice that the opioid epidemic is not just a rural phenomenon but also a suburban one, spread more among peer groups than families. The spread is stealthier in the suburbs because many users have more money and are able to better disguise their spending. Teenagers, for example, pretend to lose electronic devices when in fact they are selling them for drug money.

The death of Scott Roth helps wake Roanoke up to the seriousness of the epidemic. He was well-liked and remembered for his life-of-the-party personality, which makes his death particularly shocking.

Drug prevention coordinators have a hard time catching up—they don’t realize the connection between heroin and pills until at least 2014. Flashier drug stories like warnings about bath salts distract from the quieter problem with opioids.

Teenagers in the Hidden Valley region of Virginia become experts at finding pills, usually from other people who have been overprescribed. The 2010 reformulation of OxyContin, which makes the pills harder to crush up for an instant high, causes many to turn to heroin to fulfill their addictions. For most teenagers that develop addictions, the first drugs they took were Ritalin or Adderall (prescribed for attention deficit disorders but also abused as a study drug on campuses).

Between 1991 and 2010, prescription of stimulants like Adderall and Ritalin increases tenfold among all age groups, with some going to children as young as two years old. Although not all studies show that behavior meds lead to opioid abuse, some addiction researchers have suggested a connection. While the drugs can be helpful in the short term, there is also no evidence that these medications lead children to perform better in school over the long term—particularly if the stimulants become a gateway to harder drugs.

Brian is another member of the same Hidden Valley opioid-using group as Spencer. He becomes dependent on pills by the time he’s 17 years old. In six months, he blows $8,000 on pills. Finally, Brian’s counselor stages an intervention with his parents, and he admits to them that he’s addicted to heroin. They send him to detox. In 2012, at age 23, Brian is being weaned off Suboxone (a treatment for narcotic dependence) when he is interviewed by Macy and tells his story.

Two mothers of opioid users meet and bond at a Families Anonymous meeting: Jamie Waldrop and Drenna Banks. Jamie and her family end up paying more than $300,000 while attempting to treat her son Christopher. Jamie begins isolating herself so that her friends don’t ask her how her kids are doing.

After two weeks into his first stay at a residential treatment center, Christopher learns that his good friend Colton Banks (son of Drenna Banks) has fatally overdosed. Colton died during what was supposed to be his “last hurrah” before going in for treatment.

Drenna remembers how two years before Colton’s death, a family friend lost his son to heroin. At the time, she thought, “Why can’t you control your kid?” but she soon realized that it’s not so easy when she learned her own son had a hidden habit.

At Colton’s funeral, Drenna presents him in an open casket. She begs during the service for Colton’s death to be the last and for the stigmas about addiction to be lifted. Later, she speaks to Christopher about how Colton wouldn’t want him to start using again.

Christopher, however, does relapse. Jamie refuses to bail him out financially again. Instead, she takes him to a hotel for a week for him to detox. At the time, he’s still only 20 years old. This time, however, it works, and as of the publication of Dopesick, he has been sober for four years. He tries to give back to his community, mentoring other young people who are newly sober. Christopher is a rare case: less than a quarter of patients who receive abstinence-only counseling for heroin like he did are able to stay clean for over two years. (The recovery rate climbs to 40 to 60 percent for those who also get medical treatment, such as with methadone or naltrexone.) When Colton dies in 2012, there are still 130 opioid-addicted Americans out there for every one death.