The opioid epidemic continues across Virginia and the nation, with the state projecting a record number of lives lost to overdoses by year’s end.
Overdose deaths are projected to claim the lives of 2,619 people in Virginia in 2021, according to a report updated in October from the Chief Medical Examiner’s Office of the Virginia Department of Health. That's a 13.43% increase from the 2,309 overdose deaths in Virginia last year. Overdoses have been the most common type of accidental death in Virginia since 2014. Most of the overdose deaths since 2015 have stemmed from use of illicit opioids instead of by prescription opioids. The rate of overdose deaths involving prescription opioids has remained relatively flat since 2007, according to the report.
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A great primer on the epidemic and its origins is Roanoke resident Beth Macy’s book “Dopesick: Dealers, Doctors, and the Drug Company That Addicted America.” It’s been adapted into a limited-run series now airing on Hulu, with stars including Rosario Dawson, Michael Keaton and Peter Sarsgaard; Barry Levinson directs. It delves into various aspects of the epidemic, from the devastating impact of opioids on individuals, their families and communities to Purdue Pharma and its development and marketing of the painkiller OxyContin. Purdue Pharma pleaded guilty in 2020 in federal court to fraud and kickback conspiracies. The company was dissolved in September as part of a bankruptcy settlement.
Macy is in Ashland this evening for a screening of an episode of the series at the Ashland Theatre. Doors open at 6:30 p.m., and the screening is at 7 p.m. A mask and advance registration are required and should be open until the event begins. Macy and Andy Edmunds, director of the Virginia Film Office, will be on hand for a Q&A session at the event.
The crisis has evolved from prescription opioids to illicit drugs, but the numbers continue to rise even as access to treatments has been enhanced in Virginia through Medicaid expansion. Numerous obstacles must be navigated, including social stigma, lack of access to medical care and lack of motivation to receive help.
But many people have no interactions with health care and are more likely to end up in jail for dealing to support their habit than they are to come to a clinic or doctor’s office for treatment, according to Macy, a result of “systemic stigma as much as anything.”
Macy says that each year, 12 out of 100 people dealing with opioid use disorder are able to get treatment. “We’re still putting up barriers,” she says. “We think we’re throwing a bunch of money at it, which we are, but we’re making it too difficult for people with [Opioid Use Disorder] to access lifesaving medications like Buprenorphine or methadone. To me, that’s the No. 1 thing.”
There needs to be a greater investment in resources on multiple fronts, Macy says. Medicaid expansion in other states would help, as would helping people by boosting jobs, counseling and housing, which would pay off in the long term.
“We talk a lot about infrastructure in this country, and that’s all good, but in order to have people … to build these roads and bridges and other infrastructure, we’re going to need a human infrastructure before we need a ‘thing’ infrastructure,” Macy says.
Systemic change is something she’s wishing for, but she’s not hopeful.
The Hulu series covers the first third of the book, to about 2007. Macy earned an executive producer credit and a writer credit for the series. Her duties included additional original research and interviews.
The series follows the Purdue Pharma case and a subplot that looks at how hard it is for people to access treatment and medication to deal with their substance issues, as well as the societal stigma that blames the person dealing with substance use as a character defect, not a medical issue. “We’re not moving the needle on that fast enough,” Macy says.
Macy describes the series as a first-class production and praised Disney and Hulu for investing in the project. “It takes a lot of guts to take on billionaires, and they were willing to do it,” she says.
Feedback has been positive. Macy watched all episodes with one parent whose teenaged son had died from an OxyContin overdose. “He was just so moved,” she says. Macy has heard from people from families featured in the book and from others across the country, who told her that it was like watching their own family on television. “I think that’s good, that it can help give people this catharsis and healing, to know that it wasn’t just their loved one’s fault,” she says. “This was a cruel marketing scam promulgated on the country by a criminal corporation.”
She also had a brief part in an episode. The experience was interesting, especially so in that it entailed extensive COVID-19 mitigation measures. Everyone on the set was tested multiple times, and masks and shields were required on set. As a scene was shot, everyone on camera had to place masks under their seats and check their neighbors.
Macy calls herself a homebody, but she’s been logging many miles on the road to boost “Dopesick” and in reporting her next book, “Raising Lazarus: Hope, Justice and the Future of America’s Overdose Crisis.” It’s her fourth book for Little, Brown and Company and is set for an August 2022 release.
“Lazarus” goes afield to North Carolina, West Virginia, Northern Virginia and New York. It focuses on Purdue and the bankruptcy process and looks at treatment innovators and at activists who sought to get victims’ voices heard in bankruptcy court, according to Macy. “Dopesick was about the problems, this one is about the solutions,” she says.
By the Numbers
Mortality rates in Virginia per 100,000
- 146.6 COVID-19 death rate 2020
- 21.6 influenza and pneumonia death rate 2019
- 18.3 overdose death rate
- 11.7 firearm injury death rate
- 5.3 homicide rate
Projected fatalities by cause in Virginia through year’s end
- 2,619 drug-related fatalities (2,309 in 2020)
- 2,177 fatal opioid overdoses (1,915 in 2020)
- 1,207 gun-related fatalities (1,194 in 2020)
- 1,036 vehicle-related deaths (984 in 2020)
Sources: U.S. Centers for Disease Control and Prevention, Quarterly Drug Death Report, Q2, Virginia Department of Health
