Checking in with Beth Macy, author of Dopesick and Raising Lazarus
This Q&A, facilitated by Dr. Kevin Doyle of the Hazelden Betty Ford Graduate School of Addiction Studies, was originally published for the Hazelden Betty Ford Foundation’s monthly Recovery Advocacy Update. If you’d like to receive our advocacy emails, subscribe today.
Beth Macy is the author of Dopesick and an executive producer and cowriter on the excellent Hulu series of the same name, starring Michael Keaton. Her new book Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis comes out on August 16, and just this week, she wrote powerfully for Oprah Daily about her own family experiences with addiction and stigma. As fans of Beth’s work and fellow advocates, we were happy to connect with her about the impact of Dopesick, the innovators featured in her new book, and hope for the future.
How did the Dopesick response and impact compare to your expectations, and what was your motivation for writing the follow-up, Raising Lazarus?
I was VERY pleased that Dopesick was a bestseller and was almost immediately optioned to become a show for Hulu. The book had such a sad ending, though, that I wasn’t sure I had the gumption to write about addiction again. However, as I started speaking across the country and learning about surprising and innovative solutions that were happening — but not nearly to the scale necessary to match the scale of the epidemic — I knew that much more reporting and explaining was needed, and that I couldn’t let the issue go.
In light of the opioid litigation money coming down, I knew there was an urgent need for a follow-up book to answer the questions: Will individuals ever be held accountable for helping spawn a drug crisis that has taken more than 1 million lives since 1996? And, more importantly, what should we be doing as leaders, governments, communities, family members and individuals to turn it back?
Was there a moment when it hit you — how big it had become — and what was it like to experience it taking off in all the ways it did?
Assuming you mean the Hulu show here, it was so gratifying when people from all across America reached out to our team to say: We’ve been blaming the wrong people for their addictions. One woman told us she telephoned her addicted son for the first time in three years after watching our show. In my opinion, that’s been the best feedback from both the book and the show — hearing people with opioid use disorder say they hadn’t realized they were part of a bigger story before; they thought they were just moral failures — not so!
You have become a “warrior” for addiction treatment and recovery — how did that come about for you, and how has your life changed as a result?
My dear friend and Kentucky novelist Robert Gipe read an early draft of Raising Lazarus and scolded me a little, saying, “You’ve written how many words on this? I don’t want to read any more about what you’ve seen. Now you need to tell us what you think!” So, at the end of the new book, I take off my journalist hat in the epilogue and pivot to my warrior/activist hat. Initially, that felt a little uncomfortable for me as a journalist, but, as one of the few writers who has traveled across the country reporting on treatment barriers and how best to forge recovery innovations (especially in rural areas, where resistance can be very high), I’ve cast my net very wide for nearly a decade, and Robert was saying: You’ve earned the right to opine. With journalism in a serious democracy-threatening decline, I daresay I’m obligated, even. Too few journalists are reporting on the regions that have been impacted the longest and the hardest by this crisis.
What should we expect from Raising Lazarus?
Expect to be thoroughly wowed by some bad-ass innovators who really have figured out how to make the shift from treating people with substance use disorders as moral failures to treating them as human beings with a treatable medical condition. These are true warriors who are meeting the addicted where they are, from homeless encampments and under bridges to fast-food parking lots. They have taught me so many things about stigma and about changing hearts and minds. About what needs to happen in our jails, in our cities and towns, and among health-care providers. If only we will listen to these folks and study their work and then implement their methods in a way that matches the scale of the crisis, we really could turn around our soaring overdose deaths.
What gives you hope about the future of America’s addiction crisis, knowing there is still so much work to be done?
The people featured in my new book give me hope. The only way I knew I could deal with writing about this sad epidemic again was by thoroughly exploring the worlds of these helpers, warts and all, and (as my great editor Vanessa Mobley advised me) then “imposing hope and order on a sad, chaotic story.” We are starting to see change, though I continue to be frustrated by how slow the pace is. People are dying hourly of fentanyl while some law-enforcement leaders are still resisting carrying naloxone and fighting the legality of fentanyl test strips. The Biden Administration supports harm reduction; that’s a great first step! But we have so much more distance to cover.
What messages do you have for students studying to be addiction counselors?
Understand that addiction medicines are absolutely key to overturning overdose deaths and reducing stigma. But many people in long-term use also need housing, basic health care and social supports. They need jobs. They need a place to shower. They need friends!
Read about harm reduction so you can understand that harm reduction isn’t harm eradication. If a person with a substance use disorder is entering your office or clinic because they want to get better, try to put your judgments aside — realize that we’ve all been acculturated to Drug War thinking; that we all have blind spots around drug use — and really get to the crux of helping people by listening to them, meeting them where they are, and understanding that harm reduction leader Dan Bigg had it right when he said: “Any positive change as a person defines it for him or herself is our definition of recovery.”
Also, I would tell them: Thank you for being willing to do this important, lifesaving work.
