Virginia based writer and journalist Beth Macy, author of the book Dopesick, will appear at the Virginia Museum of History and Culture to discuss her newest work, Raising Lazarus on Tuesday November 13th at 6:00 pm. You can get tickets to that event here, and read below for our interview with Macy where we discuss her process and philosophies on journalism. This article is by Landis Wine.
Landis Wine: I want to talk about your time working at The Roanoke Times. As a child, that was my first introduction to journalism and media literacy. How did your time there influence the rest of your career?
Beth Macy: So that was my, I guess my second daily newspaper, my third paper I had worked at, but I was there for 25 years. And really, if you look at the books, except for the last one, which grew out of the one before [Dopesick], they all came out of reporting I did for the Roanoke Times. Yeah. Factory Man grew out of a series I wrote in 2012. Truevine grew out of a story I spent 25 years trying to get for the Roanoke Times. Dopesick grew out of some reporting I also did in 2012. And you know, back in the paper’s heyday, back when we were Pulitzer finalists and winning lots of awards and we were really robustly staffed. We had bureaus in places like Martinsville and Westville and the New River Valley. And as those bureaus went away with the decline of newspapers, I felt it was more important to tell stories from the rural countryside because those areas just weren’t getting covered. And they also happened to be areas that were disproportionately hard hit by rent-seeking corporations that were closing factories and shutting down lines and rent seeking pharmaceutical executives that were picked those same places to send their reps with the lie that this drug was virtually non-addictive, you know? And so then it becomes a double whammy and basically no one’s covering it in the nation. You know, so I kind of had like open season on some really good storytelling that I also see as being connected to just this terrible divide, political divide that we have in our country. And, and that’s what I’m working on right now.
LW: Absolutely. And you know you touched on it in your answer to that, but the decline of those institutions and local media has created a bit of a vacuum. I feel like you’re very good at generating empathy. I feel like that’s tough sometimes for people to be able to connect with other people even in their own city. Do you feel like there is anything that is replacing local journalism in a way that can bridge that gap? And if not, what could?
BM: Yeah. Well, I, I’m not as familiar outside of this region, but in this region alone, I mean, we still have the Roanoke Times. It’s less than a tenth of the size that it was when I came on in 1989. But they still have some really good reporters and they’re all super overworked. The editor is now editing three papers. But it’s just a skeleton staff. Several former Roanoke Times employees have started a nonprofit online news site called Cardinal News. And I thought this was an interesting choice. They mostly went after the rural countryside to begin with. Yeah. And they don’t even have a full-time Roanoke reporter yet. They privileged rural, which is interesting. I’m not sure I would’ve done that, but I get what they’re doing and they’re having great results. There’s no paywall. Dwayne Yancy, who’s the dean of political journalism in the whole state, in my opinion, is running it. You know, they have as many reporters as the Roanoke Times has now, and fewer costs. I mean, it’s a great model. We’re already, most of us, getting our news online anyway, so thank God for them. I mean, I was a Nieman Fellow at Harvard in 2010, and I was just at a reunion last weekend. And that there was this talk that like, “guys, nobody’s coming to save us. We are the ones that have to save us.” Really putting the onus back on us as journalists to create new models. And I think Dwayne and Luann Rife, who is the publisher, has have really done a good job. And we have another website called Roanoke Rambler, which is just this one guy covering the hell out of Roanoke City, and he is doing a great job, but none of that, like, you kind of need to read all three of ’em. You’re still not getting as much news or as many feature stories as you would’ve in the old Roanoke Times. Now, why am I focused on feature stories? Cause I’m a feature writer. Yes. But also, feature stories are the ones that allow you to spread empathy and allow you to say who your neighbors are, warts and all, you know, and explain who the newcomers are, explain who the new business is. I mean, all these things, like the positive stories rarely get told. So, what you’re left with is, is easy to cover stuff like cops and courts, which disproportionately makes a reader think, “oh shit, society’s really going to hell,” [Laughs] or, “I better run out and buy a gun,” you know? And these bridge building stories that I used to specialize in just, just don’t exist and, and, and we don’t even know what they are.
LW: And you know, it reminds me of how, when I think about how people that I talk to down in Martinsville now that things have sort of separated out into receiving news via social media that is either from a legitimate source or from a tertiary excitable person who has a lot of strong feelings about something. It has fueled a wider disconnect. And I think that can create an air of pessimism.
BM: Yeah. It becomes mean-spirited people saying things online that they would never say to your face. I mean, that has really taken off. It’s, it’s really discouraging.
LW: You’ve talked a lot in your work about, maybe rebuilding is the wrong term, but sort of a reckoning with the fallout from the lawsuits that happened against pharmaceutical companies and that sort of thing. I was reading a bit into the Opioid Abatement Authority in Virginia and how they’re handling funds and I’m wondering if you’ve kept an eye on how that’s playing out here and how you feel about the approach that’s being taken to that.
BM: Yeah. I mean, that’s really why I wrote Raising Lazarus, because I thought with this money about to come down, they didn’t know what’s actually working. And not only in like New York City or Washington, what’s happening in the rural hinterlands, where it hit the first and the hardest. So that’s why the book opens in a dying furniture town, Hickory North Carolina, next to a McDonald’s dumpster, because I think harm reduction. If we’re gonna turn this around, we’ve gotta begin to reach out to these folks who aren’t in our current systems of care. And the best way to do that, and there’s research on this going back 30 plus years, is harm reduction. The idea of meeting people where they are, even if they’re still using and treating them with non-judgment and care. Full stop, you know? And I’m hoping that money doesn’t get hijacked by more policing, and more drug war policies. I’m not fully up to date on what Virginia is doing, although I had a chat with the guy who heads the abatement authority. It was maybe early this year. He was like going around to communities and listening, which is a great first step. And he said, “Beth, it’s the sheriffs. We’ve gotta get the sheriffs.” he said, and some of these are sheriffs from big counties. They’re elected sheriffs who wanna be reelected, and they’re afraid that if they use evidence-based practices, they will be perceived as hug a thug. And they won’t get reelected. One sheriff, he didn’t say where it was, but he said it was a large county. He said, well, we don’t go in for that “naw loan”, not Naloxone “naw lone.” Like, he wasn’t even letting his deputies carry it. That’s, that’s a travesty.
LW: You talk about harm reduction, which I, I am a hundred percent on board with. I think that is the way to do it. But there are also a lot of, from what I’ve seen, a la carte options on how to tackle it. Each region can sort of choose how they’d like to approach it. But I think that some of those approaches may keep people who are still actively using at bay. Unfortunately, it seems like people are still afraid to admit that people who are actively using need to be met where they’re at.
BM: It’s just easier not to look at it. Right? Until it bites you in the ass by hitting your own family. And you know, when I finished Raising Lazarus, the latest surveys, which shocked me, said one third of American families had experienced strife because of the opioid crisis. Just about two months ago, new data came out, new polling data showing that two thirds, that was in the span of less than two years, it gone, we’ve gone from one third to two thirds. I mean, there are 7 million people with opioid use disorder. We we’re just gonna be okay with this huge treatment gap where it’s way easier to
get illicit substances than it is to get treatment. Are we okay with 7 million people dying, you know, when we know what the answers are? We’re just not providing them at a scale to match the scale of the crisis.
LW: Yeah, absolutely. In Richmond city, Naloxone has become something that is pretty ubiquitous. I was in Philadelphia the other week, and there are neighborhoods where it’s taped to telephone poles. It’s freely accessible. But also with some neighborhoods, there’s a perception problem associated with it. And, you know, after all of the work that you’ve done and that a lot of people have done to sort of bring awareness and push people toward the light with this, is there anything that you think will get to those people who still think that it’s an image issue and aren’t understanding the humanitarian need?
BM:I mean, unfortunately it takes people feeling it in their own family. And even though they feel it in their own family, that doesn’t necessarily mean they have educated themselves to the point where they’re gonna choose the evidence-based approach. I mean, if you think about Tess from Dopesick, I did a podcast called Finding Tess that was sort of a follow-up — it was on Audible with her mother. We went back to try to retrace her final steps in Las Vegas, and her mother still believes she’s anti-MAT. And I mean, the data going back goes back to the 1980s on how efficacious Suboxone is. Now, is the company perfect? No. Are they making money hand over fist? Yes. But it’s a protective medication and you don’t get high on it if you use it. Right. And if you do return to an illicit substance, you’re not gonna overdose. So, I mean, the data is just so clear on it. I was on a panel with Nora Volkow from the National Institute on Drug Abuse a couple weeks ago, and, it was the kind of thing where people were calling in and they’re like, “Suboxone’s harder to get off of than heroin!” Well, maybe it is, but you know what, if you’re on it, you’re not doing heroin, which means you’re not getting fentanyl and dying. You know, there’s still, I know there are many paths recovery and every person’s different, which is why it’s so important to have harm reduction in place. In the meantime, there’s a woman I wrote about in Raising Lazarus who was the one who was letting the nurse practitioner do Hepatitis C testing pizza parties at her house. And, as I went on with my reporting, she kind of dropped out of sight. Tim, her healthcare provider, was really worried about her. She wouldn’t answer my calls. She was like, ‘I’m gonna go by her damn house if I need to. She lost her kids, she became depressed. She was using not carefully. I was giving a talk in North Carolina about three or four months ago, and she showed up and she had been clean for six months. During the interim, she had overdosed 200 times. Somebody brought her up back with Narcan and she said, ‘harm reduction kept me alive.” And she is just so grateful. I mean, she posts every day about how grateful she is, and she is the best spokesman for hanging in there, you know, and people can get better, but she’s very, very lucky. She didn’t die and she knows it. Now she has her kids back and she’s like, look at me. She brought her kids to the talk and she’s like, this is the first time I haven’t had to have supervision from CPS workers. I can take my kids out. She’s working. It’s just really beautiful. But that was her path. But she was many, many years in active use.
LW: That also touches on something I was curious about..You know, your approach for all of your work, from what I’ve seen is, is very much on the ground. You’re always in the thick of it. Now that you’ve covered so much with that. Do you feel like that’s still your way forward? Regardless of the topics that you plan or would like to cover, do you feel like you’re always going to want to be embedded on that level? Or do you feel like having those experiences has made you want to have a bit of a, not a vacation from it, but a change of approach?
BM: No, I feel like too few reporters use the on the ground approach. I reported on Factory Man for a solid year before I sat down with the CEO of Bassett Furniture. I wanted to hear from the secretaries and the line workers and the babysitters and the custodians. I really wanted to feel for the town. And I’m not gonna ask the best questions if I begin with Rob Spillman. So the thing I’m doing now is I’m embedding in my hometown, I’m writing about the rural urban divide, and I try to find story beacons. And, it’s different ’cause it’s my hometown, so I know a lot of people, but like people who can get me to a large group, like I’m following a truancy officer to boy, the things I’ve seen on the ground with her, I’m following a young doctor who grew up on a dairy farm and has come back to help rural America. And I’m just astonished that, in our hometown, homelessness is so big and mental health in such a crisis. Other beacons have been teachers. I have interviewed the mayor, but I didn’t start out with the mayor. I started out with the people on the ground that are gonna get me to them. And that’s always served me well. Because I think all those other people, they always get to tell the story. It’s not fair for the people who don’t. I have a real sense of fairness because I was an outsider and an underdog myself. I want to see all kinds of stories in our media. Not just like when the recession happened, I think it was 2% of all stories written by the media or from the perspective of workers. Everything else was from the CEOs and the stockholders.
LW: Yeah. And you know, it’s interesting that you’re talking about working on this subject because again, as I mentioned, I grew up in Martinsville and in that time, during the interstitial period between NAFTA happening and the opioid crisis really ramping up considerably in that areaeveryone was encouraged to get out if you could. It didn’t matter if you were going to college, it didn’t matter if you were pursuing a trade, if you were under the age of 18, it was expected that you leave as soon as you could. So a lot of us did. And you know, you were talking about it, but in the decades since, the narrative about that, those kind of areas, across the country as well as in Virginia, has really curdled. And there’s an othering that I think has gotten more intense about folks who are in rural areas. And, you know, you’re talking about going back and doing that work in your hometown. Does that divide feel like it’s intensified?
BM: Really even just since I started working on the book in February, I feel like it’s intensified since then. There’s a New York Times column in today’s paper by Pamela Paul about what the Democrats are getting wrong. And so I sent an old friend of mine who gets all of his news on YouTube and has really gone down a rabbit hole. I thought, here’s something that we might actually agree on and could use as a starting point for the next time I interview him. And he sent it back to me with all of his comments in italics so I could see, and I mean, he called her a bitch like three times. I mean, it was so full of vehement and, not quite hatred, but just disdain. He seems more worked up and angry than the first time I interviewed him earlier this year. And this is something that has affected 38 million Americans who have lost friends and close close friendships and family members because of the divide. And that’s what I’m trying to figure it out. Many days when I’m reporting it feels like a second civil war is looming. I don’t really understand it. I don’t, I can’t really pick it apart the way I could with the opioid crisis back to Purdue. I can’t get my arms around it yet. Scratches some kind of itch that people have, you know? To be really mean and provocative and of course without any consequences.
LW:Do you think that kids and young adults growing up today really have any sense of media literacy in a way that perhaps you and I would’ve understood it?
BM: No. We all saw our parents reading the newspaper, not being addicted to their phones. I don’t want to put more on public school teachers, ’cause they’re about all we have left of our social safety net, but we need to be teaching this stuff. I’m shocked during my visits home when I hang out in the schools, just how little it is. I’ve been there on a couple different election days and you know, andthe kids don’t know what’s going on. There’s just so much mental illness now, especially since Covid — untreated mental health. The number one issue in rural America, I think probably everywhere, is untreated mental health. You’re looking at these rural counties that don’t have a single psychologist or psychiatrist and waiting list to see a counselor that goes into March right now, you know? And suicides on the rise.
LW: I think there’s a part of a lot of people who’ve left those areas that want to reengage and want a reason to go back. But the narrative and the pessimism that has festered there through both the failure certain initiatives, the additive trauma of addiction and mental illness, has really taken its toll. Right now, Southern Virginia is growing in a way that Northern Virginia isn’t. There is a little bit of an inverse growth curve going on there, which is interesting, and I wonder if that will help turn the tide.
BM: You know, my hometown is not unlike Martinsville in that there was one big dominant manufacturing force that got gobbled up by an international conglomerate, and it still does have quite a bit of manufacturing, but the problem is it actually has way more than the average amount of manufacturing and they can’t get employees. A year ago I would’ve said it’s because they can’t pass a drug test, they’re just not showing up. A lot of these factories that I’m talking to in my hometown, they stopped doing drug testing or background checks because they’re so hard up for employees and that tells me that the populace is just not healthy enough to work. But those places with like one or two industries I think have been hit the worst by this. I mean, my hometown isn’t quite as bad as Martinsville because it also has a lot of farming and healthcare, but Martinsville was really hit hard.
LWI think that you have been able to do something that I haven’t really seen in other writers or journalists who’ve covered what you have, which is people from the areas you cover really hold you in high esteem. And I think that you’ve been able to hold on to not only people’s interests, but also be able to, as I said earlier, sort of generate empathy, and if you were to somebody else approaching these topics telling this kind of story, what would you tell them about how you’ve maintained that integrity.
BM: Hmm. Well you pointed out like, I always start on the ground and I think that helps. At the same time I’m doing that, I’m also reading widely. So right now there’s a book called Twilight of Democracy. I’m reading another book by Heather Cox Richardson called Democracy Awakening. I’m writing about how I think going away to college, which was fully paid for by Pell Grants. Do you know what those are? Which barely exist anymore. Talk about fraying social network. Yeah. I mean, I’m writing about how the government beginning with Reagan and then continued under Clinton, basically took college away from poor people. And, you know, I’ll interview these people and so I’m always trying to… here’s James Baldwin on my desk. Im always trying to first start with the people, then try to build a context around it so that I can, with authority and with backup, say these things I wanna say, or show these stories that I wanna tell. But it’s a constant toggle between going really, really close to somebody and then backing up and trying to understand what these nebulous forces are that I don’t quite have my arms wrapped around yet, but I’m trying to understand it. And, you know, I’m talking to this friend of mine that I mentioned that sent the hateful email this morning, and I’m gonna meet with him next week. And this’ll be our fourth talk, I think, but he gets really angry when he talks about it. So I have to kind of steal myself and be really prepared and, because I don’t want to…. I just feel like everything is just so tender right now and things could implode at any minute. Yeah. Everywhere.
LW: [Laughs] Yeah. I feel like, again, I’d love to end on a note of positivity, but it feels very heavy. And in a way I feel like if people don’t let themselves settle into that in some way or another, they’re not really going to pay attention to it.
BM: Yeah. I mean, a third of Americans have stopped reading the news ’cause it’s so depressing. That’s pretty depressing.
LW: Yeah. It’s terrifying sometimes. Yeah. When I talk to people who I haven’t talked to in a while and just see how far away that they can drift, and people are making money on the backs of that. There is money to be made. Also the cost, in terms of the corporeal United States, the body keeps the score. Your work has covered a lot of things that have intersected with my upbringing, and my life in general. So it’s a real pleasure to be able to talk to you because I’ve seen other interviews that take an almost forensic view of small towns. I’m glad that you’ve had the patience and obviously the experience of understanding, those people and those needs in a way that other people haven’t.
BM:I mean, this is where I live, you know? I just wanna be part of the community and I told the people for the Hulu show, “I gotta go to the grocery store here.” We can’t be stereotyping Appalachia and these are, this is me. You know? Yeah. You can’t just like swoop in and use all these stereotypes to try to sell a story.