annual death toll for drug overdose: Sixty-four thousand deaths reported in 2017 for 2016: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates.
“The most damaging thing Purdue did”: Author interview, Dr. Andrew Kolodny, Jan. 6, 2016.
The point was by then moot: Author interviews, Barbara Van Rooyan, Jan. 16, 2017, and several follow-up correspondences, including letter from Department of Health and Human Services to Barbara and Kirk Van Rooyan, Sept. 10, 2013: “The Agency is requiring certain other modifications to the labeling, including the indication, for ER/LA [extended release, long-acting] opioid analgesics to help improve the safe use of these products. We decline to make the specific labeling changes you request, however.” The New Yorker article Van Rooyan refers to is Patrick Radden Keefe, “Empire of Pain,” Oct. 30, 2017.
approval of the original OxyContin: “FDA Actions on OxyContin Products, 4/16/2013,” U.S. Food and Drug Administration, which noted that it was withdrawn from the market “for safety reasons”: https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm347857.htm.
Americans, representing 4.4 percent of the world’s population: Gary Garrison, “Claire McCaskill Cites Disproven Figure on Opioid Use,” PolitiFact.com, May 10, 2017, citing International Narcotics Board data.
CHAPTER NINE. WHAC-A-MOLE
Interviews: Ashlyn Kessler, Lee Miller, Andrew Bassford, Dr. Isaac Van Patten, Tess Henry, Patricia Mehrmann, Dr. Alan Henry, Terrence Engles, Special Agent Joe Crowder, Mark O’Brien, Chief Chris Perkins, Jamie Waldrop
(“Generally speaking, there are people who overdose”): Author interviews, Ashlyn Kessler, via prison-monitored email, video exchanges, and letters, June 2016 to September 2017.
a young mother named April who’d recently: Tiffany Stevens, “Baby Turned Over to CPS After Police Find Adults Passed Out in Vehicle,” Roanoke Times, Feb. 28, 2017. April Lynne Maxwell was revived by EMTs with naloxone and taken to jail and charged with felony child neglect. Two other adults in the car with her also overdosed and were charged with being intoxicated in public.
“Ashlyn is gonna break your heart”: Author interview, Lee Miller, June 13, 2016.
fifteen thousand text messages: Author interview, Andrew Bassford, Jan. 6, 2016, and follow-up interviews in person and via email.
“Can you meet me at Sheetz on Peters Creek Road?”: Ibid.
after putting away her first heroin dealer: Ibid. and Jeff Sturgeon, “Roanoke Heroin Ring Shut Down,” Roanoke Times, Nov. 14, 2014.
“We don’t enjoy the cooperation”: Author interviews, Dr. Isaac Van Patten, May 1, 2016, and April 19, 2017; United Nations’ International Narcotics Control Board data on where heroin is produced: Christopher Woody and Reuters, “Here’s Where America’s Heroin Comes From,” March 3, 2016.
I thought of Tess Henry: Dozens of author interviews with Tess Henry and her mother, Patricia Mehrmann, took place beginning Dec. 2, 2015, and continued in person, over the phone, and via text and Facebook Messenger, up until this book went to press.
the same way four out of five heroin addicts: “79.5% of new heroin initiates in the National Survey on Drug Use and Health reported that their initial drug was a prescription opioid,” according to Richard C. Dart et al., “Trends in Opioid Analgesic Abuse and Mortality in the United States,” New England Journal of Medicine, Jan. 15, 2015.
Regulations now limited doctors: Laurence Hammack, “DEA Rule Targets Popular Painkillers,” Roanoke Times, Oct. 5, 2014. Quadrupling of prescription opioids: “Understanding the Epidemic,” Centers for Disease Control and Prevention, Aug. 30, 2017, https://www.cdc.gov/drugoverdose/epidemic/index.html.
upscheduling had been controversial: John J. Coleman, “Rescheduling Hydrocodone Combination Products: Addressing the Abuse of America’s Favorite Opioid,” American Society of Addiction Medicine, April 10, 2015.
one critic wrote in a published letter: Joe Graedon, “Patients in Pain Are Outraged About New Hydrocodone Rules,” People’s Pharmacy, Oct. 20, 2014.
“hot pack” their product: Author interview, Joe Crowder, May 1, 2016.
“I begged her public defender”: Author interview, Dr. Alan Henry, Dec. 20, 2017.
the fetus growing inside Tess: “Abrupt discontinuation of opioid use during pregnancy can result in premature labor, fetal distress, and miscarriage,” according to “A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders,” Substance Abuse and Mental Health Services Administration, Aug. 2, 2016, available at https://ncsacw.samhsa.gov/files/Collaborative_Approach_508.pdf.
now being illicitly imported from China: David Armstrong, “‘Truly Terrifying’: Chinese Suppliers Flood US and Canada with Deadly Fentanyl,” STAT, April 5, 2016.
(Some arrived from China via Mexico): “Fentanyl: China’s Deadly Export to the United States,” staff report, U.S.–China Economic and Security Review Commission, Feb. 1, 2017, https://www.uscc.gov/Research/fentanyl-china’s-deadly-export-united-states.
“Some of the companies shipping this stuff”: Author interview, Mark O’Brien, then-director of opioid overdose prevention and treatment, Baltimore City Health Department, Sept. 4, 2016.
But each time a derivative was banned: As cited by DEA spokesman Russ Baer in Sara Ganim, “China’s Fentanyl Ban a ‘Game Changer’ for Opioid Epidemic, DEA Officials Say,” CNN, Feb. 16, 2017; Kathleen McLaughlin, “Underground Labs in China Are Devising Potent New Opiates Faster Than Authorities Can Respond,” Science, March 29, 2017.
Roanoke police seized 560 grams: “Roanoke Valley Needs Assessment Partnerships for Success,” Roanoke Area Youth Substance Abuse Coalition (RAYSAC), Sept. 30, 2016, 22. The majority of those arrested were white males in their mid to late twenties.
Perkins had long championed community policing: Amy Friedenberger, “One Last Walk on the Old Beat,” Roanoke Times, March 1, 2016.
Hotels situated along the perimeter of Roanoke: Highways that pass by or cut through the city include I-81, I- 581, and U.S. 220; nearby hotels become prime heroin-dealing hot spots, according to RAYSAC survey, “Executive Summary,” 1.
shoplifting fueled by users like Tess: Author interviews, Chief Chris Perkins, Dec. 29, 2015, and April 24, 2017, and Tiffany Stevens, “Drug Initiative Faces New Street Realities,” Roanoke Times, Feb. 21, 2016.
A thirty-four-year-old woman was murdered: Violent crime up: Author interview, Van Patten; hotel murder: Neil Harvey, “Suspect in Roanoke Woman’s Death Is Denied Bond,” Roanoke Times, April 18, 2017.
Police Assisted Addiction and Recovery Initiative: Brian MacQuarrie, “‘Angel’ Opioid Initiative Thrives Despite Exit of Gloucester Police Chief,” Boston Globe, Feb. 21, 2017.
Janine had spent the previous seven years: Bobby’s story and the beginnings of the Hope Initiative outlined in multiple author interviews, Janine Underwood, beginning Aug. 3, 2016.