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Chapter 4
Themes
Key
LitCharts assigns a color and icon to each theme in Dopesick, which you can use to track the themes throughout the work.
Poverty as an Obstacle to Recovery
Cycles of History
Race, Healthcare, and Criminal Justice
Fighting the Medical Establishment
The Value of Science
Summary
Analysis
People find out about the opioid epidemic in waves, often after shocking media stories like the deaths of Philip Seymour Hoffman and Prince. One of the biggest signs of the growing awareness is when the Cincinnati Enquirer becomes the first newspaper in the country to have a reporter dedicated solely to the heroin beat.
In Roanoke, Virginia in February 2006, the local TV meteorologists Jamey Singleton and Marc Lamarre stun viewers when news breaks that they are both heavy opioid users (and that Lamarre has suffered a near-fatal overdose). The addicted weathermen are a wake-up call to Roanoke (where author Beth Macy lives), although the case of the weathermen is far from an anomaly. Previously, heroin use in Roanoke had been more or less limited to its Black residents, but increasingly, the epidemic crosses racial lines. People suffering from addiction neglect all their other relationships to focus on getting their next fix.
Macy tells her own story about how opioid abuse first became public knowledge in her own community. While the story is specific to Roanoke, it is also representative of a broader story of opioids in the United States. Weathermen are (or at least used to be) widely recognized figures in a local community. The fact that such visible people are struggling with opioid addiction suggests the epidemic really can reach anyone. They are the local equivalent of the stars like Philip Seymour Hoffman and Prince mentioned in the previous section.
Themes
In 2006, Clifton “Lite” Lee is a dealer originally from Philadelphia who helps popularize heroin in Roanoke. When he is sentenced to jail in 2008, prosecutors show how, at the height of his business, he had profits of 600 percent. At the time, his story doesn’t reach Macy, even though she works at a newspaper.
The fact that even as a journalist, Macy didn’t hear about Clifton “Lite” Lee suggests that information about the opioid crisis remained scattered, even as late as 2008. The 600 percent profits Lee earned don’t necessarily justify his dealing, but they do provide context for why he would do it.
Themes
Scott Roth is a young man in Roanoke who dies of a heroin overdose. Spencer Mumpower goes to prison in 2012 for selling Scott Roth the heroin that killed him.
Macy is setting up a story that asks questions about responsibility during the opioid crisis. If Spencer Mumpower sold Scott Roth the heroin that killed him, how much responsibility does Spencer bear for Scott’s death, and if he bears responsibility, what sort of punishment does Spencer deserve?
Themes
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Robin Roth, mother of Scott, recalls how her son had been on and off drugs since he was 17, in 2006. Though he tried to claim he’d only done weed, he had, in fact, smoked heroin. Despite her efforts to help her son with rehab, she wasn’t able to stop him from taking the heroin that would cause his fatal overdose.
The story of Robin and Scott Roth echoes some of the stories Macy has already told—particularly the part where a parent isn’t fully aware of the extent of their child’s addiction. Macy shows how the cycle of addiction repeats itself even in different situations and circumstances.
Themes
In Roanoke, 2012 is the end of the opioid epidemic’s stealth phase. Jesse Bolstridge is a high school student who trades his Adderall to classmates in exchange for painkillers. His mother, Kristi Fernandez, knows something is wrong but can’t pinpoint the exact moment that her son’s life shifts and he becomes completely addicted to the pills.
Macy has already revealed in the prologue that Jesse Bolstridge dies of an overdose. Just like Robin Roth, Kristi Fernandez isn’t able see the full extent of her son’s condition. Macy presents their stories in parallel to show that they weren’t neglectful parents: they were just facing a difficult-to-understand challenge that parents across the country have struggled with.
Themes
Kristi is a local businesswoman, and she doesn’t believe it the first time someone tells her that her son might have a pill problem.
As Macy has shown, Kristi’s denial isn’t evidence of obliviousness but evidence of how stealthily pill addiction can infiltrate communities, particularly among young and seemingly healthy people.
Themes
In 2010, news breaks that a local heroin user named Brandon Perullo has tried to rob a bank. He is sentenced to prison in 2011. His mother, Laura Hadden, tries to get the local newspaper to draw attention to the issue, but they ignore her, finding the bank robbery itself more notable than the motivation behind it. She begins to do drug-prevention advocacy but attracts little attention at first.
While Macy is a big advocate for journalism (and a journalist herself), she is also critical of the way some newspapers are run. The example with Brandon Perullo shows that many newspapers put undue emphasis on the most sensational parts of stories. For Macy, the real story here isn’t the attempted bank robbery but the nationwide opioid epidemic that is fueling crimes like the bank robbery.
Themes
Years later, Brandon is released from prison. Laura Hadden begins a new round of advocacy. Though Brandon seems to be adjusting well to life outside at first, his felony record makes it hard to find a job. Seven months after getting out of prison, he relapses, and two weeks after that, he dies of an overdose. Hadden believes the death may have been a suicide, in order to avoid dopesickness.
Brandon’s experience with the criminal justice system is an extremely negative one. His time in prison didn’t seem to rehabilitate him and if anything made it more difficult for him to adjust to life on the outside. Macy presents his story to question whether the current criminal justice system really best serves people like Brandon or if punishing small-time users is in fact counterproductive.
Themes
Kristi faces a similar situation to Hadden, but she didn’t encounter Hadden’s advocacy. Kristi knows her son has a serious problem, and so she reluctantly installs a lock on her bedroom door (so that he won’t be able to steal valuables). Robin Roth also feels like a failure because of the death of her son Scott, not realizing how many parents out there are in similar situations (since internet support groups around the issue aren’t prevalent yet).
The lock on Kristi’s bedroom door symbolizes how Kristi was forced to lock her son out of parts of her life—arguably for his own good and for hers too, although it’s a tragic situation all around. Macy cuts over to Robin Roth’s story to show that, ironically, just as many parents were feeling isolated about their situation, other parents around the country were facing the exact same circumstances.
Themes
At court in 2012, Spencer is convicted of selling Scott Roth the heroin he overdosed on. The judge suggests that it might be helpful for Robin to meet with Spencer, but she says she isn’t ready.
Given the poor outcome that Brandon Perullo had with the criminal justice system, Macy has primed her audience to expect a similar outcome for Spencer.
Themes
In summer 2012, Macy follows Robin and Spencer as Spencer prepares for prison. Spencer opens up to Macy about his past, giving tips about how parents can stop children from accessing their drugs (for example, by removing any medicine from their cabinet that ends in “codone”).
Spencer, however, seems to actually improve his behavior after hitting rock bottom. His openness about his past behavior suggests that he has reflected on it and that he doesn’t want other young people to find themselves in the same situation as him.
Themes
Spencer recalls the night he sold Scott the heroin that led to Scott’s death and Spencer’s imprisonment. The two hadn’t seen each other since high school, three years earlier. When Scott showed up to buy from Spencer, Scott looked like a full-blown junkie, weighing just 135 pounds. Later, in jail, Spencer has a hard time at first before finally hitting rock bottom and deciding to change.
Spencer is willing to admit that he showed bad judgement by selling to Scott (who was clearly a danger to himself based on all the drugs he was taking). Spencer’s ability to acknowledge his error suggests that he has the capacity for change.
Themes
In jail, after Spencer decides to turn his life around, he writes an apology letter to Robin Roth (which her therapist keeps until she’s ready). By 2012, he is drug-free for two years and has replaced his drug addiction with a new focus on karate.
Spencer’s experience in jail is in many ways the ideal outcome—he learns from his mistakes and is ready to make amends. Macy leaves the question open, however, whether Spencer’s progress happened due to his time in jail or in spite of it. One of the themes she returns to is how, in spite of broad patterns in common, everyone’s journey with addiction is different, and what works for one person might not work for another.
Themes
Robin begins to soften toward Spencer, and she learns from other newspaper stories that she is not alone. A drug-use survey at the local high school reveals that 6.4 percent of students have tried heroin and almost 10 percent have used prescription drugs illegally. While family members of victims go to Families Anonymous meetings, most keep quiet, either out of grief or out of shame.
Robin’s sympathy for Spencer seems to suggest a growing awareness that, while Spencer did play a role in Scott’s death, there are perhaps other forces that played an even greater role. The quiet of many grieving families represents quiet on the issue of opioids in general—in many parts of the U.S., there is still a stigma against discussing addiction in the open.
Themes
