Book Review: Raising Lazarus: Hope, Justice and the Future of America's Overdose Crisis

With a book titled Raising Lazarus, you would think Beth Macy would highlight the main point of that biblical passage in John 12:

Jesus said to her, “I am the resurrection and the life. The one who believes in me, even if he dies, will live. Everyone who lives and believes in me will never die. Do you believe this? ”

“Yes, Lord,” she told him, “I believe you are the Messiah, the Son of God, who comes into the world.” (John 12:25-27)

When Jesus raised Lazarus from the dead, it was one of the most significant miracles He'd performed, and it was led to the religious leaders of Israel amping up their efforts to assassinate Him.

"But the chief priests had decided to kill Lazarus also, because he was the reason many of the Jews were deserting them and believing in Jesus." (John 12:10-11)

So from the start, it was a bit off-putting to track the author's misuse of a biblical text intended to magnify Jesus as the Savior of the world to make a point about the lengths we should go to aid and treat those addicted to opioids.

To make faith matters worse, Macy consistently denigrates abstinence-based programs of addiction treatment that require counseling which are often faith-based. She's an advocate of "evidence-based" and "scientific" methodologies that treat OUD (opioid use disorder) and SUD (substance use disorder) with other medicines - namely buprenorphine, suboxone and others.

It is left to the people she interviewed late in the book to correct her plethora of veiled (and not-so-veiled) disparagements of faith-based approaches:

"The role that religion and spirituality played in many people's recoveries shouldn't be dismissed... So I think there's something to be said for the abstinence-based service model," ~Tracy Helton Mitchel

Macy is a local journalist, hailing from Roanoke, Virginia. That's a hop, skip and a jump from where I live. She spent most of the pandemic interviewing, writing and researching for this book. I learned a ton about the opioid crisis and the lengths to which some grassroots warriors are going to give help, counsel and aid to those trapped in the devastating whirlpool of OUD.

Macy and others work hard to communicate to the public that opioid addiction should be seen as a disease, like alcoholism. She and others eschew a tough-love approach, instead preferring to come alongside of the addicted, tracking them down and serving them with clean needles, buprenorphine and aiding them (over and over again) on their road to recovery.

There is so much to mourn about the opioid (and overdose) crisis that it's overwhelming. Macy describes the methods that irk many conservatives as activists work behind the scenes, delivering supplies, food and clean needles (always clean needles because they are the "carrot") to those caught in addiction. This strategy of meeting SUD/OUD people where they are and hoping to gradually lift them out of addiction is called "harm reduction." One pastor in Charleston, West Virginia described it as the motto of "Just. Don't. Die."¹

There's so much to learn. Macy also tracks the legal tale of the protection of Purdue Pharma and the attempted legal accountability of the Sackler family who notoriously continued to market Oxycontin even when they knew it was a dangerous gateway drug for so many into a life of ruin, devastation and death from addiction.

I was struck with a few things along the way. Macy and others are no fans of Big Pharma, but as she wrote during the pandemic, she was remarkably naive and uncritical about the COVID vaccines. In one sentence, she'd criticize the greed of Purdue Pharma related to Oxycontin and decry their legal loophole protections (and how employees at the FDA colluded with the company to get the drug approved and marketed - and were late hired by the company!) and then she'd ignore the same proven greed from manufacturers of COVID vaccines.

While the nation's political apparatuses did little to hold Big Pharma's feet to the fire, parts of the planet succumbed to fires and floods. COVID roared back with deadly new variants [she said this in 2021]. The climate crisis mirrored the overdose crisis in that each had been triggered by greed, deepened by political inaction, and defined by those intent on subverting science and manufacturing doubt so Americans wouldn't understand the risks to their health and safety."

Yes, Macy made sure to punch Right for most of the book (she does find room to criticize the Left, though not often). From LGBTQ+ activism and support to the climate crisis, to COVID vaccines, to TRUMP, to anyone who dared to disagree that the only way to treat the addicted was with more meds.

Even so, the lives of those destroyed by addiction (and their families, friends and country) deserve us to read, understand and apply proactive, creative solutions. Love demands action and wisdom. I agree with Macy that we cannot not see those spun into this web of health crisis as castaways. We must pursue solutions (and especially salvation) together.

It benefits us all even from a crass, bottom-line perspective. One estimate put "the cost of overdose deaths... at $1 trillion per year - the equivalent of roughly half of America's economic growth last year."

Macy's book would have been much stronger without the misuse of a biblical passage as her overarching theme to make her point (because she didn't glorify or commend Jesus at all). It would have been stronger and more professional without her own profanity lacing the narrative (I don't mind it in quotations in a book of this nature), for it reduced, not added to, the maturity of her points. I am doubtful that she did any research at all into the effectiveness of faith-based, abstinence-only plans that are matched with counseling, career-planning and expectations (though two of her activists found success and freedom from addiction through such programs). In fact, there so many stories that she tells of terrible relapses and ultimate overdoses from those who had recovered for a time (after experiencing harm-reduction programs) that one wonders if Macy shouldn't do a more formal comparative research project instead of just touting the tired, old lines of "evidence-based" and "scientific." Her own stories seem to reveal more failure than success.

My own epilogue

Macy's book was published before we learn the final results of the Purdue Pharma legal case. In July 2024, the Supreme Court ruled that the owners of Purdue Pharma (the Sackler family) were not exempt from from prosecution themselves (though they'd unethically attempted to divorce themselves from the company, taking $10 billion with them when they left). "In a 5-4 decision, the Supreme Court said that because the Sacklers had not filed for bankruptcy themselves, they cannot be shielded under bankruptcy law without permission from those who might sue."²

Read the book; it's a page-turner and a compassion-generator. Yet, also balance the reading with more view points in the continuing debate over whether harm reduction as a method actually reduces harm in the long run.

1. Is harm reduction harmful? by Grace Snell (World: July 24, 2024)

2. Paying for the opioid epidemic, Mary Munsey (World Radio Podcast: July 2, 2024)