I loved and appreciated Beth Macy's magnificent work in Dopesick, and I was riveted by this Audible-exclusive audio follow up to the story of Tess Henry, whose struggle to overcome her opiate addiction was so deftly and heartbreakingly told by Macy in Dopesick. This unique Audible audio documentary follows Beth Macy and Patricia, the mother of Tess, on a journey to Las Vegas to understand more about the final months of Tess's life, with the hint that they just might find some information on her murder. Beth Macy is a powerful journalist and deft storyteller, and this is SUCH an important story. I wish everyone in America (especially politicians and anyone with a loved one with an opioid use disorder) would read Dopesick.
This follow-up, however, felt somehow less authentic than Dopesick, and I think it's simply, understandably, because of how close the author got with the subject and her family during the work of the first book. She is clearly very emotionally attached to Tess Henry and her mother. Macy is honest in disclosing her closeness and emotional connection, and it's that connection that allows us so deeply into Tess's family, but it also leads her to draw a picture of Tess that felt, at times, like she was put on a pedestal as a saintly figure who is only a victim of a series of unfortunate and unfair circumstances, with no agency whatsoever in her own fate. This is not to say that I blame Tess for her death - she was murdered by a murderer, entirely not her fault. Nor do I blame Tess for the failures and weaknesses of a medically unsound, abstinence-based treatment network that does such a disservice to people who need medically-assisted treatment for opioid addiction. But the book does seem to gloss over the tsunami of damage that Tess wrought in the lives of the people around her.
Macy dances delicately on the edge of conflicts within Tess's family - her mother's enabling (and then deep regrets that she set stronger boundaries at the end, when more of her previous enabling might have at least prolonged Tess's life), her father and sister's belief in the "rock-bottom" myth that proponents of faith-based abstinence approaches like AA follow, the grandfather who keeps throwing money at the problem, all trying their best to save Tess but also live their lives and insulate themselves from the chaos and destruction around Tess. In this way, the Henrys are every family who has tried to navigate the sometimes-impossible challenge of loving an opioid addict back to health in the face of insurmountable systemic barriers to effective treatment. Patricia, in particular, is cursed with the terrible dual guilt of being told that she over-enabled Tess but also feeling that if she had just done more, her critics be damned, her beloved daughter might still be alive. She did the best that any mother could do, just love as best she could, imperfectly, as we all do. If love were enough, Tess would be alive today. She had an abundance of that, and it is not Patricia's fault that Tess is dead.
The short book ends, somewhat frustratingly, with no answers. Endless questions, with a slightly hopeful note that emergency treatment in Roanoke, VA, Tess's hometown, has improved somewhat with access to medication-assisted treatment in the ER setting for opioid addicts, something that may have saved Tess's life if she had been able to maintain steady access to the medication. I'm hopeful this important book may help reduce the stigma against MAT, especially among addicts themselves, and may help other families know they are not alone in their struggles to navigate and set healthy boundaries through a loved one's addiction and treatment.
What is really clear from Finding Tess, and what I wish everyone would understand, is that the AA model of waiting for the addict to hit "rock bottom" before they can find recovery is an utter and complete LIE. It's a lethal myth that is contributing unnecessarily to the deaths of young women heroin addicts. When you are a beautiful young woman with a heroin addiction, there is literally NO rock bottom but death. Sex trafficking is an ever-present trap, and sex work means there is an endless, endless supply of money for heroin. It was literally impossible for Tess to reach the "rock bottom" that adherents to the AA 12-step model think that loved ones should allow an addict to reach -- friendless, broke, literally at the end of their rope. For a young woman, there is always a deeper, darker bottom, as there is ALWAYS a demand for sex work. Loved ones should NOT wait for this mythical bottom to appear. Rapes, diseases, overdoses, and murder are far, far more likely to appear than a rock bottom that makes the addict suddenly, magically want to stop using. Tess Henry *wanted* to stop all along. But the ubiquitous availability of money through sex work (or trafficking) made it far, far more navigable to keep using than to stop, given the lack of effective, available treatment options. Beth Macy illustrates this truth through Tess's story with heartbreaking effectiveness.
The unconventional format of this audio documentary includes audio from Tess herself (taken during research for Dopesick) and interviews with her family, friends, and others, which makes it a unique and Rich listening experience. Highly recommended.