Part III — Fist-pounding Moments

Investigative reporter Jason Cherkis on his 21,000 word multimedia piece on opioids and treatment

via All In with Chris Hayes

“It wasn’t meant to be long at all,” said Cherkis, the writer behind the HuffPost’s “Dying To Be Free,” a 21,000 word multimedia story on the opioid epidemic. Cherkis arrived in Kentucky the day after Philip Seymour Hoffman was found dead of a heroin overdose, on Super Bowl Sunday 2014.

Weeks before Hoffman’s death, Cherkis was also Kentucky reporting not on heroin, but on Mitch McConnell’s roll out of Obamacare, looking at how the state was selling it.

A nurse working in one of state’s health centers told Cherkis, “listen, there are all these people in Kentucky doing heroin. It’s a real problem. You should call this coroner in Lexington.” Unsure what he’d get out of it, he called the coroner, and returned home to Washington, D.C.

When the coroner mailed him death certificates from 2013, which identified 93 counts of heroin-related overdoses in three counties, Cherkis’ interest was piqued. Eventually, he returned to Kentucky on that Monday — the day after the Super Bowl, or Hoffman’s overdose, depending on who you ask — to interview two of the 93 families who had lost children to heroin.

His editor at the time called, asking him write something that night, anticipating the clicks they’d get on the tails of Hoffman’s death. “There’s no way I was doing that, I couldn’t,” said Cherkis.

“Just as the death of Rock Hudson thirty years ago forced the country to recognize AIDS, Hoffman’s death awoke it to the opiate epidemic,” writes Quinones in his award-winning 2015 book, Dreamland. Celebrity deaths tend to capture national attention. When they are rooted in heroin or pills — from Heath Ledger in 2008 to Hoffman in 2014 to Prince in 2016 — opioid addiction enters the public discourse for a while. However, public interest is not usually sustained, as an icon’s death stops appearing in headlines.

Initially, Cherkis’ editors were skeptical of a long-form piece about opioid addiction. “It just wasn’t on their radar either,” Cherkis said, “so I kept it on a back-burner.” Cherkis heard that leadership at the HuffPost — formerly the Huffington Post — wanted more criminal justice coverage. He took that opportunity to re-pitch his heroin story, “thinking it was a criminal justice piece, or trying to sell it that way,” he said.

Though perspectives on drug addiction are changing, for much of the 20th and 21st Centuries, the default mentality was that of a “war on drugs.” Solutions to addiction crises were often led by law enforcement and the criminal justice system, not doctors and treatment facilities.

Once he secured support from his editors, Cherkis began his investigation. In contrast to how the piece was pitched, Cherkis tackles the opioid epidemic from a treatment-centric point of view.

Using court documents, jail and parole records, and the death certificates, Cherkis pieced together stories of the victims. He also started interviewing parents and people in recovery. One of the addicts he spoke to was Kenny Hamm, who was in treatment at the Grateful Life Center in Kentucky. There, Hamm participated in an abstinence-based 12-step recovery program.

Cherkis wrote a story about Hamm, and remembered being particularly struck by his trouble with recovery. He and his editor “kept struggling with the paragraph describing Kenny Hamm’s struggle,” Cherkis said. “We had no idea why he was failing treatment, and my editor was like, ‘why don’t you make that the story?’” said Cherkis.

Considering taking on the treatment world, Cherkis decided he needed to first understand the history behind drug treatment. He bought books, watched documentaries, even received a lecture from Dr. Mary Jeanne Kreek, one of the three scientists behind methadone. “I was adamant that I wasn’t going to write a piece that was bashing 12-step, without myself understanding it,” he said. His commitment to his homework sets his investigative piece apart; a beat reporter may not have the luxury of months of research, but Cherkis was able to immerse himself in the opioid world.

In addition to all his research, Cherkis relied heavily on the parents of victims, who would become the cornerstones of his piece. “The story was very much guided by them,” he said. Their experiences illuminated elements of the epidemic he hadn’t yet understood. “I didn’t really get the problem with locking up addicts at the time,” he remembered. Jail time, often seen as a valid “tough love” approach, puts addicts through brutal withdrawal in a cell, and rarely results in sustainable recovery.

In Chapter Five — one of the more frustrating of the eight — Cherkis examines the criminal justice side of Kentucky’s treatment framework. He writes

“Among Suboxone’s most unyielding critics are the people with the most power to dictate treatment options. The drug court judges in Northern Kentucky’s Campbell, Boone and Kenton counties are adamant in their refusal to make Suboxone available to the addicts who come through their doors.”
via The Huffington Post

One friend, looking over the chapter, was infuriated by the judges and their stance on treatment. He told Cherkis, “that’s a key moment, don’t mess that moment up.” Like Cherkis’ friend-turned-editor, most readers will have their own fist-pounding moments somewhere in 21,000 words.

Cherkis, perhaps thinking these bits of the story weren’t frustrating enough in print, includes video of a judge expressing her anti-medication assisted treatment philosophies.

“Dying To Be Free” over a year after Cherkis began his investigation, and his time-consuming reporting was met with a drawn-out editing process. According to Vanity Fair, the piece gave former editor-in-chief Arianna Huffington pause. Huffington’s daughter is a recovering cocaine addict who got sober through a 12-step, abstinence-based process. Understandably, Huffington’s personal connection to the issues of addiction and recovery, impacted the way she viewed Cherkis’ piece, according to Vanity Fair.

Cherkis declined to comment to Vanity Fair about Huffington’s role in the editing process. He did tell the Washingtonian that “all the editing that went into the piece was to its benefit.” In 2016, Cherkis’ piece was a finalist for a Pulitzer Prize in National Reporting in 2016, for “deeply researched multimedia reporting on opioid addiction that punctured conventional wisdom by showing how many drug overdose deaths may have been preventable, not inevitable.”

It is unclear to what extent Cherkis’ thesis was impacted by the rigorous editing process, but the reported friction within HuffPost itself speaks to the sensitivity of the subject. Even though Cherkis’ piece is fairly and accurately reported, he and any journalist who tackles treatment will be met with some resistance.

Most American’s lives have been, in one way or another, touched by addiction. Alcoholics Anonymous is an American-made institution, Cherkis explained. “Everybody knows somebody who’s been through AA,” he said. Many readers come to stories with preconceived notions about addiction, treatment, and how to solve this epidemic.

Ignorance about drug addiction is a “bipartisan problem,” Cherkis said. Across party lines, policymakers struggle to agree on sustainable approaches to treatment. However, this issue isn’t exclusive to policymakers. Sometimes, journalists also ask the wrong questions.

“You see a lot of arguments, and a lot of stories about bed space, and the need for treatment, but it’s rare that you see stories that are specifically about what kind of treatment,” Cherkis said. Seeing stories about supply and demand of beds in treatment facilities, rather than stories that explore treatment itself, is a “pet peeve” for Cherkis. He finds himself wondering why reporters aren’t talking about methadone or Suboxone.

Medication assisted treatment, whether it is ideologically agreeable for readers, is a necessary part of the conversation. Cherkis doesn’t make an argument for or against medication assisted treatment. He uses case studies with people in abstinence-based programs to point out their potential flaws, especially as an addict’s only means to recovery.

via The Huffington Post

To complement his in-depth reporting Cherkis incorporates photos, video, audio, data visuals, and maps throughout the entire piece. As you scroll, black and white photographs fade into subdued color, subtle enough you barely notice it. There are addicts’ handwritten notes scanned into their stories. A powerful audio recording features a father recounting the moment when he found his son dead of a heroin overdose in his bathroom. The audience can hear the father’s trembling voice; Cherkis doesn’t need to characterize that pain in words. Readers are thrown into the lives of the families torn apart by this epidemic. In this case, a multimedia approach proves more powerful than print. Somewhere in these eight chapters, a reader may find themselves numb to the tragedy. Should that happen, one of these breaks in the text will pull them back in.

Cherkis remembered one editor — a friend and recovering addict — who didn’t take to the piece at first. He had gotten sober through AA and NA, and they would debate abstinence versus medication assisted treatment. Once the story came out, he liked it, Cherkis said.

“Partly because I came to conclusion — and this was not an easy one — that it came down to choice. My story is about choice.”

Cherkis’ piece was, overall, well received. “I was heartened somewhat that the response to my story wasn’t a total bloodbath,” he said. After it ran, people from different recovery centers were calling, thanking him for opening their eyes to a new way to see treatment.

As a journalist, Cherkis aims to present these choices to his readers, informed by the most up-to-date science available. “In the best possible world, somebody who is addicted to heroin can go see a doctor, and then make an educated, well informed decision on what kind of treatment could best fit their addiction,” Cherkis said.

“The one story no one has done — I’ve not really seen it, it’s hard to do, and I haven’t done it — is just a thorough takedown of private treatment,” said Cherkis. People go into facilities where they are inaccessible to loved ones. “They come back and who knows what they got,” he said.

Cherkis is right; there is too little oversight in private, for-profit addiction treatment. Unfortunately, a thorough look at that industry would require substantial research, and few newspapers seem to be dedicating resources to reporting on this issue.

There is one newspaper, the Cincinnati Enquirer, who, a little over a year ago, moved experienced editor and reporter Terry DeMio to a new beat: heroin.

Read about DeMio’s experience crafting her own heroin beat in Part IV.