Macy illustrates why it was so hard to stop drug trafficking in Roanoke during the 2010s. Ashlyn Keikilani Kessler was an “unlikely addict, a young mom and paralegal with a criminal justice degree from Jerry Falwell’s Liberty University” (190) who became addicted after her doctor prescribed opioids for a breast duct infection after her pregnancy. She used drugs and carried drugs back and forth between her community and wholesalers, making it difficult to put a stop to drug trafficking because people like her are virtually invisible to law enforcement.

The problem is that the legal system is “not nimble enough to combat heroin’s exponential growth. The drug’s too addictive, the money too good” (194). Macy describes the day when agents arrested Ashlyn with over 700 bags of heroin and her abandoned “Narcotics” Anonymous book stashed in her car. Ashlyn ended up in prison, having been a major source for drugs in her community. However, arresting her did nothing to stop the flow of heroin into Roanoke; there were many others like her. Ashlyn lost custody of her son as a result of her conviction.

Although the FDA finally cracked down on Purdue Pharma for its role in normalizing opioid abuse, communities still had to deal with multiplying problems like addiction-driven crime and illnesses like hepatitis C and HIV that circulated more freely among those who injected heroin using needles.