Dr Art Van Zee set out in the early 2000s to tell anyone who would listen how a powerful opioid was destroying lives. Two decades later, he’s still in disbelief

When Dr Art Van Zee finally understood the scale of the disaster looming over his corner of rural Virginia, he naively imagined the drug industry would be just as alarmed.

So the longest serving doctor in the struggling former mining town of St Charles set out in the early 2000s to tell pharmaceutical executives, federal regulators, Congress and anyone else who would listen that the arrival of a powerful new opioid painkiller was destroying lives and families, and laying the ground for a much bigger catastrophe.

Two decades later, as Van Zee surveys the devastation caused by OxyContin and the epidemic of opioid addiction it unleashed, he is still in disbelief at the callous indifference to suffering as one opportunity after another was missed to stop what has become the worst drug epidemic in US history.

But the 76-year-old doctor is also shocked that the crisis has got so much worse than even he imagined as one fresh wave of narcotics after another dragged in new generations and drove the death toll ever higher.