Q&A with Laura Essay, author of Side Effects Are Minimal

As a child, Laura Essay learned an important lesson from her grandfather, the writer Raymond Woodbury Pence: the use of storytelling to influence social change. A graduate of the University of Nebraska, Essay earned a Juris Doctor (JD) degree from Creighton University School of Law and later served as an assistant attorney general for the State of Nebraska; she was also a professor in the College of Journalism at her alma mater and acted as editor for various periodicals, which was a catalyst for her interest in research. Essay—now a full-time volunteer whose work has included advocating for foster children & youth, the homeless, and refugees—makes her debut as a novelist with the legal thriller Side Effects Are Minimal, which draws on her knowledge of the opioid crisis and Big Pharma’s role in perpetuating it.

Recently, Ms. Essay took time away from her philanthropic activities to discuss the makings of her novel. Topics included her entry point(s) into the opioid crisis and what further study revealed, why fiction proved a powerful lens through which to examine fact, how the realities of addiction often contradict the myths, and what she hopes readers might glean from her book. She also reflected on her grandfather’s indelible influence and the power of storytelling throughout her life and offered sage advice for those struggling to find the time and tenacity to follow their creative interests.

John Valeri: What was your entry point into the world of opioid addiction, and why did you feel that a novel was the right vehicle to explore this issue?

Laura Essay: The nightly news, newspaper articles, online news sites, and witnessing the issue firsthand grabbed my attention and continued to poke at me. I had to ask myself, “How big is this? How did it start? Is it just the cartel we see on TV? How many people are affected? Who are they?” I needed answers to these questions. As I discovered the truth, I felt like a child who had found a dark secret and needed to tell. Maybe telling would make it stop. I chose a novel as the vehicle because fiction allows for emotional depth and personal connection. Through storytelling, I could blend fact and fiction to humanize the statistics and shed light on the broader societal implications.

Valeri: Your protagonist, Claire Hewitt, has herself been touched by the consequences of opioid addiction. In what ways does this manifest itself in her personal and professional lives—and how did you use her character and the Satoris, to show the degrees of devastation in those who have lost loved ones to overdose?

Laura Essay: Claire’s journey is deeply personal—her sister Molly’s death, likely linked to opioids, has haunted her for decades. This case forces Claire to confront her unresolved guilt and the harsh truths about an industry that prioritizes profit over people. Professionally, she channels her grief and shame into a relentless pursuit of justice for the Satoris, a prominent Philadelphia family who have also lost a daughter to opioid addiction. Their prominence and wealth contrast sharply with the stereotype of families affected by addiction, emphasizing that the opioid crisis does not discriminate. Claire embodies the qualities of a determined and compassionate lawyer who fights for the underdog while reconciling her past and never losing sight of herself.

Valeri: Emma Satori and Claire’s sister, Molly—both victims of opioid addiction—illustrate the problem of physician-approved opioid use for chronic pain management. Tell us about the significance of their experiences and how they exemplify the myth that recreational drug use is the most common cause of addiction and subsequent overdose/death.

Laura Essay: Emma and Molly’s experiences highlight a critical aspect of the opioid crisis: the transition from prescribed pain management to addiction. Most of society thinks of drug addicts as different from themselves. We believe it’s an us-and-them game. But it’s not. Addiction is waiting on the front porch for every one of us. What begins as a professional and trusting relationship between a physician and patient can become an overnight devastation. The treatment of post-operative pain or chronic pain with an opioid could become a drug addiction and downward spiral from the beginning. This challenges the myth that recreational drug use is the primary path to addiction. In reality, many addictions start with legal prescriptions.

Valeri: The fictional Nova Analgesic Systems, Inc. (NAS) is a stand-in for real pharmaceutical companies that perpetuate the cycle of prescription drug abuse. How are NAS’s tactics illustrative of the ways in which big pharma can manipulate data and marketing in support of drugs that may not be as safe, or non-addictive, as advertised (to both physicians and the public)?

Laura Essay: NAS embodies the unethical practices of some actual pharmaceutical companies. They manipulate data and marketing to present opioids as safe and non-addictive. The title Side Effects Are Minimal signifies the blinders society is wearing and the lies we tell ourselves so we can sleep at night. The title came directly from the mouth of Phil Westcott, who might have believed what he was saying but may very well have been too self-absorbed to face what he was doing. This deception is a central theme in the book, highlighting how big pharma’s tactics can have devastating consequences.

Valeri: Given the book’s thesis, statistics and historical context are integral to understanding the opioid epidemic. How did you endeavor to incorporate the numbers in a way that felt natural—and, of those statistics, what numbers or touchpoints do you think are most important for readers to know in their own consideration of the problem?

Laura Essay: Researching this novel was akin to falling down a rabbit hole. Each news report led to another story, which referenced another until I confronted an epidemic far more extensive than ever revealed. One of the most startling discoveries was the statistic from the National Institute on Drug Abuse: approximately 80% of people who use heroin first misused prescription opioids. Both victims in this story naturally exemplify these statistics to provide context and underscore the severity of the crisis. These numbers highlight the deceptive power of opioids and the widespread impact of the opioid epidemic.

Valeri: You hold a law degree. How did that expert knowledge allow you to envision both the logistics and challenges of prosecuting a pharmaceutical company for negligent death? Also, what creative license did you allow yourself for storytelling?

Laura Essay: As a former assistant attorney general, I have seen firsthand the devastation wrought by drugs and the relentless pursuit of justice. This background allowed me to envision Claire’s legal intricacies and challenges in prosecuting a pharmaceutical company. However, I also took creative license to ensure the story remained engaging and accessible to readers. Balancing factual accuracy with a compelling narrative was essential to highlight the real-world implications while keeping readers invested in the characters and their journeys.

Valeri: You dedicate the book to your great-grandfather, Raymond Woodbury Pence. In what ways has his example inspired your life and, more specifically, your relationship with the written word?

Laura Essay: As a child, I watched my great-grandfather, Raymond Woodbury Pence. I examined his face. I studied his hands. I considered his gentle movements as he held a book. I then slipped away to write. I envisioned him as I discovered my own path. What I saw as his distinguished reputation significantly guided my life and the decisions I made. His dedication to education and literature inspired my love for writing. His commitment became my commitment to use storytelling for social change. His example taught me the power of words and the importance of advocating for knowledge and understanding through the written word.

Valeri: You came to writing as a second act of sorts. What satisfaction does storytelling give you that other outlets don’t? Also, please share any words of guidance you may have for others who feel a calling toward creative pursuits but may lack the confidence (or perceived time) to commit.

Laura Essay: Writing has been a part of me for my entire life. From hiding in my closet writing poems to participating in writing contests from elementary school through law school, writing has been an avenue for knowledge, communication, creativity and success. Winning a contest in the third grade for a piece I wrote about the Wright brothers was as inspiring as winning a contest for best brief in law school. Each experience flamed the fire inside of me. Storytelling offers further fulfillment by allowing the creative side to shine more. It allows the storyteller to build a relationship between the reader and the characters through emotional connections and, sometimes, unforeseen actions or words.

For those who feel a calling toward creative pursuits but lack the confidence or time, I would say: Grab a notepad and pick up a pen. Step away from your computer where you search the web, play games and pay bills. Sit with yourself and listen to the ideas that come into your head. Write down every word you hear. When your time is up, you’ve written something. It can be rearranged, rewritten and revised later. It’s a start, and that’s all you need. Pa, my great grandfather, would always tell me, “Just show up. The story will write itself.”

About Side Effects Are Minimal by Laura Essay:

When ambitious attorney Claire Hewitt is asked to represent the Satoris, one of Philadelphia’s most prominent families, in a lawsuit over the death of their daughter, she is thrust into an opioid nightmare with deadly impact—and not for the first time. Claire’s guilt for not saving her sister, Molly, has not subsided in the twenty years since Molly’s almost certainly opioid-related death. Now, with this new assignment, her guilt comes full circle. Who was really at fault in Molly’s death? And who is at fault now?

What begins as a quest for truth becomes infinitely more complicated as Claire struggles to balance her desire for justice with the Satoris’ thirst for revenge. She knows she needs to expose the greed that transforms legal opioid production into illicit fabrications and the neglect that is the breaking point between physicians and their patients. But there are powerful people who will seemingly stop at nothing to prevent these truths from seeing the light of day, and she is sabotaged at every turn. Can she push past the obstacles in her way to build a winning case?