Dopesick: Dealers, Doctors, and the Drug Company that Addicted America

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America

by Beth Macy


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From the New York Times bestselling author of Factory Man comes the only book to fully chart the opioid crisis in America-an unforgettable portrait of the families and first responders on the front lines.

2018 Los Angeles Times Book Prize Winner for Science & Technology

In this masterful work, Beth Macy takes us into the epicenter of America's twenty-plus year struggle with opioid addiction. From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once-idyllic farm towns; it's a heartbreaking trajectory that illustrates how this national crisis has persisted for so long and become so firmly entrenched.

Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, Macy endeavors to answer a grieving mother's question-why her only son died-and comes away with a harrowing story of greed and need. From the introduction of OxyContin in 1996, Macy parses how America embraced a medical culture where overtreatment with painkillers became the norm. In some of the same distressed communities featured in her bestselling book Factory Man, the unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death.

Through unsparing, yet deeply human portraits of the families and first responders struggling to ameliorate this epidemic, each facet of the crisis comes into focus. In these politically fragmented times, Beth Macy shows, astonishingly, that the only thing that unites Americans across geographic and class lines is opioid drug abuse. But in a country unable to provide basic healthcare for all, Macy still finds reason to hope-and signs of the spirit and tenacity necessary in those facing addiction to build a better future for themselves and their families.

"Everyone should read Beth Macy's story of the American opioid epidemic" -- Professor Anne C Case, Professor Emeritus at Princeton University and Sir Angus Deaton, winner of the Nobel Prize in Economics

Product Details

ISBN-13: 9780316551243
Publisher: Little, Brown and Company
Publication date: 08/07/2018
Pages: 384
Sales rank: 67,771
Product dimensions: 6.20(w) x 9.40(h) x 1.60(d)

About the Author

Beth Macy is the author of the widely acclaimed and bestselling books Truevine and Factory Man. Based in Roanoke, Virginia for three decades, her reporting has won more than a dozen national awards, including a Nieman Fellowship for Journalism at Harvard.

Table of Contents

Author's Note 1

Prologue 3

Part 1 The People v. Purdue

Chapter 1 The United States of Amnesia 15

Chapter 2 Swag 'n' Dash 31

Chapter 3 Message Board Memorial 57

Chapter 4 "The Corporation Feels No Pain" 87

Part 2 Objects in Mirror Are Closer Than They Appear

Chapter 5 Suburban Sprawl 103

Chapter 6 "Like Shooting Jesus" 122

Chapter 7 FUBI 146

Chapter 8 "Shit Don't Stop" 164

Part 3 "A Broken System"

Chapter 9 Whac-A-Mole 189

Chapter 10 Liminaliry 209

Chapter 11 Hope on a Spreadsheet 232

Chapter 12 "Brother, Wrong or Right" 250

Chapter 13 Outcasts and Inroads 269

Epilogue: Soldier's Disease 297

Acknowledgments 309

Notes 313

Index 365

What People are Saying About This

Professor of Economics and Public Affairs, Emeritus at Princeton University and Sir Angus Deaton, FBA HonFRSE and winner - Anne C Case

“Everyone should read Beth Macy’s story of the American opioid epidemic, of suffering, of heroism and stupidity, and of the corporate greed and regulatory failure that lies behind it. With compassion and humanity, Macy takes us into the lives of the victims, their families, law enforcement, and even some of the criminals. A great book!”

U.S. Senator (Va) - Tim Kaine

“Beth Macy writes about our opioid epidemic but Dopesick is not about the drugs. It’s a book about kids and moms and neighbors and the people who try to save them. It’s about shame and stigma and desperation. It’s about bad policy, greed and corruption. It’s a Greek tragedy with a chorus of teenage ghosts who know how to text but can’t express how they feel.”

Author of Glass House: The 1% Economy and the Shattering of the All-American Town - Brian Alexander

“Dopesick will make you shudder with rage and weep with sympathy. Beth Macy's empathy and fearless reporting reaches beyond the headlines to tell the stories of how real people have been left to cope with the fallout of corporate greed, and the willful blindnesses of businesses and the government. Macy again shows why she's one of America's best non-fiction writers”

Tom Hanks

“Beth Macy is not satisfied with myths or side-bars. She seeks the very hearts of the people who are running the long marathons of struggle and survival - of Life. Dopesick is another deep - and deeply needed - look into the troubled soul of America.” - Tom Hanks

Author of What You Are Getting Wrong About Appalachia - Elizabeth Catte

"With the greatest compassion, Beth Macy plunges us into a world that deserves our knowing, filled with grieving mothers, cut-throat pharmaceutical executives, determined first-responders, and indifferent lawmakers. Radiating out from Appalachia, where the collision of poverty and pain created the ghoulish market for OxyContin, to the quiet addiction of suburbs and farming communities, you will recognize this world and weep for it. And then you will want to change it, because there can be no other response. Dopesick is both a tribute to those who lost and a fierce rebuke to those who took, and the new guidebook for understanding this quintessentially American crisis."

Pulitzer Prize winning author of the National bestseller Confederates in the Attic - Tony Horwitz

“I’m still in withdrawal from Dopesick, a harrowing journey through the history and contemporary hell-scape of drug addiction. Beth Macy brings a big heart, a sharp eye, and a powerful sense of place to the story of ordinary Americans in the grip of an extraordinary crisis.”

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Dopesick: Dealers, Doctors, and the Drug Company that Addicted America (Signed Book) 4.7 out of 5 based on 0 ratings. 9 reviews.
smg5775 5 months ago
Timely and informative. Educational and scary. Beth Macy writes of the opioid addiction using Virginia as her base (but this is happening everywhere.) The book is written in three parts. The first on how the crisis came about and was overlooked by many in high government positions but not the doctors and social workers treating those addicted to OxyContin. The trajectory of the addiction was opposite of what was usually seen (small town to big city rather than big city to small town.) The second part was what was happening and how it was being done. The third part was bringing it under control and getting treatment. I learned a lot reading this book. Not being within the subculture of drug addiction I did not realize how deep it goes. Listening to the news and hearing about Perdue Pharmaceuticals then reading this I realize why the attorney generals of the states opposing the settlement are taking their actions. There is so much destruction that has occurred over the two decades this medication, as well as others, has been on the market. How it spread shocked me and what was done to get it into the hands of patients disgusted me. I liked the interviews with the addicts, the dealers, the doctors, and those left behind. It showed a story that very few of us hear or live (although maybe more live it than I realize. I admit to being a little sheltered.) I wish that treatment were more humane instead of the all or nothing approach that is taken by many programs. The treatment seems more a punishment. I also wish those who created the problem would be accountable for their actions rather than the little guy who gets caught using or selling. Much more needs to be done to stop the drugs (even those prescribed by your doctor) from being abused. More needs to be done to help those addicted recover and go on to live their lives but this is a start, being aware of what is happening around us of which we are blind.
Twink More than 1 year ago
Another fantastic social commentary. Dopesick takes a look at the opioid epidemic that has swept across all lines - age, gender, economic status and more. Macy details the beginnings of the opioid crisis - the greed and push of BigPharma to saturate the populace with these highly addictive and massively destructive drugs. And at what cost? Macy includes stories of addicts and their families - their struggles and their losses. These are simply heartbreaking to read. I learned much from Macy's book. I have no answers, but do have a clearer understanding of what has happened and what is being done by those trying to turn the tide and those trying to change their lives.
Anonymous More than 1 year ago
The author did a good job of personalizing this epidemic and relaying the fear and frustration that their loved ones live with. I would like to hear more about the macro side of this. It feels like the medical community and the government have both failed our country in a myriad of ways, from health to economics. This is a sad reality.
Anonymous More than 1 year ago
that this book was given 5 stars in the only two reviews, and yet under the title on the cover or first page, there are only 3 stars? Just sayin'.
Ragamuffin More than 1 year ago
I have just finished reading this book, which covers the opioid crisis, located in my home region of southwestern Virginia. The details written by Beth Macy is shocking and saddening. Macy writes as a reporter but also as a person of compassion for the people who in some ways have been exploited by the big pharma and by certain “treatment” programs. I would highly recommend this book to anyone interested in this topic. Just because we don’t know about it, doesn’t mean that it doesn’t exist. I do feel the need to say that this does not include "everyone" in Southwestern Virginia and that this book should not be taken as stereotyping and painting a picture with a broad brush like Vance's Hillbilly Elegy did. As a resident of Appalachia, I disagree with Vance's portraiture of Appalachia and feel that he has sensationalized his story to line his pockets. And if those outside of Appalachia believe that everyone here is like this, they are very wrong. While as a local resident, I know that we have an epidemic. I believe this book paints and accurate picture of some of the people in this region, but not all. Furthermore, this book has burdened me even more to do what I can to help fight this problem. I volunteer with an organization that serves the under served Appalachian woman and when I worked with the latest participants of the program this summer, all but one woman was attempting recovery from some type of addiction. When this occurred I realized that I needed to know more and understand better what these ladies experience. I am a educated native of the region and I live and I choose to stay here because this is my home and because I love my family. For the most part people in this area just want jobs that will help them live a decent life and provide for their needs. This is their home and they want to stay here. There are local law enforcement and judicial officials that I am personally acquainted with who are quoted in this book. I know that these are good people who are trying to make a difference for our SWVA residents. The people of Appalachia do not want a handout but they do need help and this book sheds light of the kind of help many of them need.
bookaholique More than 1 year ago
I'll be honest with you, before I requested this book from Netgalley, I asked myself - do I really need to read a whole book about the opioid crisis? Seriously - what is there left to understand? Well - let me tell you. There was a lot left for me to understand. The author takes us from when opioids where first introduced and slowly shows us how it has turned into today's epidemic. From the first individuals who tried to raise a cry of alarm to the multitudes of professionals and families who band together to tell their stories of lost patients and loved ones to bring a focus to this devastating situation. This angered me over the influence of big pharma (surprise!) and made me sad to read about all these families who's lives have been forever changed by this drug. This book was so well written. Once I started it, I could not put it down. The author really does have a talent for making this very readable. At a minimum, I think every parent who wants to say "not my child" needs to read this. And really it is a good wake up call for anyone who wants to say "not in my community". Bravo Ms. Macy! I received this from Little, Brown and Co. via Netgalley.
Circusgirrrl More than 1 year ago
This is a book that broke the heart of the journalist who wrote it many times over. Those who are wondering "How did we end up with this opioid epidemic?" will find the answers in this investigative exploration. This American-made tragedy began with a pharmaceutical company's deception, was supported by the medical community's complicity, and, fueled by greed and unlimited advertising budgets, resulted in a virality that spared no segment of the population. Beth Macy's writing style is to identify the disparate threads in a story, which she then weaves together to provide a complex, whole roadmap. Unfortunately, she was not able to draw that roadmap from the 10,000 foot level. Her journalist-journey put her face to face with a doctor and a nun who, as prescient canaries in coal country, turned activist when they realized what was happening to their community. These are true American heroes. In Tess and other young addicts, Macy finds heroines amid the heroin, and realizes that while she must be there as the tragedy unfolds in order to tell it, her humanity and compassion must be tempered with the ability to find some line to keep herself from being swallowed whole. Macy is a mom; she talks to mothers and daughters and sons and is heartbroken along the way, just as they are. Then there are the dealers who are picking up the slack with readily-available heroin when the prescriptions and illicit pill pipeline evaporates. Heroin is the rabbit hole users willingly jump down to avoid being "dopesick." Here Macy explores what must have been dangerous territory. The roadmap follows the players as they regularly run their route from Baltimore to Roanoke, Virginia (where both Macy and I live). She encounters federal agents who make whatever progress they can in a game where, just like when a player is taken out in a video game, the game continues with a virtually unlimited number of alternate players. I've heard first- and secondhand accounts locally of drug deals going down in a downtown Roanoke restaurant/bar owned by a person of prominence. It was apparently a regular, weekly thing! The police were told what van and it was pointed out to them. Nothing changed. It wasn't until I read Macy's "Dopesick" that it clicked together. Holy crap -- that was one of the stopping points on the roadmap she drew! And that's the point -- this book hits home, locally and nationally. Others may find their "aha" moment in other aspects of this brave tome, whether in trying to find a glimmer of understanding regarding the addiction of their child, parent, nephew, niece, uncle, aunt, friend, neighbor, coworker -- you need only point to a group of people in any given place and they know an addict, or are one. This book does not really provide solutions, which is out of Macy's wheelhouse, but through her keen eye she presents concrete ideas of what might help and what isn't working. She seems right. I was listening to a radio program discussing a 12-step program that includes God or a higher power in their methodology, and they mentioned it has a less than 5% success rate. This addiction is a different animal than alcoholism. This addiction goes straight to the brain, and fast. Read this book to gain a greater understanding of the moving parts that are the roadmap of this American tragedy. Read it to understand how it is affecting neighbors, family members, and communities. It's a memorable book that punctures the heart and lingers long in the mind.
TedMorgan More than 1 year ago
An important report that fairly clearly looks at opioid addiction in the United States without providing simplistic or unreliable information . This is one of the best news piece I have read about addictions. I worked at a probation officer for a quarter century with misdemeanor drug and alcohol related offenders. Ms. Macy better than anyone I have read knows how difficult this problem is. I highly recommend this work.
diane92345 More than 1 year ago
To an opioid user, either on “legal” OxyContin or heroin, the goal is to avoid the debilitating withdrawal of being Dopesick. Most have only two options, steal or sell the same drugs to other, usually new, users to finance their own habit. Moving from rural Virginia in 1996 to suburbs and cities by the mid-2000s, the opioid crisis is now the leading cause of death for Americans under 50. More than 300,000 have died in the past 15 years and it is projected that the same number will die in the next five years. This is a story of how doctors tried, and mostly failed, to alert the producer, the government, and finally the media to the very real dangers of OxyContin. But corporate and physician greed overrode the warnings. After the government did begin to notice the epidemic and strengthen the usage guidelines, users turned to illegal heroin to avoid the Dopesick caused by OxyContin withdrawal. Dopesick has valuable information for anyone who has friends or relatives with an opioid problem. However, it doesn’t have many solutions. It does have one clear warning: “Those who cannot remember the past are condemned to repeat it”—George Santayana This same pattern of an overuse of a miracle drug becoming a scourge on the populace was first seen in 1864. Returning soldiers from the Civil War were prescribed morphine, which led to the same addiction and other social consequences as the OxyContin crisis. Hopefully, it will not take all the current addicts’ deaths to move past the OxyContin epidemic as that was the way the Civil War era issue was resolved. 3 stars. Thanks to the Little, Brown and Company and NetGalley for an advanced copy.