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

by Beth Macy

Overview

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.

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:	14,255
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

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.”

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."

Editorial Reviews

Macy's strengths as a reporter are on full display when she talks to people, gaining the trust of chastened users, grieving families, exhausted medical workers and even a convicted heroin dealer…Macy captures an Appalachian landscape in a state of emergency and in the grip of disillusionment…

The New York Times - Jennifer Szalai

…a harrowing, deeply compassionate dispatch from the heart of a national emergency. [Dopesick]…is a masterwork of narrative journalism, interlacing stories of communities in crisis with dark histories of corporate greed and regulatory indifference…In a poignant early scene…a mother at the grave of her 19-year-old son…wants to know "how Jesse went from being a high school football hunk and burly construction worker to a heroin-overdose statistic, slumped on someone else's bathroom floor." That question—and its larger implications—becomes an engine for the entire investigation, driving it forward with plain-spoken moral force…Taken as a whole…this gripping book is a feat of reporting, research and synthesis.

The New York Times Book Review - Jessica Bruder

★ 06/11/2018
Journalist Macy (Truevine) takes a hard and heartbreaking look at the cradle of the opioid addiction crisis, the Appalachian region of Virginia and nearby states. She places the responsibility for the epidemic squarely on Purdue Frederick, makers of OxyContin, and its sales division, Purdue Pharma, which engaged in near-predatory marketing practices to sell a drug that has wreaked havoc on the lives of 2.6 million Americans who are currently addicted, with more than 100 dying per day from opioid overdoses. In the first of three sections, she addresses “big pharma” in telling detail, outlining how the overprescribing of pain medication in doctors’ offices and emergency rooms created a market demand that was then met by illegal drug peddlers on the streets. Section two follows the spiral of addiction as users of prescription pills no longer able to afford their habit turn to heroin, a cheaper and more lethal solution to feed their fix. In the last section, the author changes the focus to what has become an addiction treatment industry. Macy potently mixes statistics and hard data with tragic stories of individual sufferers, as well as those who love and attempt to treat them. One addict, Tess Henry, was just 26 when she was first interviewed by Macy and, despite multiple attempts at rehab so that she could raise her infant son, she was dead within three years. Macy’s forceful and comprehensive overview makes clear the scale and complexity of America’s opioid crisis. (Aug.)

Publishers Weekly

★ 2018-05-10
Harrowing travels through the land of the hypermedicated, courtesy of hopelessness, poverty, and large pharmaceutical companies.A huge number of Americans, many of them poor rural whites, have died in the last couple of decades of what one Princeton researcher has called "diseases of despair," including alcoholism, suicide, and drug overdoses caused by the hopeless sense that there's a lack of anything better to do. Roanoke-based investigative journalist Macy (Truevine: Two Brothers, a Kidnapping, and a Mother's Quest: A True Story of the Jim Crow South, 2016, etc.) locates one key killer—the opioid epidemic—in the heart of Appalachia and other out-of-the-way places dependent on outmoded industries, bypassed economically and culturally, and without any political power to speak of, "hollows and towns and fishing villages where the nearest rehab facility was likely to be hours from home." Prisons are much closer. Macy's purview centers on the I-81 corridor that runs along the Appalachians from eastern Tennessee north, where opioid abuse first rose to epidemic levels. She establishes a bleak pattern of high school football stars and good students who are caught in a spiral: They suffer some pain, receive prescriptions for powerful medications thanks to a pharmaceutical industry with powerful lobbying and sales arms ("If a doctor was already prescribing lots of Percocet and Vicodin, a rep was sent out to deliver a pitch about OxyContin's potency and longer-lasting action"), and often wind up dead or in jail, broke and broken by a system that is easy to game. Interestingly, Macy adds, "almost to a person, the addicted twentysomethings I met had taken attention-deficit medication as children." Following her survey of the devastation wrought in the coal and Rust belts, the author concludes with a call to arms for a "New Deal for the Drug Addicted," a constituency that it's all too easy to write off even as their number climbs. An urgent, eye-opening look at a problem that promises to grow much worse in the face of inaction and indifference.

Kirkus Reviews

An "impeccably reported tale"—Tina Jordan & Isabella Biedenharn, Entertainment Weekly

"[Macy] spent more than a decade following these trails in search of facts.... what finally emerged is not only riveting, but multi-layered."—Darrell Laurant, News & Advance

"Truevine is a moving attempt to reconstruct this David and Goliath story...If even "Eko and Iko" can be given back their stories, there might be hope for us all."—Julian Lucas, The New Republic

"A vivid and moving history that uncovers much more than exploitation and racism."—Randy Dotinga, Christian Science Monitor

"While it was clearly no picnic, Macy portrays life in a circus sideshow as a community experience that could provide emotional support, protection - and a living - to those who might otherwise have been ostracized or locked away."—Susan Linnee, StarTribune

"Macy's digging, and how she chronicles her effort to find the truth... make 'Truevine' a true mystery that provides insight into a long-gone world that still has echoes today."—Dale Singer, St. Louis Post-Dispatch

"Intriguing, enlightening and multi-layered... In so diligently and thoughtfully researching and writing this book, Macy has paid tribute to George, Willie and Harriet, and ensured their life stories have finally been accurately and fairly told."—Sharon Chisvin, Winnipeg Free Press

"An inarguable page-turner, Truevine is a fascinating and shocking account of Jim Crow's legacy and America's strange (and often brutal) past."—Dianca London, Lenny Letter

Praise for Factory Man

A New York Times Notable Book of 2014

One of Janet Maslin's Top 10 Books of 2014 in the New York Times

One of The Christian Science Monitor's Top 10 Nonfiction Books of 2014

One of Publishers Weekly Best Books of 2014: Nonfiction

"In a class with other runaway debuts like Laura Hillenbrand's "Seabiscuit" and Katherine Boo's "Behind the Beautiful Forevers": These nonfiction narratives are more stirring and dramatic than most novels. And Ms. Macy writes so vigorously that she hooks you instantly. You won't be putting this book down."—Janet Maslin, New York Times

"Nonfiction storytelling at its finest.... It does what the best business books should: It delivers a heavily researched, highly entertaining story, at the end of which you realize you've learned something.... This is a great American story, the kind that we don't read often enough."—Bryan Burrough, New York Times

"A truly remarkable work of researched narrative nonfiction, one the probes every corner of its topic and values every subject who has something to say.... Factory Man does justice to every hidden corner of the story. It's a book that leaves you feeling better for having read it."—Lucas Mann, San Francisco Chronicle

"A well-crafted and epic tale.... Artfully told."—Anna Lembke, author of Drug Dealer, M.D., psychiatrist and professor of addiction medicine at Stanford University School of Medicine, Marc Levinson, The Wall Street Journal

From the Publisher

04/15/2018
"Americans, representing 5 percent of the world's population, consume 80 percent of its opioids." Macy (Factory Man; Truevine) brings that statistic down to the personal level as she relates individual stories of OxyContin use in the United States, while also tracing its regulatory history and legal, medical, and social ramifications. The intertwined factors that have led to today's opioid epidemic play out in stories of health-care providers, patients, pharmaceutical companies, politicians, drug dealers, users, and family members. Starting with her own community of Roanoke, VA, Macy effectively shows how opioid abuse plays no favorites as it works its way into all socioeconomic levels, races, and ethnicities. The accounts of addicts and their families leave no doubt about the power the chemicals hold over the brains they alter. Addicts soon begin using to avoid the symptoms of withdrawal (dopesick) rather than gaining any pleasurable high. Controversies abound over what treatments work. Abstinence versus medication-assisted therapy is an ongoing debate, while profit motives and insurance problems are also factors. VERDICT Macy's use of current research by various experts makes clear how complex the opioid problem is, but the strength of this narrative comes from the people in the day-to-day battle.—Richard Maxwell, Porter Adventist Hosp. Lib., Denver

Library Journal

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