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

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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 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.


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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 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.

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

  1. 4 out of 5

    Julie

    Dopesick: Dealers, Doctors, and the Drug Company Who Addicted America by Beth Macy is a 2018 Little, Brown and Company publication. “Because the most important thing for the morphine-hijacked brain is, always, not to experience the crushing physical and psychological pain of withdrawal: but to avoid dope sickness at any cost.” While some may remain untouched, most Americans are painfully aware of the grip opiate addiction has on our country. Like the synopsis states: “From distressed small commun Dopesick: Dealers, Doctors, and the Drug Company Who Addicted America by Beth Macy is a 2018 Little, Brown and Company publication. “Because the most important thing for the morphine-hijacked brain is, always, not to experience the crushing physical and psychological pain of withdrawal: but to avoid dope sickness at any cost.” While some may remain untouched, most Americans are painfully aware of the grip opiate addiction has on our country. Like the synopsis states: “From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once-idyllic farm towns’, no one is immune. We see and read news reports, we see parents OD’d, passed out in their cars, with needles sticking out of their arms while their toddler sits in the back seat. Those images and the sheer volume of deaths is staggering. Beth Macy takes us on a journey that exposes Purdue Pharma, and the Sackler Brothers, to the doctors who make big money on ‘pain management’, to the street dealers who took up the demand when patients ran of legal options, and destroyed entire towns in the process, as well all the red tape, lack of funding, political rhetoric, and the struggle to keep those addicted alive long enough to have the slim hope they’ll someday manage to kick their addiction, which tends to follow the pattern of : Oxy, Roxy, then Heroin. “Lets’ be clear”, a Purdue Pharma spokesman said in August 2001, in a meeting with Virginia’s attorney general. “The issue is drug abuse, not the drug.” The product shouldn’t be blamed for the deaths, because in many cases the victims were also drinking alcohol and taking other drugs. Van Zee scoffed, telling a Roanoke Times reporter: “To me, that’s like somebody who was shot with a howitzer and a BB gun, and you walk up and say it’s a little hard to tell what killed him. Was it the howitzer that took off half his chest, or was it the BB gun?” But, more importantly, the author gives the reader intimate portraits of the victims, the families, and the absolute, literal hell they have gone through. Macy pulls no punches. This book is raw, terrifying, frustrating, and made my blood boil. The government- for the past twenty years, at least, through Republican and Democratic administrations have dropped the ball. The approach is outdated, doesn’t work, and keeps people from ever having a chance at a productive life, and does very little to stymie the epidemic when they are lining their own pockets with money from Big Pharma and ‘for profit’ prisons. “They don’t rehabilitate you in prison, and they don’t make it easy for you to get a job. I truly believe they don’t make it easy because they want you back, and they want you back because that’s the new factory work in so many places now- the prison. “You have to be very strong mentally when you get out to not make the same mistakes.” By the end of this book, I felt weak with grief. I’d cried so hard and felt a loss so keen, for the families who lost children, or siblings, sometimes more than one, with whole families involved with opiates, either by selling or using. My heart ached for those who live with addiction, and the loved ones who must live life in a state of chronic limbo and constant worry. One parent was so desperate she even removed all the doors in her home, so her son couldn’t hide his drug use- but to no avail. ‘One woman was in the habit of kissing her husband goodbye in the morning, putting her kids on the school bus, then driving to Baltimore to buy enough to last the day before returning to Woodstock just as school bus brought her kids home.' Those are just a couple of examples, with many even more heart wrenching. Good, ordinary people, with bright futures, who had been prescribed pain medications ended up committing felony crimes to support a drug habit, sinking to lows that are hard to imagine. Dope sickness is so horribly agonizing some people would consider suicide to avoid it. That’s hard to fathom, and it’s hard to read about people living in such circumstances and even harder to digest that more lives are going to be destroyed if the mindset of the country doesn’t change. This book is very well organized, presented not only by the statistics, and the history, and the various ways the opiate addiction is dealt with from law enforcement to drug companies, to doctors, to prisons, and to the government, all which bear some blame, but from the viewpoint of the families who are living with the addiction, either battling it themselves, or watching loved ones succumb, or live in agony. Their representation, their voice, is what makes the book so very powerful. The author obviously did a lot research, but she also spent a lot of time with those who have experienced the devastation up close and personal. She’s tough in places, as balanced in presenting the facts as could be hoped for, but she’s also invested herself emotionally. I’m about as ‘bleeding heart’ as they come, and I must say this book left me feeling completely drained. But, it is a book I highly recommend. Although this is not a book that offers pat answers or solutions, there is some proof we can staunch some of the bleeding, and maybe the more informed we are, the more we realize how easily this could be you, or one of your children, you will be more diligent, be aware of your doctor’s motives, ask for different methods of pain management, because Oxy, is so addictive one round of pain meds may be all it takes. Don’t think the marginalized poor in the Appalachian regions are the only ones at risk. The more you know, the more power you have, and with the information provided in this book, if this country has an ounce of compassion left in its black soul, will find its hardened heart pricked with something resembling sympathy, will feel righteous indignation and refuse to look the other way, and will for once avoid passing judgements on the victims. The only people working for change seem to be the victims and their families and the stark, frank, and shocking truth is that no one seems to care- which is yet another American epidemic. 5 stars

  2. 4 out of 5

    PorshaJo

    Shocking.....just shocking! I had no idea how bad things have become and who was responsible. You hear news about the opioid crisis and it's getting worse and we need to do something about it.....but we don't. Giving out Narcan to folks so if they overdose they have the fix, not sure if I fully agree with it. Aren't we just enabling it more by this? I remember once someone telling me at a hospital someone came in, OD'd. Given Narcan, revived. Awesome! They were given Narcan to take with them. Lat Shocking.....just shocking! I had no idea how bad things have become and who was responsible. You hear news about the opioid crisis and it's getting worse and we need to do something about it.....but we don't. Giving out Narcan to folks so if they overdose they have the fix, not sure if I fully agree with it. Aren't we just enabling it more by this? I remember once someone telling me at a hospital someone came in, OD'd. Given Narcan, revived. Awesome! They were given Narcan to take with them. Later that same day, they were back...OD'd again. But we need to look at the root cause, the pharma companies and doctors that over-prescribe. Listening into my husbands conversation recently with someone who tore a muscle at work, on the job. He had to get their medical history. At the ER, they were given Oxy for pain. REALLY? That's what you get for a torn muscle now. This person was smart enough to throw out the prescription. But many think 'I'll take just one pill, I can handle it' but the sad thing is, that's all it takes. You want it more and more. And in the end, you try to stop but you get so sick...dopesick. So you continue to take it just to avoid the dopesickness. A vicious cycle. Anyway, this book is a very detailed look at this crisis and how it came about and how fast it spread and continues to spread. You get intimate details of the people hit with this, families recovering (or trying to) from loosing loved ones, or just trying to get a loved on straight. We might think oh this is only something that happens in the downtrodden areas of the US, where people don't have jobs, have no money, and so on. But it's not the case. The wealthy, affluent have also been affected. Big business does well to keep people hooked on these drugs, drug reps make tons of cash to have doctors peddle their drugs, even when not needed. And doctors are too lenient in handing out drugs like tic-tacs. So if you want an in-depth look at this crisis, grab this one. It's heartbreaking, sad, enraging,.....but a great read. I listened via audio, which was read by the author. She did a wonderful job but at times there were too many people and too many facts and that sort of stuff is hard to track via audio. Print might have been better for me. Perhaps I should now just say....rant off.

  3. 4 out of 5

    Theresa Alan

    This is a well-researched nonfiction book about how the Sackler family of the privately-held company Purdue Pharma, their sales reps, unethical and misinformed doctors, our pitiful healthcare system that only helps some people, and our misguided law enforcement and incarceration laws created an opioid crisis that became a heroin crisis that led to overdosing becoming the leading cause of death for young Americans. Our country needs to ensure that everyone has access to healthcare, including menta This is a well-researched nonfiction book about how the Sackler family of the privately-held company Purdue Pharma, their sales reps, unethical and misinformed doctors, our pitiful healthcare system that only helps some people, and our misguided law enforcement and incarceration laws created an opioid crisis that became a heroin crisis that led to overdosing becoming the leading cause of death for young Americans. Our country needs to ensure that everyone has access to healthcare, including mental health and substance abuse care. We also need to change our drug laws so tax payers aren’t funding prisons for people who are low-level drug users. It costs a minimum of thirty-thousand dollars a year to incarcerate someone. In states like New York and California, the cost is seventy- to more than one-hundred grand. What if we used that money on healthcare and education and substance abuse treatment? According to Macy’s book, “Rehab is . . . a multibillion-dollar lie.” It’s unevenly regulated and largely abstinence-focused, meaning people who are trying to get weaned off opioids aren’t supposed to take drugs like Suboxone, even though it’s proven to help dramatically in keeping people off drugs. Most rehab centers, which are unaffordable to many, are abstinence, faith-based 12-step programs (5 of the 12 steps refer to a Higher Power) even though for opioid abuse, there is significant evidences that medication-assisted treated for the long term is a more reliable solution for sobriety. “When you spend that much money, you think it’s going to work. But it’s killing people for that myth to be out there—that the only true cure is abstinence.” Not to mention, even for people who might be able to afford (barely) incare treatment, there aren’t nearly enough beds in residential treatment centers to meet the demand. “The most important thing for the morphine-hijacked brain is, always, not to experience the crushing physical and psychological pain of withdrawal: to avoid dopesickness at any cost. To feed their addictions, many users recruit new customers. Who eventually recruit new customers. And the exponential growth continues until the cycle too often ends in jail or prison . . . a grave.” In terms of the opioid crisis, by now we know it’s a national problem that begin in small towns, places like Appalachia that were one-industry towns. When coal-mining stopped being lucrative because of alternate sources of energy like fracking and wind turbines, there were no more jobs. People often had on-the-job injuries and were overprescribed opioids. A drug that should only be used for end-of-life care or cancer, people were getting hooked after just two weeks and then ultimately turned to the cheaper heroin. Four of five people heroin addicts now come to the drug by originally being prescribed opioids. What’s the difference between our schwag and other sales reps? Asked a representative for Purdue Pharma, the company that hooked our citizens on Oxycontin. The Sacklers that own Purdue are one of the richest families in America. The difference is that “People aren’t stealing from their families or breaking into their neighbors’ homes over blood-pressure pills,” said small-town Dr. Van Zee, a major voice to change how this drug is prescribed, which took years. “Doctors started prostituting themselves for a few free trips to Florida,” said lawyer Emmitt Yeary, who represented the families of people who committed Oxy-related crimes (stealing copper from buildings to get another fix, for example). “We know from other countries that when people stick with treatment, outcomes can bet better than fifty percent. But people in the United States don’t have access to good opioid-addiction treatment.” The state of Virginia, where many of the stories from both sides of the law that Macy reports on, is one of the states that refused to accept Medicaid expansion in the wake of the Affordable Care Act, sacrificing $6.6 million a day in federal funds for insurance coverage. “In states where Medicaid expansions were passed, the safety-net program had become the most important epidemic-fighting tool, paying for treatment, counseling, and addiction medications and filling other long-standing gaps in care. It gave coverage to an additional 1.3 million addicted users who were not poor enough for Medicaid but too poor for private insurance.” “ If only (politicians) understood that Medicaid would actually save money and lives!” “It takes about eight years on average, after people start treatment, to get one year of sobriety . . . and four or five different episodes of treatment for that sobriety to stick.” Because I’m passionate about healthcare reform, justice reform, and an end to people’s lives getting ruined because they had some injury and became addicted to strong opioids almost overnight, I really enjoyed this book and highlighted many, many pages. We need to treat people with addictions with respect because addiction is not a moral failing of not having enough willpower, it’s about how addicted brains work differently than nonaddicted brains. For more reviews, please visit http://www.theresaalan.net/blog

  4. 4 out of 5

    Matt

    “The informant leaned into [Lieutenant Richard] Stallard’s cruiser. ‘This feller up here’s got this new stuff he’s selling. It’s called Oxy, and he says it’s great,’ he said. ‘What is it again?” Stallard asked. ‘It’s Oxy-compton…something like that.’ Pill users were already misusing it to intensify their high, the informant explained, as well as selling it on the black market. Oxy came in much higher dosages than standard painkillers, and an 80-milligram tablet sold for $80, making its potential f “The informant leaned into [Lieutenant Richard] Stallard’s cruiser. ‘This feller up here’s got this new stuff he’s selling. It’s called Oxy, and he says it’s great,’ he said. ‘What is it again?” Stallard asked. ‘It’s Oxy-compton…something like that.’ Pill users were already misusing it to intensify their high, the informant explained, as well as selling it on the black market. Oxy came in much higher dosages than standard painkillers, and an 80-milligram tablet sold for $80, making its potential for black-market sales much higher than that of Dilaudid and Lortab. The increased potency made the drug a cash cow for the company that manufactured it, too. The informant had more specifics: Users had already figured out an end run around the pill’s time-release mechanism, a coating stamped with OC and the milligram dosage. They simply popped a tablet in their mouths for a minute or two, until the rubberized coating melted away, then rubbed it off on their shirts. Forty-milligram Oxys left an orange sheen on their shirtsleeves, the 80-milligrams a tinge of green. The remaining tiny pearl of pure oxycodone could be crushed, then snorted or mixed with water and injected. The euphoria was immediate and intense, with a purity similar to that of heroin…” - Beth Macy, Dopesick: Dealers, Doctors, and the Drug Company that Addicted America Every morning at the train station, I find myself staring at the iconography of the opioid epidemic. Next to me, there is an advertisement for Narcan, a naloxone nasal spray that can be used in case of an opioid overdose. Across the tracks, another ad, this one for a residential treatment center focused on opioid addiction. When I step on the train, I am greeted with a placard that says: Stop! Don’t Run! It is a public service announcement, reminding users that they will be given prosecutorial immunity if they call 911 and stay with a person who has overdosed. It is a law that is meant to stop users from running away and allowing a person to die in order to avoid a possession rap. Day after day, it is easy to allow such things to recede into the background. To become part of normal life. If you are like me, you have heard the phrase “opioid epidemic” so often it has started to lose meaning. Whether we pay attention or not, it is happening. Over the past fifteen years, 300,000 Americans have died from drug overdoses. Seventy-two thousand died just last year. It is the leading cause of death for Americans under fifty, and is deadlier than guns, car accidents, and peak HIV. Beth Macy’s Dopesick tells the story of the crisis by giving it details. She provides the faces and the names and the unhappy endings. It is a potent, at times unbearably powerful story. She follows everyone: cops and criminals and users; prosecutors and judges; doctors and nurses and treatment providers. Mostly, though, this is a story of mothers. A tale of mothers and their dead sons and daughters. While the opioid crisis has its tentacles in every corner of the nation, Macy traces it from its origin in rural America, specifically western Virginia. As a journalist based out of Roanoke, she was there at the beginning, with Perdue Pharma’s introduction of OxyContin: The 1996 introduction of OxyContin coincided with the moment in medical history when doctors, hospitals, and accreditation boards were adopting the notion of pain as “the fifth vital sign,” developing new standards of pain assessment and treatment that gave pain equal status with blood pressure, heart rate, respiratory rate, and temperature. A paradigmatic shift turned patients into health care consumers. Accordingly, pharmaceutical companies sent their sales reps across the country to evangelize for new medications to prescribe to these customers. Macy devoted years to this story, and she begins Dopesick with the story of Perdue Pharma and OxyContin. She describes how this potent drug was sold to physicians, who then over-prescribed it to their patients. And when I say “sold,” I mean that in a literal sense. Sales reps were buying loyalty with free lunches and junkets and swag. Physicians, for their parts, were enjoying catered lunches and filling Oxy scripts with indefinite refills. At the time Oxy hit the market, unfortunately, it was not tamper resistant, meaning that this incredibly potent drug could be altered for an incredible high. This high came at an even more incredible cost. “Dopesick” is the term used to describe withdrawal, and it explains why opioids are so dangerous. Once your body has entertained the euphoria of opioids, it has a hard time going back. Symptoms of withdrawal include aches, diarrhea, fevers, profuse sweating, stomach cramping, nausea, vomiting, anxiety, restlessness, and irritability. A person undergoing this extreme manifestation of absence becomes desperate to reverse course, to feed the addiction in order to make the sickness go away. An addict will do anything to get enough money for the next hit. The slang junkie, after all, refers to a person who scrapped metal in order to support their addiction. Eventually, the trend that began with Oxy exploded into a rebirth of heroin, leading to a public health crisis that devastated rural communities, filling the boneyards and the prisons. Macy devotes a lot of time to following the resistance, a small band of people who tried to fight City Hall, even though City Hall had been purchased by Corporate America. We are introduced to a small-town doctor who was the canary in the coal mine, warning of Oxy’s dangers as he saw his patients dying; there is a dogged ATF agent, who broke one of Virginia’s largest heroin rings; there is a nurse practitioner who takes her mobile health wagon into the old coalfields, where the uninsured multitudes await; and there is a no-nonsense Catholic nun whose activism could help remind the moribund husk of a beleaguered Church that faith without works is dead. (Dopesick features beautiful black & white portraits of most of these people, taken specifically for the book. It adds a great deal to have a face to go along with the names). Perdue Pharma is an easy target. It is a corporation, after all, a molten mass of money surrounded by the impenetrable layers of the mythic “corporate veil,” endowed by the Supreme Court with all the rights of a human person, but none of the moral responsibilities or potential legal consequences. Macy, though, does not stop with them. She looks at the many other contributing factors, such as an acquiescent FDA, where top officials transition directly from the agency into high-paying corporate positions; and physicians who failed to do their due diligence before reaching for their Perdue Pharma ballpoints to write a script; and at the potency of opioids themselves, which makes recovery extremely difficult. In the latter half of Dopesick, Macy turns this into a furious critique of the treatment-industrial complex. She advocates strongly for medication assisted treatment (MAT), using drugs such as Suboxone to quell cravings and subdue withdrawal symptoms (without getting the person high). According to Macy, this is the only feasible way to break the epidemic. However, the legal and medical systems are extremely wary of using drugs to defeat drug addiction, even though we live in a hyper-medicated culture in which there is a prescription for everything. Dopesick is deeply researched, nicely balancing the big-picture statistics with on-the-ground reporting. But as hard as she tries, this is not a work of objective journalism. Macy was in the trenches a long time, essentially embedding herself in fraying communities. To follow these lives, she became a part of those lives, to the point where she would get texts from users asking her to drive them to rehab. Frankly, I do not see this as a problem. If journalism requires a person to put their humanity on hold, then journalism is not worth a damn. The surprising thing to me is that she was able to maintain her empathy. Addicts are extremely frustrating. I was a public defender for nine years, and the number of drug users I represented who maintained their sobriety was depressingly low. Addicts will – and do – steal from the people they love the most, lie to the people they love the most, let down the people they love the most. It becomes very hard, very quickly, to feel sorry for them. This brings us back to the mothers. Mothers are the beating heart of Dopesick, and we follow them closely as they try to save their kids. It makes for dispiriting reading, as these young people trade their futures to chase a high, joining a cycle of sobriety and relapse that lasts for years, and is physically and psychologically difficult to escape. From the outside, it is easy to say: Cut them off. Stop helping them. Let them go. Three strikes and you’re out. From the outside, it is easy to ask: When is it enough? But that is only what you say when it is not your child. Because when it is your child, there is never a point where you quit. And maybe that is the only redemption to be found in Dopesick: the mothers who keep trying to save their kids. Many of them do not succeed. Macy begins her book with a fitting line from Agatha Christie. “A mother’s love for her child is like nothing else in the world,” Christie writes in The Last Séance. “It knows no law, no pity, it dares all things and crushes down remorselessly all that stands in its path.” Christie was describing a mother’s love, but she might have been describing opioids themselves. Unfortunately, it does not seem that even love can triumph over the ruthless power of an insidious drug.

  5. 5 out of 5

    JanB

    I personally know 5 families who have lost a family member(s) to heroin/fentanyl. Good, strong, well-educated families. It is happening all around us, in all walks of life. There are plenty of heartbreaking personal accounts in this book from families who have lost a loved one, and the steps they took in an attempt to save them. It can, and does, happen to anyone. They aren’t “other”, they are us, and it is heart-wrenching to read. According to the author the roots of the epidemic stems from a pe I personally know 5 families who have lost a family member(s) to heroin/fentanyl. Good, strong, well-educated families. It is happening all around us, in all walks of life. There are plenty of heartbreaking personal accounts in this book from families who have lost a loved one, and the steps they took in an attempt to save them. It can, and does, happen to anyone. They aren’t “other”, they are us, and it is heart-wrenching to read. According to the author the roots of the epidemic stems from a perfect storm of factors: - the government mandate that physicians make adequate pain control a priority - Purdue Pharma, who aggressively marketed Oxycontin to doctors as effective without causing dependency. They hid evidence that this was a highly addictive drug - physicians writing large amounts of the narcotic Oxycodone, often for minor procedures - outdated methods of treating addicts, proven by multiple studies to be unsuccessful - treating addicts like criminals – again, exhaustive research tells us it doesn’t work - once addicted to Oxycontin, and no longer able to obtain a supply, the addicted turn to the cheaper heroin/fentanyl combination (according to some, this is a small percentage – see below) - economic factors at play – in a population where poverty and unemployment is the norm, the conditions are ripe for drug use/addiction. Appalachia was among the first places where OxyContin gained a foothold in the mid-1990s. Medicine has changed, no longer do doctors prescribe large amounts of narcotics as a matter of routine care after surgery. In fact, physicians face sanctions for prescribing narcotics "inappropriately" and many have chosen to just stop prescribing. I read this book a month ago but have hesitated to write a review because I'm conflicted. There is another side to the story and chronic pain patients are the unintended victims. I wish the author had addressed this issue and given a more balanced report. Not everyone who uses Oxy will go on to become a drug addict. According to https://www.drugabuse.gov/publication... while prescription opioid misuse is a risk factor for starting heroin use, only a small fraction of people who misuse pain relievers switch to heroin. According to a national survey, less than 4 percent of people who had misused prescription pain medicines started using heroin within 5 years.1  Side note: I’m an RN and I have a disease that causes chronic pain. I'm fortunate that my disease is under control through the use of biologics, and I have no need for pain medicine. But I keep abreast of what is happening in the chronic pain community, and all too often those who suffer from chronic pain are the unfortunate victims of new laws and government mandates. I’ve personally visited pain clinics where I felt treated like a criminal even though I wasn’t there for a narcotic prescription. I can't imagine what it would have been like if I had needed one. Doctors are being pressured to taper chronic pain patients off opioid regimens that have been working for them for years. Most chronic pain patients use the drugs in order to function but are now treated with suspicion and judgement, even if they have been using the drugs for years with no problem. Many can't get their prescriptions filled at the pharmacy. Some experts claim most of the harm from opioids are from the drugs being smuggled into the country from China and Mexico, but nearly all the government's solutions are based on limiting access to pain medication for people in pain. For more information: https://www.theguardian.com/commentis... https://www.thefix.com/other-side-opi... http://nationalpainreport.com/enough-...

  6. 4 out of 5

    Michelle

    In 2012, author and investigative social journalist, Beth Macy began writing about the worst drug (heroin) epidemic in world history. “Dopesick: Dealers, Doctors, and The Drug Company That Addicted America” began in the hills and valleys of Appalachia, the mid-western rust belt, rural Maine before rapidly spreading throughout the U.S. In 2016, 64,000 Americans perished from drug related causes and overdoses-- outnumbering the total of those killed during the Viet Nam War. Macy explored the terri In 2012, author and investigative social journalist, Beth Macy began writing about the worst drug (heroin) epidemic in world history. “Dopesick: Dealers, Doctors, and The Drug Company That Addicted America” began in the hills and valleys of Appalachia, the mid-western rust belt, rural Maine before rapidly spreading throughout the U.S. In 2016, 64,000 Americans perished from drug related causes and overdoses-- outnumbering the total of those killed during the Viet Nam War. Macy explored the terrible destructive impact on society, those who have helped and harmed, and the brave individuals sharing their own stories of tragedy and loss, casting aside stigma and shame to alert and help others. In the late 1990’s, Appalachian country doctor (St. Charles, Virginia) Art Van Zee M.D. was among the first to sound the urgent alarm how OxyContin had infiltrated his community and region. Patients were admitted to hospital ER’s in record numbers from drug related causes. Rates of infectious disease including Hepatitis C, along with petty and violent crime had increased substantially, a police car was fire-bombed—addicts were desperate for cash to support their drug habit, an elderly patient had resorted to selling pills from his nursing home bed. Van Zee called public meetings to advocate and alert others of the opioid health crisis, and didn’t hesitate to file complaints against Purdue Pharma for aggressive marketing campaigns promoting OxyContin. By 2001, he and Sister Beth Davies were attending two funerals per day of the addicted dead. In 2007, with over $2.8 billion USD earned in drug profits, Purdue Pharmaceuticals was found guilty in federal and civil criminal courts for their role/responsibility for creating the opioid epidemic, for “misbranding OxyContin”: with aggressive marketing techniques that downplayed and minimized the potential for addiction. The $600 million USD fine was worth the risk for Purdue; the executives charged were forced to listen to victim impact statements, and were compared to Adolf Hitler and the mass destruction of humanity, yet these men served no jail time. Both Doctor Van Zee and Sister Davies were outraged that none of the fine was allocated for drug recovery and addiction programs. Instead, it was appropriated for Medicaid/Medicare reimbursement and for criminal justice and law enforcement. Macy documents the vast suffering, heartbreak of the families, friends, medical staff and first responders, the foster parents, clergy left behind to carry on after destruction and death had taken its toll. The closed down factories, lumber mills, furniture manufacturing warehouses and stores, coal mines-- jobs that had once sustained the middle class were grim reminders that for the average American-- life would never be the same again. Some desperate families impacted by “the disease of despair” had lost life savings attempting to pay for costly drug rehabilitation programs for loved ones, only to realize addiction was a lifelong process and the likelihood of relapse might be a day away. Providers of rehab facilities were not in agreement over MAT (medication assisted treatment) though medical experts contend that MAT is absolutely necessary to battle the intense cravings of addiction and increase the rates of successful treatment. Many of the stories were harsh and brutal. Too many politicians and policy makers believe addiction is a personal moral failing and criminal offense rather than a treatable disease that robs victims of their dignity and freedom of choice. Macy’s book easily compares to Sam Quiones outstanding award winning book “Dreamland: The True Tale of America’s Opiate Epidemic” (2015). Macy is the author of the bestselling “Factory Man” (2014) and “Truevine” (2016). ** With thanks and appreciation to Little Brown and Company via NetGalley for the DRC for the purpose of review.

  7. 5 out of 5

    Jennifer

    "But you can't put a corporation in jail; you just take their money, and it's not really their money anyway. The corporation feels no pain." Beth Macy has made a name for herself with her award-winning research and journalism, and she put her skills to good use in covering America's opioid crisis from past to present. Dopesick: Dealers, Doctors, and the Drug Company that Addicted America discusses all the warnings history has left for us concerning the addictive qualities of opiates, referen "But you can't put a corporation in jail; you just take their money, and it's not really their money anyway. The corporation feels no pain." Beth Macy has made a name for herself with her award-winning research and journalism, and she put her skills to good use in covering America's opioid crisis from past to present. Dopesick: Dealers, Doctors, and the Drug Company that Addicted America discusses all the warnings history has left for us concerning the addictive qualities of opiates, referencing opium, laudanum and morphine in the nineteenth century leading up to modern-day prescription drugs such as Vicodin, Percocet and Lortab. But OxyContin was supposed to fix all that. Reportedly, it was designed to discourage abuse and addiction with its time-release quality. Allegedly, big pharma took their new wonder drug and pushed it like you've never seen. This is the part of the book where Macy excels. Where did the pharmaceutical companies market OxyContin? What did they do to encourage mass prescriptions for large quantities of their drug? How did they even get it approved with safety claims? I'd like to say you'll be surprised but if you're like me you probably won't be. I believe every word. A well-rounded piece of nonfiction, Dopesick is filled with corporate greed, criminal prosecution, science: pharmacokinetics, challenges of recovery, the segue to heroine, the noteworthy timing of media coverage/public intervention, and in-depth interviews with and about the users who have ridden this nasty roller coaster. Dopesick is a must read for anyone who has been impacted by the opioid crisis in some way, which is pretty much every tax payer in America. If you know someone who is recovering (or not) from opiates/opioids, this book may also help you understand why the process seems insurmountable. Now we need to see this kind of victim-sensitive coverage on cocaine/crack cocaine. Quote: “What happens is, it takes about eight years on average, after people start treatment, to get one year of sobriety...and four to five different episodes of treatment for that sobriety to stick. And many people simply don't have eight years.” Note: If interested in learning what being "dope sick" entails, I found some information on this recovery website.

  8. 5 out of 5

    Lauren

    "When a new drug sweeps the country, it historically starts in the big cities and gradually spreads to the hinterlands, as in the cases of cocaine and crack. But the opioid epidemic began in exactly the opposite manner, grabbing a toehold in isolated Appalachia, Midwestern rust belt counties, and rural Maine. Working-class families who were traditionally dependent on jobs in high-risk industries to pay their bills—coal mining in southwest Virginia, steel milling in western Pennsylvania, logging "When a new drug sweeps the country, it historically starts in the big cities and gradually spreads to the hinterlands, as in the cases of cocaine and crack. But the opioid epidemic began in exactly the opposite manner, grabbing a toehold in isolated Appalachia, Midwestern rust belt counties, and rural Maine. Working-class families who were traditionally dependent on jobs in high-risk industries to pay their bills—coal mining in southwest Virginia, steel milling in western Pennsylvania, logging in Maine—weren’t just the first to experience the epidemic of drug overdose; they also happened to live in politically unimportant places, hollows and towns and fishing villages where the treatment options were likely to be hours from home.” Macy opens the book with a deep dive into the history of heroin and morphine addiction, and how the drugs were reformulated over the decades into a prescription pill that has left an indelible mark on the US. A scathing indictment of Purdue Pharma follows: this the company that started with ear wax removal and shifted their focus to "pain mangement and OxyContin production in the 1990s. Looking at the large events, Macy then "brings it home" to her corner of the world, the Interstate-81 corridor in and around Roanoke, Virginia. She creates the context of factory closings and mining towns shut down, depressed and impoverished people with little work and chronic pain, and the ripe soil when a "miracle drug" comes along, and then the desire for even more - heroin, fentanyl, etc. Macy briefly touches on the science of addiction, and many others have done this. She chooses to focus on the faces (the largely young faces of teenagers and twentysomethings), the stories, and the rehabilitation efforts made by communities and small towns. Impactful journalism.

  9. 4 out of 5

    Hannah

    Heartbreaking, infuriating, incredibly well-researched. This is an impeccably researched overview of the US-American opioid crisis, enriched by case studies of people affected. Macy manages to show both the immediate, private reach of this crisis and the overarching problems in the health system that led to it.

  10. 4 out of 5

    Rachel

    Compelling, informative, compassionate, and harrowing. Dopesick is a comprehensive account of America's opioid crisis that has plagued disparate rural areas throughout the country, though Beth Macy mainly narrows down her research to her local Appalachia. She pieces together interviews with doctors, advocates, addicts, and individuals who have lost family members to the drug, to weave some kind of narrative out of the onslaught of factors which have contributed to the epidemic. While the reality Compelling, informative, compassionate, and harrowing. Dopesick is a comprehensive account of America's opioid crisis that has plagued disparate rural areas throughout the country, though Beth Macy mainly narrows down her research to her local Appalachia. She pieces together interviews with doctors, advocates, addicts, and individuals who have lost family members to the drug, to weave some kind of narrative out of the onslaught of factors which have contributed to the epidemic. While the reality of the opioid crisis was not lost on me before this (a friend of mine from high school died of an overdose about a year ago, which spurred my interest in this subject in the first place), Dopesick fills in the disturbing details. How Purdue Pharma saturated the market with Oxycontin in the 90s and continuously shifted blame from the addictive nature of the drug to the addicts themselves; how doctors have been made to prescribe these highly addictive painkillers at the drop of a hat (mainly to white patients, due to racial stereotyping that they are less likely to get addicted, which is why the opioid epidemic has hit white communities the hardest); how the government has essentially turned a blind eye and continues to deny adequate funding to address this issue; how MAT (medication-assisted treatment) has been stigmatized to the extent that many rehab programs require patients to be clean before checking in; and how feeling 'dopesick' is so miserable that addicts will do anything to quell the incredibly painful withdrawal symptoms. Beth Macy fuses thorough research with unfailingly compassionate anecdotes shared with her by mothers who have lost children to the drug. Their individual stories litter Macy's larger narrative, most of them following the exact same trajectory: being prescribed oxycodone for a minor injury, developing a dependency, being cut off from their supply, turning to illegal means of obtaining the drug, trying to get clean, failing to get clean, overdosing. There's one statistic that Macy repeats a few times throughout this book that stayed with me - on average it takes an addicted person eight years of recovery before they've gone a full year without relapsing. That is how impossible it is to quit this drug. Since this crisis isn't going anywhere any time soon, between a lack of funding, the refusal to acknowledge MAT as a legitimate rehabilitation technique, and incarceration of drug users and dealers as the primary tool being used by the government as a band-aid solution, Dopesick is well worth reading as a starting point, for anyone wondering how this crisis has reached such a critical state with so little government intervention.

  11. 4 out of 5

    Laurie Anderson

    This astounding book should be read by every parent, politician, police officer, judge, and health care policy wonk in the country. It's eye-opening, devastating, and infuriating. The insights I most appreciated were the explanations of how opiates affect the addicts brain (which totally explains their decision-making process) and how doctors were bribed by Big Pharma to overprescribe opiates. Highly recommended!

  12. 5 out of 5

    Esil

    Dopesick was very well done and thought provoking. But it took me a long time to listen to the audio because it felt like I could only listen to so much bleak information about the opioid crisis at any given time. Beth Macy looks at opioid addiction from many perspectives, including its causes and the failing efforts to implement a solution that works. But what makes this one especially difficult and compelling are the stories of individual addicts and their families. Macy got very close to seve Dopesick was very well done and thought provoking. But it took me a long time to listen to the audio because it felt like I could only listen to so much bleak information about the opioid crisis at any given time. Beth Macy looks at opioid addiction from many perspectives, including its causes and the failing efforts to implement a solution that works. But what makes this one especially difficult and compelling are the stories of individual addicts and their families. Macy got very close to several of her subjects. This made for a powerful, and sometimes almost unbearable, listening experience. Recommended and important, but brace yourself for the experience.

  13. 4 out of 5

    Malia

    Dopesick is a very informative and well-written book about the opioid epidemic. Unfortunately, I listened to the audiobook, and I really hate to whine about this, but the author narrates it, and her voice reminded me so much of that of Sarah Huckabee Sanders. This isn't anyone's fault, of course, but I do wonder whether a different performer might have brought more life to the narration. That being said, the author tells an important series of stories and does so in a compassionate way I fund co Dopesick is a very informative and well-written book about the opioid epidemic. Unfortunately, I listened to the audiobook, and I really hate to whine about this, but the author narrates it, and her voice reminded me so much of that of Sarah Huckabee Sanders. This isn't anyone's fault, of course, but I do wonder whether a different performer might have brought more life to the narration. That being said, the author tells an important series of stories and does so in a compassionate way I fund compelling. I learned a lot, and finished the book feeling rather depressed about the state of things in this country, so to cheer myself up I'll read a murder mystery next;-) In all seriousness, though, I was deeply moved and disturbed by the story this book tells and it opened my eyes to a terrible reality with which so many people live and are unable to escape. Find more reviews and bookish fun at http://www.princessandpen.com

  14. 5 out of 5

    Dianne

    Disheartening deep dive into the opioid crisis in America, from its inception twenty years ago via OxyContin prescriptions to today’s desperate consumption of heroin and synthetic opioids. Big Pharma and corporate greed play a huge role, as does public policy. Still, history is interesting and informative, but what is needed are solutions. I’m wondering if there are any, given that there is actually no “cure” for opioid addiction - it is a chronic lifelong condition that can be treated and manag Disheartening deep dive into the opioid crisis in America, from its inception twenty years ago via OxyContin prescriptions to today’s desperate consumption of heroin and synthetic opioids. Big Pharma and corporate greed play a huge role, as does public policy. Still, history is interesting and informative, but what is needed are solutions. I’m wondering if there are any, given that there is actually no “cure” for opioid addiction - it is a chronic lifelong condition that can be treated and managed only. The addiction changes the psychology and the neural circuits of the brains of individuals who are addicted. Treatment and management is expensive, time consuming and unlikely to work without medication assisted treatment (MAT) using methadone, buprenorphine or naltrexone. Access to treatment programs that use MAT is extremely limited. And so it goes....and grows, with no real end in sight. The drugs become stronger and more dangerous, the addicts more desperate, the safety nets more shredded and scarce. The author weaves in many personal stories of people impacted by this epidemic - addicts and their families, law enforcement, doctors and social workers - as well as lots of historical information, statistics and pages of footnotes. Very interesting but a bit of a choppy reading experience. Because public policy plays a big role in the management of this epidemic, there is a definite political slant to this book, so beware if that is an irritant. As I sit here writing this review, there is actually a television ad for Treatment Centers of America running right now. Such bitter irony. At least they offer MAT....if you are lucky enough to live near one of their seven outpatient centers in Georgia and Florida.

  15. 4 out of 5

    Ang

    This was ridiculously excellent. Macy is a fantastic writer, and she is so good at getting you to care about the people and issues in this book. I read Dreamland: The True Tale of America's Opiate Epidemic but didn't think it was particularly good, in terms of helping me understand WTF was going on with the opioid crisis. Macy's book is just SO. MUCH. BETTER. at that aspect of this, while including narrative and biography. (Abandon Hope All Ye Who Enter Here. This is not at all hopeful, and there This was ridiculously excellent. Macy is a fantastic writer, and she is so good at getting you to care about the people and issues in this book. I read Dreamland: The True Tale of America's Opiate Epidemic but didn't think it was particularly good, in terms of helping me understand WTF was going on with the opioid crisis. Macy's book is just SO. MUCH. BETTER. at that aspect of this, while including narrative and biography. (Abandon Hope All Ye Who Enter Here. This is not at all hopeful, and there's not much redemption to be found in its pages, sadly.) Thanks to the publisher for the ARC! (Picked up at PLA.)

  16. 5 out of 5

    Geoffrey

    (Note: I received an advanced electronic copy of this book courtesy of NetGalley.) Beth Macy has crafted a work that expertly utilizes both a grander narrative and the personal tragic tales of numerous figures and families, all to great effect to show how the ongoing epidemic came to be. This is a work that will tear out your heart before filling you with a ferocious fury. Fury at the shameless drug companies who targeted economically depressed communities with their painkillers. Fury over the co (Note: I received an advanced electronic copy of this book courtesy of NetGalley.) Beth Macy has crafted a work that expertly utilizes both a grander narrative and the personal tragic tales of numerous figures and families, all to great effect to show how the ongoing epidemic came to be. This is a work that will tear out your heart before filling you with a ferocious fury. Fury at the shameless drug companies who targeted economically depressed communities with their painkillers. Fury over the countless warnings from men and women about the new and growing crisis that went ignored until addiction crept from devastated rural areas and into the suburbs and cities. Fury over the absurdly patchworked American healthcare system that makes it so difficult for the addicted to get the care they need. Fury over a system that punishes the victims of the epidemic far more than the perpetrators ever could be. Fury over the countless parade of tragedies that affect the families covered in this work. "Dopesick" just will not stop filling you with rage alongside your new knowledge until you've reached the very last page. In other words, Macy has done her job incredibly well here. If you want to better understand the opioid epidemic that still burns on, this is THE book to read.

  17. 4 out of 5

    Maureen

    3.5 Stars - 4 for the importance of the subject matter, 3 for the quality of the writing. I felt like there were just too many players to keep track of in the narrative. Someone introduced on page 30 by their full name is going to be unforgettable when introduced by their first name after there have been 40 or so other people introduced during the ensuing pages. Such fragmented storytelling proved to be frustrating to this reader. Nevertheless, an important book about a problem that will not soo 3.5 Stars - 4 for the importance of the subject matter, 3 for the quality of the writing. I felt like there were just too many players to keep track of in the narrative. Someone introduced on page 30 by their full name is going to be unforgettable when introduced by their first name after there have been 40 or so other people introduced during the ensuing pages. Such fragmented storytelling proved to be frustrating to this reader. Nevertheless, an important book about a problem that will not soon go away.

  18. 4 out of 5

    ♥ Sandi ❣

    4 stars Thank you to NetGalley and Little Brown and Company for a chance to read this book. Published August 7, 2018. For me this was a book that needed a bit of time, after reading, to be able to review it. The author Beth Macy is a favorite author of mine. I enjoy the way she lays her information out. Every book I have read by her was about a vastly different subject, but all were researched well and, although non fiction, were presented in a story-like offering. Obvious by the title, this boo 4 stars Thank you to NetGalley and Little Brown and Company for a chance to read this book. Published August 7, 2018. For me this was a book that needed a bit of time, after reading, to be able to review it. The author Beth Macy is a favorite author of mine. I enjoy the way she lays her information out. Every book I have read by her was about a vastly different subject, but all were researched well and, although non fiction, were presented in a story-like offering. Obvious by the title, this book speaks to the opioid scourge that is, and has been, striking destruction across the United States since the 1996 introduction of Oxycontin. This book covers the first onset by the Pharma Manufacturing Company to the latest remarks by U.S. President Trump and the various drug use bringing us to that point. Pharma put the drug out for pain relief, doctors were ignorant of the addiction abilities and Pharma claimed that any addiction was minor in comparison to pain relief. Millions of pills went into unsuspecting hands. The Appalachian area was hardest hit. People were losing jobs, economy was at an all time low, depression was rampant. It was not unheard of for over 60,000 pills to be distributed in one week in this area. Martinsville Va had more Oxycontin prescribed than any other place in the United States. Teen football players were dying of overdoses. These overdose deaths have gone on for years. In the last 15 years 300,000 deaths have been caused by the wrongful use of Oxycontin. That same number, 300,000 deaths, will happen again, within the next 5 years. By the year 2020 more deaths will have been caused by the overdose of Oxycontin than all deaths caused by HIV-Aids, since the beginning of the Aids epidemic. Macy humanized this story by telling the personal battles of a number of people, both those addicted and the families of those who have passed. She chose the Roanoke area as her research grounds. The word "Dopesick" refers to the sickness that a drug addict experiences when they are coming down off their drug of choice. This is the point in time that addicts are at their worst. They will usually do anything to get their hands on drugs to prevent that feeling. Hence, the circular trap - they are no longer seeking that 'high', but seeking a fix to prevent being dopesick.

  19. 4 out of 5

    lp

    An emotional, powerful, important must-read. This book wasn't trying to do what HILLBILLY ELEGY was trying to do, but it did it, anyway. It did a great job getting close to answering those big questions. I got a huge understanding of the cycle of addiction and struggle in Appalachia. Beth Macy writes with her heart and her skill. Both are enormous.

  20. 4 out of 5

    Melora

    Wow. Well, that was a real eye-opener for me. I've tended to see the opioid crisis from the perspective of compliant chronic pain patients, whose access to effective pain medication is increasingly restricted due to attempts to limit drug abuse. A close family member whose pain had previously been tolerably controlled is currently bedridden thanks to drug crisis driven medication cut-backs, and, reading here about the horrible abuse of fentanyl, I worry about future availability of a drug that p Wow. Well, that was a real eye-opener for me. I've tended to see the opioid crisis from the perspective of compliant chronic pain patients, whose access to effective pain medication is increasingly restricted due to attempts to limit drug abuse. A close family member whose pain had previously been tolerably controlled is currently bedridden thanks to drug crisis driven medication cut-backs, and, reading here about the horrible abuse of fentanyl, I worry about future availability of a drug that provided such relief to my mother as she died of cancer last year. Turns out, though, that the other side of the story is just as tragic and far, far more severe than I had realized. When my mom, in hospice care at home, was prescribed fentanyl, the nurses warned us not to tell anyone that she was receiving it, as there were frequent home break-ins by addicts in search of the stuff (at the time we were living quite close to the area of Virginia Macy focuses on, in the North Carolina county with the highest number of opioid overdoses, third highest for heroin, so they were not kidding). And yet, as Macy repeatedly reminds readers, drug addiction has such a stigma that its prevalence can be easy to overlook unless it hits home. Macy's descriptions of the death and damage left by this tidal wave of drug abuse were absolutely staggering, as were the descriptions of the heartless greed of the drug company Purdue Pharma. Poorly informed or unethical prescribing by physicians, deceptive drug company advertising, conflicting attitudes and strategies from law enforcement and health care providers, policies and laws driven by politics rather than facts, an emphasis on arrests and incarceration over treatment, and a failure on the part of the general public to recognize the magnitude of the crisis have allowed it to escalate to a horrifyingly spectacular extent. I had a little trouble keeping the various young addicts and desperate parents Macy profiles straight – there are quite a few of them, and they all seem to come to the same end – but for the most part she does an admirable job telling the stories of individuals involved in various aspects of the “drug war.” She spends time with law enforcement, drug dealers, doctors, nurses, social service workers, and addicts and their families, and this helps lay out the complexity of the problem and the difficulties of solving it. It's not a hopeful picture. The best she can offer in that regard is a hearty hats-off to the courageous, unflagging devotion and determination of those individuals who are working so hard to save the addicted, and that is no small thing.

  21. 5 out of 5

    Ellen Gail

    If you've seen my reviews of books like American Pain and Dreamland, you'll know that I work in pharmacy. (also that I am totally a shill for 'Big Pharma'. Cause I can't possibly review books and, you know, have my own opinions on them?) Seems awfully suspicious to me. “I can remember telling my residents, ‘A patient can’t get hooked on fourteen days’ worth of [opioid] pills.’ And I was absolutely wrong.” Anyway, talking about Dopesick. You've got a really good bit of nonfiction here. Timely, wel If you've seen my reviews of books like American Pain and Dreamland, you'll know that I work in pharmacy. (also that I am totally a shill for 'Big Pharma'. Cause I can't possibly review books and, you know, have my own opinions on them?) Seems awfully suspicious to me. “I can remember telling my residents, ‘A patient can’t get hooked on fourteen days’ worth of [opioid] pills.’ And I was absolutely wrong.” Anyway, talking about Dopesick. You've got a really good bit of nonfiction here. Timely, well researched, and interweaving a number of personal touches, Beth Macy fearlessly tackles the nitty gritty. Focusing primarily on Purdue and Oxycontin before scoping outward to look at the opioid epidemic and recovery in general, it's impressive with how much it manages to address, miraculously without feeling overstuffed. “You’re throwing up. You have diarrhea. You ache so bad and you’re so irritable that you can’t stand to be touched. Your legs shake so bad you can’t sleep. You’re as ill as one hornet could ever be,” she recalled. “And believe me, you’ll do anything to make that pain go away.” It's not a book that has any easy answers to offer. It discuses potential solutions and ways of harm reduction - MAT (medication assisted therapy, ie Suboxone or Subutex), needle exchanges, better access to comprehensive rehab. I wouldn't call this a depressing book, but perhaps if you're less exposed to the opioid problem beforehand, you might come out of this feeling shocked and saddened. Even when it's a story that's still raging on outside the confines of these pages / digitized copy / audiobook / whatever medium you use to read, it's natural to want a happy, neatly tied up ending. Natural, but unrealistic. There's not much more I can say about this one. But I do want to address one quick point! In June 2017, the DEA recommended that first responders wear safety goggles, masks, and even hazmat suits to avoid skin contact with fentanyl and other powerful synthetics Look, fentanyl is unquestionably a powerful drug. It has some incredibly useful analgesic purposes, and yes, large abuse potential. But it's not the boogeyman. It's actually difficult to absorb through the skin, which is why they had to develop a delivery system via fentanyl patches for chronic pain. If just rubbing it on yourself worked, there would have been no need. Basically what I'm saying is yes, it can be dangerous. No, you won't overdose just from touching a package of it. Be aware and informed, but don't let fearmongering outweigh facts. I can't say I know much more about opioids, overprescribing, and drug use than I did going in. I did learn some more specifics of the many lawsuits and legalities surrounding Purdue. And that was pretty cool. But this was sort of in my wheelhouse anyway, so that won't be the case for all readers. It's not going to be a must read for all bookworms, but if the subject interests you, it's definitely worth picking up.

  22. 4 out of 5

    Peter Mcloughlin

    I have read several books on the opioid epidemic but never had I read a nonfiction narrative documenting such a landscape of relentless distress and horror. This book is heartwrenching as individuals and communities sink into levels of hell that grow worse and worse. The author Beth Macy is a reporter at a Roanoke Virginia newspaper and covers the story of the opioid epidemic from the grotesque greed of Purdue pharma which pushed these pills by taking doctors on junkets to sell their OxyCodone i I have read several books on the opioid epidemic but never had I read a nonfiction narrative documenting such a landscape of relentless distress and horror. This book is heartwrenching as individuals and communities sink into levels of hell that grow worse and worse. The author Beth Macy is a reporter at a Roanoke Virginia newspaper and covers the story of the opioid epidemic from the grotesque greed of Purdue pharma which pushed these pills by taking doctors on junkets to sell their OxyCodone in the 1990s which started the worst drug epidemic in US history. The doctors some mislead, some looking the other way, and some just as culpable as Purdue condemned individuals to squalid addiction and often an early ignominious death to the extreme distress of loved ones around them. From the politicians who were blind and indifferent to the problem to the confused, often misguided attempts of law enforcement and healthcare workers (often working at cross purposes) attempting to respond to the devastation. The stories of addicts and their families and the communities affected make the narrative of pain, suffering, and horror hard to take in while reading. War Zones and Disaster Areas don't come close to describing misery and loss of hundreds of thousands or millions of people in this conflagration. It was overwhelming. To get a sense of the magnitude which has claimed the lives of 300,000 people to overdose in the past twenty years and is on track to take 300,000 more in the next five is impossible to wrap one's head around but the Macy's book certainly makes a good stab at getting across.

  23. 4 out of 5

    Stephanie

    If you want to know the backstory of America's opioid epidemic, look no further than Beth Macy's meticulously researched book. The personal vignettes bring a face to the stories we read about in the paper. I know many people will compare it to Hillbilly Elegy, which I learned a great deal from, but this book raised more questions for me. I think it would be a fantastic book club discussion. It points out a broken health care system that will continue to let people down if we don't make changes s If you want to know the backstory of America's opioid epidemic, look no further than Beth Macy's meticulously researched book. The personal vignettes bring a face to the stories we read about in the paper. I know many people will compare it to Hillbilly Elegy, which I learned a great deal from, but this book raised more questions for me. I think it would be a fantastic book club discussion. It points out a broken health care system that will continue to let people down if we don't make changes soon. I received an advanced electronic copy of this book courtesy of NetGalley. Thank you for the opportunity to read it.

  24. 5 out of 5

    Kelli

    Another story about hardworking Americans being led to their demise by a greedy American corporation (that flat out did not care about the havoc it was unleashing), in this case Purdue Pharma. The facts within are devastatingly sad and often inconceivable. I need a few more days to put some quotes down, but I’m not sure I can review this well. I literally do not have the DNA to understand how people (in medicine, no less) can knowingly do this to unsuspecting people. It is unconscionable. It is Another story about hardworking Americans being led to their demise by a greedy American corporation (that flat out did not care about the havoc it was unleashing), in this case Purdue Pharma. The facts within are devastatingly sad and often inconceivable. I need a few more days to put some quotes down, but I’m not sure I can review this well. I literally do not have the DNA to understand how people (in medicine, no less) can knowingly do this to unsuspecting people. It is unconscionable. It is criminal. It is a national crisis. I have more to say...hold, please.

  25. 4 out of 5

    Kathleen

    Dopesick is an excellent companion to Sam Quinones’ Dreamland: The True Tale of America’s Opiate Epidemic. Macy expands on Quinones' reporting on Purdue Pharmaceutical’s indefensible marketing of OxyContin that resulted in thousands and thousands of addicted users. Perdue was forced to reformulate and paid serious fines, but left devastated lives (and deaths) in its wake. Macy excels at recounting the individual stories of families that have had to deal with their sons and daughters being addict Dopesick is an excellent companion to Sam Quinones’ Dreamland: The True Tale of America’s Opiate Epidemic. Macy expands on Quinones' reporting on Purdue Pharmaceutical’s indefensible marketing of OxyContin that resulted in thousands and thousands of addicted users. Perdue was forced to reformulate and paid serious fines, but left devastated lives (and deaths) in its wake. Macy excels at recounting the individual stories of families that have had to deal with their sons and daughters being addicted to first pills, and then heroin and more. Many of these young adults come from solid middle class families, and have had the benefit of supportive parents enabling them to get treatment. But—studies have shown that it takes 4-5 efforts at getting clean before being able to go for a year without drugs. It is the severe dopesickness that drives them to seek more drugs. The pain of withdrawal is just too excruciating for them to bear. Macy strongly advocates for more and better treatment for addicted users for she has gotten to know entirely too many that have ended up dead. The nation clearly has to do more to address this crisis.

  26. 4 out of 5

    Renata

    This was eye-opening in several respects. Being generally aware and reading about this epidemic is one thing, but having such a detailed account of the hurdles and obstacles people have to overcome to get treatment, is a whole other thing. I found the writing a little choppy at times - anecdotes and side comments thrown in spots - which I could have done without. But overall, this was as good as it was difficult to read. The most frightening thing is that it is not entirely clear how we get out This was eye-opening in several respects. Being generally aware and reading about this epidemic is one thing, but having such a detailed account of the hurdles and obstacles people have to overcome to get treatment, is a whole other thing. I found the writing a little choppy at times - anecdotes and side comments thrown in spots - which I could have done without. But overall, this was as good as it was difficult to read. The most frightening thing is that it is not entirely clear how we get out of this mess we have created. The drug dealers and cartels are not going away; there’s just way too much money to be made. So what do we do? Treatment is clearly part of the equation, but if the system is as saturated as the author describes, then it’s not a viable option for a large percentage of the population that needs help. I wholeheartedly recommend this book, but be prepared to get angry and frustrated.

  27. 4 out of 5

    Lisa

    Incredibly well researched with a clear understanding of all the different facets of why and how Opioid addiction manifests and spreads like a wildfire out of control. Why the current laws and legislation will never outsmart the current model of profiteering and abuse. Unfortunately it's a war where only those affected will see and live the reality of what some will only see as a "godsend". The Pain medication debate resulting with a "steamrolling" epidemic, where the balance between assisting i Incredibly well researched with a clear understanding of all the different facets of why and how Opioid addiction manifests and spreads like a wildfire out of control. Why the current laws and legislation will never outsmart the current model of profiteering and abuse. Unfortunately it's a war where only those affected will see and live the reality of what some will only see as a "godsend". The Pain medication debate resulting with a "steamrolling" epidemic, where the balance between assisting in life and ending it was lost to greed, opportunists, and to those that didn't have a choice of finding their way back. A cure where only a magician will ever be able to solve the complexities of rehabilitation. But acknowledgment is a great start.........

  28. 4 out of 5

    Jill Mackin

    An excellent book about the opioid crisis in America. Dopesick is a very readable book about a major problem, which began in the central Appalachia area of Virginia, and has spread across the country.

  29. 5 out of 5

    Tfalcone

    Thank you Net Galley for the free ARC. I had barely started reading and I was immediatly getting fired up. First of all - the greed of drug companies, salespeople and doctors.Whatever happened to "First do no harm"? I never realized the amount of money that was at stake here. I also did not realize that doctors caved in so easily to drug reps. But then, really in the end the decision to take the drugs lies within each individual. On some level you have got to know that you should not need any opi Thank you Net Galley for the free ARC. I had barely started reading and I was immediatly getting fired up. First of all - the greed of drug companies, salespeople and doctors.Whatever happened to "First do no harm"? I never realized the amount of money that was at stake here. I also did not realize that doctors caved in so easily to drug reps. But then, really in the end the decision to take the drugs lies within each individual. On some level you have got to know that you should not need any opioids four weeks after having your gallbladder out because your scar hurts. You can never justify leaving your baby starving and dehydrated while you are overdosing on heroin. That is a choice and there are no excuses. (I know I am sanctimoniously judging a life I do not understand.) After reading this book, I highly recommend some reading up on the Opium Wars. All of China's economy and much of Britain's was based on opium and it was abundantly grown. At one time, the estimate was that 9 out of 10 Chinese were addicted and they have been dealing with opium addiction for centuries ( Although Mao pretty much eradicated it by hanging all the drug dealers). Other countries that are up there in current addiction rates:Afghanistan (main producer) and Iran (neighbor). Maybe it has something to do with availability??? And speaking of availability, 70 some percent of the heroin comes over the southern border. This complicates things even more. I wonder if anybody has a real solution to stopping the flow of drugs and the reign of drug cartels? Great book, makes you angry, makes you think.

  30. 4 out of 5

    Paul

    From Roanoke to Maine to Humbolt County, the opioid crisis has swept across the United States with pundits on every side calling for action. Macy cuts through the debate with well-documented research that advocates for a combination of Medication-Assisted Treatment and a twelve step program. Word by word she builds a most striking argument for change. Even in the face of a lack of federal action and the complaints of nimbys, the author provides real solutions and hope. Macy’s work and her writin From Roanoke to Maine to Humbolt County, the opioid crisis has swept across the United States with pundits on every side calling for action. Macy cuts through the debate with well-documented research that advocates for a combination of Medication-Assisted Treatment and a twelve step program. Word by word she builds a most striking argument for change. Even in the face of a lack of federal action and the complaints of nimbys, the author provides real solutions and hope. Macy’s work and her writing is indispensable; this book is a must-read for every politician and parent, and really every American. The Highest Recommendation. Full review can be found here: http://paulspicks.blog/2018/07/09/dop... All reviews can be found on my blog. https://paulspicks.blog

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