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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. 5 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. 5 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.

  3. 5 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.

  4. 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.

  5. 5 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.)

  6. 4 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 5 out of 5

    Liz Bartek

    Great work by Macy, as always; truly heartbreaking, we're not doing enough to address this epidemic.

  15. 5 out of 5

    John Spiller

    If you have read "Dreamland" by Sam Quinones, then "Dopesick" may be a bit redundant but still a worthy read. I thought Quinones did a better job examining how the change in approach to pain management, which was ruthlessly exploited by Purdue Pharma (the maker of Oxycontin), ultimately spawned what is now known as the "opioid crisis". Macy does a better job detailing the human cost of opioid addiction. I have read numerous books on the lives of heroin addicts, and Macy still managed to gut me w If you have read "Dreamland" by Sam Quinones, then "Dopesick" may be a bit redundant but still a worthy read. I thought Quinones did a better job examining how the change in approach to pain management, which was ruthlessly exploited by Purdue Pharma (the maker of Oxycontin), ultimately spawned what is now known as the "opioid crisis". Macy does a better job detailing the human cost of opioid addiction. I have read numerous books on the lives of heroin addicts, and Macy still managed to gut me with her accounts of wasted lives and the Sisyphean efforts of their loved ones trying to save them. Perhaps even more depressing, she explains just how intractable the problem is.

  16. 4 out of 5

    Betsy Holcombe degolian

    A fascinating look into the history and reality of the opioid epidemic. Macy did her research and compassionately tells the story of those touched and living in the throes of the epidemic.

  17. 5 out of 5

    Beth

    I remember back in high school, as part of a senior project about drugs and drug use, I had to write a paper. My argument in that paper was that legalization of any drug was a terrible idea, and would ultimately do more harm than good. This was back in 1990, when "just say no" was the all-encompassing message sent out to kids around the country. That paper, and the overly-simplistic attitude and mindset are not things I think about very often these days...but they definitely come to mind upon fi I remember back in high school, as part of a senior project about drugs and drug use, I had to write a paper. My argument in that paper was that legalization of any drug was a terrible idea, and would ultimately do more harm than good. This was back in 1990, when "just say no" was the all-encompassing message sent out to kids around the country. That paper, and the overly-simplistic attitude and mindset are not things I think about very often these days...but they definitely come to mind upon finishing this book. So many of the attitudes as related in this book - by doctors, law enforcement, citizens - are still the same narrow-minded and overly-simplistic ones I remember from back then. While this epidemic rages - almost no one remains untouched (My best friend's husband, long addicted to Oxy, left her and their daughter for meth - stealing their savings and pawning so many of their belongings. While she was dealing with a diagnosis of MS and helping their daughter recover from spinal surgery, she was also dealing with the betrayal, hurt, and anger - and helping him into multiple rehab centers. He's currently in prison, not having seen his daughter for years, and still addicted.). Beth Macy, expanding on her reporting for the Roanoke Times, explains how and why Oxy became a gateway drug to harder ones like heroin, and delves into just why treatments as they currently stand have such terrible relapse rates. She is unflinching in explaining how bureaucracies and out-of-date policies collide with the NIMBY viewpoints of many and the belief that abstinence-only rehabs are "superior" to make sure that few addicts truly get the treatments they need to be successful. It's a heartbreaking book, and an infuriating one. It's educational (I'm a parent who prays fervently that my children never ever find themselves in this struggle - but if they do, I'll have a head start on what treatment options have science to back them.), and it's eye-opening. Frankly, everyone should read this book, because this epidemic will not go away until more people truly have an awareness of what it's like on the front lines of this disease. NOTE: I urge everyone reading this review and/or this book, or even those just interested - please follow the Surgeon General's new guidelines and get trained on the use of nalaxone. Then have a kit with you. We can all do our part. For more information, please go to https://www.drugabuse.gov/related-top...

  18. 5 out of 5

    Christine

    People, just read this. I never claimed to know much about drugs, and this book confirmed that I was right. What a sad sad book! If you have children, I highly recommend you check this book out. Literally, from your library if necessary! It will remind you to always keep your eyes open in regards to your children. Talk to them! This book affected me on a deep level, and I don't have kids to worry about, and I have never really taken prescription drugs. Especially those discussed in this book. It People, just read this. I never claimed to know much about drugs, and this book confirmed that I was right. What a sad sad book! If you have children, I highly recommend you check this book out. Literally, from your library if necessary! It will remind you to always keep your eyes open in regards to your children. Talk to them! This book affected me on a deep level, and I don't have kids to worry about, and I have never really taken prescription drugs. Especially those discussed in this book. It starts by talking about the history of Oxycontin in America, and goes into many other Opioids. It's scary out there! I highly recommend this book to ALL PEOPLE!

  19. 5 out of 5

    Traci at The Stacks

    I enjoyed the content overall. I didn’t always like the writing style. At times felt very sympathetic to certain kinds of addicts. It’s a good book but I wonder about the story being told and who is vilified and who isn’t.

  20. 5 out of 5

    Lucas Brandl

    This is one of the saddest and most terrifying books I've ever read. Drug overdose is currently "the leading cause of death for Americans under the age of fifty, killing more people than guns or car accidents, at a rate higher than the HIV epidemic at its peak." This book captures many tragic stories of users, dealers and pharmaceutical executives, explaining how opioids in America have exploded into the seemingly uncontrollable mess it is today. The opioid crisis is not specific to towns or cit This is one of the saddest and most terrifying books I've ever read. Drug overdose is currently "the leading cause of death for Americans under the age of fifty, killing more people than guns or car accidents, at a rate higher than the HIV epidemic at its peak." This book captures many tragic stories of users, dealers and pharmaceutical executives, explaining how opioids in America have exploded into the seemingly uncontrollable mess it is today. The opioid crisis is not specific to towns or cities. It isn't specific to poor or rich people. And it is not specific to lost souls seeking escape. Many of the stories are people in tremendous physical pain from factory work or military injuries or whatever else, who were then gratuitously prescribed oxycontin or other painkillers by doctors who didn't understand the overwhelmingly addictive nature of these drugs. The author does more than lay out the enormity of the problem though, she takes a stand on what she believes to be viable solutions. Some of the things she advocates like supervised clean needle clinics for heroin addicts or increased prescriptions of methadone might sound radical. But they sound a lot less radical after a few hundred pages of this book and the harrowing stories it tells. She takes both Donald Trump and Barack Obama to task for being weak on this issue, and caring more about optics than making meaningful progress. There are many studies mentioned in Dopesick that suggest the death toll will only continue to rise exponentially for the foreseeable future, and at some point the country will need to truly confront whether increased punishment and incarceration is working, or if reinvesting in compassion and treatment is a better way forward.

  21. 4 out of 5

    Jeremy

    ‘I knew that I might not see change in my lifetime, but I was going ahead with this battle anyway.’ - Van Rooyan, 68 He seemed more concerned about being honest than trying to control the narrative. - 116 ‘There are so many families struggling with the same thing Colton has been struggling with. It’s insidious, and it’s evil, and it’s not just pot...And I know there’s a social stigma attached to this, but don’t hide. Don’t hide from it. I know there are at least three other boys here that I know C ‘I knew that I might not see change in my lifetime, but I was going ahead with this battle anyway.’ - Van Rooyan, 68 He seemed more concerned about being honest than trying to control the narrative. - 116 ‘There are so many families struggling with the same thing Colton has been struggling with. It’s insidious, and it’s evil, and it’s not just pot...And I know there’s a social stigma attached to this, but don’t hide. Don’t hide from it. I know there are at least three other boys here that I know Colton wants me to help. And you know who you are...I know now that I’m supposed to be here for you boys, and we’re gonna make it through.’ - Deanna Banks, 142 The local emergency room was by now accustomed to the classic fake and fraud: a moaning patient claiming kidney stone pain and pleading for Dilaudid, also known as ‘that one that starts with a D.’ - 148 News that people were dying from fentanyl-laced heroin didn’t intimidate heroin addicts, according to several I [Beth Macey] interviewed. On the contrary, the lure of an even stronger high drew them to it more. - 201 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 medication, 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. - 206 The buprenorphine made her ‘feel normal,’ as Tess thought of it, with insurance covering 80 percent of the medication’s costs. Visits to her addiction doctor were cash only, though, requiring $700 up front and $90 to $100 per follow-up visit, as many as four a month, in order to be monitored and receive the buprenorphine, which prevents dopesickness and reduces cravings, theoretically without getting you high. ‘It’s a real racket,’ Tess’s mom, Patricia, said of cash-only MAT practices. 'And there are waiting lists just to get into most of these places.’ - 211 Tess’s problems were growing worse by the minute, and the systems designed to address them were lagging further behind, mired in bureaucratic indifference. - 216 “It’s like there’s a demon inside her,” Patricia said. “I do get mad at her, and there are times I want to say, ‘I quit.’ But the truth is, and I want her to know this, I’ll never give up on her.” - Patricia Mehrmann, 230 That weekend Patricia bought matching bracelets for the two of them with the inscription ‘Your heart is my heart.’ The saying was inspired by an e. e. cummings poem Tess admired and adopted as a kind of mantra about her feelings for her son. Tess had won a national high school poetry competition in 2001; Patricia still kept her winning poems displayed in her kitchen. Over the next several months, whenever she texted me with updates, she referred to Tess as ‘our poet.’ - 231 On her way out, the week after Thanksgiving, Tess left a note on her mom’s kitchen counter: Gone to Carilion [psychiatric ward]. Mental Breakdown. I LOVE you so much Mom. You are my everything. I want to get better & won’t stop trying. - 231 But there is still only one treatment bed available for every five people trying to get into rehab, and at a cost far beyond the financial reach of most heroin users. - 238 The latest research on substance use disorder from Harvard Medical School shows it takes the typical opioid-addicted user eight years — and four to five treatment attempts — to achieve remission for just a single year. And yet only about 10 percent of the addicted population manages to get access to care and treatment for a disease that has the same incidence rate as diabetes. - 243 ‘Because there is no love you can throw on them, no hug big enough that will change the power of that drug; it is just beyond imagination how controlling and destructive it is.’ - Patricia Mehrmann, 244 ‘I think it’s asinine to tell a drug addict you’ve got to be clean before you can come to my facility.’ - 247 She had already chosen the spot where she would sprinkle her daughter’s ashes if it came to that: at a confluence of the cape Fear River and the ocean where they had loved walking the dogs and searching for sand dollars, not far from the family’s old beach house. - 248 An annual $35 billion lie — according to a New York Times exposé of a recovery industry it found to be unevenly regulated, rapacious, and largely abstinence-focused when multiple studies show outpatient MAT is the best way to prevent overdose deaths. - 251 In the 1970s, America decided to deal with drug addiction and dependence as a crime problem rather than a health problem, ‘because it was popular to find a new community of people to criminalize,’ Stevenson explained. ‘And everybody was preaching the politics of fear and anger.’ As that narrative of addicts as criminals further embedded itself into the national psyche, the public became indifferent to an alternative response that could have eased treatment barriers, he said. As an example he cited Portugal, which decriminalized all drugs, including cocaine and heroin, in 2001, adding housing, food, and job assistance — and now has the lowest drug-use rate in the European Union, along with significantly lowered rates of drug-related HIV and overdose deaths. In Portugal, the resources that were once devoted to prosecuting and imprisoning drug addicts were funneled into treatment instead. - 256 The biggest barrier to collaboration is the fact that everyone involved views the problem too rigidly — through the lens of how they get paid, according to Pack. - 259 Baltimore dealers continued to hot-pack their heroin with fentanyl, an area halo one trainer told me, because when someone dies, customers flock to his or her dealer, chasing a better high. “It’s like, ‘I might lose three of my customers, but in the long run I’ll gain ten of yours,’ “ theorized the trainer, a mom who’d lost a son to a fentanyl-laced heroin. - 266 Today, courts largely continue to send the addicted to prisons when reliable treatment is difficult to secure, and many drug courts controlled by elected prosecutors still refuse to allow MAT, even though every significant scientific study supports its use. Not every patient wants or needs maintenance drugs, because every human experiences addiction differently, and what works for one might not work for another. Still, it is crucial to preserve treatments for people with addiction and help them obtain the means needed to get off drugs, rather than simply treat them as criminals who have no right to health care. - 270 “I had put off going to RAM [Remote Area Medical] for years because I figured they’d make you feel like shit about yourself, like ninety percent of the social service people do,” he said. “But everyone was just . . . so . . . kind.” - Craig Adams, 273 And by the time treatment could be arranged, “the damage was already done, and he couldn’t overcome it [hepatitis C],” said his father, who owns a twenty-seven-acre cemetery. The man buried his son near his office so he could visit him daily, he said. - 277 America’s approach to its opioid problem is to rely on Battle of Dunkirk strategies — leaving the fight to well-meaning citizens, in their fishing vessels and private boats — when what’s really needed to win the war is a full-on Normandy Invasion. - 280 “The worst thing for politicians, I was told, was for them to appear they were being soft on drugs. Even under Obama, federal [Substance Abuse and Mental Health Services Administration] employees were told not to use the term ‘harm reduction,’ “ she said, sighing. - Caroline Jean Acker, 281 Opioids are now on pace to kill as many Americans in a decade as HIV/AIDS has since it began, with leveling-off projections tenuously predicted in a nebulous, far-off future: sometime after 2020. - 284 “Our wacky culture can’t seem to do anything in a nuanced way,” explained Dr. Marc Fishman, a Johns Hopkins researcher and MAT provider. - 286 Asked how the epidemic had changed her community, Susan sighed and told me it was now just an ingrained part of the culture. Her fifteen-year-old son believes the only way to avoid its perils is to move away. “I can’t live here, Mom,” he told her. “There’s nothing here but drugs and nursing homes.” - 287 Van Zee told me his greatest fear now was of being hit by an intoxicated driver while he jogged the winding roads — not because he feared his own death but because where, then, would his patients go? - 288 “Even in a mission-based organization, there’s still so much stigma around how we should treat addiction,” Gaeta said. “You have to constantly fight this notion that we shouldn’t wrap our arms around people who don’t want treatment.” - 289 Everywhere in America, it was painstaking to walk skeptics through the social, criminal, and medical benefits of helping the least of their brethren, but worth it — even if you had to get your ass kicked. - 289 Judge Moore asked me, three times in one sitting, what I had learned from my reporting that he could feel hopeful about. He chuckled as he said, “I can’t wait to read your book, because then maybe we’ll know what to do” — but he seemed closer to tears than laughter. - 291 “We want to show [the addicted] that they’re loved and cared about,” he told me. “And we’re trying to teach the lay folk, ‘They’re not really bad people,’ and ‘That’s a sin’ doesn’t really work.” - Bob Garrett, 292 ...he believes the five-year treatment model, common for addicted doctors and airline pilots, is ideal. It’s why they tend to have opioid-recovery rates as high as 70 to 90 percent. - Steve Loyd, 294 Denying opioid-addicted participants medicine they have legitimately been prescribed is akin to denying diabetics their insulin on the grounds that they’re fat. If 90 percent of people with diabetes were unable to access medical treatment, there would be rioting in the streets. - Steve Loyd, 295 She wanted me to convey both the depth of her grief and the ways in which she believed she had failed her son: “I wish I would have built him a stronger support system. I thought I could do it all as a single mom. I made a mistake. Find at least four adults your young adult can trust and turn to. Know their names and let them know that you are counting on them to help you assist your child to make good choices.” - Robin Roth, 299 When I floated the idea at a Carilion-sponsored forum that every doctor who’d accepted a Purdue Pharma freebie should feel morally compelled to become waivered to prescribe Suboxone as a way to beef up treatment capacity, the response among the doctors in the room was . . . crickets. - 302 The story made national news, and Patricia, determined that people should understand both the disease of addiction and her daughter’s incredible strength, spoke to every reporter who contacted her. The attention made some family members uncomfortable. - 306 She was dead now, her grieving family a perfect microcosm of the nation’s response to the opioid epidemic: well-meaning but as divided as it was helpless, and utterly worn out. - 306 It was January 2, Tess’s birthday. She would have been twenty-nine. Patricia tucked the treasures of her daughter’s life inside the vest — a picture of her boy and one of his cotton onesies that was Tess’s favorite, some strands of Koda’s hair, and a sand dollar. - 308

  22. 4 out of 5

    Michelle

    My feelings/thoughts about this book have kept me up at night. Beth Macy is a journalist and in DOPESICK she tracks the ascent of oxycontin and what it's done to this country. Obviously there is a need for pain medication and the drug has legitimate uses, however, the way this drug was marketed, pushed, etc. is absolutely sickening. I thought I was somewhat educated on the topic, because I have specifically made it a point to understand how we came to this, but this went beyond anything I've see My feelings/thoughts about this book have kept me up at night. Beth Macy is a journalist and in DOPESICK she tracks the ascent of oxycontin and what it's done to this country. Obviously there is a need for pain medication and the drug has legitimate uses, however, the way this drug was marketed, pushed, etc. is absolutely sickening. I thought I was somewhat educated on the topic, because I have specifically made it a point to understand how we came to this, but this went beyond anything I've seen/heard/read. The drug was basically marketed to unemployed people on medicaid so they could get lots of drugs on the cheap and the government would pay for it. Drug companies shipped over NINE MILLION pills of oxycontin to ONE pharmacy in a West Virginia town (population 394) over a TWO YEAR period. 9 million pills! One town! Towns that were once coal mining now have their chief industry as drug dealing. It's incredible and heartbreaking. Then, of course, it gets to the suburbs and people freak out and there's an overcorrection. People that legitimately need pain medication can't get it as easily and addicts can no longer get their fix, so they're turning to heroin or fentanyl. Not a good solution for anyone--and a problem this deeply rooted over so many years is going to take a lot more to ameliorate. Now before people are all "I use pain meds and not every person with an prescription is an addict"... obviously. That is not the point and I think this book is a must-read for ANYONE, whether you've used pain meds, or haven't, or have used them appropriately, or have not. I feel so lucky that my kids were not part of the generation who didn't fully understand the risks, or still thought "well it's prescribed and it's a 'legal' drug, so it must be safe." I hope we are all so much smarter now. This book also completely changed my views about treatment for addiction. All in, the author takes a very compelling and empathetic approach to the problem's causes, its current/ongoing challenges, and solutions that don't work, and some that might (or at least show hope). She does an excellent job of mixing scientific/factual data with human stories, because that's where the problem feels most relatable. Along with the villains (Rudy Giuliani makes an appearance--of course), there are some real heroes in this book, doctors and nuns and healthcare providers, and even the addicts themselves who so clearly wanted to be clean. Thank you to Beth Macy for such an important book.

  23. 5 out of 5

    Lissa

    4.5 stars. It's not often that you read a book that just feels so important and relevant to current society.  This follows the Opioid epidemic from the time that OxyContin was being aggressively hyped to doctors treating overworked mineworkers in Appalachia to the current time as Heroin is being used across class lines.  This is a frightening book and anger-inducing book but I think it is so important for as many people as possible to understand how this happens.  My only quibble is with the str 4.5 stars. It's not often that you read a book that just feels so important and relevant to current society.  This follows the Opioid epidemic from the time that OxyContin was being aggressively hyped to doctors treating overworked mineworkers in Appalachia to the current time as Heroin is being used across class lines.  This is a frightening book and anger-inducing book but I think it is so important for as many people as possible to understand how this happens.  My only quibble is with the structure, which jumps around quite a bit, introducing her interviewees over and over again, but that in no way detracts from the necessity of this book.  I received a digital ARC of this book from NetGalley in exchange for an honest review. 

  24. 5 out of 5

    Jen

    I have lived a very, VERY sheltered life. Despite going through public school in America, I never saw drug use or was offered drugs by anyone. Or if I did, I was too naive to know what was being offered or what I saw. Seriously, sheltered. So I was of the very mistaken opinion that druggies were stupid, that they were the idiots who took drugs in the first place and that they deserved what they got. They should have known better. This book pointed out to me that I am the idiot for not understand I have lived a very, VERY sheltered life. Despite going through public school in America, I never saw drug use or was offered drugs by anyone. Or if I did, I was too naive to know what was being offered or what I saw. Seriously, sheltered. So I was of the very mistaken opinion that druggies were stupid, that they were the idiots who took drugs in the first place and that they deserved what they got. They should have known better. This book pointed out to me that I am the idiot for not understanding that it doesn't always work that way, if at all. That sometimes, when drug companies want to make money, they snow/bribe doctors to push their pills and that many innocent people who trust their doctors, get hooked. Big Pharma is evil, because the love of money is the root of all evil and pretty much all companies care about is money. Not the end user. This book shows just one instance of how Big Pharma being greedy has LITERALLY costs LIVES. Not just for the poor person who is now addicted to pain meds or the street equivalent, heroin, but also the families and friends that try to help them or deal with the consequences of addiction, the doctors, nurses, EMS who try and many times fail, to help those addicted, to the neighborhoods and other innocent people who are affected by the crime and OD'ing of those addicted. There are too many sad stories of people OD'ing while driving with their kids in the car. This book is full of stories, of those who managed to stay clean by the end of the writing of the book, who went back and forth between clean and relapse and of those who didn't make it. Of their family members and loved ones who never give up, even after it's too late. It takes a LONG time and a LOT of money to get clean. It takes months to years for the brain to start functioning normally again, after it's been hijacked by opioids. That takes time, money and it doesn't help that much of the treatment out there is only for a month, maybe two and that some use abstinence as the way to deal with it, while others use drugs that are less potent to help ween the person off of the drugs and that both camps argue with one another over which is the best method. "Dopesick" isn't just the title of this book, it's also what someone going through withdrawl of opioids goes through when the body becomes addicted. Viciously sick. Out both ends, shaking, pain, it's horrible. It doesn't hurt that the first high is the best and many people "chase the dragon" looking for that elusive first high again. For some reason, the drug doesn't want to let go. It causes pain when trying to drop it and promises the best pleasure ever if you continue to take it. It breaks my heart. So many people out there hurting because Big Pharma wanted more money and doctors didn't know better or do any research on their own to make sure they weren't handing poison to their patients. Well, that's all they have been trained to do and the medical system we have doesn't encourage doctors to actually think about what they are handing their patients and many don't have the time. America's health care system is badly broken and until it can be fixed, we patients need to think for ourselves and be our best advocates. We shouldn't rely on our doctors or companies to take care of us. I sound like I'm ragging on doctors, but they have LOTS of patients to have to take care of. They are only human, so things can slip through the cracks. It's not fair to place the burden on them to be super-humans that can fix all of our ills with a pill, while we do nothing about our own health. We should be partners with them in figuring out the best treatment for us and if they don't have the time to research a pill, we should be. We are the ones taking it, it affects us much more than the doctor. That being said, they shouldn't be swayed by all-expense paid trips to Palm Springs and have a Big Pharma company "sponsor" their daughter's birthday party, topics also covered in this book. This book is so important. For sheltered people like me with no clue, for those in the thick of it, to know they aren't alone. For legislators and the medical system, to change antiquated ways of thinking about addiction and treatment. For those who work for Big Pharma and the doctors courted by them, to realize that what they are doing, for money or through ignorance, is hurting the people in this country. 5, super important and should be required reading, stars. Seriously, read this book. It's sad, but also hopeful. When you name the problem, when you look it in the eye and acknowledge it is there, that's when it can begin to be dealt with. That is what this book does. It's removing the stigma of being addicted, addressing the problem in a humane way and shows that there is treatment and hope. Please, read this book. My thanks to NetGalley and Little, Brown and Company for an eARC copy of this book to read and review.

  25. 4 out of 5

    Jennifer

    This book should be read by everyone..... Less stigma and more treatment for these individuals.

  26. 5 out of 5

    Elizabeth Jamison

    You can count on any book by Beth Macy to be a master class in excellent research and reporting, while never losing sight of the most important element of any story - the people at its center. In this regard, Macy's Dopesick continues her streak of excellence while tackling the brutal topic of opioid addition and the insidious way that it is has invaded our nation's communities by using three Virginia communities as the book's heartbeat. The perspectives Macy brings to the discussion are the way You can count on any book by Beth Macy to be a master class in excellent research and reporting, while never losing sight of the most important element of any story - the people at its center. In this regard, Macy's Dopesick continues her streak of excellence while tackling the brutal topic of opioid addition and the insidious way that it is has invaded our nation's communities by using three Virginia communities as the book's heartbeat. The perspectives Macy brings to the discussion are the ways in which structures of power have fed and encouraged this epidemic in ways that have been largely invisible to the American public - until now. Macy educates her readers on the interdependent roles that Big Pharma, medicine, traditional addiction treatment approaches, illicit drug trade and the fear of community social stigma play to weave a web from which few of its victims escape, but many could have been prevented. Beth Macy breaks your heart by showing us that all of these factors have been right in front of us the whole time. Dopesick may be Macy's most timely and gripping work yet. It is so incredibly devastating that I found myself wondering how she found the strength to stay in this world long enough to write it. This book was so impactful in so many ways, it is difficult to put into words. If you live in a community you care about, you must read this book. Dopesick will change how you see the community that's been right in front of you - and the difference is literally life and death.

  27. 5 out of 5

    Crystal

    I have just finished reading this book, which covers the opioid crisis, located in my home region of southwestern Virginia. The details written by Beth Macy are shocking and saddening. Macy writes as a reporter but also as a person of compassion for the people who in some ways have been exploited by the big pharma and by certain “treatment” programs. I would highly recommend this book to anyone interested in this topic. Just because we don’t know about it, doesn’t mean that it doesn’t exist. I d I have just finished reading this book, which covers the opioid crisis, located in my home region of southwestern Virginia. The details written by Beth Macy are shocking and saddening. Macy writes as a reporter but also as a person of compassion for the people who in some ways have been exploited by the big pharma and by certain “treatment” programs. I would highly recommend this book to anyone interested in this topic. Just because we don’t know about it, doesn’t mean that it doesn’t exist. I do feel the need to say that this does not include "everyone" in Southwestern Virginia and that this book should not be taken as stereotyping and painting a picture with a broad brush like Vance's Hillbilly Elegy did. As a resident of Appalachia, I disagree with Vance's portraiture of Appalachia and feel that he has sensationalized his story to line his pockets. And if those outside of Appalachia believe that everyone here is like this, they are very wrong. While as a local resident, I know that we have an epidemic. I believe this book paints and accurate picture of some of the people in this region, but not all. Furthermore, this book has burdened me even more to do what I can to help fight this problem. I volunteer with an organization that serves the under served Appalachian woman and when I worked with the latest participants of the program this summer, all but one woman was attempting recovery from some type of addiction. When this occurred I realized that I needed to know more and understand better what these ladies experience. I am a educated native of the region and I live and I choose to stay here because this is my home and because I love my family. For the most part, people in this area just want jobs that will help them live a decent life and provide for their needs. This is their home and they want to stay here. There are local law enforcement and judicial officials that I am personally acquainted with who are quoted in this book. I know that these are good people who are trying to make a difference for our SWVA residents. The people of Appalachia do not want a handout. While economic recovery takes quite a while, we acknowledge that help is needed and this book sheds light of the kind of help a larger number of them need.

  28. 4 out of 5

    gaudeo

    This is a remarkable book, full of all kinds of things I didn't know. Most of all, it alerted me to the fact that I surely know people who have been affected by opioid addiction, even if they hide it out of embarrassment or shame. But the real criminals brought out in the book are the drug companies, particularly the one that makes OxyContin (or OxyCoffin, as some call it). This company will do anything to make the most money possible, treading on an infinite number of bodies as it goes along. I This is a remarkable book, full of all kinds of things I didn't know. Most of all, it alerted me to the fact that I surely know people who have been affected by opioid addiction, even if they hide it out of embarrassment or shame. But the real criminals brought out in the book are the drug companies, particularly the one that makes OxyContin (or OxyCoffin, as some call it). This company will do anything to make the most money possible, treading on an infinite number of bodies as it goes along. I wish Macy had spent some time in the book explaining the physiological process of addiction, but that's a minor omission in what is a fine, if sobering and distressing, book. Highly recommended.

  29. 4 out of 5

    Bryn

    Wow. I couldn't put this book down. It is an eye-opening, heartbreaking expose of the opioid epidemic in this country. I feel like I've largely been able to insulate myself from this crisis (although we do have one family friend, a pillar of my hometown community in rural Michigan, who is currently serving a jail sentence as a result of his descent into addiction), but the portrait that emerges here is nothing short of heartrending, and it is clear to me that this epidemic hasn't yet peaked, nor Wow. I couldn't put this book down. It is an eye-opening, heartbreaking expose of the opioid epidemic in this country. I feel like I've largely been able to insulate myself from this crisis (although we do have one family friend, a pillar of my hometown community in rural Michigan, who is currently serving a jail sentence as a result of his descent into addiction), but the portrait that emerges here is nothing short of heartrending, and it is clear to me that this epidemic hasn't yet peaked, nor is anyone immune from it. I'd recommend this book to everyone, just to increase your awareness and empathy for those struggling with addiction of any kind, but particularly opioid addiction, which, as the book explains, is a category unto itself. I only gave the book four stars because I found it hard to follow exactly who was who, a result, I think of the more journalistic writing in the book, as opposed to a truer narrative style.

  30. 5 out of 5

    Nancy

    When I heard this book reviewed on NPR, I knew I would read it. It takes a very personal look at the opioid crisis...life stories of parents, kids, police, caregivers, medical doctors, government workers,...the reader can understand why not one simple approach can “solve” the epidemic. It is a must to read...I think I fell into the judgmental group before reading it...it is much more complicated than that.

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