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

by Beth Macy

Overview

Notes From Your Bookseller

From the author who blessed the world with Factory Man, Dopesick tells the story of the opioid epidemic from the cause to the ongoing effect. This is a masterclass in journalistic writing, equal parts engaging and urgent.

A Hulu limited series inspired by the New York Times bestselling book by Beth Macy.

Journalist Beth Macy's definitive account of America's opioid epidemic "masterfully interlaces stories of communities in crisis with dark histories of corporate greed and regulatory indifference" (New York Times) — from the boardroom to the courtroom and into the living rooms of Americans.
  In this extraordinary work, Beth Macy takes us into the epicenter of a national drama that has unfolded over two decades. From the labs and marketing departments of big pharma to local doctor's offices; wealthy suburbs to distressed small communities in Central Appalachia; from distant cities to once-idyllic farm towns; the spread of opioid addiction follows a tortuous trajectory that illustrates how this 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 sets out to answer a grieving mother's question-why her only son died-and comes away with a gripping, unputdownable story of greed and need. From the introduction of OxyContin in 1996, Macy investigates the powerful forces that led America's doctors and patients to embrace a medical culture where overtreatment with painkillers became the norm. In some of the same 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, compelling, and unforgettably humane portraits of families and first responders determined to ameliorate this epidemic, each facet of the crisis comes into focus. In these politically fragmented times, Beth Macy shows that one thing uniting Americans across geographic, partisan, and class lines is opioid drug abuse. But even in the midst of twin crises in drug abuse and healthcare, Macy finds reason to hope and ample signs of the spirit and tenacity that are helping the countless ordinary people ensnared by addiction build a better future for themselves, their families, and their communities.

"An impressive feat of journalism, monumental in scope and urgent in its implications." — Jennifer Latson, The Boston Globe

Product Details

ISBN-13:	9780316551304
Publisher:	Little, Brown and Company
Publication date:	08/06/2019
Pages:	400
Sales rank:	48,606
Product dimensions:	8.10(w) x 5.50(h) x 1.10(d)

About the Author

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

Table of Contents

Author's Note 1

Prologue 3

Part 1 The People v. Purdue

Chapter 1 The United States of Amnesia 15

Chapter 2 Swag 'n' Dash 31

Chapter 3 Message Board Memorial 57

Chapter 4 "The Corporation Feels No Pain" 87

Part 2 Objects in Mirror Are Closer Than They Appear

Chapter 5 Suburban Sprawl 103

Chapter 6 "Like Shooting Jesus" 122

Chapter 7 FUBI 146

Chapter 8 "Shit Don't Stop" 164

Part 3 "A Broken System"

Chapter 9 Whac-A-Mole 189

Chapter 10 Liminality 209

Chapter 11 Hope on a Spreadsheet 232

Chapter 12 "Brother, Wrong or Right" 250

Chapter 13 Outcasts and Inroads 269

Epilogue: Soldier's Disease 297

Acknowledgments 309

Notes 313

Index 365

What People are Saying About This

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

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

U.S. Senator (Va) - Tim Kaine

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

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

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

Tom Hanks

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

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

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

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

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

Editorial Reviews

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

The New York Times Book Review - Jessica Bruder

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

The New York Times - Jennifer Szalai

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

Publishers Weekly

A New York Times Bestseller
Winner of the 2019 Library of Virginia People's Choice Award in NonfictionLA Times Book Prize for Science & Technology Winner
American Society of Addiction Medicine Annual Media Award Winner
2018 Kirkus Prize Finalist
2019 Library of Virginia People's Choice Award for Nonfiction finalist
2019 Ohioana Book Award in nonfiction finalist
Andrew Carnegie Medal shortlist
800-CEO-READ 2018 Business Book Awards Longlist
A New York Times Bestseller
One of New York Times Book Review's 100 Notable Books of 2018
New York Times critic Janet Maslin's Top Five Best Books
An NPR's On Point Top Title of 2018
One of Literary Hub's Ultimate Best Books of 2018
One of ALA's 2018 Notable Books
A Chicago Tribune Best Book of the Year
One of Atlanta Journal-Constitution'sBest Southern Books of 2018
One of Newsweek's 61 Best Books of 2018
Washington Post Best Book of the Year
An Amazon Best Book of 2018
One of Anne Lamott's Favorite Books of 2018

"Macy's harrowing account of the opioid epidemic in which hundreds of thousands have already died masterfully interlaces stories of communities in crisis with dark histories of corporate greed and regulatory indifference."—New York Times Book Review, Editors' Choice

"A harrowing, deeply compassionate dispatch from the heart of a national emergency...a masterwork of narrative journalism, interlacing stories of communities in crisis with dark histories of corporate greed and regulatory indifference."—Jessica Bruder, New York Times Book Review

"This book is comprehensive, compassionate and forceful. No matter what you already know about the opiod crisis, Dopesick's toughness and intimacy make it a must."—Janet Maslin, New York Times

"An impressive feat of journalism, monumental in scope and urgent in its implications...gritty and heartbreaking."—Jennifer Latson, The Boston Globe

"You've probably heard pieces of this story before, but in Dopesick we get something original: a page-turning explanation."—Matt McCarthy, USA Today

"Macy has waded into a public health morass that has also become a political minefield...Macy's strengths as a reporter are on full display when she talks to people, gaining the trust of chastened users, grieving families, exhausted medical workers and even a convicted heroin dealer, whose scheduled two-hour interview with the author ended up stretching to more than six hours."—Jennifer Szalai, New York Times

"Ms. Macy focuses on southern and western Virginia, though the lessons of her narrative apply broadly...Macy embedded herself in the lives of four heartsick families whose children's lives were ravaged—and sometimes lost—because of opioid addiction...for those new to the topic there is much to learn."—Dr. Sally Satel, Wall Street Journal

"Macy reports on the human carnage with respect and quiet compassion."—Gabriel Thompson, The San Francisco Chronicle

"Macy's book reveals a more complex truth of an epidemic that has been manufactured by the players of her subtitle."
—John Warner, The Chicago Tribune

"Heartbreaking, exhaustively researched...a fierce indictment of racism, corporate greed and wily dealers...a terrifying, essential read."—People's Book of the Week

"Macy is a terrific reporter, scrupulous in detailing the significance of her findings...Dopesick's second section—filled with gut-wrenchingly candid interviews with addicts and their families—is the most essential, placing broken faces onto horrifying data sets."—David Canfield, Entertainment Weekly

"Macy's book doubles as a history and a call to action."—Inside the List, New York Times Book Review

"In Dopesick, journalist Beth Macy chronicles the crisis at large, and holds a mirror up to the pharmaceutical companies that are fueling it. Macy does exhaustive research for her books and it's encouraging that, despite all she's learned, she still has hope that our country can effectively combat this epidemic."—Amazon Book Review

"Dopesick pulls together [Macy's] decades of research and interviews to highlight why and how doctors, dealers and drug companies conspired (in some cases knowingly) to get large swaths of the American population addicted to painkillers."
—Jessica Roy, Deputy Editor of Elle, Best Books of 2018

"A ferocious piece of journalism distinguished by unyielding compassion."—The Atlanta Journal-Constitution

"Beth Macy puts a human face on America's opioid crisis."—Christian Science Monitor

"Until I read Dopesick by journalist Beth Macy, I didn't grasp all of the factors that have combined to produce the present crisis...Although Macy's stories are set in Virginia, they could happen anywhere in the United States."—Susan Okie, The Washington Post

"Just as she did with her last book, Truevine, Macy is able to develop an intimacy with key individuals that allows her to understand and explain the hearfelt feelings of her characters...The end result is an on-the-ground survey of the crisis that explores it from both the head and the heart."—Paul Markowitz, The National Book Review

"Shifting effortlessly between the sociopolitical and the personal, Macy weaves a complex tale that unfolds with all the pace of a thriller, her deep journalism — interviews with dealers, police officers, activists, local politicians as well as users and their families — matched by a sense of barely suppressed anger at what is happening to communities like Roanoke, Virginia, where she has lived since 1989."—Sean O'Hagan, The Guardian

"Beth Macy's recent Dopesick outlined the synergistic destruction that legal and illegal narcotics wreak on users and their communities."—Abigail Zuger, The New York Times

"A dogged and empathetic reporter on the ills of Appalachia (see her earlier Factory Man), Macy sets her roving eye on the victims and villains of the opioid crisis...Macy's approach is fresh in its humanity and its outlook, which is at once comprehensive and hyperlocal."—Boris Kachka, Vulture

"Dopesick follows the long chain of preventable, profit-driven human misery that is the opioid crisis."—The Approval Matrix, New York Magazine

"This book blends memoir and reportage, leaving nearly no stone unturned, looking at the opioid epidemic."—Book Riot

"The Roanoke, Va.-based writer tasked herself with unravelling a demonically complex issue, and Dopesick is both devastating and sprawling in scope. In part, it's a David-versus-Goliath narrative like her first book, Factory Man."—Macleans

"A sensitively written and rigorously reported book on the opioid epidemic"—Entertainment Weekly

"[Macy] brings a clear eye for journalistic detail and a searching humanity to her account of the people who turn to crime to avoid dopesickness...Dopesick will enrage you and bring you to tears, often on the same page.—Steve Mitchell, Lit South

"[a] masterful work."
—Misty Hawkins, The Charleston Express

From the Publisher

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

Kirkus Reviews