Very few books command your attention to the extent that you'll sit up all night reading them, Dopesick, by Beth Macy, is one of those books.

I learned so much about drug addiction and the current crisis in the U.S. from Macy's research and interviews. I was so naive, I wondered why people ever got started on Oxycontin, if it was such a dangerous and addictive substance; why ever put the first pill in your mouth? Because I found out that doctors were prescribing it so freely, soaking up freebies from pharmaceutical reps who pushed the drugs to earn huge five- and six-figure bonuses.

So: many patients simply trusted their doctors and took what was prescribed, not dreaming they could become so dependent on this drug in, say, two weeks, they'd wind up stealing, lying and doing whatever it took to score more of it.

The statistic about how many people remain addicted, and how hard it is to get off the drug and stay clean, are horrifying,

I have a deeper understanding of this issue now. It's chilling, but we need to know what happened to bring society to this point, and what it takes to help addicts, before our own families are caught up in addiction. This is an important book, and i highly recommend it. Thanks to NetGalley for my e-copy. These are my honest opinions.

DOPESICK by Beth Macy examines the opioid crisis in America using the personal stories of those affected. This book is just so timely, well-written and well-researched – although I admit that it took me a long time to finish. It’s not something I felt compelled to continue reading each day and I can’t put my finger on why. Too depressing maybe? Anyway, readers who enjoyed other timely, quasi-sociological books like Evicted, Hillbilly Elegy or Dreamland will want to pick up DOPESICK and take their time with it.

This is a powerful, well-researched book about the origins of and current state of the opioid epidemic in Appalachia and across the U.S. It's an eye-opening (at times shocking and disheartening) look at the role Big Pharma and the medical industry have played in the epidemic. I highly recommend this book to anyone interested in this subject. I look forward to reading other books by this author. Thank you to NetGalley and the publisher for allowing me to read this outstanding book.

DOPESICK by Beth Macy is a fascinating work of non-fiction that deals with "Dealers, Doctors, and the Drug Company that Addicted America." Macy, an award-winning journalist and author of Factory Man, explores the opioid crisis through the lives of four families whose teenage children's addiction resulted in devastating emotional and economic costs. As she tells it, this is a story of rehab and prison, of recovery and relapse, of "the crushing and sometime contradictory facets of an inadequate criminal justice system often working at cross-purposes against medical science." Macy argues that "the flood of painkillers pushed by rapacious pharma companies," particularly Purdue Pharma, began in isolated and politically unimportant places. A resident of Roanoke, Virginia, she attempts to "retrace the epidemic as it shape-shifted across the spine of the Appalachians, roughly paralleling Interstate 81 as it fanned out from the coalfields and crept north up the Shenandoah Valley." In addition to the collapse of work, she points to denial coupled with fear and ready stereotypes ("affliction of jobless hillbillies") plus the lack of resources for local papers to cover the enfolding story as several reasons for why it took so long for this epidemic to be widely recognized.

The abuse of opioids is a high interest topic for our students, both in Health classes and for Junior Theme and they will find much valuable information in Macy's work, as well as other titles such as Sederer's The Addiction Solution and Quinones' Dreamland (to which Macy refers). DOPESICK is extensively researched, with more than twenty percent of the book devoted to notes. Chosen as an Amazon Best Book of August 2018, DOPESICK also received starred reviews from Booklist, Kirkus and Publishers Weekly.

Link in live post: https://treviansbookit.blogspot.com/2018/05/the-addiction-solution-by-lloyd-sederer.html

I can't properly express the importance of this book. As a person who lives with multiple chronic pain conditions, including Lyme disease and fibromyalgia, I know all too well how easy it could be to fall into the trap of addictive prescription medications. Doctors hand out the pills, because that's what they were taught to do and, really, what else is there to do for a patient in chronic pain? And up until recently, few doctors and patients understood how horribly addictive medications like Oxycontin really are. So no one was warned. In fact, the opposite happened; doctors were told it was absolutely safe, and consequently they helped create an epidemic of addiction.

Too many people remain in their bubble, thinking addiction only affects the poor or the weak or someone else's kids. Until addiction strikes someone close to them, and their world is tipped upside down. We've cultivated a society in which people believe prescription medications are safe, and that Oxy isn't dangerous like heroin, when Oxy really is just heroin wrapped up in a prettier package.

This book takes on the myth of Oxycontin's safety, and how it leads to heroin use because that's the cheaper option. We see exactly how the drug's manufacturer intentionally downplayed the addiction factor and specifically targeted their marketing strategy at vulnerable areas of the country. These pharmaceutical companies are more dangerous than the drug dealers importing heroin and cocaine, and yet they continue getting rich off the addicts they create.

Beth Macy shows us exactly where and how opioid addiction began, how it evolved, and where it led. We meet addicts, many of whom are middle class kids and young adults from good homes, and not the stereotypical gangbanger or disenfranchised poor. We see the destruction and the desperation through their eyes.

The point here is not to label all opioids as evil, but to educate on their use and abuse. I really hope everyone reads this book.

To an opioid user, either on “legal” OxyContin or heroin, the goal is to avoid the debilitating withdrawal of being Dopesick. Most have only two options, steal or sell the same drugs to other, usually new, users to finance their own habit.

Moving from rural Virginia in 1996 to suburbs and cities by the mid-2000s, the opioid crisis is now the leading cause of death for Americans under 50. More than 300,000 have died in the past 15 years and it is projected that the same number will die in the next five years.

This is a story of how doctors tried, and mostly failed, to alert the producer, the government, and finally the media to the very real dangers of OxyContin. But corporate and physician greed overrode the warnings. After the government did begin to notice the epidemic and strengthen the usage guidelines, users turned to illegal heroin to avoid the Dopesick caused by OxyContin withdrawal.

Dopesick has valuable information for anyone who has friends or relatives with an opioid problem. However, it doesn’t have many solutions. It does have one clear warning:

“Those who cannot remember the past are condemned to repeat it”—George Santayana

This same pattern of an overuse of a miracle drug becoming a scourge on the populace was first seen in 1864. Returning soldiers from the Civil War were prescribed morphine, which led to the same addiction and other social consequences as the OxyContin crisis. Hopefully, it will not take all the current addicts’ deaths to move past the OxyContin epidemic as that was the way the Civil War era issue was resolved. 3 stars.

Thanks to the Little, Brown and Company and NetGalley for an advanced copy.

Thanks to NetGalley and Little, Brown, and Company for providing me with this galley in exchange for an honest review.
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This book is both fascinating and infuriating. Macy looks at the history of opium and its various iterations over the last 200+ years. She then traces the origins of Oxycodone, the drug that began the current opioid epidemic ravaging our country. She examines Purdue Pharma's marketing of the drug: claiming it was not addictive, claiming it was needed because too many people were suffering from pain, having sales reps push the drug to doctors who then prescribed it to anyone. Its use in the "left behind " (her words) towns of Appalachia and Maine, as jobs dried up and people went on disability and were given Oxycodone for "pain".

She continues down this timeline--how doctors created addicts, and then cut them off. In their desperation to avoid dopesickness (diarrhea, the shakes, pain--it's physical and very real and very miserable), they went underground. To stealing pills, stealing and selling anything, buying pills on the black market, and finally heroin. And the overprescribing spread across the country, as doctors and law enforcement and judicial systems and govt offices refused to listen to sufferers and their survivors. They still believed the drug company.

And while the drug company did finally lose a case in court, the epidemic has continued. Who in this country cannot name someone who has died of an opioid overdose? (Usually because of fentanyl, now being imported from China per Macy.) Macy follows the trajectories of addicts, dealers, parents, recovery workers, doctors, and more in the Roanoke area as she looks at where this epidemic is might be going and what might be done to slow or stop it.

Apparently the final print version of this book has pictures--these were not in my Galley. I would love to see them.

I did have some issues with this book and had a few questions that were not addressed.
• Macy has a chip on her shoulder regarding poor people in Appalachia. She thinks this epidemic happened because the government does not care about poor white people. I would argue that the government cares more about corporations (Purdue Pharma) than ANY citizens. It was not until heroin became big (it's cheap) and the production and selling was therefor completely illegal that the government did anything--punishing regular people. Punishing users and small-time dealers and occasionally slightly bigger dealers. But still not punishing the corporation that started it all with their lies and marketing--they are still legally selling the legal version.
• How did people in these small towns get on disability so easily? Where I am at it is incredibly difficult and takes years--and they are constantly reviewing to kick people off. How did these people get on and just get handed so many drugs? Were the doctors trying to scam the government? I would have liked more info on this.
• In chapter 12 she suggests sending released felons to "friendlier" places with more services, like Seattle, where low-level drug and prostitution offenders are diverted from prosecution. I have SO MUCH I could say about this (none of it nice), but first she complains about "left-behind towns" (again, her words) where people survive on disability and various charities (churches, the health wagon, etc) because there is no work (yet those still there choose to stay and be "left behind"), and now she thinks released felons should be shipped to out-of-state cities to take advantage of the programs in other jurisdictions, that other people in other states pay taxes for? Just wow. Maybe Virginia should start such programs if they are so successful. She does not actually go into why felons should be shipped out of state rather than have such programs started in-state. Perhaps other people should be the ones to pay for them?

A very important and engaging book. This will be a great fit for our non-fiction section at the library.

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.

This is the book we need to understand the world we are living in. Profits vs. people. Corporations getting richer while we get sicker. The illegal drug trade fed by unethical prescribing practices. A nuanced and well-researched look at the complexities and corporate culpability in the opioid/heroin epidemic.

“For centuries, dealers of opium, morphine, and heroin understood that an addicted person’s fear of running out – of becoming dopesick – portended one hell of a business model.”

The mother’s search, the politicians’ platitudes, the fixer’s cooked numbers, the prosecutor’s insomnia, the drug company’s pitch, and the addict’s dopesick wails. Traveling up and down the Shenandoah Valley’s Interstate 81, Beth Macy captures every face of the opioid crisis in her landmark book Dopesick. In a tone that is compassionate, yet urgent and frustrated at times, her book is an important exposé showing all the unfortunate reasons why rural America has become a breeding ground for OxyContin and heroin addiction.

Layered with the history of the opiates, from opium to morphine to fentanyl to heroin, Macy describes how addiction has cut across all races, classes, and geographic lines. She powerfully discusses the stigma, fear, and misinformation that has created two sides in the search for care, one advocating for imprisonment of criminals and the other for treatment of patients. She details the role the law, and local and federal politics play in the options for rehabilitation. And how big pharm has influenced and encouraged a quick, but dangerous fix for pain to doctors and counselors over the past 20 years.

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.

Thank you to NetGalley, Little, Brown, and Co, and Beth Macy for an advanced copy for review.

This book, Dopesick, is an eye-opening look into the world of opioid addiction. It takes the reader through the history of opioids from the 1920’s through today. The author does a great job of personalizing the face of addiction throughout Appalachia, Maine, and other rural settings of today. Since everyone has been touched by this plague, I highly recommend this book to help people understand how it began, and where it is headed in the future.

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.

Macy's thorough research and commitment to demystifying opioid addiction has led to an informative and important book. Excellent!

I highly recommend this book for anybody and everybody to read. I know that opioid addiction is all around me. I grew up in southwestern Ohio, live in Tennessee now, but I've never had direct contact with it. Reading about the struggles people face, and the shameful way opioid pills were allowed to circulate so freely, helped me understand the wider problem and to empathize with people struggling to beat their addictions.

A compelling work of investigative journalism that lays out how we arrived at the country’s opioid crisis, and where we go from here. Macy’s narrative humanizes the news stories and introduces readers to a cast of characters ensnared on all sides of addiction.

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.

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 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 rages on, this is THE book to read.

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.