Books · Emotional Health

Two New Explosive Books Go Inside the Opioid Crisis


Make no mistake, the opioid crisis is coming to your neighborhood. In its wake will be left mourning parents, parentless children, and financial ruin. Two new books, Ohio and Dopesick, one fiction and the other nonfiction, show the underbelly of this national disaster. Vastly different in their approaches, these books give intimate, detailed, and emotionally nuanced portraits of the people and the communities that are dying as a result of this scourge.

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America is reporter Beth Macy’s nonfiction account of the history of the crisis, especially as it affects her native Virginia. She begins by tracing the origins of the epidemic, which can be traced back to 1996, when Purdue Pharma released OxyContin with the false claim that its new pills would be less addictive than other opioids on the market. Though OxyContin contained more medication than the others, Purdue emphasized that its time-release formula (the “contin” was pharma-speak for “continuous”) would make a quick high impossible, and thus it would be unappealing to addicts. Instead, addicts quickly learned how to dissolve the outer coating and turn the pills into exactly what they wanted.

Macy recounts how the Sackler family, owners of Purdue, became vastly wealthy as their firm aggressively pushed doctors to prescribe their product. Drug reps were treated to bonuses and luxury trips. Perks and luxuries lured doctors. While many were unaware of the harm being done to their patients, some of the unscrupulous were churning out thousands of prescriptions for addicts and abusers.

Before long, almost anyone who had ever had a painful medical or dental procedure had a bottle of Oxy in the medicine cabinet. If they themselves did not become addicted, many people had their leftover pills taken by curious family members, often teenagers, wanting to try them. They became quickly addicted and discovered that buying pills was more expensive than the comparable street drugs. Purchasing illegal, impure heroin became the next, and for many, fatal step. Now, 20 years into the process “drug overdoses, fueled by opioid abuse, are now the leading cause of death for Americans under 50.”

In Roanoke, Virginia, where Macy lives, she says, “no one was paying attention to heroin arrests when they only concerned the children of inner-city black families.” The media began to take notice as white people in the suburbs started dying. Macy goes into great detail as she explores the devastating impact of addiction as it developed in her town and a couple of hours north of Roanoke along the I-81 corridor in Woodstock where 94 percent of the residents are white.

In Dopesick (a term that refers to the immediate and sick cravings that come whenever drugs are not available), we meet mothers, fathers, children, and a few recovered addicts that all bring an emotionally wrenching vision of the situation. One moment your son is a rising senior and football star at the local high school. The next year, he is dead from an overdose. A father recalls that he first heard the word “OxyContin” when the police came to tell him his son was dead.

Macy shows how many users went from having a legitimate prescription—as the case of a 15-year-old who left an urgent-care clinic after being treated for a sprained thumb with a bottle of 25 Oxy pills—to becoming sellers of street drugs. Many rural residents would make day trips up to Baltimore to score drugs, bringing back enough to sell so they could finance their addiction. In Roanoke, for example, though some pros worked the area, heroin dealers “were local users” Macy writes, “many of them female, dispatched to buy the heroin from a bulk dealer out of state, in exchange for a cut.”

The government has been slow and inconsistent in their response to the opioid crisis, alternating between too much coddling for pain, to criminalizing the pursuit of pain medication. One of Macy’s friends, suffering chronic pain from a spine malformation, has obtained significant relief from Oxy but now finds it harder and harder to get her prescriptions. While some countries like Portugal have had great success with medically assisted treatments (MATs), here we have been slow to use them. Even the use of emergency anti-overdose drugs by first responders that have been proven to save lives, has been slow to catch on. Despite promises from the federal government, until a full, multi-pronged and comprehensive approach is adopted, the crisis and the deaths will continue.

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  • S. Sapunor September 13, 2018 at 11:41 am

    Read Sam Quinones’ Dreamland: The True Tale of America’s Opiate Epidemic (2015) !