This was one of those books that’s a tough read, but an important subject we should know more about. And Macy does a nice job of balancing medical, business, and legal information with personal stories. Dopesick is about OxyContin and the way it was rolled out in the U.S., leading to so many addictions and deaths. In particular, she focuses on the Appalachian region of the country, where these pills were deliberately marketed because the region had high rates of people on disability.
The real perfect storm fueling the opioid epidemic had been the collapse of work, followed by the rise in disability and its parallel, pernicious twin: the flood of painkillers pushed by rapacious pharma companies and regulators who approved one opioid pill after another.
I think the story of OxyContin is one of true evil. We have a gallery here in DC, the Freer Sackler Gallery, that I will never go to again because of its connection to the Sackler family, who made a fortune peddling these drugs even knowing how harmful they were (though I have to say in all fairness maybe I can’t blame all Sacklers for what some of them did).
The opioid epidemic is one that touches many people, whether rich or poor, but Macy really shows how this crisis fell squarely on the backs of the poor. Rural, low-income communities were flooded with these addictive painkillers, while doctors got all kinds of freebies for handing them out, and the medical industry made a fortune. Many of the poorest addicts end up in jail because the drug alters their brain and they commit crimes just to get another dose.
Though I’d covered immigration in rural Mexico and the cholera epidemic in northern Haiti, I told him, never before had I witnessed desolation at this scale, less than four hours from my house. Most of America would be shocked by the caved-in structures, with their cracked windows and Confederate flags, and burned-out houses that nobody bothered to board up or tear down.
Although Macy goes back and forth a little bit in this book between poor communities and wealthy ones, which felt a little confusing at times. It seems the epidemic begins in communities with a lot of poor people on disability payments who need painkillers. And then it moves to kids in wealthy communities who take it at parties, immediately become addicted and start “chasing the high” until many of them overdose or go to prison. In a way I felt like Macy was really telling two different stories, even though it all goes back to the same drugs.
We should be infuriated to know how far back this goes (the 90’s) and how little was done until wealthy people started dying. OxyContin was told early on that they needed to do something to their pills to prevent them from being crushed or injected, and apparently that’s something pill manufacturers know how to do. If they only work on a time-release basis, you can still become addicted but they are much less powerful and are less likely to end up in the hands of dealers. A simple thing that OxyContin chose not to do, although they did it later, well after many people died.
A few things I took away from this book: one (and we know this already but Macy really brings it home) is that addiction destroys families, not just the person who is addicted. Macy writes about family funds being depleted and parents spending years trying to heal from the problems in their children’s lives (or their too-early deaths).
Another is that treatment/rehabilitation for opioid addiction is complicated and not available to most people, or not covered by insurance. Families spend all they have just to get their loved ones into rehab, but many of the rehab facilities are shoddy or don’t believe in the use of medication to treat the addiction. Macy argues that medication is really needed and little understood.
You can tell this book really affected me, and I think it’s a book most people should read, if for no other reason to get a better understanding of addiction AND to understand what’s in your own medicine cabinet. This stuff is in mine and I want it gone.
Note: I read this book for the Doing Dewey Nonfiction Reading Challenge, the Read Harder challenge, and the Reading Women challenge.