American Overdose: The Opioid Tragedy in Three Acts by Chris McGreal. Chris is a reporter for the Guardian and was a former correspondent in Johannesburg, Jerusalem and Washington DC.
He has won awards for his reporting of the Rwandan genocide, Israel/Palestine, and the economic recession in America. In fact, Chris has been recognized by the James Cameron prize for “work as a journalist that has combined moral vision and professional integrity.” He won the Martha Gellhorn Prize for Journalism. In fact he was recognized for reporting that “penetrated the established version of events and told an unpalatable truth”.
This is the fifth book of five that I have read regarding the opioid crisis. In contrast, Chris’ view as a foreign reporter brings a global perspective to our country.
In fact, what Chris sees looking into America is how opioids have deeply gutted smaller communities all across the country. Moreover, his use of statistical data helps drive home how damaging this toll has taken.
Written in three acts, Chris is addressing Dealing, Hooked, and Withdraw. Hence, Dealing begins by documenting America’s business driven healthcare system. Big Pharma profits off pain, and the FDA is somewhat complicit. Following this, Hooked is focusing on addiction. And in the closing act Withdraw, drug cartels succeed by certainly understanding how to ‘game’ the addiction marketplace.
A House of Cards
As addressed throughout the previous four books, the misinformation of addiction in the New England Journal of Medicine by Dr. Russell Portenoy certainly pulled the wool over the eyes of physicians who wanted to help their patients deal with pain. However, it takes a turn for the worse: very powerful narcotics are prescribed for tooth aches and minor injuries? Similarly, the timing was perfect for America’s culture desire to find the answer to every question in the form of a pill.
Two million tablets for a small pharmacy in one year, of one drug, is pretty amazing. That’s a lot of money, a lot of income for not only the pharmacy but the distributor.
pg. 399
Pill Mills
Addiction is certainly a terrible condition and opioids moved this to new financial models for Big Pharma, doctors and wellness clinics who created immense Pill Mills across middle America.
The result is a largely American epidemic. The United States consumes more than 80 percent of the world’s opioid painkillers yet accounts for less than 5 percent its population. Doctors wrote more than 200 million opioid prescriptions a year. As Congressman Harold “Hal” Rogers put it, That’s enough painkillers to medicate every American adult around the clock for a month.
pg. 21
Subsequently, those Pill Mills had little if any record keeping. Compromised doctors met with patience only one time while allowing addicts to phone in prescriptions. Pharmacies were dispensing millions of pills and fully understood the profits would be in the billions of dollars while looking away from any accountability of those would die of overdoses.
Millions and millions of pills
Likewise, after the crisis was churning at full steam, Congress tried to act, only to be kneecapped by politicians with campaign money linked to Big Pharma. Testimony was nothing but staged softball questions:
The questions homed in on McKesson’s supply of 5.6 million opioids to the Sav-Rite in Kermit over just two years and Cardinal Health’s large deliveries to drugstores in Williamson. McKesson’s CEO, John Hammergren, was asked how, when his company’s own monitoring system required that orders larger than 8,000 opioid pills a month should be scrutinized, the firm was delivering the equivalent of 9,650 pills a day to the Sav-Rite. Hammergren admitted that deliveries “should have been terminated sooner” but put the failure to do so down to error. The system had broken down, he said. By an apparent remarkable coincidence, the other distributors suffered from the same kind of breakdown that allowed them to go on delivering millions of pills for years on end.
pgs.521-522.
In conclusion, Chris and other authors cite Appalachia was the data driven target and exploited area in this crisis. In fact, Big Pharma was spending billions to market directly to these consumers with false educational videos to empower their sales. This is a powerful book which reveals how many aspects came together to kill so many Americans.