Dopesick: Dealers, Doctors, and the Drug Company Who Addicted America by Beth Macy. Beth holds a master’s degree from Hollins University. She was a reporter for The Roanoke Times from 1989 to 2014 writing extensively about the opioid crisis in Appalachia.
Beth has written op-eds for The New York Times. She was awarded the 2010 Nieman Fellowship for Journalism by Harvard University. In addition, Dopesick was shortlisted for the 2019 Andrew Carnegie Medal for Excellence in Nonfiction.
Additionally, by June 2020 Hulu broadcast a limited series (eight episodes) based upon the book starring Michael Keaton. This is the second book of five that I chose to read to understand the crisis.
Beth has taken time to interview parents of children who died from opioids. In fact, this book moves from the local drug dealer in Virginia in 2012 to the Sackler family and beyond. However, Beth also begins by sharing how a single batch of opioids in Huntington West Virginia would cause 26 overdoses in a single day. This was due to Carfentanil, a synthetic opioid imported from China via the internet. In fact, Carfentanil is 100 times more powerful than Fentanyl, which is roughly 50 times more powerful than heroin.
Moreover, the spread of fentanyl in 2012 was fast becoming the most deadly opioid. While 300,000 Americans died of drug overdose in the previous 15 years, another 300,000 would die in just the next 5 years. Opioids are net leading cause of death for Americans under the age of 50. More than guns, auto accidents, and HIV.
Because the most important thing for the morphine-hijacked brain is, always, not to experience the crushing physical and psychological pain of withdrawal: but to avoid dope sickness at any cost.
pg. 36
An avalanche of teenage deaths
Beth then shares the story of Jesse Bolstrige, a 19 year old construction worker and recent high school football star found slumped over on a stranger’s bathroom. the Hulu series portrays Jesse’s death via character Betsy Mallum. However, the movement of opioid crisis was not from traditional big cities to small rural Appalachian towns like cocaine and crack in the 1980s and 90s. OxyContin made its debut in 1996 via pain prescriptions. Addictions would soon follow driving this crisis first within those small communities. This also highlighted that opioids killed all races, all incomes, all professions. No family was immune when prescribed OxyContin.
Downstream impacts
Beth’s stories of families losing children to opioids continues painfully. So, Beth references Sam Quinones book Dreamland regarding generations people died of alcohol addition in late middle age. However, alcohol was replaced by OxyContin. The demand was so lucrative that mid-level dealers could make $15,000 in a single weekend.
Data mining like amazon.com
In fact, the true horror is learning how Purdue Pharma targeted coal-mining zip codes to drive opioid sales. Purdue certainly understood the marketing data and didn’t care how many became addicted.
A glimmer of hope
The story of Dr. Art Van Zee and Sister Beth Davies seemingly are indeed the book’s only glimmer of hope. Beth introduces and carries their efforts throughout. Both are confronted with bias about drugs, users, and jail as the only solution. Their efforts along with the story of Cheri and David Hartman also provide insights early into the crisis. Yet their treatment of opioid abuse with buprenorphine also ran into closed minds at both healthcare systems and politicians.
In conclusion, Beth’s writing is numbing as entire towns are destroyed with local police, healthcare, and government drowning in unplanned costs while politicians cannot provide solutions. No one is immune. Beth’s work is very draining as readers confront death after death including those families left grieving for not one but two children. As Empire of Pain reveals the Sackler family, Beth is providing deeply personal stories.