Book of the week
Dopesick: Dealers, Doctors, and the Drug Company That Addicted America
(Little, Brown, $28)
We have badly needed a book like Dopesick, said Jennifer Latson in The Boston Globe. A work of journalism “monumental in its scope and urgent in its implications,” it delivers a cinematic account of the greatest drug crisis in U.S. history at a moment when fatal overdoses are still rising and yet public alarm remains muted. Author Beth Macy, a veteran journalist, has tracked the opioid epidemic backward to the mid-1990s, when Connecticut-based Purdue Pharma developed the painkiller OxyContin, absurdly claimed an addiction rate of less than 1 percent, and then aimed its sales push at Appalachia because of that region’s concentration of disabled workers. You’ll know much of the story: As painkiller addiction spread, so, too, did the share of addicts turning to heroin and fentanyl. Opioid-related overdose deaths in the U.S. topped 72,000 in 2017.
The story, as Macy tells it, “may make you weep,” said Sean O’Hagan in TheGuardian.com. “It will almost certainly make you angry.” OxyContin’s addiction rate turned out to be roughly 50 percent, and meanwhile Purdue was pouring millions into spreading its use, enriching shareholders and sales reps alike. Macy strings together “crushing” tales of lives cut short or destroyed by opioid use, said Jeff Calder in The Atlanta Journal-Constitution. But just as her book threatens to collapse under the weight of its tragedies, she pivots, turning Dopesick into “a first-rate crime thriller” about commuter-dealers on Interstate 81 in Virginia and an ATF agent who tried to shut that channel down. Macy is even better when she tackles the urgent subject of treatment, demonstrating that opioid addiction is a lingering affliction that typically can’t be shaken without expensive medication-assisted therapies.
“Like many journalists, Macy writes about the tenacity of addiction as if it were a purely physiological process,” said Sally Satel in The Wall Street Journal. She writes of “morphine-hijacked” brains as if every user were doomed to addiction, even though all the teen addicts she focuses on had used other drugs or demonstrated psychological distress before resorting to opioids. But four out of five addicts started on prescription painkillers, so we doctors deserve blame, too, said Matt McCarthy in USA Today. A decade ago, the profession embraced the idea that pain could be eradicated with pills, and that “wildly misguided” approach led to unimaginable suffering. With 200 Americans dying each day from an epidemic doctors helped unleash, “we’ve still got tremendous work to do.” ■