Having grown up in an area where drug overdoses are unfortunately too common, the book Dopesick by Beth Macy definitely hits close to home. In the book Beth details the long, troubling history of Purdue Pharma, the Sackler family, and the doctors who deliberately targeted Appalachia due to its collapse of work within the coal mines and the rise of disability among workers making it a ripe target for crooked doctors and big pharma executives to cash in on a vulnerable population. Beth does a solid job at weaving together both the historical element of the opioid crisis as well as the personal stories of the people impacted by this epidemic. The stories of those impacted by the epidemic are heartbreaking and gut wrenching to read. From stories of young students in high school/college where their lives were tragically uprooted by heroin and painkillers prescribed to them as an end to pain, a devastating lie.
The details of the opioid crisis are infuriating to read, and Beth does a good job pointing out the absurdities that have led to this crisis exploding in the last decade. Absurdities like how a part of our country was targeted by Purdue pharma because they saw a weak population, and flooded them with pills that they knew would addict the population, and create essentially an endless loop of money from addicted patients to trigger happy doctors handing out prescriptions like candy. Doctors who were complicit in the overprescribing of Americans got rewarded with fat bonus checks, and the Purdue executives were making money hand over first by poisoning patients.
The corruption ran so deep, that medical conditions caused by opioids, such as opioid induced constipation, had a market for more pharmaceutical companies to create a drug to counteract the manufactured effects of the opioid crisis. Purdue pharma was marketing a new laxative to help with the issue called Senokot, and they marketed it during the Super Bowl at its height. Not only would they prescribe you poison that would alter your body and how it functions, but they gave you the “solution” on the way out, doubling their profits from a totally avoidable situation.
Perhaps more frustrating and disheartening than the big pharma companies taking advantage of others for their own profits at disgusting levels of deep corruption, is the mistreatment of the poor people affected by this situation. Painkillers and powerful opioids like heroin and fentanyl rewire the brain, so that it becomes a serious medical dependency. It might be a choice the first time these people used, but most of them were prescribed the pills from a doctor that graduated them to heroin. People they were told to trust had given them these pills, and at the time there was no social stigma against pills, they were acceptable. They were addicted and lied to by people who weren’t being punished for their wrongdoings while they were incarcerated and treated as lesser than for being addicted. This sentiment still holds true to this day with us refusing to acknowledge that people who have been severely addicted have a medical condition, and sometimes medication is needed in treatment. The abstinence only treatment route, in comparison to the MAT treatment route, is highlighted excellently in this book and was a complicated dynamic of the crisis that I never knew about. It will truly make you reflect on just how poorly, and inhumanely this whole crisis is. The mishandlings have undoubtedly cost far too many lives and this book painfully highlights that.
In conclusion, the book's name plays perhaps the biggest role. Macy highlights the pain and suffering that addicts who suffer from Dope Sickness experience. That it isn’t bad people doing bad things, but good people who have been essentially poisoned and are left to suffer for the sins of Big Pharma and Purdue. Writing the book through this lens creates a different perspective on what the user is experiencing, and it sheds a sympathetic light on the situation which is desperately needed. A quote in the book by a Johns Hopkins researcher and MAT provider summarizes the misguidedness within our culture on the opioid crisis simply and accurately, “Our wacky culture can’t seem to do anything in a nuanced way.” This book gets a solid 5/5 stars from me, and is a must read to everyone living in this age as fentanyl is now the main killer amongst young people in America, surpassing 100,000 deaths for the first time ever this past year, and sadly that number is going to increase if we don’t get our acts together.