Just finished this one. Dopesick: Dealers, Doctors, and the Drug Company That Addicted America by Beth Macy, published 2018. At first I wondered if this was going to be just like Patrick Radden Keefe’s Empire of Pain from earlier this year (my fave book of 2021 so far), but they actually complement each other very well.
While PRK focuses on the Sacklers and the higher-level corporate/legal/political drama, Beth Macy’s book is an on-the ground look at the opioid epidemic sweeping into the U.S. and primarily Appalachia. As someone from Appalachia, I really appreciated her focus on this area of the country, which is constantly overlooked, misunderstood, and forgotten. And she does it in a way that looks at EVERYONE in Appalachia, including the even-more-underrepresented Black communities, unlike OTHER authors of popular books on our region (@JD Vance). A heartbreaking portrait of a system overwhelmed in every way — healthcare providers, the courts, law enforcement, corporations, housing, poverty, racism, the failures and futility of rehab centers, stigma about evidence-based MAT, rural and suburban and urban areas, divided and drowning in opioid addiction, its causes and effects.
“...as loved ones and advocates eager to help heroin users navigate treatment have shown me, threading a needle blindfolded over a hot bed of coals might have made for a less complicated odyssey.”
Honestly sort of despairing, which I guess isn’t surprising for a book published in the middle of an ongoing crisis. Really makes you think, like, my G-d, the only way things could be this entirely, thoroughly fucked is if it’s on purpose... which is something Macy touches on. But, this book, I don’t want to call it surface-level or middle-of-the-road, because it’s excellent, but it doesn’t dive quite as deep into the how and why of the “War on Drugs” or recommend solutions as much as, say, Chasing the Scream does.
However, VERY readable and approachable and explains a range of issues related to addiction/opioid use disorder/harm reduction. Probably the book I would recommend to like, my mom (Macy focuses (primarily?) on the parents, esp mothers, of people who use drugs in Virginia) or other people who aren’t too familiar with this subject. Looking forward (I think) to the Hulu series coming out next month based on this book.
“The answer is always community.” What a difficult fucking road ahead of us, almost unimaginably so. As Macy writes, maybe we haven’t even reached the apex of this crisis. But worth it to keep fighting, for each other and our loved ones.
