“How do you meet a mother at her son’s grave near the football field where he had once made the crowds roar and not want to help her figure out what happened to her kid?” asks Beth Macy, author of the New York bestseller Dopesick: Dealers, Doctors and the Drug Company that Addicted America (Back Bay Books).

To answer her question, Macy, an investigative journalist, takes readers into board rooms and pharmaceutical laboratories, dying rural communities and the seemingly perfect lives of those living in suburban McMansions. She visits a prison for a follow-up interview with a convicted drug dealer and meets with parents who have lost their children. She talked to doctors, read trial transcriptions in case of big pharmaceutical companies accused of hiding information about the addictiveness of their drugs and conferred with law enforcement. As she was doing all this research, she had a nagging thought—would it all be out of date by the time her book was published?
“I thought by then there would be a good chance we would have solved the opioid crisis,” says Macy.
But we hadn’t and still haven’t. Between 1999 and 2017, 702,000 people died from opioid overdoses. According to data from the National Center for Health Statistics, Centers for Disease Control and Prevention, provisional data for 2018, adjusted for delays in reporting, showed a slight decrease. Unfortunately the decline was so light that it’s questionable whether it’s even the beginning of a trend or just a blip. After all this time the data proves just one thing, opioid death rates are still extremely high.
“It was all happening fast,” says Macy, noting at times she was typing up her interviews with sources only to learn that they had overdosed and died. “I listened to the stories of how people became addicted–sadly so many stories were typical. People were injured or in pain from surgery, were over-prescribed opioids and became addicted.”
Indeed, Macy talked to one woman who had lost her job in the coal fields.
“She had gall bladder surgery and became addicted because she was over-prescribed and in the end no doctor would write her a prescription,” says Macy. “Her neighbor had surgery and had also lost her job and needed money to pay for her high blood pressure medicine and her rent, so she sold her medicine to her.”
Over-prescribing often started a downward spiral—lost jobs, broken marriages, families finally worn out from helping addicts over and over again, homelessness and finally death. Mothers told her of daughters who used sex to get meds. Stress communities, those where the addiction and death rates are high, are everywhere though Macy notes that in upper income areas people are “still cloaked in this sense of stigma and shame.”
It’s a crisis that impacts us now but will continue to do so in the future.
“We’ve lost generations in some of these stress communities—there’s a county in Tennessee where I’m told that 90% of the children are being raised by someone else,” she says.
What can be done? Macy says law enforcement officials tell her that educating people is an important part of the solution. And so that has become her goal.
“I want to get the stories out,” she says, “in order to help.”
Dopesick is the winner of the following awards:
The 2019 Library of Virginia People’s Choice Award in Nonfiction
LA Times Book Prize for Science & Technology Winner
American Society of Addiction Medicine Annual Media Award Winner
2018 Kirkus Prize Finalist
2019 Library of Virginia People’s Choice Award for Nonfiction finalist
2019 Ohioana Book Award in nonfiction finalist
Andrew Carnegie Medal shortlist
800-CEO-READ 2018 Business Book Awards Longlist