"Dopesick" by Beth Macy; Little Brown (376 pages, $28)
In "Dopesick," newspaper reporter Beth Macy focused her investigative skills and journalistic compassion to the devastating opioid epidemic. She tells a real-life horror story.
For three decades, Macy worked in Roanoke, Va., where she witnessed the sprawl of the epidemic across central Appalachia, "among the first places where the malaise of opioid pills hit the nation in the mid-1990s, ensnaring coal miners, loggers, furniture makers, and their kids." By the mid-1990s, pills had become the new coal, a boom-and-bust occupation and fixation.
A refrain she heard often as she traveled through Appalachia: "For that strong of a drug, for it to be everywhere you looked, it was like the government was controlling it, trying to get rid of the lowlifes."
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Macy traces the transformation of the drug from its quiet origins more than 100 years ago into Purdue Pharma's modern juggernaut. She tells the stories of dealers, addicts, the doctors who raised alarms and those who handed out the drugs. She packs the story with devastating statistics.
The surviving parents of lost children are the heart of the book. Their stories are achingly similar: promising young lives derailed, lack of adequate treatment, impossible negotiations with insurers and the lost opportunities to get help. That golden moment of an addict's willingness to go in for treatment is so precious and fleeting that it has a name: liminality.
Only 10 percent of opioid addicts manage to get treatment. Even when they do, remission is elusive. The book has heroes, too: a country doctor, a nun-turned-drug-counselor, and researchers who pushed the alarm over and over.