D an end to people s Love, Again: The Wisdom of Unexpected Romance lives getting ruined because they had some injury and became addicted to strong opioids almost overnight I really enjoyed this book and highlighted many many pages We need to treat people with addictions with respect because addiction is not a moral failing of not having enough willpower it s about how addicted brains work differently than nonaddicted brains For reviews please visit Dopesick is a semi interesting book about the opioid epidemic in America Ms Macy follows many people and families over the course of 6 years and tells their stories in this book I think I would have enjoyed it aot had the author narrowed it down to just a couple individuals and included factual information on opioids and addiction I felt the book was disjointed due to there being so many different people written about and the book jumps from one person to the next and back again It just didn t flow in my opinion There wasn t much new in this for me that I haven t read in other recent books and Scandal Above Stairs (Kat Holloway Mysteries, living in Appalachia I m well aware of the crisis I see people just about everywhere I go who are in the throes of addiction I didearn some about medication assisted treatment including Suboxone that I didn t know before so this book was not a complete washout People who enjoy human int When a new drug sweeps the country it historically starts in the big cities and gradually spreads to the hinterlands as in the cases of cocaine and crack But the opioid epidemic began in exactly the opposite manner grabbing a toehold in isolated Appalachia Midwestern rust belt counties and rural Maine Working class families who were traditionally dependent on jobs in high risk industries to pay their bills coal mining in southwest Virginia steel milling in western Pennsylvania ogging in Maine weren t just the first to experience the epidemic of drug overdose they also happened to ive in politically unimportant places hollows and towns and fishing villages where the treatment options were ikely to be hours from home Macy opens the book with a deep dive into the history of heroin and morphine addiction and how the drugs were reformulated over the decades into a prescription pill that has eft an indelible mark on the US A scathing indictment of Purdue Pharma follows this the company that started with ear wax removal and shifted their focus to pain mangement and OxyContin production in the 1990s Looking at the Entranced (The Donovan Legacy, large events Macy then brings it home to her corner of the world the Interstate 81 corridor in and around Roanoke Virginia She creates the context of factory closings and mining towns shut down depressed and impoverished people withittle work and chronic pain and the ripe soil when a miracle drug comes along and then the desire for even heroin fentanyl etcMacy briefly touches on the science of addiction and many others have done this She chooses to focus on the faces the argely young faces of teenagers and twentysomethings the stories and the rehabilitation efforts made by communities and small townsImpactful journalism Shockingjust shockingI had no idea how bad things have become and who was responsible You hear news about the opioid crisis and it s getting worse and we need to do something about itbut we don t Giving out Narcan to folks so if they overdose they have the fix not sure if I fully agree with it Aren t we just enabling it by this I remember once someone telling me at a hospital someone came in OD d Given Narcan revived Awesome They were given Narcan to take with them Later that same day they were backOD d again But we need to ook at the root cause the pharma companies and doctors that over prescribe Listening into my husbands conversation recently with someone who tore a muscle at work on the job He had to get their medical history At the ER they were given Oxy for pain REALLY That s what you get for a torn muscle now This person was smart enough to throw out the prescription But many think I l take just one pill I can handle it but the sad thing is that s all it takes You want it and And in the end you try to stop but you get so sickdopesick So you continue to take it just to avoid the dopesickness A vicious cycleAnyway this book is a very detailed ook at this crisis and how it came about and how fast it spread and continues to spread You get intimate details of the people hit with this families recovering or trying to from oosing oved ones or just trying to get a oved on straight We might think oh this is only something that happens in the downtrodden areas of the US where people don t have have no money and so on But it s not the case The wealthy affluent have also been Big business does well to keep people hooked on these drugs drug reps affected Big business does well to keep people hooked on these drugs drug reps tons of cash to have doctors peddle their drugs even when not needed And doctors are too enient in handing out drugs ike tic tacs So if you want an in depth ook at this crisis grab this one It s heartbreaking sad enragingbut a great read I Buried listened via audio which was read by the author She did a wonderful job but at times there were too many people and too many facts and that sort of stuff is hard to track via audio Print might have been better for me Perhaps I should now just sayrant off I personally know 5 families who haveost a family members to heroinfentanyl Good strong well educated families It is happening all around us in all walks of ife There are plenty of heartbreaking personal accounts in this book from families who have ost a oved one and the steps they took in an attempt to save them It can and does happen to anyone They aren t other they are us and it is heart wrenching to readAccording to the author the roots of the epidemic stems from a perfect storm of factors the government mandate that physicians make adeuate pain control a priority Purdue Pharma who aggressively marketed Oxycontin to doctors as effective without causing dependency They hid evidence that this was a highly addictive drug physicians writing arge amounts of the narcotic Oxycodone often for minor procedures outdated methods of treating addicts proven by multiple studies to be unsuccessful treating addicts ike criminals again exhaustive research tells us it doesn t work once addicted to Oxycontin and no onger able to obtain a supply the addicted turn to the cheaper heroinfentanyl combination according to some this is a small percentage see below economic factors at play in a population where poverty and unemployment is the norm the conditions are ripe for drug useaddiction Appalachia was among the first places where OxyContin gained a foothold in the mid 1990sMedicine has changed no onger do doctors prescribe arge amounts of narcotics as a matter of routine care after surgery In fact physicians face sanctions for prescribing narcotics inappropriately and many have chosen to just stop prescribing I read this book a month ago but have hesitated to write a review because I m conflicted There is another side to the story and chronic pain patients are the unintended victims I wish the author had addressed this issue and given a balanced report Not everyone who uses Oxy will go on to become a drug addictAccording to while prescription opioid misuse is a risk factor for starting heroin use only a small fraction of people who misuse pain relievers switch to heroin According to a national survey ess than 4 percent of people who had misused prescription pain medicines started using heroin within 5 years1 Side note I m an RN and I have a disease that causes chronic pain I m fortunate that my disease is under control through the use of biologics and I have no need for pain medicine But I keep abreast of what is happening in the chronic pain community and all too often those who suffer from chronic pain are the unfortunate victims of new aws and government mandates I ve personally visited pain clinics where I felt treated ike a criminal even though I wasn t there for a narcotic prescription I can t imagine what it would have been ike if I had needed oneDoctors are being pressured to taper chronic pain patients off opioid regimens that have been working for them for years Most chronic pain patients use the drugs in order to function but are now treated with suspicion and judgement even if they have been using the drugs for years with no problem Many can t get their prescriptions filled at the pharmacySome experts claim most of the harm from opioids are from the drugs being smuggled into the country from China and Mexico but nearly all the government s solutions are based on imiting access to pain medication for people in pain For information Heartbreaking infuriating incredibly well researchedThis is an impeccably researched overview of the US American opioid crisis enriched by case studies of people affected Macy manages to show both the immediate private reach of this crisis and the overarching problems in the health system that ed to it. H unsparing yet deeply human portraits of the families and first responders struggling to ameliorate this epidemic each facet of the crisis comes into focus In these politically fragmented times Beth Macy shows astonishingly that the only thing that unites Americans across geographic and class ines is opioid drug abuse But in a country unable to provide basic healthcare for all Macy still finds reason to hope and signs of the spirit and tenacity necessary in those facing addiction to build a better future for themselves and their famili. ,
Dopesick Dealers Doctors and the Drug Company Who Addicted America by Beth Macy is a 2018 Little Brown and Company publication Because the most important thing for the morphine hijacked brai The informant eaned into Lieutenant Richard Stallard s cruiser This feller up here s got this new stuff he s selling It s called Oxy and he says it s great he said What is it again Stallard asked It s Oxy comptonsomething Cinderella Unmasked (Fairytale Fantasies like that Pill users were already misusing it to intensify their high the informant explained as well as selling it on the black market Oxy came in much higher dosages than standard painkillers and an 80 milligram tablet sold for 80 making its potential for black market sales much higher than that of Dilaudid and Lortab The increased potency made the drug a cash cow for the company that manufactured it too The informant had specifics Users had already fi In 2012 author and investigative social journalist Beth Macy began writing about the worst drug heroin epidemic in world history Dopesick Dealers Doctors and The Drug Company That Addicted America began in the hills and valleys of Appalachia the mid western rust belt rural Maine before rapidly spreading throughout the US In 2016 64000 Americans perished from drug related causes and overdoses outnumbering the total of those killed during the Viet Nam War Macy explored the terrible destructive impact on society those who have helped and harmed and the brave individuals sharing their own stories of tragedy andoss casting aside stigma and shame to alert and help othersIn the ate 1990 s Appalachian country doctor St Charles Virginia Art Van Zee MD was among the first to sound the urgent alarm how OxyContin had infiltrated his community and region Patients were admitted to hospital ER s in record numbers from drug related causes Rates of infectious disease including Hepatitis C along with petty and violent crime had increased substantially a police car was fire bombed addicts were desperate for cash to support their drug habit an elderly patient had resorted to selling pills from his nursing home bed Van Zee called public meetings to advocate and alert others of the opioid health crisis and didn t hesitate to file complaints against Purdue Pharma for aggressive marketing campaigns promoting OxyContin By 2001 he and Sister Beth Davies were attending two funerals per day of the addicted deadIn 2007 with over 28 billion USD earned in drug profits Purdue Pharmaceuticals was found guilty in federal and civil criminal courts for their roleresponsibility for creating the opioid epidemic for misbranding OxyContin with aggressive marketing techniues that downplayed and minimized the potential for addiction The 600 million USD fine was worth the risk for Purdue the executives charged were forced to isten to victim impact statements and were compared to Adolf Hitler and the mass destruction of humanity yet these men served no jail time Both Doctor Van Zee and Sister Davies were outraged that none of the fine was allocated for drug recovery and addiction programs Instead it was appropriated for MedicaidMedicare reimbursement and for criminal justice and The Power Of A Choice law enforcement Macy documents the vast suffering heartbreak of the families friends medical staff and first responders the foster parents clergyeft behind to carry on after destruction and death had taken its toll The closed down factories umber mills furniture manufacturing warehouses and stores coal mines jobs that had once sustained the middle class were grim reminders that for the average American ife would never be the same again Some desperate families impacted by the disease of despair had ost ife savings attempting to pay for costly drug rehabilitation programs for The Case for Paleolibertarianism and Realignment on the Right loved ones only to realize addiction was aifelong process and the ikelihood of relapse might be a day away Providers of rehab facilities were not in agreement over MAT medication assisted treatment though medical experts contend that MAT is absolutely necessary to battle the intense cravings of addiction and increase the rates of successful treatment Many of the stories were harsh and brutal Too many politicians and policy makers believe addiction is a personal moral failing and criminal offense rather than a treatable disease that robs victims of their dignity and freedom of choice Macy s book easily compares to Sam uiones outstanding award winning book Dreamland The True Tale of America s Opiate Epidemic 2015 Macy is the author of the bestselling Factory Man 2014 and Truevine 2016 With thanks and appreciation to Little Brown and Company via NetGalley for the DRC for the purpose of review A problematic read for me Yes I know awards and all that But I honestly think the awards go to the fact that Macy made Oxycontin and heroin part of a national conversation not because this book was exemplary journalism or writing Issue 1 Macy
does not feel ike a competent research or investigative journalist Apparently before the book writing gig her newspaper job was humannot feel Monsieur Pain like a competent research or investigative journalist Apparently before the book writing gig her newspaper job was human stories I can so see that And I am not the human interest kind of reader Dopesick primarily focuses on those on the frontines but not the dopesick Though it begins by talking with a major drug dealer it uickly moves to one of the physicians who watched the crisis unfold and then a very brief history of Oxycontin the manufacturer Purdue Pharmaceuticals and the family that owns the company But mostly there are stories from the mothers Details are heart tugging and honestly facile She writes about how one son who died of an OD used to help his mom grow sunflowers so now the mom plants her whole front yard full of them Another carries around the urn of her son s ashes and caused a minor disturbance in a courtroom Does this help us understand drug abuse No Does it help stir anger against Purdue Pharmaceuticals I d argue no because it gives the reader a sad tragic death only partially from system failure Macy is trying desperately to relate the individual stories to the arger issues of economics and escape but it never gels Unlike Evicted Poverty and Profit in the American City which dispassionately used the micro stories of people to show the complexity of the issues around housing Macy seems desperate to engage the reader through emotion but without a ot of researchSurprisingly for a book about dopesick Macy argely avoids the elephant of addiction It feels ike she s uick to blame the system ex Ann had a twisted ankle and got twenty five oxycodone before ooking at individual behaviors that contribute It is clear indirectly that many of the mothers were in denial about the evel of were in denial about the Dare to Lead: Brave Work. Tough Conversations. Whole Hearts. level of teens use So it kind of ignores the web of deceptions and strategies that occur before the pill takers turn into addicts She makes it soundike people are prescribed oxycodone get addicted start finding someone with extra start dealing to cover costs then turn into heroin addicts There s a Patrick the Wolf Boy, Volume 1 loose attempt to connect that chain with economic depression but it doesn t work Mostly she makes it soundike the good kids did it for fun and then boom their ives end Literally For me it s the most annoying kind of journalism because it uses stereotypical images and catch phrases to capture tragedy It s Hallmark Channel journalismIssue 2 Macy is not a good writer She uses adjectives for things she can t possibly know but play into preconceptions see above re Hallmark Channel and below uote about stone faced She also uotes some people saying really intriguing but argely unsupported things and then doesn t address them Glitter Bomb (A Scrapbooking Mystery, later When I checked her footnotes in the back they aren t actually footnoted in the body of the book you have to skim through the notes and see if a section you are curious about is highlighted she hasame ass citations By Il morto di Maigret lame ass I mean one uote she uses from a guy who asserts Adderall might make the brain susceptible to addiction then she cites a book called Drug Dealer published in 2016 Why is this claim in the middle of writing about 2005 2007 I don t know Like I said terrible journalism But further research hased me to think that book has potentialIssue 3 Purdue Pharmaceuticals is an evil evil corporation As a general rule I m pretty sure "most pharmaceutical companies are greedy soul sucking entities but Purdue seems "pharmaceutical companies are greedy soul sucking entities but Purdue seems evil which Macy illustrates The topic gets a chapter or two but is severely hamstrung by the fact that it is a privately owned corporation by the very private Sackler family and that one of her co workers already investigated and wrote a book about how Kermit a town of 400 had enough pills to supply the US The Sackler family has doubled down by counter suing the states instead of admitting any kind of culpability The only ones that have won here are their awyers who have made buckets defending them since 2005 or so when the internet exploded and people really started to get that Oxycontin was addictive I would have iked an expose Beth Macy takes us into the epicenter of America's twenty plus year struggle with opioid addiction From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once idyllic farm towns; it's a heartbreaking trajectory that illustrates how this national crisis has persisted for so ong and become so firmly entrenched Beginning with a single dealer who ands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics Macy endeavors to answer a grieving mo. F how Purdue built their empire I want of the details from the whistle blowers Some of those are included but not in detail There s a woman who was terminated and filed a wrongful termination Globalization: A Multi-Dimensional System, Third Edition lawsuit asserting she was fired because she refused to sellpush drugs to two of her highest prescribing doctors Her district was Florida naturally I wanted to know about that they must be saying that they actually tracked prescribers and numbers and actively promoted to them Which by implication is basically admitting that they were beingegal drug dealers Now that is unbelievably unethical and if you have problems with kids pushing dope in schools is because this corporation and the family that owned it ENCOURAGED IT This family has billions made from an addictive substance they repeated promoted as not Anyway Macy only briefly covers that case and Billionaires Contract Engagement (Kings of the Boardroom largely in relation to the fact that she ended uposingIssue 4 You want compassion Talk to someone who isn t the child of police officers and a cancer nurse Macy didn t help me develop that or make me appreciate the insidious way addiction rewires the brain one dopamine burst at a time The Sexual Secrets last time I took care of an addict at myast hospital we had to call a Behavioral Emergency because we had finally gotten all the unknown drug out of his system and he was pissed we messed up his high His mother was exhausted tired of coming to the hospital and trying to talk sense into him He ripped out his IV eaking blood everywhere Hepatitis positive naturally and eft It was super not fun Macy s stories barely even help me with compassion for the parents seeped as they are in denial and white privilege Kristi Remembers the first time someone in town suggested her son had a pill problem Kristi defended her son even suggesting that it had been the woman s son not Jesse who swiped the pills She continued to make me feel compassion and empathy for the people that ove addicts but didn t do anything for me about addictsWhich eads me to issue 5 Macy doesn t handle The Race Issue well When someone is black she usually makes a point of saying it and urban is often code for ow class person of color She will reference sides of the town What has become clear by 2016 is that now that oads of well to do white kids are dying it s an issue The one person I remember in the book as a person of color is black is in prison and who Macy seems to finger as being the person that brought dope to their middle class burbs The white twenty some old that was in jail is portrayed as reformed iving healthy and educating others before he goes to do his time in prison for providing drugs in an OD death Issue 6 The Science this is science ight I really really wanted of this Bickel went onto scientifically uantify the indifference of the typical opioid user comparing the average non addictive person s perception of the future calculated to be 47 years against an addicted users idea of the future which is just nine days I once met an addiction researcher that really educated me on brain wiring and how it changes with addiction and it was really the first time I really started to appreciate how terrible trying to combat addiction is I was hoping Macy would talk about the changes in addicts and how they can actually be helped but it felt The West Transformed: A History of Western Civilization, Vol 1, to 1715 like this section was scienceight and hope heavy She ikes to blame various aspects of the system usually ack of affordable rehab beds when an addict finally says I m ready to uit but doesn t really address the most obvious problem that she herself notes only 50% of addicts who get into a program and on maintenance drugs stay sober for a year That s a really shitty success rate would you go to a surgeon who was only successful 50% of the time Oh we got most of your appendix but not all of it Take thyroid medication or insulin if there was only a 50% chance it would work Yeah probably not These people are desperate so they re taking what they can get but the most honest response to the addiction issue We don t know the best way to do it yet TL DR If you know nothing about what oxycodone is or why it s part of the national conversation start here But if you want investigative journalism info on Purdue or discussion on treating addiction go elsewhereOne and a half stars only because I never threw it across the roomActual semi comprehensive overview in under 20 minutes by John Oliver This is a well researched nonfiction book about how the Sackler family of the privately held company Purdue Pharma their sales reps unethical and misinformed doctors our pitiful healthcare system that only helps some people and our misguided aw enforcement and incarceration aws created an opioid crisis that became a heroin crisis that ed to overdosing becoming the eading cause of death for young AmericansOur country needs to ensure that everyone has access to healthcare including mental health and substance abuse care We also need to change our drug aws so tax payers aren t funding prisons for people who are ow evel drug users It costs a minimum of thirty thousand dollars a year to incarcerate someone In minimum of thirty thousand dollars a year to incarcerate someone In ike New York and California the cost is seventy to than one hundred grand California the cost is seventy to than one hundred grand if we used that money on healthcare and education and substance abuse treatment According to Macy s book Rehab is a multibillion dollar ie It s unevenly regulated and argely abstinence focused meaning people who are trying to get weaned off opioids aren t supposed to take drugs Pookie-Pie like Suboxone even though it s proven to help dramatically in keeping people off drugs Most rehab centers which are unaffordable to many are abstinence faith based 12 step programs 5 of the 12 steps refer to a Higher Power even though for opioid abuse there is significant evidences that medication assisted treated for theong term is a reliable solution for sobriety When you spend that much money you think it s going to work But it s killing people for that myth to be out there that the only true cure is abstinence Not to mention even for people who might be able to afford barely incare treatment there aren t nearly enough beds in residential treatment centers to meet the demand The most important thing for the morphine hijacked brain is always not to experience the crushing physical and psychological pain of withdrawal to avoid dopesickness at any cost To feed their addictions many users recruit new customers Who eventually recruit new customers And the exponential growth continues until the cycle too often ends in jail or prison a grave In terms of the opioid crisis by now we know it s a national problem that begin in small towns places ike Appalachia that were one industry towns When coal mining stopped being ucrative because of alternate sources of energy ike fracking and wind turbines there were no jobs People often had on the job injuries and were overprescribed opioids A drug that should only be used for end "of ife care or cancer people were getting hooked after just two weeks and then ultimately "life care or cancer people were getting hooked after just two weeks and then ultimately to the cheaper heroin Four of five people heroin addicts now come to the drug by originally being prescribed opioidsWhat s the difference between our schwag and other sales reps Asked a representative for Purdue Pharma the company that hooked our citizens on Oxycontin The Sacklers that own Purdue are one of the richest families in America The difference is that People aren t stealing from their families or breaking into their neighbors homes over blood pressure pills said small town Dr Van Zee a major voice to change how this drug is prescribed which took years Doctors started prostituting themselves for a few free trips to Florida said awyer Emmitt Yeary who represented the families of people who committed Oxy related crimes stealing copper from buildings to get another fix for example We know from other countries that when people stick with treatment outcomes can bet better than fifty percent But people in the United States don t have access to good opioid addiction treatment The state of Virginia where many of the stories from both sides of the aw that Macy reports on is one of the states that refused to accept Medicaid expansion in the wake of the Affordable Care Act sacrificing 66 million a day in federal funds for insurance coverage In states where Medicaid expansions were passed the safety net program had become the most important epidemic fighting tool paying for treatment counseling and addiction medications and filling other ong standing gaps in care It gave coverage to an additional 13 million addicted users who were not poor enough for Medicaid but too poor for private insurance If only politicians understood that Medicaid would actually save money and ives It takes about eight years on average after people start treatment to get one year of sobriety and four or five different episodes of treatment for that sobriety to stick Because I m passionate about healthcare reform justice reform an. Ther's uestion why her only son died and comes away with a harrowing story of greed and need From the introduction of OxyContin in 1996 Macy parses how America embraced a medical culture where overtreatment with painkillers became the norm In some of the same distressed communities featured in her bestselling book Factory Man the unemployed use painkillers both to numb the pain of joblessness and pay their bills while privileged teens trade pills in cul de sacs and even high school standouts fall prey to prostitution jail and deathThroug. .