book review: Dopesick by Beth Macy


Little Brown, 2018


Compelling, informative, compassionate, and harrowing. Dopesick is a comprehensive account of America’s opioid crisis that has plagued disparate rural areas throughout the country, though Beth Macy mainly narrows down her research to her local Appalachia. She pieces together interviews with doctors, advocates, addicts, and individuals who have lost family members to the drug, to weave some kind of narrative out of the onslaught of factors which have contributed to the epidemic.

While the reality of the opioid crisis was not lost on me before this (a friend of mine from high school died of an overdose about a year ago, which spurred my interest in this subject in the first place), Dopesick fills in the disturbing details. How Purdue Pharma saturated the market with Oxycontin in the 90s and continuously shifted blame from the addictive nature of the drug to the addicts themselves; how doctors have been made to prescribe these highly addictive painkillers at the drop of a hat (mainly to white patients, due to racial stereotyping that they are less likely to get addicted, which is why the opioid epidemic has hit white communities the hardest); how the government has essentially turned a blind eye and continues to deny adequate funding to address this issue; how MAT (medication-assisted treatment) has been stigmatized to the extent that many rehab programs require patients to be clean before checking in; and how feeling ‘dopesick’ is so miserable that addicts will do anything to quell the incredibly painful withdrawal symptoms.

Beth Macy fuses thorough research with unfailingly compassionate anecdotes shared with her by mothers who have lost children to the drug. Their individual stories litter Macy’s larger narrative, most of them following the exact same trajectory: being prescribed oxycodone for a minor injury, developing a dependency, being cut off from their supply, turning to illegal means of obtaining the drug, trying to get clean, failing to get clean, overdosing. There’s one statistic that Macy repeats a few times throughout this book that stayed with me – on average it takes an addicted person eight years of recovery before they’ve gone a full year without relapsing. That is how impossible it is to quit this drug.

Since this crisis isn’t going anywhere any time soon, between a lack of funding, the refusal to acknowledge MAT as a legitimate rehabilitation technique, and incarceration of drug users and dealers as the primary tool being used by the government as a band-aid solution, Dopesick is well worth reading as a starting point, for anyone wondering how this crisis has reached such a critical state with so little government intervention.