Dopesick (book)

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Dopesick: Dealers, Doctors, and the Drug Company that Addicted America
Dopesick (book) front cover.jpg
First edition
Author Beth Macy
CountryUnited States
LanguageEnglish
GenreNarrative nonfiction
Publisher Little, Brown and Company
Publication date
2018
Media typePrint, e-book
Pages384 pages
ISBN 0316551244

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America is a 2018 non-fiction book by American author Beth Macy. The book covers the origin and evolution of the opioid epidemic in the United States beginning primarily with the 1996 release of the drug OxyContin, and examines its effects on small town America and the Appalachian region in particular. It was well received by critics and won the Los Angeles Times Book Prize for Science and Technology. In 2021, the book was adapted into a Hulu miniseries starring Michael Keaton. [1]

Contents

Background

Author Beth Macy worked as a journalist for the Roanoke, Virginia-based newspaper The Roanoke Times from 1989 until 2014. [2] In 2012, following the completion of her first book, Factory Man, Macy was assigned a story by the newspaper to report on a local teen who had died of a heroin overdose. [3] Macy's subsequent reporting on the topic prompted her to suggest heroin and opioid abuse as the subject of her next book. Her New York City-based publishers, having already seen a heroin epidemic in their city, didn't see the topic's novelty, and Macy ended up writing Truevine as her second book instead. The 2015 publication of the opioid study Dreamland by Sam Quinones, combined with further research into the effect of the drugs on America, brought the issue further into the public consciousness, and Macy began writing Dopesick soon after. [3]

Synopsis

Dopesick combines an overview of the history of opioid prescription and abuse in the United States with interviews and anecdotes from people whose lives the drugs have affected. [4] The book goes back to the Civil War and the widescale distribution of morphine to wounded soldiers, followed later by Bayer 's marketing of heroin as safe and effective, in displaying the history of careless treatment of opiates by many in the medical and pharmaceutical fields. [5] Macy traces the more recent epidemic to Purdue Pharma and their 1996 release of the opioid painkiller OxyContin. [4]

Purdue was successful in having the drug approved for less serious ailments than opiates were typically prescribed due to the company's claim that its extended release (the "-Contin" in its name being short for "continuous") made it safe from recreational users and addicts seeking a quick fix. [4] In reality, users quickly learned that removing the pill's outer layer allowed access to the concentrated narcotic located inside. [5] This discovery resulted in drug dealers taking advantage of the medical field's readiness to prescribe OxyContin to create "pill mills", the effects of which were felt hardest in rural America. [4] [5]

The book goes on to describe personal stories from affected people and families in the Appalachian region. [4] Many people who had been prescribed opiates had become addicted but could no longer afford to pay for the pills. They often turned to heroin, which was being imported into rural areas on an unprecedented scale. [6] Teens who had tried pills embraced heroin as an easily obtained alternative, with one remarking, "I did my first bag of heroin before I drank my first bottle of beer." [6] The widespread use of opioids also introduced new demographics to heroin dealers in the form of women and people with more disposable income. [7]

Finally, the book examines the science behind medication-assisted treatment, which involves the monitored use of an opiate-derived medicine to combat addiction. [6] Macy interviewed Nora Volkow, the director of the National Institute on Drug Abuse, who remarked that "[a]ll studies – every single one of them – show superior outcomes when patients are treated" with buprenorphine and other maintenance medications. [6] Macy describes resistance to such treatment, much of which was found in the South where communities had been hit hardest by the epidemic but still believed in a "cold turkey" approach to recovery. [8]

Reception

Dopesick received generally positive reviews. Jessica Bruder of The New York Times Book Review called it a "harrowing, deeply compassionate...masterwork of narrative journalism." [9] Janet Maslin of The New York Times said that "no matter what you already know about the opioid crisis, [Dopesick's] toughness and intimacy make it a must." [10] Entertainment Weekly 's David Canfield called Macy a "terrific reporter" and said Dopesick was a "definitive attempt at confronting the epidemic, from its source to its current scale." [11] Brian Volck of The Christian Century praised the book's thoroughness but likened its portrayal of so many affected people and their heartbreaking stories to a "mass of indistinguishable misery like characters in a 19th-century Russian novel." [5]

Dopesick was named one of the 100 Notable Books of 2018 by The New York Times Book Review and made the 2018 year-end "best-of" lists of The Washington Post , Chicago Tribune , and Amazon. [7] [12] It was a New York Times best seller and received the 2018 Los Angeles Times Book Prize for Science and Technology. [7] [13]

Adaptation

In 2020, it was announced that the streaming service Hulu was adapting Dopesick for an eight-episode limited series. [14] Michael Keaton was signed to star in the series, which would be led by showrunner Danny Strong and director Barry Levinson. [14] Macy, who was an executive producer and co-wrote some episodes, succeeded in her attempt at having the series filmed in Virginia where much of the book took place. [15] She was also an advocate for the show's inclusion of the benefits of medication-assisted treatment, which Patrick Radden Keefe said was "hugely important" in helping the American viewing public begin to talk about such measures in combating the epidemic. [8]

The show premiered in October 2021. [16] It received critical acclaim and was nominated for 14 Primetime Emmy Awards, with Keaton winning for Outstanding Lead Actor in a Limited or Anthology Series or Movie. [17] It also received a 2021 Peabody Award in the entertainment category. [18]

Related Research Articles

<span class="mw-page-title-main">Oxycodone</span> Opioid medication

Oxycodone, sold under various brand names such as Roxicodone and OxyContin, is a semi-synthetic opioid used medically for treatment of moderate to severe pain. It is highly addictive and is a commonly abused drug. It is usually taken by mouth, and is available in immediate-release and controlled-release formulations. Onset of pain relief typically begins within fifteen minutes and lasts for up to six hours with the immediate-release formulation. In the United Kingdom, it is available by injection. Combination products are also available with paracetamol (acetaminophen), ibuprofen, naloxone, naltrexone, and aspirin.

<span class="mw-page-title-main">Arthur M. Sackler</span> American physician and marketing executive (1913–1987)

Arthur Mitchell Sackler was an American psychiatrist and marketer of pharmaceuticals whose fortune originated in medical advertising and trade publications. He was also an art collector. He was one of the three patriarchs of the controversial Sackler family pharmaceutical dynasty.

<span class="mw-page-title-main">Purdue Pharma</span> American pharmaceutical company (1892–2019 bankruptcy)

Purdue Pharma L.P., formerly the Purdue Frederick Company (1892–2019), was an American privately held drug cartel pharmaceutical company founded by John Purdue Gray. It was sold to Arthur, Mortimer, and Raymond Sackler in 1952, and then owned principally by the Sackler family and their descendants.

Raymond Sackler was an American physician and businessman. He acquired Purdue Pharma together with his brothers Arthur M. Sackler and Mortimer Sackler. Purdue Pharma is the developer of OxyContin, the drug at the center of the opioid epidemic in the United States.

Mortimer David Sackler was an American-born psychiatrist and entrepreneur who was a co-owner, with his brothers Arthur and Raymond, of Purdue Pharma. During his lifetime, Sackler's philanthropy included donations to the Metropolitan Museum of Art, the Tate Gallery, the Royal College of Art, the Louvre and Berlin's Jewish Museum.

<span class="mw-page-title-main">Sam Quinones</span> American journalist

Sam Quinones is an American journalist from Los Angeles, California. He is best known for his reporting in Mexico and on Mexicans in the United States, and for his chronicling of the opioid crisis in America through his 2015 book Dreamland, followed by, in 2021, his book, The Least of Us. He has been a reporter for 35 years. He is now a freelance journalist. Prior to that he was a reporter for the Los Angeles Times from 2004 to 2014.

<span class="mw-page-title-main">Pill mill</span> Illegal pain clinic

A pill mill is an illegal facility that resembles a regular pain clinic, but regularly prescribes painkillers (narcotics) without sufficient medical history, physical examination, diagnosis, medical monitoring, or documentation. Clients of these facilities usually receive prescriptions only against cash. Pill mills contribute to the opioid epidemic in the United States and are the subject of a number of legislative initiatives at the state level.

<span class="mw-page-title-main">Opioid epidemic in the United States</span> Ongoing overuse of opioid medication in the US

There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. The epidemic began in the United States in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years.

Hershel M. Jick was an American medical researcher and associate professor of medicine at Boston University School of Medicine, where he was the director of the Boston Collaborative Drug Surveillance Program.

<span class="mw-page-title-main">Richard Sackler</span> American billionaire (born 1945)

Richard Stephen Sackler is an American billionaire businessman and physician who was the chairman and president of Purdue Pharma, a former company best known as the developer of OxyContin, whose connection to the opioid epidemic in the United States was the subject of multiple lawsuits and fines, and that filed for bankruptcy in 2019. It has been claimed that Richard Sackler's Purdue is among "the worst drug dealers in history" and the Sackler family have been described as the "most evil family in America". The company's downfall was the subject of the 2021 Hulu series Dopesick and the 2023 Netflix series Painkiller.

<span class="mw-page-title-main">Beth Macy</span> American journalist and writer

Beth Macy is an American journalist and non-fiction writer. She is the author of four published books, including national bestsellers Factory Man (2014) and Dopesick (2018).

Massachusetts v. Purdue is a lawsuit filed on August 14, 2018, suing the Stamford, Connecticut-based company Purdue Pharma LP, which created and manufactures OxyContin, "one of the most widely used and prescribed opioid drugs on the market", and Purdue's owners, the Sacklers accusing them of "widespread fraud and deception in the marketing of opioids, and contributing to the opioid crisis, the nationwide epidemic that has killed thousands." Purdue denied the allegations.

The Sackler family is an American family who owned the pharmaceutical company Purdue Pharma and later founded Mundipharma. Purdue Pharma, and some members of the family, have faced lawsuits regarding overprescription of addictive pharmaceutical drugs, including OxyContin. Purdue Pharma has been criticized for its role in the opioid epidemic in the United States. They have been described as the "most evil family in America", and "the worst drug dealers in history".

<span class="mw-page-title-main">Opioid epidemic</span> Deaths due to abuse of opioid drugs

The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.

<span class="mw-page-title-main">Timeline of the opioid epidemic</span>

The timeline of the opioid epidemic includes selected events related to the origins of Stamford, Connecticut-based Purdue Pharma, the Sackler family, the development and marketing of oxycodone, selected FDA activities related to the abuse and misuse of opioids, the recognition of the opioid epidemic, the social impact of the crisis, lawsuits against Purdue and the Sackler family.

<i>Dopesick</i> (miniseries) 2021 American drama miniseries

Dopesick is an American drama television miniseries, created by Danny Strong for Hulu. Based on the non-fiction book Dopesick: Dealers, Doctors, and the Drug Company that Addicted America by Beth Macy, it premiered on October 13, 2021, and concluded on November 17, 2021, after eight episodes.

Joss Sackler is a fashion designer. She is also known for her marriage to David Sackler, whose father Richard Sackler was the chairman and president of Purdue Pharma, and oversaw its manufacturing of the highly addictive opioid Oxycontin, a leading drug in the opioid epidemic.

Curtis Wright IV is an American former government official known for his role in the Food and Drug Administration's approval of OxyContin for Purdue Pharma in 1995, followed by his subsequent employment by the company, which led to portrayals in films and reports in nonfiction books, magazines, and news media outlets of his alleged role as one of the key figures in the current opioid epidemic in the United States. Wright was implicated in a criminal conspiracy outlined in a 2006 United States Department of Justice review document that was first made public in Purdue Pharma's 2019 bankruptcy proceedings. Although that case was settled in a 2007 plea agreement deal, members of United States Congress have requested the full 2006 documentation from the Department of Justice with the goal of opening a new case based upon the evidence then gathered. Parts of Wright's sworn depositions in 2003 and 2018 have internal contradictions and differ from documentary evidence described the 2003–2006 U.S. Federal Government investigation into Purdue Pharma.

Painkiller is an American drama television miniseries created by Micah Fitzerman-Blue and Noah Harpster. Based on Patrick Radden Keefe's New Yorker article "The Family That Built an Empire of Pain" and Pain Killer: An Empire of Deceit and the Origin of America's Opioid Epidemic by Barry Meier, the series focuses on the birth of the opioid crisis, with an emphasis on Purdue Pharma, the company owned by Richard Sackler and his family that was the manufacturer of OxyContin. The Sackler family has been described as the "most evil family in America", and "the worst drug dealers in history".

In response to the surging opioid prescription rates by health care providers that contributed to the opioid epidemic in the United States, US states began passing legislation to stifle high-risk prescribing practices. These new laws fell primarily into one of the following four categories:

  1. Prescription Drug Monitoring Program (PDMP) enrollment laws: prescribers must enroll in their state's PDMP, an electronic database containing a record of all patients' controlled substance prescriptions
  2. PDMP query laws: prescribers must check the PDMP before prescribing an opioid
  3. Opioid prescribing cap laws: opioid prescriptions cannot exceed designated doses or durations
  4. Pill mill laws: pain clinics are closely regulated and monitored to minimize the prescription of opioids non-medically

References

  1. ↑ Leger, Donna Leinwand (August 22, 2022). "'Dopesick' author Beth Macy joins Washington Post reporters Higham, Horwitz for a book talk on opioid crisis, Sept. 22". The National Press Club. Retrieved May 13, 2024.
  2. ↑ Moret, Stephen (Third Quarter 2019). "Virginia's rural storyteller: A conversation with Beth Macy". Virginia Economic Development Partnership. Retrieved May 13, 2024.
  3. 1 2 McNamara, Sylvie (September 2022). "Chronicling a crisis". The Washingtonian. Vol. 57, no. 12. pp. 31–35.
  4. 1 2 3 4 5 Szalai, Jennifer (July 25, 2018). "Dopesick traces the opioid crisis, from beginning to blow up". The New York Times.
  5. 1 2 3 4 Volck, Brian (March 27, 2019). "Roots of the opioid crisis". Christian Century. 136 (7): 36–37.
  6. 1 2 3 4 Okie, Susan (September 28, 2018). "Heartbreaking stories of lives lost and families crushed in the opioid epidemic: Beth Macy traces the devastation wrought by the flood of opioids into American towns". The Washington Post.
  7. 1 2 3 Roberts, Frances C. (July–September 2019). "Dopesick: Dealers, Doctors, and the Drug Company That Addicted America, by Beth Macy". Baylor University Medical Center Proceedings. 32 (3): 466–467. doi:10.1080/08998280.2019.1589894. PMC   6650232 .
  8. 1 2 Miller, Stuart (August 21, 2022). "Hope on opioid front". The Los Angeles Times. p. E9.
  9. ↑ Bruder, Jessica (August 5, 2018). "The worst drug crisis in American history". The New York Times Book Review. p. 11.
  10. ↑ Maslin, Janet (December 4, 2018). "'The Witch Elm,' 'Dopesick' and More: Janet Maslin's Favorite Books of 2018". The New York Times.
  11. ↑ Canfield, David (August 17, 2018). "Heart of the matter". Entertainment Weekly. No. 1524/1525. p. 102.
  12. ↑ New York Times Book Review (November 19, 2018). "100 Notable Books of 2018". The New York Times. Retrieved May 15, 2024.
  13. ↑ "Los Angeles Times Book Prizes winners announced". The Los Angeles Times. April 12, 2019. Retrieved May 16, 2024.
  14. 1 2 Allen, Mike (June 19, 2020). "Roanoke author's book 'Dopesick' to be adapted into Hulu series". The Roanoke Times. p. A2.
  15. ↑ Curran, Colleen (October 11, 2021). "'Dopesick' cast, crew rave about filming in Virginia and their love for Richmond". The Richmond Times-Dispatch. pp.  A1, A13.
  16. ↑ Berrier Jr., Ralph (October 10, 2021). "'Dopesick' to begin its Hulu run". The Roanoke Times. pp.  D1, D2.
  17. ↑ Andreeva, Nellie; Hipes, Patrick (July 12, 2022). "Emmy Nominations: The Complete List". Deadline . Archived from the original on July 12, 2022. Retrieved July 13, 2022.
  18. ↑ Dickens, Tad (June 7, 2022). "'Dopesick' streaming adaptation wins Peabody Award". p. B8.
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