Beth Macy
(Little, Brown)

In Dopesick, journalist Beth Macy gives the opioid epidemic a human face, but not at the expense of historical and scientific context. This epidemic, she argues, can be traced to the greed of one pharmaceutical company. Purdue Pharma’s release of OxyContin in 1996 led to an epidemic of iatrogenic (doctor-caused) opioid addiction, the third in US history. The first epidemic had led to the deaths of countless Civil War veterans to morphine; the second had killed off thousands of middle-class housewives before heroin was banned in 1924, twenty-six years after its release as an over-the-counter drug. But Purdue couldn’t have succeeded without thousands of unscrupulous doctors and sales reps who cashed in at the expense of the most susceptible. OxyContin’s arrival also coincided with patients becoming healthcare consumers and pain becoming “the fifth vital sign,” to be avoided at all costs. Not treating pain was tantamount to abuse, preached the new medical experts funded by Big Pharma. It wasn’t long before courts and prisons were overwhelmed as addicts started stealing from their families and neighbors and switching to heroin, not seeking a high but simply to stave off the “dopesickness” of withdrawal.

Treatment, regulation, education, and new criminal justice approaches are all urgently needed, but it will take more than that to stem the great tide of despair of which this scourge is but a symptom.