Dopesick the Book

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Opiod Crisis

By now you have likely heard of the new book Dopesick: Dealers, Doctors, and the Drug Company That Addicted America by Beth Macy. Reviews are everywhere, and Macy appeared on radio station NPR and a PBS episode on TV this month. A reviewer at the Roanoke Times, where Macy once worked, says the book “humanizes the opioid epidemic.” And here’s the reason why it’s making news: he says “It is difficult to imagine a deeper and more heartbreaking examination of America’s opioid crisis than this new book by investigative reporter Beth Macy of Roanoke.”

Dope Sick

A reviewer in the San Francisco Chronicle says: “Macy reports on the human carnage with respect and quiet compassion, but it is gut-check reading.” Dope Sick, for the uninitiated, “is the slang term for being in withdrawal from opiates such as narcotic painkillers (oxycodone, hydrocodone, [morphine, fentanyl, or prescription opioids]) and heroin and refers to the symptoms you experience after stopping or drastically reducing opiate drugs after heavy and prolonged use (i.e., several weeks or more),” according to this website. It’s one of the things about addiction that has users going back to drugs, to avoid the horrible symptoms: nausea, vomiting, stomach upset, diarrhea, leg cramps restlessness, cold sweets, loss of appetite, lack of energy, lethargy, dilerium and …other signs…,” according to the Urban Dictionary. So it’s an apt term to use in the title of a book about the opioid epidemic. And what’s so horrendous, Macy says in the PBS interview, is that epidemiologists say we haven’t even hit the peak of the scourge yet; that’s not due until after 2020. Macy traces the history of the problem, and if you think to yourself, here we go again, you’re in for a surprise.

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Addiction Treatment

What she says is really interesting. She points out that middle class Americans were able to hide what was happening longer. Parents didn’t want to tell their neighbors what was going on in their house, so the trouble was allowed “to fester and grow.” If you haven’t heard about some of the early heroes, she mentions a doctor named Art Van Zee who saw what was happening in Appalachia as more people got addicted and tried to get the attention of those in power. They didn’t listen. Macy also discusses the controversy over medication-assisted treatment (M.A.T.), and the TV viewer immediately understands how the “national divide” is not helping in fighting the problem. The PBS program stops in at an M.A.T program run by a former heroin addict to help make her point. Here’s how Macy explained the divide in a 2016 article: “Among public health officials, the effectiveness of M.A.T. has become an article of faith; after all, treatment with buprenorphine and methadone has been found to cut opioid overdose deaths in half when compared to behavioral therapy alone, and it’s hard to argue with that. An addict treating his opioid disorder with Suboxone, many argue, is no different from a diabetic taking insulin.

Addicts & Their Families 

But increasingly, law enforcement officials — and many former addicts and their families — are lining up on the other side, arguing that Suboxone only continues the cycle of dependence and has created a black market that fuels crime.” Here is a more recent article Macy wrote about part of her book. She starts with a call she got from a mother whose addicted daughter was found murdered. Macy had been following the daughter’s story for a couple of years. The woman was taking Suboxone again and was supposedly on her way home to Roanoke from Las Vegas, but was found dead in a dumpster after she didn’t arrive. As the mother had said on the PBS program, it’s hard to know when to offer help to an addicted child and when to push away, for your own good and for the good of others. There’s always a story about a mother and a child in this epidemic, and it never gets any easier. At the end of the program, Macy says that she’d like to mobilize people to care. There have been a number of books written about the opioid epidemic, but if you read just one book about it this year, make it this one.

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