Beth Macy's investigation into America's opioid epidemic gave us new insight into a problem we've heard about but didn't really understand until we read
. We talked about this book endlessly in the office and knew it had to land on our list of the best books of the year. Here's our interview with Macy, originally published on August 29, 2018.
With lawsuits now pending against some of those who helped distribute millions of pills into cities and towns across America, Beth Macy’s new book, Dopesick, is more timely than ever before. Painstakingly researched, Dopesick tells the story of how a powerful painkiller made the pharmaceutical industry billions of dollars and left a record number of patients with a crushing addiction. With just the right blend of personal stories and cold hard facts, Dopesick is a powerful book that incites conversation and we were eager to talk to the author about her experience writing it.
I called Macy, and we talked for almost an hour about the years she spent researching and writing Dopesick. It's obvious from reading the book how passionate she is about the subject and the people she got to know, but when I spoke with her, her emotion and conviction poured through the phone line.
When I asked how she decided on the perspectives she used in the book, Macy said, "my goal wasn’t to write a day-in-the-life story of what it’s like to be a heroin addict, it was to write about the people fighting back because, a) I thought it would be the only way I could be mentally healthy and live in that world, and write the book, and b) I also felt like an average reader/voter/person-who-might-want-to-help-call-attention-to-the-epidemic would probably relate better to a mother, a police officer, a country doctor." Macy has tremendous compassion for the addicts, but she's realistic about how hard that is for the rest of us to look at. She gets it. Macy's heart was clearly broken by the loss of one young woman who fought addiction for years, and whose life ended badly and needlessly.
I was shocked by what Macy uncovered in her research, and wondered if she'd gone into the project with any expectations. Macy told me she'd known that she "wanted to go back to the coal fields and write about OxyContin, because that’s just four hours from my home, and here in Roanoke is where the office that investigated Purdue Pharma was based." She also noted that "I always think an aftermath story is interesting, ‘cause in journalism we rarely have time to do that, and you can learn so much. Like how are the people, the people that first felt this crisis, how are they doing now? I felt like nobody had really told that story…"
Is our country's current opioid crisis the result of a perfect storm of the medical community's shift in pain management strategies, the "rating" of doctors, and the influence of pharmaceutical companies? According to Macy, "I think it was a perfect storm, but Purdue Pharma [the makers of OxyContin], I think the lion’s share of the blame goes to them. The Feds proved that they criminally mishandled the drug, they plead guilty to it." But in a deal orchestrated by none other than Rudy Giuliani (employed at the time by Purdue Pharma), it was actually the holding company who put their name on the guilty plea, leaving Purdue Pharma able to continue with business as usual. "That was another juncture where, if Purdue Pharma itself would’ve been banned from doing business with government, Medicaid, Medicare, Tricare, that would’ve really cut down OxyContin sales, but after the settlement they continued to climb."
And as revenues rose so did spending on political lobbying. Macy told me about some data she recently discovered and wrote about for Politico Magazine earlier this month, "$900 million dollars spent by Big Pharma for political campaigns and lobbying between 2006-2015...WAY more than the gun lobby spent. And congress has been calling some of these opioid makers to testify, you know, we’re going to bring people to account; but some of the people leading the questioning have accepted money from the pharmaceutical companies!"
This could all seem depressing, but Dopesick is not a depressing book. It's galvanizing. Opioid addiction, it's cause, and what we can do--these are not simple issues. As Macy told me, "the hard part about explaining this whole thing over the book is that now more than half the country knows somebody or has somebody in their family, and they know it really well. And then the other half of the country, or almost half the country, doesn’t know it at all and doesn’t really want to know it because it’s so dark! That was my goal, to sort of mobilize more people to care about this."
Macy is a talented investigative journalist and a compassionate human being who tells this story like no one else has so far. Dopesick has the power to change the conversation, and once you've read it, I think you'll find it a book that's hard to stop talking about it...