Themes
Key
LitCharts assigns a color and icon to each theme in Dopesick, which you can use to track the themes throughout the work.
Poverty as an Obstacle to Recovery
Cycles of History
Race, Healthcare, and Criminal Justice
Fighting the Medical Establishment
The Value of Science
Summary
Analysis
Rosemary Hopkins, a Virginia OxyContin user who first discovered the drug in 1998, used to feel like it offered everything she needed in life. Since 2009, she has been receiving treatment for her addiction from Van Zee. She is one of many who hold a cynical theory about that drug: that the government is deliberately allowing its spread in order to get rid of “lowlifes.”
Macy does not bring up Hopkins’s theory about the government weeding out “lowlifes” because Macy herself believes it’s true; rather, she is showing how, in the absence of an effective government response, it is understandable that people would take up the most cynical interpretation.
Themes
The prosecutor Bassford has his own conspiracy theory: that rehab is “a lie.” In fact, a New York Times exposé shows that there is truth to Bassford’s claim and that the highly profitable but lightly regulated recovery industry often focuses on unproven, abstinence-only methods.
Again, Macy shows how a conspiracy theory, while not really true, probably arose from something with a grain of truth in it. Macy herself is a critic of the recovery industry (particularly its emphasis on abstinence-only treatment), although her reasons for this differ from Bassford’s.
Themes
Macy hopes that interviewing the dealer Ronnie Jones will help reveal the connections between addiction, the criminal justice system, and the medical system. She comes to him in prison expecting a two-hour interview with no devices allowed. She wonders how much of Virginia’s heroin problem can be blamed on him.
One of the recurring themes of the opioid crisis is a lack of information, so perhaps Macy hopes to rectify this situation by finding a common thread that will connect many of the stories she has told in Dopesick: Ronnie Jones. As she will see, however, fitting the facts into a neat narrative isn’t always possible and may at times be the wrong approach.
Themes
Ronnie, 39 at the time Macy visits him, remains guarded at first but polite. Jones has been studying Arabic and Swahili, as well as reading books about criminal justice like The New Jim Crow and Just Mercy, which Macy has also read. These books suggest that the “Just Say No” approach to drugs of the 1980s led to racist policies that disproportionately affected Black Americans.
Ronnie and Macy have read the same books, suggesting that they have common ground, even though their lives are wildly different. While Macy was never quite critical of Jones in earlier chapters, her tone towards him does become more sympathetic when she recalls her own meetings with him (as opposed to earlier chapters, when she was portraying Jones through the perspective of the law enforcement officers chasing him). This suggests that hearing a person’s story firsthand may make you more sympathetic to their motivations.
Themes
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Ronnie had been in prison twice before his current 23-year sentence. Despite even many law enforcement officials agreeing that “We can’t arrest our way out of this problem,” drug offenders continue to represent a large portion of prison populations, with Black and Hispanic people being statistically overrepresented compared with white drug users and dealers.
Macy dives more explicitly into the topic of race, which was in the background of previous discussions about criminal justice but which now moves to the forefront. As she does with other controversial topics, Macy uses statistics to tell the story, since statistics help give legitimacy to her argument.
Themes
Black Americans have not, however, been addicted to opioids at the same rate as white Americans, in part because unconscious biases among doctors seem to have caused them to prescribe weaker painkillers to people of color.
Macy’s exploration of race shows that, ironically, in one case Black Americans may have benefited from the unconscious bias of their doctors. Studies show that doctors take pain more seriously when expressed by white patients than by Black patients, leading them to prescribe weaker painkillers to Black patients overall. This leads to the opioid impact disproportionately affecting white people. Macy’s consideration of this does not diminish her larger argument that Black Americans have suffered disproportionately more than white Americans from drug enforcement laws.
Themes
The government’s response to the opioid crisis remains slow, but local volunteers begin picking up the slack to help fill gaps in treatment. A half hour north of Woodstock (where Ronnie’s heroin ring operated), the area’s first drug court is established to help drug offenders get treatment, housing, and work.
Macy returns to the theme of how local communities can fill in the gaps in coverage left by the federal government. This support contrasts with the situation of Ronnie Jones, who grew up with little support.
Themes
Ronnie didn’t have this level of support when he first got out of prison—all he had was an overworked parole officer. Many ex-drug-offenders face similar problems, coming out of prison with no driver’s license, no support system, and no way to pay back their court fines and other expenses. Some states even bar them from food stamps. Unable to pay their bills, many former offenders turn back to crime.
Just as Macy traced Tess’s story to show how individual people with addictions are more than a statistic, she tells Ronnie Jones’s story to show how Jones has his own life and is more than simply a “criminal.” The problems he faces with getting a job (and the fact that getting a job is necessary for so many things he needs) provides a clear parallel with the struggles of opioid addicts.
Themes
Macy wonders how Ronnie Jones’s life would be different if he’d had help from people like the ones who work for the Equal Justice Initiative (founded by Bryan Stevenson, author of Just Mercy). Stevenson helps former prisoners find legitimate work in cities that are more tolerant to ex-felons. He tells Macy that reducing the prison population by 25 percent would save 20 billion dollars, some of which could then be directed toward treatment. He notes that Portugal decriminalized all drugs in 2001 but added housing, food, and job assistance, all of which led to it having the lowest rates of drug use in the European Union.
Once again, Macy uses the opinions of experts to boost her own argument, in this case turning to Bryan Stevenson, who is well known for his writings about justice and for his activism. While Stevenson sees a moral need for justice, he also puts forward an economic argument for reducing prison populations, in order to hopefully make his argument appealing to a wider range of people. Like Macy, Stevenson uses statistics and examples from elsewhere in the world in order to offer a blueprint for positive change.
Themes
Ronnie’s criminal history began with a felony grand larceny charge before his senior year of high school, when he borrowed a car from a girlfriend and used it to meet another girl, causing a fight that got him arrested for theft. He got another felony while on probation for that offense, while driving without a license in a car with stolen goods.
Like the opioid users who got prescribed a heavy painkiller for a fairly minor complaint, Ronnie was sent to jail for something that seems like a minor crime. This one moment of bad judgment (or perhaps bad luck) arguably played a role in shaping his life. Macy raises the question of whether or not this is really fair.
Themes
Thomas Jones, Ronnie’s brother, recalls how as a kid, Ronnie could be difficult but generally wasn’t bad. Now, Thomas is a music promoter based in Charlotte. Their uncle was on the famous state-championship football team from Remember the Titans and their grandfather was a housing activist who once met with George H.W. Bush.
Thomas helps to further humanize Ronnie. Thomas’s own successful career, as well as their illustrious family history, show that Jones was by no means “destined” to turn out a criminal—perhaps in different circumstances he would have ended up more like his brother or his other relatives.
Themes
Ronnie grew up in Virginia’s Section 8 housing until a fight between him and his brother led to Ronnie being sent to live with his father in Alexandria. Ronnie’s father and uncle were both regular drug users. Ronnie began acting out in school, which culminated in him getting arrested for the first time for stealing his girlfriend’s car. Ronnie’s felony record made it hard to get jobs, but he finally got one stocking shelves at a grocery store an hour away. Eventually, a cousin introduced him to cocaine, and Ronnie realized he could make more in a day selling cocaine than he could make in two weeks of stocking shelves.
Section 8 is a policy that helps low-income people rent houses. Growing up in Section 8 housing means that Ronnie and his family were poor. In addition to this, Ronnie also came from a family of regular drug users, suggesting that in many ways the odds were already stacked against him. While drug dealing may seem like a reckless choice, Macy shows how for someone in Ronnie’s position, it might have been preferable to low-paid drudge work.
Themes
Ronnie recalls that he never did any drugs, and only drank on his birthday and New Year’s Eve. Selling drugs, however, earns him money and respect—at least until he’s caught driving with cocaine in his car, then later caught selling drugs to an undercover cop. For the latter, Ronnie accepts the first plea deal given, on the encouragement of his overworked court-appointed attorney.
Ronnie’s clean living shows that he doesn’t fit the typical profile of a user-dealer. Despite this, however, his relationship with money does bear many similarities to what a drug user experiences. Just as Macy does with drug users, she tries to understand Jones’s money “addiction” in a sympathetic way.
Themes
Ronnie finishes high school in jail, then takes computer-repair classes, getting certified. Ronnie gets out of prison in 2008, right when Thomas’s music career is taking off. His rap name is Big Pooh, and he’s part of the group Little Brother, which has a major label deal and is touring Asia. Thomas gives Ronnie money to help him get set up. Ronnie finds a job but is soon impatient that he can’t advance at the company, seemingly because of his felony record.
Macy shows how Ronnie’s felony record continues to haunt him, even after he has supposedly repaid his debt to society through prison time. While the relationship between Thomas and Ronnie is very different than the one between Tess and Patricia, there are some striking similarities. Thomas, for example, wants to help Ronnie but is often powerless to and sometimes fears that his “help” could do more harm than good, enabling Ronnie’s bad tendencies.
Themes
In 2010, Thomas gets a call that Ronnie is locked up again, this time for credit card fraud. This charge eventually sends Ronnie to the work-diversion program at George’s Chicken. Ronnie seems to get his life together, telling his family he has a computer repair start-up. At one point, he asks Thomas to help him get a liquor license for a Caribbean restaurant (since felons can’t apply), but Thomas refuses. When Thomas visits Ronnie, he finds his brother owns a very expensive truck and starts to doubt the whole computer-repair story.
Just as healthy drug users are often able to hide their addiction problems from loved ones, Ronnie is able to hide his career problems from his brother. Ronnie’s computer repair start-up isn’t real, but on some level, both he and Thomas wish it were. Macy tells this part of the story from Thomas’s perspective to emphasize how painful and confusing it is for people to watch their loved ones get involved with something they can’t control.
Themes
Thomas is on tour when he gets the news that Ronnie will be serving a 23-year federal prison sentence. Thomas himself has never had legal trouble but says he has been racially profiled at traffic stops and is always cautious as a result.
Thomas seems to have a more careful personality than Ronnie, but he knows from his experience with the criminal justice system, particularly his interactions at traffic stops, that his success is also partly a matter of luck.
Themes
Back in 2012, when Ronnie first arrived in Woodstock, he was charmed by small-town touches, like when drivers waved to each other on the roads. He kept working at George’s Chicken after his diversion sentence, until he got sick and was hospitalized for a week, losing the job. He owed $5,000 in medical bills and $20,000 in court fines and restitution. He got work at another chicken plant, but it paid even less. Finally, he decided that dealing drugs full time would be more profitable.
Some drug enforcement officers might paint Ronnie as a ruthless or callous person, but Macy challenges this perception by showing how Ronnie actually liked Woodstock when he first arrived. Like many people profiled in Dopesick, his seemingly self-destructive decisions are motivated by his desperate financial situation, and viewed from that perspective, in some ways they make sense.
Themes
Ronnie rationalizes his drug-selling by figuring that if users are going to buy anyway, they may as well get it from him, instead of making a dangerous, expensive trip to Baltimore. He also notes that he didn’t introduce heroin to the Woodstock area—it was already very much there. Though many charges against him are true, he denies that he ever used drugs to have sex with dopesick users.
Ronnie is trying to present himself in the best light, so it’s reasonable to treat his claims with skepticism. Macy seems to believe that, in spite of this, his perspective is worth hearing as part of an attempt to piece together the whole story. She also confirms that some of what he says is true: certainly Ronnie’s arrest doesn’t stop Woodstock heroin users from trying to get their supply elsewhere.
Themes
Ronnie recalls how he didn’t want to end up like his father. Though he didn’t develop a drug addiction, however, Ronnie realizes he had his own addiction: the lifestyle that being a drug dealer afforded him. One of Ronnie’s big regrets is losing contact with his daughters and their mothers.
Ronnie’s concerns are relatable; like Metcalf, he doesn’t want to follow in the footsteps of his addicted father, and like Tess, he wants to be a better parent but faces significant obstacles along the way. These similarities suggest that people on all sides of the opioid epidemic share a common humanity.
Themes
After speaking with Ronnie, Macy drives back to Roanoke, too tired to visit Kristi Fernandez in Woodstock. She dreads telling Kristi how little light her interview with Ronnie shed on Jesse’s death. Kristi still visits her son’s grave several times each month and has recently worked up the courage to see the police pictures of him dead in the immediate aftermath of his overdose.
Macy’s plan for Jones to tie the whole narrative together doesn’t quite pan out. She mentions details like how she was too tired to visit Kristi in order to give readers an inside look at how her book came together, offering greater transparency.
Themes
Overdoses begin to spike as fentanyl becomes more prevalent. One week in October 2016 sees 19 overdoses in the Shenandoah Valley region. Baltimore dealers continue to sell fentanyl because, even if fentanyl kills a client, it generally leads to new clients (who seek out the dead user’s dealer in order to chase a higher high). A day after Macy interviews Ronnie, she finally tells Kristi that Ronnie doesn’t even recognize Jesse’s name.
It’s notable that fentanyl begins to spike when Ronnie is already in prison. Though it’s perhaps doubtful that Ronnie would have protected his users more than other dealers, what is clear is that imprisoning Ronnie Jones did little-to-nothing when it came to stopping deadly overdoses. If imprisoning Ronnie doesn’t stop overdoses, Macy asks what does it accomplish.
Themes
Haddox of Purdue Pharma gives a speech about how his company is making opioids safer. Opioids remain difficult to regulate because, unlike tobacco, they do have some legitimate medical uses. Haddox continues repeating old marketing lines about how pain is the real problem, and the only recent consequence for the Sacklers is that they have fallen from 16th to 19th on a Forbes list of the richest families in America.
A lot of time has passed since Haddox last appeared in the book, and yet he’s still repeating basically the same marketing lines. The fact that the Sacklers have barely even slipped on the Forbes family wealth list shows how little things have changed. Macy mentions these details not to diminish the work of activists, only to show how much work still needs to be done.
Themes
