Dopesick: Chapter 9 Summary & Analysis

Bassford’s portrait of Garfield and his cowboy boots show that he tries to be eccentric. Once again, Macy returns to the theme of how fictional depictions of law enforcement provide a distorted view of the reality: while Macy doesn’t state it outright, she implies that Bassford isn’t nearly as smooth as the cops from TV that he idolizes.

Bassford’s comparison to Whack-A-Mole is evocative and easy to understand, which is why Macy uses it in the chapter title. The comparison to Whack-A-Mole could suggest that maybe the approach of arresting and imprisoning dealers is flawed from the premise, since more will just pop up, but Bassford and others might disagree with that interpretation.

Although she is introduced somewhat late in the book, Tess will become one of the most important subjects Macy profiles, in part because Macy goes into greater depth with her story than any of the others. Part of what makes Tess’s story interesting is that, as a “middleman,” her experience is fairly average, and she was in regular contact with both users and dealers. But Macy is careful not to reduce people to stereotyped labels like “addict,” and Macy goes deep on the specifics of Tess’s life in order to demonstrate how all people struggling with addiction are more than just a statistic or a label.

Tess’s story has some parallels with Ashlyn and with countless others: her family history made her vulnerable but ultimately it was a chance medical problem that caused her to first discover opioids. The government makes an effort to solve the problem of over-prescribed painkillers, but as is often the case in Dopesick, the response is too little, too late, particularly for Tess.

Tess’s trajectory follows that of many other people with opioid addictions, with the addiction leading to crimes that she likely wouldn’t have otherwise committed. Tess’s story also shows how normal life events, like pregnancy, don’t stop because of an addiction and how by the time Tess is arrested, her unexpected pregnancy is so common among opioid users that jails have protocols in place to deal with it.

The fact that so many drug users deliberately seek out fentanyl helps to underscore just how self-destructive some people can act when they are motivated by an addiction.

The flexibility and ingenuity that Perkins uses when looking for a solution to addiction provide a contrast with the more rigid solutions proposed by the federal government. Macy is an advocate for people in their own communities helping to fill in the gaps in the federal response to the opioid crisis, and Perkins represents a case study for one way to do this.

As with RAPP, from previous chapters, many of the most passionate activists for change are people who have watched family members die of opioids. Macy shows how one of the silver linings of grief is that it can motivate people to seek out positive change, although she is careful not to sugarcoat the harsh reality that many parents of opioid victims face.

Macy shows how the federal government’s decision to leave many aspects of healthcare up to individual states has made things complicated for activists. What works in one state might not be possible in another, hindering progress. Healthcare reform, such as Medicare for All on the left and the movement to repeal the Affordable Care Act on the right, are an important context for this passage, but Macy largely avoids mentioning specific political platforms, perhaps because healthcare is such a contentious issue and because she wants to maintain some objectivity.