Dopesick

Dopesick

by

Beth Macy

Teachers and parents! Struggling with distance learning? Our Teacher Edition on Dopesick can help.
MAT is the acronym for medication-assisted treatment. It involves treating opioid addicts with less powerful drugs in order to help them cope with their addiction and avoid dopesickness. Although MAT has been proven to be perhaps the most effective treatment option available for addiction, it can be controversial, partly because of the cost and partly because many treatment centers advocate for “abstinence-only” treatment (which has been proven to be less effective).

MAT Quotes in Dopesick

The Dopesick quotes below are all either spoken by MAT or refer to MAT. For each quote, you can also see the other terms and themes related to it (each theme is indicated by its own dot and icon, like this one:
Poverty as an Obstacle to Recovery  Theme Icon
). Note: all page numbers and citation info for the quotes below refer to the Back Bay Books edition of Dopesick published in 2018.
Chapter 8 Quotes

NIDA, the Institute of Medicine, the World Health Organization, and the White House drug czar’s office would all agree that indefinite (and maybe even lifelong) maintenance treatment is superior to abstinence-based rehab for opioid-use disorder. And even Hazelden, the Betty Ford-affiliated center that originated the concept of the twenty-eight-day rehab, changed its stance on medication-assisted treatment, or MAT, offering Suboxone to some patients in 2012.

But the rehab Jesse went to was aimed at abstinence, as most were, then and now.

Related Characters: Jesse Bolstridge, Kristi Fernandez
Page Number: 174
Explanation and Analysis:
Chapter 10 Quotes

Tess was nearly seven months pregnant when she left jail in June 2015. For a month, she lived with her mom and tried to make a go of it with her boyfriend, the baby’s father—“disastrous,” Patricia and Tess agreed—before they found a private treatment center two hours away that would take Tess during her final month of pregnancy. Private insurance covered most of the $20,000 bill while her dad paid the $6,500 deductible, using the remainder of Tess’s college-savings fund. The Life Center of Galax was one of the few Virginia facilities that accepted patients on medication-assisted treatment (methadone or buprenorphine). Tess was now taking Subutex, a form of buprenorphine then recommended for some pregnant mothers. (Suboxone is typically the preferred MAT for opioid users because it also contains naloxone, an opiate blocker; Subutex, which is buprenorphine with no added blocker, was then considered safer for the baby but more likely to be abused by the mom.)

Related Characters: Tess Henry, Patricia Mehrmann
Page Number: 209
Explanation and Analysis:
Chapter 11 Quotes

Harm reduction remained slow to catch on in most of the Bible Belt, including Roanoke. When I told Janine about an idea hatched at an opioid brainstorming session in Boston—to segregate users on a boat in international waters, where they could legally inject under medical supervision, ideally then transitioning to counseling and MAT—she was repulsed. “That’s crazy! We’ve created this problem, and now we decide we’re just going to continue to let it happen, and that’s the answer?”

And yet she was miles ahead of most leaders in her conservative community. She’d told her son’s story recently to the local school board and county officials, hoping to raise money for the county’s risk prevention council, which was currently running on fumes and a few small federal grants. She’d explained how she’d pulled strings to get her kids into the Hidden Valley school zone because she considered it a superior place to raise children. But the affluence she believed would protect her family had instead allowed the festering of shame and inaction. Almost daily the Hope Initiative took a call about a heroin user from Hidden Valley or nearby Cave Spring, and police data showed that the problem was worse by far in those two communities than in other, less affluent areas of the county.

Related Characters: Janine Underwood (speaker), Beth Macy, Chris Perkins, Bobby
Page Number: 241
Explanation and Analysis:
Chapter 13 Quotes

If the federal government wouldn’t step in to save Appalachia, if it steadfastly refused to elevate methods of treatment, research, and harm reduction over punishment and jail, Appalachia would have to save itself.

Page Number: 296
Explanation and Analysis:
Epilogue Quotes

Tess was still homeless, and another week passed before she called Patricia with an address via a borrowed phone, possibly belonging to a current or former pimp. “Are you in danger?” her mom asked, and Tess claimed she was not, repeating a line she often said: “I’m a soldier, Mom. I’ll be fine.

“Yes, love.” Patricia responded. “But sometimes even soldiers fall.”

Related Characters: Tess Henry (speaker), Patricia Mehrmann (speaker), Beth Macy
Page Number: 304
Explanation and Analysis:
Get the entire Dopesick LitChart as a printable PDF.
Dopesick PDF

MAT Term Timeline in Dopesick

The timeline below shows where the term MAT appears in Dopesick. The colored dots and icons indicate which themes are associated with that appearance.
Chapter 10
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
Many public health officials consider buprenorphine, a type of MAT, to be the gold standard treatment for opioid addiction, reducing the chance of overdose by... (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
Because of the high demand for buprenorphine and other MAT drugs, there’s also a lot of black market dealing of these drugs, with some even... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
The Value of Science Theme Icon
...drives Tess and her baby to Narcotics Anonymous meetings. Though Narcotics Anonymous theoretically approves of MAT, many of the members at Tess’s chapter seem to shun her because of her involvement... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
The Value of Science Theme Icon
Controversy over MAT goes back all the way to the birth of methadone, which was created as a... (full context)
The Value of Science Theme Icon
...on to have significant value on the black market. Some doctors remain skeptical about all MAT, drawing parallels between the development of heroin in 1898. Macy believes, however, that hardline stances... (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
Many in the medical community, including Art Van Zee, express frustration over anti-MAT skepticism, claiming that it prevents doctors from being able to use one of their most... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
The Value of Science Theme Icon
...a place to live, then prove her sobriety. She struggles to find a doctor for MAT that will accept Medicaid, which she’s currently on. (full context)
Chapter 11
Cycles of History Theme Icon
Fighting the Medical Establishment Theme Icon
...but she puts a lot of energy into the Hope Initiative. She remains skeptical of MAT but tries to keep an open mind. She supports bills to involuntarily commit users, but... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
The Value of Science Theme Icon
...few months of the Hope Initiative, they see 57 people, referring about 15 to outpatient MAT programs and admitting two to residential treatment. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Fighting the Medical Establishment Theme Icon
...to Tess, with long wait lists for expensive treatment. Joey tries to wean herself off MAT, believing it will make it easier for her to get accepted for treatment. (full context)
Chapter 13
Cycles of History Theme Icon
The Value of Science Theme Icon
In the 1970s, the first MAT drugs were developed, but even today courts are more likely to send users to prison,... (full context)
Fighting the Medical Establishment Theme Icon
...doctor-shopping). Though Virginia was well behind in its initial response, state officials now begin expanding MAT. The costs of addiction-related illness are high, and they force health systems to integrate addiction... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...and Art Van Zee find that in the Appalachian Bible Belt, it helps to blend MAT with twelve-step programs (the latter of which are only rarely effective for opioid addiction on... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
Lloyd repeatedly argues that MAT is an essential part of treatment, particularly since many patients are limited to 28 days... (full context)
Epilogue
Cycles of History Theme Icon
Fighting the Medical Establishment Theme Icon
...there is less heroin on the streets. A major addiction researcher receives money to expand MAT in Virginia, but despite the expansion, long waitlists remain a problem in Roanoke. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
...texts about going back into rehab. Her mother, Patricia, has tried to get Tess into MAT in Virginia, but the limited resources in Roanoke mean that enrollment is currently limited to... (full context)