Dopesick

Dopesick

by

Beth Macy

Teachers and parents! Struggling with distance learning? Our Teacher Edition on Dopesick can help.
An opioid is a compound that resembles opium, and it refers to a wide range of legal and illegal drugs associated with pain relief (including heroin, codeine, and OxyContin). While there are legitimate medical uses for opioids as painkillers, even legal opioids can lead to addiction and may be abused. One of the reasons that opioid addiction is so difficult to treat is because addicts who try to wean themselves off the drugs often experience dopesickness.

Opioid Quotes in Dopesick

The Dopesick quotes below are all either spoken by Opioid or refer to Opioid. 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.
Prologue Quotes

Though the opioid epidemic would go on to spare no segment of America, nowhere has it settled in and extracted as steep a toll as in the depressed former mill and mining communities of Central Appalachia, where the desperate and jobless rip copper wire out of abandoned factories to resell on the black market and jimmy large-screen TVs through a Walmart garden-center fence crack to keep from “fiending for dope.”

Related Characters: Beth Macy
Related Symbols: Coal
Page Number: 15
Explanation and Analysis:

Three months before visiting Jones, in the spring of 2016, Kristi Fernandez and I stood next to Jesse’s grave on a rolling hillside in Strasburg, Virginia, in the shadow of Signal Knob. She’d asked me to meet her at one of her regular cemetery stops, on her way home from work, so I could see how she’d positioned his marker, just so, at the edge of the graveyard.

It was possible to stand at Jesse’s headstone—emblazoned with the foot-high number 55, in the same font as the lettering on his Strasburg Rams varsity jersey—and look down on the stadium where he had once summoned the crowd to its feet simply by running onto the field and pumping his arms

Page Number: 6
Explanation and Analysis:
Chapter 1 Quotes

In the United States of Amnesia, as Gore Vidal once called it, there were people in history who might have expressed skepticism over Haddox’s claim, had anyone bothered reading up on them. Ever since the Neolithic humans figured out that the juice nestled inside the head of a poppy could be dried, dehydrated, and smoked for the purposes of getting high or getting well, depending on your point of view, opium had inspired all manner of commerce and conflict.

Related Characters: Dr. J. David Haddox
Page Number: 21
Explanation and Analysis:

By the 1870s, injecting morphine was so popular among the upper classes in Europe and the United States that doctors used it for a variety of ailments, from menstrual pain to inflammation of the eyes. The almost total lack of regulatory oversight created a kind of Wild West for patent medicines, with morphine and opium pills available at the nearest drugstore counter, no prescription necessary. As long as a doctor initially OK’d the practice, even injected morphine was utterly accepted. Daily users were not socially stigmatized, because reliance on the drug was iatrogenic.

Related Characters: Heinrich Dreser
Page Number: 22
Explanation and Analysis:

But what exactly was adequate pain relief? That point was unaddressed. Nor could anyone define it. No one questioned whether the notion of pain, invisible to the human eye, could actually be measured simply by asking the patient for his or her subjective opinion. Quantifying pain made it easy to standardize procedures, but experts would later concede that it was objective only in appearance—transition labor and a stubbed toe could both measure as a ten, depending on a person’s tolerance. And not only did reliance on pain scales not correlate with improved patient outcomes, it also had the effect of increasing opioid prescribing and opioid abuse.

Page Number: 28
Explanation and Analysis:
Chapter 2 Quotes

Industrywide, pharmaceutical companies spent $4.04 billion in direct marketing to doctors in 2000, up 64 percent from 1996. To get in the doctor’s door, to get past the receptionist and head nurse, the reps came bearing gifts, from Valentine’s Day flowers to coupons for mani-pedis.

The average sales rep’s most basic tool was Dine ’n’ Dash, a play on the juvenile-delinquent prank of leaving a restaurant without paying the bill. For a chance to pitch their wonder drug, reps had long offered free dinners at fancy restaurants. But soon, to-go options abounded, too, for a busy doctor’s convenience. Reps began coming by before holidays to drop off a turkey or beef tenderloin that a doctor could take home to the family—even a Christmas tree. Driving home from the office, doctors were also invited to stop by the nearest gas station to get their tanks topped off—while listening to a drug rep’s pitch at the pump, a variation the reps nicknamed Gas’n’ Go. In the spring, the takeout menu featured flowers and shrubs, in a version some dubbed—you guessed it—Shrubbery ’n’ Dash.

Related Characters: Dr. Steve Huff
Page Number: 32
Explanation and Analysis:

The doctors were witnessing the same thing that Lieutenant Stallard had seen a year earlier, in 1997, on the streets. “We had always had people using Lortabs and Percocets, but they were five- or ten-milligram pills you could take every day and still function. They didn’t have to have more,” Stallard said.

“The difference with OxyContin was it turned them into nonfunctioning people”

Page Number: 39
Explanation and Analysis:
Chapter 3 Quotes

Though it took nearly a decade before police, the press, and drug-abuse experts fully understood what was happening, Ed Bisch watched the urbanization of the pill epidemic play out on his front lawn in 2001, as paramedics carried his son’s body away.

He retreated to his computer, where he was shocked to learn that his son’s death had been the region’s thirtieth opioid overdose in the past three months.

How was that possible when he’d only just learned the word? “The internet was still new, and back then it was mostly message boards as opposed to websites,” he said.

Related Characters: Ed Bisch, Eddie Bisch
Page Number: 60
Explanation and Analysis:

In the fall of 2006, Purdue’s lawyers began to sense that this case against them was different; that a full-court press meant nothing when the opposing counsel was the United States of America. Was it really possible the small-town lawyers had compiled enough evidence to indict both the company and its top executives on a host of felony charges, not just for misbranding the drug but also for mail fraud, wire fraud, and money laundering? It seemed so, according to a memo written by the federal prosecutors to Brownlee at the time.

Related Characters: John L. Brownlee
Page Number: 81
Explanation and Analysis:
Chapter 4 Quotes

Conspicuously absent from the courthouse drama was the family that owned the company and its 214 affiliates worldwide- and benefited the most from the drug’s sale. Purdue had earned over $2.8 billion from the drug by 2007, including $595 million in earnings in 2006 alone. Unlike a public company that answers to shareholders, privately held Purdue answered only to the Sacklers.

In 2015, the family would earn its way onto Forbes’s “America’s Richest Families” list. With an estimated net worth of $14 billion, the OxyContin clan would edge out such storied families as the Busches, Mellons, and Rockefellers. Having gone from selling earwax remover and laxatives to the most lucrative drug in the world, the family had museum wings and college institutes named for it from Boston to Tel Aviv.

Page Number: 94
Explanation and Analysis:
Chapter 5 Quotes

Awareness of the opioid crisis has typically come in waves, often celebrity-studded and well covered by the media: the death by overdose of Philip Seymour Hoffman, in 2014, then two years later the death of Prince. But for ordinary citizens, the news that opioids had crossed over from Not me and not anyone I know to mainstream traveled more slowly, in dribs and drabs, maybe when the Cincinnati Enquirer became the first newspaper in the country to dedicate a reporter solely to the heroin beat.

Page Number: 103
Explanation and Analysis:

The skin-popping weathermen represented Roanoke’s first wake-up call. But it was wrongly viewed, by myself and other area journalists, as an anomaly. The story was so tawdry that the Roanoke Times assigned two beat reporters to track it, one from courts and the other from media and entertainment. It received much more attention, for instance, than the national story that broke in our backyard when Purdue Pharma settled with the feds a year later.

Page Number: 105
Explanation and Analysis:
Chapter 6 Quotes

In rural counties decimated by globalization, automation, and the decline of coal, the invisible hand manifested in soaring crime, food insecurity, and disability claims. In Martinsville and surrounding Henry County, unemployment rates rose to above 20 percent, food stamp claims more than tripled, and disability rates went up 60.4 percent…

It was easy to understand the connection between joblessness and hunger, to get that hunger fueled some of the crime. It was growing clearer, too, that the federal disability program was becoming a de facto safety net for the formerly employed, a well-intentioned but ultimately disastrous way of incentivizing poor people to stay sick, with mental illness and chronic pain—conditions that are hard to prove and frequently associated with mental health and substance use disorders—prompting the majority of disability awards.

Related Symbols: Coal
Page Number: 123
Explanation and Analysis:
Chapter 7 Quotes

In the picturesque Shenandoah Valley town of Woodstock, more than two hours north of Roanoke, bulk heroin cut in a Harlem lab had just made its way down I-81. It was the last thing Shenandoah County sergeant Brent Lutz, a Woodstock native, would have expected to find himself doing: stalking a major heroin dealer. But here he was, at all hours of the day and night, clutching a pair of binoculars while crouched in the upstairs bedroom of his cousin’s house a few miles outside of town. He’d spent so much time there in recent days that the mile-wide stench of chicken entrails coming from George’s Chicken across the road no longer bothered him.

Related Characters: Brent Lutz, Ronnie “D.C.” Jones
Related Symbols: Interstate 81
Page Number: 146
Explanation and Analysis:
Chapter 8 Quotes

Later that day, when Metcalf finally got his first close-up look at Ronnie Jones in a county jail interviewing room in Front Royal, he found him to be “very smug, very arrogant.”

The feeling was mutual. “He was very aggressive; he harassed people,” Jones said of Metcalf. Jones hated him for delivering a subpoena to the mother of his oldest child—at work, embarrassing and intimidating her, he said—and for interviewing Jones’s mom.

Related Characters: Bill Metcalf (speaker), Ronnie “D.C.” Jones (speaker)
Related Symbols: Interstate 81
Page Number: 166
Explanation and Analysis:

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 9 Quotes

By 2014, the suburban heroin-dealing scene had become entrenched in Roanoke’s McMansion subdivisions and poor neighborhoods alike. But the largest dealers weren’t twice-convicted felons like Ronnie Jones with elaborate dope-cutting schemes, multiple cars, and hired mules. They were local users, many of them female, dispatched to buy the heroin from a bulk dealer out of state, in exchange for a cut. And they were as elusive as hell to catch.

Related Symbols: Interstate 81
Page Number: 189
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:

I just left goodwill, can you please transfer $4 so I can get a pack of cigarettes please?

Related Characters: Jordan “Joey” Gilbert (speaker), Tess Henry, Patricia Mehrmann
Page Number: 245
Explanation and Analysis:
Chapter 12 Quotes

I hoped the stories of Ronnie Jones and his victims would illuminate the ruts in both a criminal justice system that pursues a punishment-fits-all plan when the truth is much more complicated and a strained medical system that overtreats people with painkillers until the moment addiction sets in—and health care scarcity becomes the rule.

I hoped, too, that my interview with Jones would help answer Kristi Fernandez’s questions about what led to her son Jesse’s premature death. Was Ronnie Jones really the monster that law enforcement officials made him out to be? Had the statewide corrections behemoth that returns two thousand ex-offenders a year to Virginia’s cities, counties, and towns played a role in his revolving door of failures?

Page Number: 252
Explanation and Analysis:
Chapter 13 Quotes

The birthplace of the modern opioid epidemic—central Appalachia—deserves the final word in this story. It is, after all, the place where I witnessed the holiest jumble of unmet needs, where I shadowed yet more angels, in the form of worn-out EMTs and preachers, probation officers and nurse-practitioners. Whether they were attending fiery public hearings to advocate for more public spending, serving suppers to the addicted in church basements, or driving creaky RVs-turned-mobile-clinics around hairpin curves, they were acting in accordance with the scripture that nurse-practitioner Teresa Gardner Tyson had embroidered on the back of her white coat:

Verily I say unto you, inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me. (Matthew 25:40)

Related Characters: Teresa Gardner Tyson
Page Number: 273
Explanation and Analysis:

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:

It was January 2, Tess’s birthday. She would’ve been twenty-nine.

Patricia tucked the treasures of her daughter’s life inside the vest—a picture of her boy and one of his cotton onesies that was Tess’s favorite, some strands of Koda’s hair, and a sand dollar.

Related Characters: Tess Henry, Patricia Mehrmann
Page Number: 308
Explanation and Analysis:
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Dopesick PDF

Opioid Term Timeline in Dopesick

The timeline below shows where the term Opioid appears in Dopesick. The colored dots and icons indicate which themes are associated with that appearance.
Prologue
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
The Value of Science Theme Icon
...from Jones’s cell), and it kills 26 people in a single day. A new synthetic opioid from China called fentanyl has proven to be particularly deadly. And the issue isn’t limited... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Seeking to understand the opioid epidemic from another angle, Macy visits Kristi Fernandez in Strasburg, Virginia, in the spring of... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
...the questions of mourners like Kristi are a central part of the story of the opioid epidemic. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
...move out to rural areas, as was the case with cocaine and crack. But the opioid epidemic went in reverse, starting in places like Appalachia, the Rust Belt, and rural Maine—places... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Opioids made an impact in a diverse variety of communities. First were the coalfields, in places... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
...until 2012. There, the epidemic followed the same pattern as elsewhere: users began with prescription opioids, then increasingly turned to heroin and to dealing themselves in order to avoid the pain... (full context)
Chapter 1
Poverty as an Obstacle to Recovery  Theme Icon
The opioid epidemic affects just about every segment of the American population, but its most severe toll... (full context)
Cycles of History Theme Icon
The Value of Science Theme Icon
...that the effects of their prescriptions will be disastrous—by 2017, the economic toll of the opioid crisis is estimated at $1 trillion. (full context)
Chapter 2
Fighting the Medical Establishment Theme Icon
...finds himself overwhelmed by the volume of patients who had been prescribed large amounts of opioids by his predecessors. He cuts back severely on narcotics prescriptions and finds the whole experience... (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...and he ends up spending much of his career dealing with the fallout of the opioid crisis. (full context)
Fighting the Medical Establishment Theme Icon
...official, begins in the late 1990s to call other officials to look into the burgeoning opioid crisis. They don’t listen and mostly pass the blame elsewhere. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
In the early days of the opioid epidemic, Van Zee watches as 24 percent of juniors at a local high school report... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
...of 2000, before small-town newspapers were widely online, Van Zee doesn’t yet know that the opioid epidemic is also affecting other communities. He first gets the news from a copy of... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
At a meeting about crimes related to the opioid epidemic, Van Zee has a chance to speak with Haddox. Despite Van Zee’s concerns and... (full context)
Chapter 3
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...Times article published on February 9, 2001. By the summer, it is clear that the opioid abuse epidemic is spreading out from areas like Virginia and Maine, into the rest of... (full context)
Cycles of History Theme Icon
...iatrogenic morphine and opium addiction that swept through the nation about a century earlier. Eventually, opioid addiction died out in most places except big cities (where heroin was part of the... (full context)
Fighting the Medical Establishment Theme Icon
...with a story similar to Bisch. She lost an 18-year-old son named Randy to the opioid epidemic. Though she initially hesitates to reach out because of grief, she eventually connects with... (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...fact that no clinical studies have been done to look at the long-term risks of opioid abuse. The FDA ends the forum promising to monitor the abuse situation more closely, but... (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...of Pain Killer and a New York Times journalist). Udell gets Meier taken off the opioid beat at the newspaper because, as the author of a book about OxyContin, he has... (full context)
Fighting the Medical Establishment Theme Icon
...A sentencing hearing in mid-July will also force these executives to meet the parents of opioid abuse victims. At the press conference, Brownlee’s team shows evidence from their vast collection of... (full context)
Chapter 4
Fighting the Medical Establishment Theme Icon
...be known for upscale boutiques and farm-to-table restaurants. On July 20, 2007, the relatives of opioid victims gather in Abingdon to see the Purdue executives sentenced. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
At the courthouse, many relatives of opioid victims argue that the Purdue executives deserve jail time and that even the multi-million-dollar settlement... (full context)
Chapter 5
Cycles of History Theme Icon
People find out about the opioid epidemic in waves, often after shocking media stories like the deaths of Philip Seymour Hoffman... (full context)
Cycles of History Theme Icon
...Jamey Singleton and Marc Lamarre stun viewers when news breaks that they are both heavy opioid users (and that Lamarre has suffered a near-fatal overdose). The addicted weathermen are a wake-up... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
In Roanoke, 2012 is the end of the opioid epidemic’s stealth phase. Jesse Bolstridge is a high school student who trades his Adderall to... (full context)
Chapter 6
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
Macy learns about the connections between poverty, disability, and opioid addiction when the Basset Furniture store (in Basset, Virginia) is burned down by an accidental... (full context)
Cycles of History Theme Icon
In rural America in the 2000s, the opioid epidemic enters its “wily adolescence.” It spreads like an infectious disease, jumping in particular between... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
In 2010, police begin to notice that the opioid epidemic is not just a rural phenomenon but also a suburban one, spread more among... (full context)
Cycles of History Theme Icon
...2014. Flashier drug stories like warnings about bath salts distract from the quieter problem with opioids. (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...young as two years old. Although not all studies show that behavior meds lead to opioid abuse, some addiction researchers have suggested a connection. While the drugs can be helpful in... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
The Value of Science Theme Icon
Brian is another member of the same Hidden Valley opioid-using group as Spencer. He becomes dependent on pills by the time he’s 17 years old.... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Two mothers of opioid users meet and bond at a Families Anonymous meeting: Jamie Waldrop and Drenna Banks. Jamie... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
The Value of Science Theme Icon
...such as with methadone or naltrexone.) When Colton dies in 2012, there are still 130 opioid-addicted Americans out there for every one death. (full context)
Chapter 7
Cycles of History Theme Icon
The Value of Science Theme Icon
...County, with better indicators of average health: fewer smokers, fewer uninsured, and less drug-related mortality. Opioids are also prescribed at a much lower rate. Still, the declining workforce is a problem... (full context)
Chapter 8
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
...Chapmanville, West Virginia, a poor area that would eventually become a breeding ground for the opioid epidemic. At the time, there were few options for a young man in the area,... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
The Value of Science Theme Icon
...more effective than abstinence. By 2016, some government agencies are recommending that medical-assisted treatment for opioids should be indefinite, perhaps even lifelong. One researcher estimates that after the start of treatment,... (full context)
Fighting the Medical Establishment Theme Icon
...dead are young men. The FDA is slow to act: they continue to approve new opioids and don’t recall an opioid due to its abuse potential until 2017. (full context)
Chapter 9
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
...both sides. A routine visit to the urgent-care center for bronchitis leads to two 30-day opioid prescriptions (one for codeine cough syrup and another for hydrocodone to ease throat pain). Soon... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
...trimester of a pregnancy and is given a Tylenol to stop her fetus from having opioid withdrawal. (full context)
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Six weeks later, there is a spike in opioid overdoses, due to the synthetic opioid fentanyl, which is 25 to 50 times more potent... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
...Chris Perkins, the 46-year-old police chief, knows that fentanyl is going to change the whole opioid epidemic, for the worse. Catching user-dealers becomes harder as open-air markets are made obsolete by... (full context)
Chapter 10
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...health officials consider buprenorphine, a type of MAT, to be the gold standard treatment for opioid addiction, reducing the chance of overdose by more than half compared to just behavioral therapy.... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
The Value of Science Theme Icon
...a synthetic painkiller in German laboratories shortly after World War II. Methadone’s ability to treat opioid addiction was discovered early, but regulatory agencies continued to restrict its use. Buprenorphine and naltrexone... (full context)
Chapter 11
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
In late 2016, Virginia’s state health commissioner declares the opioid crisis a public health emergency. This means anyone can now buy Narcan (a drug that... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
The Value of Science Theme Icon
Even among Hope Initiative members like Janine, the harm reduction approach to opioid treatment is controversial. Still, she tries to keep an open mind. Within the first few... (full context)
Chapter 12
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
Black Americans have not, however, been addicted to opioids at the same rate as white Americans, in part because unconscious biases among doctors seem... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
The government’s response to the opioid crisis remains slow, but local volunteers begin picking up the slack to help fill gaps... (full context)
Cycles of History Theme Icon
The Value of Science Theme Icon
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... (full context)
Chapter 13
Cycles of History Theme Icon
The Value of Science Theme Icon
...15 percent of “normal” patients, including healthcare professionals, could also become addicted when exposed to opioids. (full context)
Cycles of History Theme Icon
The Value of Science Theme Icon
Macy asks why it took so long for the government to respond to the opioid crisis, with the CDC only issuing voluntary prescribing guidelines in 2016. These guidelines did not... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
The Value of Science Theme Icon
To finish her story, Macy looks back to Central Appalachia, where the modern opioid epidemic began. She speaks with nurse-practitioner Teresa Gardner Tyson, who hosts a major medical outreach... (full context)
Cycles of History Theme Icon
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
Macy contends that the current political response to the opioid epidemic is far from adequate. She proposes a “new New Deal for the Drug Addicted.”... (full context)
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Opioids are currently on pace to kill as many Americans in one decade as HIV/AIDS has... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...to blend MAT with twelve-step programs (the latter of which are only rarely effective for opioid addiction on their own). They get to know patients who suffer with addiction in their... (full context)
Fighting the Medical Establishment Theme Icon
...people make but the social and economic conditions that make certain people more susceptible to opioid abuse. (full context)
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Macy looks at the work of Dr. Steve Lloyd, a former opioid user who has become a charismatic leader against drug abuse. He credits his own recovery... (full context)
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Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...Macy concludes that if the federal government won’t step in to save Appalachia from the opioid epidemic, “Appalachia would have to save itself.” (full context)
Epilogue
Cycles of History Theme Icon
...property, as if as a memorial to Scott and to the other victims of the opioid epidemic. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
...make national news. Just like the U.S. itself is divided in its response to the opioid crisis, Tess’s grieving family is also divided, despite everyone’s good intentions. (full context)