Dopesick

Dopesick

by

Beth Macy

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OxyContin Term Analysis

OxyContin is the drug that caused the opioid crisis. Introduced by Purdue Pharma in the mid-1990s, the drug was heavily marketed and overprescribed, in part because executives at Purdue misled the public about the drug’s addictive properties.

OxyContin Quotes in Dopesick

The Dopesick quotes below are all either spoken by OxyContin or refer to OxyContin. 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:
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 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:
Get the entire Dopesick LitChart as a printable PDF.
Dopesick PDF

OxyContin Term Timeline in Dopesick

The timeline below shows where the term OxyContin appears in Dopesick. The colored dots and icons indicate which themes are associated with that appearance.
Prologue
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
...diverse variety of communities. First were the coalfields, in places like St. Charles, Virginia (where OxyContin was introduced in 1996). Then there were the suburbs, like the ones around Roanoke, Virginia,... (full context)
Chapter 1
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
...comes up to Stallard’s car and tells him about a new drug called “Oxy,” a.k.a. OxyContin. Users have learned how to get around the pill’s time-release mechanism, giving them a massive... (full context)
Cycles of History Theme Icon
The Value of Science Theme Icon
The FDA approved OxyContin in 1995. The drug is the invention of a comparatively little-known pharmaceutical company called Purdue... (full context)
Cycles of History Theme Icon
The Value of Science Theme Icon
History, however, provides several reasons to be skeptical about Haddox’s claims about OxyContin’s lack of addictive properties. Even Neolithic humans understood the power of poppy plants, and opium... (full context)
Cycles of History Theme Icon
The Value of Science Theme Icon
...Drugs” that began in the 1980s, in the 1990s history began to repeat itself. Purdue’s OxyContin is chemically similar to Bayer’s heroin, but in spite of the historical parallels, no one... (full context)
Cycles of History Theme Icon
The Value of Science Theme Icon
When OxyContin arrives in 1996, one of the big trends in medicine is the idea that pain... (full context)
Fighting the Medical Establishment Theme Icon
In the early days of OxyContin, there are few who raise warnings, and many of these warnings aren’t very strong. Eventually,... (full context)
Chapter 2
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
OxyContin becomes a huge marketing success in rural America, where disability claims are already high. Purdue... (full context)
Cycles of History Theme Icon
Fighting the Medical Establishment Theme Icon
...former pharmacist who has been a longtime health-department director in Virginia, sees the arrival of OxyContin as particularly ill-timed. The decent-paying mining jobs and lower-paying production jobs have all been steadily... (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...Pain Killer, which was one of the first books to explore the harmful effects of OxyContin. Van Zee was ahead of his time in recognizing the dangers of OxyContin, and he... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
In the 1990s when OxyContin first arrives in Virginia, however, Van Zee is still confused about what’s happening. He calls... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
...a 27-year-old woman who lives a couple counties east of Van Zee. She is prescribed OxyContin and Percocet after routine gall bladder surgery that continues to leave her in pain. When... (full context)
Poverty as an Obstacle to Recovery  Theme Icon
...Zee watches as 24 percent of juniors at a local high school report having tried OxyContin, as well as nine percent of seventh graders. Many of his friends from the community... (full context)
Fighting the Medical Establishment Theme Icon
...calls a local Virginia reporter to complain about her crime coverage (which mentions connections to OxyContin).  (full context)
The Value of Science Theme Icon
By late 2000, Purdue is giving doctors a promotional video about how OxyContin is helping patients with pain get their lives back. They push back against claims that... (full context)
Fighting the Medical Establishment Theme Icon
...Van Zee is frustrated that his letters are doing nothing while the harmful effects of OxyContin in his community only get worse, with people resorting to increasingly bold crimes to get... (full context)
Fighting the Medical Establishment Theme Icon
...will add a black-box warning (the highest kind for prescription drugs) to the label for OxyContin. Purdue tries to downplay the black box, suggesting that “legitimate patients” are being hurt by... (full context)
Chapter 3
Poverty as an Obstacle to Recovery  Theme Icon
The story of the OxyContin epidemic doesn’t reach national media until a New York Times article published on February 9,... (full context)
Cycles of History Theme Icon
The new movement of OxyContin from rural areas into the cities and suburbs resembles the wave of iatrogenic morphine and... (full context)
Cycles of History Theme Icon
Fighting the Medical Establishment Theme Icon
...He starts a message board called OxyKills.com. In 2001, the same year OxyKills.com is founded, OxyContin hits $1 billion in sales for the first time. (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...Barbara Van Rooyan’s 24-year-old son Patrick is another victim. Van Rooyan asks Van Zee how OxyContin ever got approved for sale by the FDA. As it turns out, Van Zee receives... (full context)
Fighting the Medical Establishment Theme Icon
...not. She picks up where Van Zee left off, formally submitting a recall petition for OxyContin to the FDA in 2005. (full context)
Fighting the Medical Establishment Theme Icon
...former Purdue sales representative. The representative believes she was fired because she refused to sell OxyContin to doctors who were illegally overprescribing it. White has a single lawyer with no staff,... (full context)
Fighting the Medical Establishment Theme Icon
...big win so that he can run for office, and he sees an opportunity with OxyContin lawsuits. (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...off the opioid beat at the newspaper because, as the author of a book about OxyContin, he has a financial conflict of interest. For the most part, Meier doesn’t write about... (full context)
Fighting the Medical Establishment Theme Icon
The Value of Science Theme Icon
...fraud investigator, Gregg Wood), keep in communication with Van Zee and RAPP about the latest OxyContin news. Wood in particular is passionate about collecting dirt on Purdue. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
...miner in Lee County, Virginia, who injured his shoulder in the 1990s and got prescribed OxyContin. Though McCauley is not the ideal client for a lawsuit against Purdue (since he has... (full context)
Fighting the Medical Establishment Theme Icon
...unveils news of the settlement: Purdue has pleaded guilty to falsely advertising the benefits of OxyContin while concealing its potential for abuse. As a result, Purdue will pay $600 million in... (full context)
Chapter 4
Fighting the Medical Establishment Theme Icon
...director), Michael Friedman (the CEO), and Udell seem stunned to see the families of the OxyContin victims there. Purdue’s lawyers try to argue that the stigma of a criminal conviction is... (full context)
Chapter 6
Cycles of History Theme Icon
...infectious disease, jumping in particular between family members. The main hub is Interstate 81, where OxyContin spreads up and down the Appalachians. (full context)
Poverty as an Obstacle to Recovery  Theme Icon
Fighting the Medical Establishment Theme Icon
...at finding pills, usually from other people who have been overprescribed. The 2010 reformulation of OxyContin, which makes the pills harder to crush up for an instant high, causes many to... (full context)
Chapter 7
Race, Healthcare, and Criminal Justice Theme Icon
...phone at weddings and out working on Christmas Day. Ever since the 2010 reformulation of OxyContin, Lutz has been tracking heroin users, many of whom make commutes to Baltimore, which is... (full context)
Chapter 8
Fighting the Medical Establishment Theme Icon
...notifies Barbara Van Rooyan that part of her petition to recall approval for the original OxyContin formulation has been approved. This doesn’t matter, however, because Purdue has already voluntarily withdrawn the... (full context)
Chapter 9
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Race, Healthcare, and Criminal Justice Theme Icon
...to take extreme quantities of drugs without overdosing. She first got addicted after being prescribed OxyContin for back pain that lingered after the 2008 birth of her son. When OxyContin is... (full context)
Race, Healthcare, and Criminal Justice Theme Icon
Fighting the Medical Establishment Theme Icon
...rid of one dealer, more just show up, like Whack-A-Mole. Despite Van Zee’s prediction that OxyContin would be recalled once rich kids in suburbs started dying, he is dismayed to see... (full context)
Chapter 12
Poverty as an Obstacle to Recovery  Theme Icon
Cycles of History Theme Icon
Rosemary Hopkins, a Virginia OxyContin user who first discovered the drug in 1998, used to feel like it offered everything... (full context)