DeMetrovich 1

Cate DeMetrovich

Dr. Browning

PHIL 0335

4 December 2019

The Unspoken Crisis: Beth Macy’s Perspective on the Factors of the Opioid Crisis

Beth Macy, a renowned American journalist, uses her power of communication and

investigation to open the public’s mind to the opioid crisis through her book Dopesick. Macy has

previously written two other books, Truevine and Factory Man, which also enlighten readers to

other important social issues that the media may shield them from. A daughter of a factory

worker and a housepainter, Macy writes what she knows. She has spoken all over the country

and continues to educate the public on unspoken issues.

Dopesick tells the story of the emergence of the opioid crisis, specifically in the

Appalachian region. It provides background on Purdue Pharma and how they managed to

successfully create an opioid addiction throughout the nation. The book follows the lives of

victims, families, drug dealers, doctors, and advocates, while providing statistics about the

harmful effects of the drugs. Dopesick does a successful job of educating the population of an

epidemic occurring that most people are unaware of.

One of the strengths of Macy’s book is her investigation into the background of the crisis

as well as the strategy of Purdue Pharma in implementing their drugs. Macy begins Dopesick by

providing a background of the crisis, starting with Lee County, Virginia. The drugs primarily

spread to people returning from the war and injured coal miners, but quickly develops into a

widespread issue from teenagers to the elderly. Macy exposes Purdue Pharma by displaying their

progression of marketing the drugs and convincing doctors to prescribe them. They have evaded
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punishment from their lies but have continued to make a profit off of these highly addictive

drugs.

Contemplating the rationality of doctors when prescribing mass amounts of opioids is

difficult without knowing Purdue Pharma’s strategy. They first began with wide-spread

marketing of their products using pens, binders, wall charts, clipboards, lanyards, and much more

(28). The company put their name in the front of the doctors’ and nurses’ minds before moving

further. Once they achieved this goal, the representatives from Purdue came to the hospitals

bearing gifts such as coupons, meals, filled gas tanks, and flowers (33). Most doctors took

advantage of this newfound attention, relishing in the benefits of listening to the representatives.

However, the sales pitches did not stop here. To increase the representatives’ incentives, they

increased their bonuses from $1 million to $40 million. They started giving patients coupons for

free OxyContin prescriptions, while providing doctors with free trips to Florida (47). Purdue

Pharma stopped at nothing to get people to start taking their drugs. When the addictions started

becoming known, they protected themselves by saying, “The issue is drug abuse, not the drug,”

arguing that the users should be blamed for the deaths instead of the product (51). By 2015, the

Sackler family, who owns Purdue Pharma, earned the title on Forbes’s “America’s Richest

Families” list (95). The way that the company motivated its representatives to manipulate doctors

and nurses makes it slightly easier to understand how this crisis began.

Macy uses stories of many victims to display the ease of becoming addicted to opioid

drugs, the constant physical and emotional battle within themselves, and the pain felt by the

families affected. The first story introduced involves Eddie Bisch, a teenager who overdosed on

opioids. Eddie was a high school senior athlete with decent grades. His father never suspected

that he would have been addicted to drugs, let alone opioids. Before his death, it was not known
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that these painkillers had reached this region or demographic. His father admitted that the first

time he had ever heard of OxyContin, his son was dead from it (58). It caused Eddie’s father to

search the internet for similar cases, and he soon discovered that many parents were experiencing

the same trauma that he was.

Scott Roth was another normal, likeable teenager who was caught up in the opioid crisis.

Both Scott and his mom, Robin, were constantly fighting the battle of beating his addiction, but

he eventually lost this battle. At this point in time, opioid overdoses were becoming more

common, and parents were more aware of what to watch for. This did not alleviate the pain that

Scott’s mother felt when she learned of her son’s death. Unlike Eddie’s father, Robin had more

opportunity to create change. She used the pain she felt to advocate for the families who were not

able to fight for themselves and attended hearings targeted at Purdue Pharma. Although justice

has still not been brought to those involved, Macy allows us to feel some of the emotions that

these families feel on a daily basis.

Tess Henry’s story has a major impact on the entire book. Her story begins as a simple

infection, bronchitis, that turns into a full-blown opioid addiction that cannot be cured. She,

along with her entire family, attempts to fight this addiction for years. Constantly trying to keep

up a normal appearance, Tess continued to waitress to fulfill her addiction needs. However, the

story deepens when she finds out that she is pregnant, and the baby is most likely to have

Neonatal Abstinence Syndrome (NAS). Luckily, the baby is perfectly healthy, but Tess’s story

just begins at this time. She fights extremely hard for the remainder of her life, constantly in

rehab and trying to better herself. However, her fate is similar to most of the other victims of

opioid addition. Beth Macy does a successful job of capturing the audience with Tess’s story.

She is extremely relatable in most aspects, especially her courage and motivation to live for
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herself, her family, and her baby. Her failure shows readers how difficult it is to overcome this

addiction, no matter how hard one desires to become clean.

Beth Macy not only uses stories of victims to relate to the readers, but also includes many

shocking statistics throughout the book. Although most people do not realize this crisis has been

occurring for decades, “By 1990, more than 250,000 Americans were addicted to opium-derived

painkillers” (25). This statistic exaggerates the amount of time that has passed without much, if

any, change to the system. Without change, opioid addiction has continued to increase. Macy

states that the annual death toll for drug overdose had climbed to 64,000 based on statistics from

2017 (185). With most drug addiction, it is assumed to be within the majority of impoverished,

low-income people; however, the opioid addiction has traveled to high schools and become a

popular drug of choice. Studies show that “within two years of the [OxyContin’s] release, 24%

of Lee High School juniors reported trying OxyContin, and so had 9% of the county’s seventh-

graders” (43). It also continues in other areas of this region, such as Roanoke. Surveys completed

displayed that “in the fall of 2012, 6.4 percent reported using heroin one or more times, and

almost 10 percent said they’d tried illicit prescription drugs” (121). These statistics exaggerate

how widespread this issue has become. Macy successfully uses many more shocking statistics

throughout her book to engage the reader.

Two important problems in the book stand out. One exaggerates the punishment of

victims rather than the emphasis on treatment. Throughout this entire process, the government

has constantly exaggerated the importance of jail time rather than treatment. Many officials

began realizing that jail would keep the victims clean only until they served their sentence. Soon

after, they would be back in the same position. However, legislators argued that “it’s easier to

give money to the corrections system – to the tune of one billion in the state of Virginia – than it
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is to take a couple of million dollars and provide inpatient treatment for our problem” (207). In

this case, as many others before, the government is looking at the problem from a financial

standpoint rather than the effect the drugs are having on the victims. Police officers were some of

the first people to take a stand against punishment with their movement of Police Assisted

Addiction and Recovery Initiative (203). They began allowing people the option of seeking

treatment instead of jail time if they gave them their drugs. However, the system of punishment

continued, specifically shown with the rule that “people with drug charges are permanently

barred from getting food stamps” (255). This rule incentivized many people to turn back to drugs

to make money to feed themselves and their families. Overall, Macy exaggerates the importance

of treatment over punishment.

Another prominent issue within the book is the ignorance towards using drugs to treat

drug addiction. Scientifically, it is not safe for a drug addict, especially an opioid addict, to quit

drugs completely. The victim’s body has become accustomed to the chemicals in those drugs,

and it can be extremely dangerous for them to completely eradicate them. However, the Federal

Bureau of Narcotics was extremely against using drugs to treat drug addiction (217). Due to their

outright rejection, many programs rejected addicts who were known to be on these “helpful”

drugs, which further limited help provided to opioid addicts. Macy sees this problem in almost

every case she investigates after the time period when these drugs were considered as legal and

beneficial to opioid addicts. She uses these instances to emphasize that the stigmatism

surrounding these drugs results in small opportunities for addicts to find help.

Dopesick serves as an exposé towards the opioid crisis occurring throughout America.

Beth Macy successfully describes the history of the crisis, while emphasizing the corruption and

manipulation of Purdue Pharma. However, her weakness lies within the structure of the book.
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Her constant shifts make it slightly difficult for the reader to follow. Being a journalist, Macy is

tempted to tell the story in chronological order, which works for much of the historical and

statistical aspects. However, the random placement of stories results in slight confusion for the

reader. She frequently refers to many previous characters and expects the readers to keep

plentiful knowledge of their story, but this is a difficult expectation since so many new characters

and stories are introduced throughout the book.

Using her power as a journalist, Beth Macy highlights many of the medical ethical issues

that Purdue Pharma, doctors/nurses, and the government have created relating to the opioid

crisis, while also providing her opinion regarding the necessary steps to take moving forward.

Purdue Pharma’s entire strategy to promote the addictive drugs was unethical. They knowingly

created a widespread addiction throughout the public and still have not taken responsibility for it.

Purdue has taken advantage of small-town, impoverished people as a way to make their fortune.

Also, Macy has showcased the societal downfall of punishing the victims of addiction. These

people never receive the help that they need to overcome their addiction, which allows the drug

to spread. However, Macy encourages more knowledge towards the crisis to allow for more

opportunity to advocate for the punishment of the Sackler family. Despite owning Purdue

Pharma and encouraging the continued sales of the addictive drugs, they have managed to escape

punishment and blame for years, but with more education and advocacy, the government may be

more responsive to the events that have occurred. Lastly, Macy emphasizes the importance of

medication-assisted treatment (MAT) with overcoming the addiction. She highlights the stigma

surrounding these medications; however, poses her opinion that they must be used. She hopes

that changing the perception around victims as a whole can create a society more willing to help

these people overcome addiction.

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Works Cited

Macy, Beth. Dopesick. Head of Zeus, 2019.