Beth Macy Head of Zeus, an Apollo book, 2018, HB, 384pp, £20.00, 978-1788549370
Dopesick is an unflinching look at the opioid crisis in the US, which is predicted to kill more Americans in a decade than HIV has since it emerged in the 1980s.
Beth Macy tells the story from the point of view of the communities that have been devastated by a surge in opioid addicts and heroin users. Macy puts the blame firmly at the foot of Purdue Pharma, the makers of OxyContin, who marketed the drug as a safe analgesic for non-cancer pain with the potential for addiction of less than 1%. She details their massive annual marketing budget ($4bn), the financial bonuses the drug reps were given, and the way that family doctors continued to prescribe the drugs to avoid affecting their income-linked patient satisfaction scores. The ease with which doctors prescribed these drugs and the considerable volumes prescribed to patients flooded these communities with opioids. Patients, now addicted, soon realised that they could rub off the slow-release coating from the drugs, snorting or injecting the contents for an immediate high.
Macy documents the initial denial and then disbelief in rural towns as ordinary people suddenly started dying from drug overdoses. She shares heartbreaking stories from addicts and their families, which all seem to start with a prescription for seemingly harmless painkillers from their doctor. She finds that the same health system that allowed such easy access to these drugs makes accessing drug detoxification and treatments like methadone almost impossible.
Truly shocking in some places, Dopesick is a wake-up call for doctors and the pharmaceutical industry to examine the way we prescribe opioids and the catastrophic harm that can be done when we give these out indiscriminately and without proper monitoring. It gives some context to recent events that have led to bankruptcy filing by Purdue Pharma, as it attempts to shield the Sackler family’s private wealth from over 2600 lawsuits seeking billions of dollars in damages led by a number of local governments and state prosecutors.
- © British Journal of General Practice 2019
