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Dopesick Dealers Doctors and the Drug Company that Addicted America

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S fall prey to prostitution jail and death Through unsparing compelling and unforgettably humane portraits of families and first responders determined to ameliorate this epidemic each facet of the crisis comes into focus In these politically fragmented times Beth Macy shows that one thing uniting Americans across geographic partisan and class lines is opioid drug abuse But even in the midst of twin crises in drug abuse and healthcare Macy finds reason to hope and ample signs of the spirit and tenacity that are helping the countless ordinary people ensnared by addiction build a better future for themselves their families and their communities An impressive feat of journalism monumental in scope and urgent in its implications Jennifer Latson The Boston Globe. Dopesick is a semi interesting book about the opioid epidemic in America Ms Macy follows many people and families over the course of 6 years and tells their stories in this book I think I would have enjoyed it a lot had the author narrowed it down to just a couple individuals and included factual information on opioids and addiction I felt the book was disjointed due to there being so many different people written about and the book jumps from one person to the next and back again It just didn't flow in my opinion There wasn't much new in this for me that I haven't read in other recent books and living in Appalachia I'm well aware of the crisis I see people just about everywhere I go who are in the throes of addiction I did learn some about medication assisted treatment including Suboxone that I didn't know before so this book was not a complete washout People who enjoy human interest stories will no doubt like this than I did The author certainly did her research and writes with much insight and compassion Not a bad read by any means just not the best for me Rituals of Pleasure years and tells their stories in this book I think I would have enjoyed it a lot had the author narrowed it down to just a couple individuals and included factual information on opioids and addiction I felt the book was disjointed due to there being so many different people written about and the book jumps from one person to the next and back again It just didn't flow in my opinion There wasn't much new in this for me that I haven't read in other recent books and living in Appalachia I'm well aware of the crisis I see people just about everywhere I go who are in the throes of addiction I did learn some about medication assisted treatment including Suboxone that I didn't know before so this book was not a complete washout People who enjoy human interest stories will no doubt like this than I did The author certainly did her research and writes with much insight and compassion Not a bad read by any means just not the best for me

Download ó PDF, eBook or Kindle ePUB free ↠ Beth Macy

Soon to be a Hulu Original Series  Journalist Beth Macy's definitive account of America's opioid epidemic masterfully interlaces stories of communities in crisis with dark histories of corporate greed and regulatory indifference New York Times from the boardroom to the courtroom and into the living rooms of Americans  In this extraordinary work Beth Macy takes us into the epicenter of a national drama that has unfolded over two decades From the labs and marketing departments of big pharma to local doctor's offices; wealthy suburbs to distressed small communities in Central Appalachia; from distant cities to once idyllic farm towns; the spread of opioid addiction follows a tortuous trajectory that illustrates how this crisis has persisted for so long and. A problematic read for me Yes I know; awards and all that But I honestly think the awards go to the fact that Macy made Oxycontin and heroin part of a national conversation not because this book was exemplary journalism or writing Issue 1 Macy does not feel like a competent research or investigative journalist Apparently before the book writing gig her newspaper job was 'human interest' stories I can so see that And I am not the human interest kind of reader Dopesick primarily focuses on those on the front lines but not the dopesick Though it begins by talking with a major drug dealer it uickly moves to one of the physicians who watched the crisis unfold and then a very brief history of Oxycontin the manufacturer Purdue Pharmaceuticals and the family that owns the company But mostly there are stories from the mothers Details are heart tugging and honestly facile She writes about how one son who died of an OD used to help his mom grow sunflowers so now the mom plants her whole front yard full of them Another carries around the urn of her son's ashes and caused a minor disturbance in a courtroom Does this help us understand drug abuse No Does it help stir anger against Purdue Pharmaceuticals I'd argue 'no' because it gives the reader a sad tragic death only partially from system failure Macy is trying desperately to relate the individual stories to the larger issues of economics and escape but it never gels Unlike Evicted Poverty and Profit in the American City which dispassionately used the micro stories of people to show the complexity of the issues around housing Macy seems desperate to engage the reader through emotion but without a lot of researchSurprisingly for a book about 'dopesick' Macy largely avoids the elephant of addiction It feels like she's uick to blame the system ex 'Ann' had a twisted ankle and got twenty five oxycodone before looking at individual behaviors that contribute It is clear indirectly that many of the mothers were in denial about the level of their teens' use So it kind of ignores the web of deceptions and strategies that occur before the pill takers turn into addicts She makes it sound like people are prescribed oxycodone get addicted start finding someone with extra start dealing to cover costs then turn into heroin addicts There's a loose attempt to connect that chain with economic depression but it doesn't work Mostly she makes it sound like the 'good' kids did it for fun and then 'boom' their lives end Literally For me it's the most annoying kind of journalism because it uses stereotypical images and catch phrases to capture 'tragedy' It's Hallmark Channel journalismIssue 2 Macy is not a good writer She uses adjectives for things she can't possibly know but play into preconceptions see above re Hallmark Channel and below uote about stone faced She also uotes some people saying really intriguing but largely unsupported things and then doesn't address them later When I checked her 'footnotes' in the back they aren't actually footnoted in the body of the book you have to skim through the notes and see if a section you are curious about is highlighted she has lame ass citations By 'lame ass' I mean one uote she uses from a guy who asserts Adderall might make the brain susceptible to addiction then she cites a book called Drug Dealer published in 2016 Why is this claim in the middle of writing about 2005 2007 I don't know Like I said terrible journalism But further research has led me to think that book has potentialIssue 3 Purdue Pharmaceuticals is an evil evil corporation As a general rule I'm pretty sure most pharmaceutical companies are greedy soul sucking entities but Purdue seems actively evil which Macy illustrates The topic gets a chapter or two but is severely hamstrung by the fact that it is a privately owned corporation by the very private Sackler family and that one of her co workers already investigated and wrote a book about how Kermit a town of 400 had enough pills to supply the US The Sackler family has doubled down by counter suing the states instead of admitting any kind of culpability The only ones that have won here are their lawyers who have made buckets defending them since 2005 or so when the internet exploded and people really started to get that Oxycontin was addictive I would have liked an expose of how Purdue built their empire; I want of the details from the whistle blowers Some of those are included but not in detail There's a woman who was terminated and filed a wrongful termination lawsuit asserting she was fired because she refused to sellpush drugs to two of her highest prescribing doctors Her district was Florida naturally I wanted to know about that they must be saying that they actually tracked prescribers and numbers and actively promoted to them Which by implication is basically admitting that they were being legal drug dealers Now that is unbelievably unethical and if you have problems with kids pushing dope in schools is because this corporation and the family that owned it ENCOURAGED IT This family has billions made from an addictive substance they repeated promoted as not Anyway Macy only briefly covers that case and largely in relation to the fact that she ended up losingIssue 4 You want compassion Talk to someone who isn't the child of police officers and a cancer nurse Macy didn't help me develop that or make me appreciate the insidious way addiction rewires the brain one dopamine burst at a time The last time I took care of an addict at my last hospital we had to call a Behavioral Emergency because we had finally gotten all the unknown drug out of his system and he was pissed we messed up his high His mother was exhausted tired of coming to the hospital and trying to talk sense into him He ripped out his IV leaking blood everywhere Hepatitis positive naturally and left It was super not fun Macy's stories barely even help me with compassion for the parents seeped as they are in denial and white privilege Kristi Remembers the first time someone in town suggested her son had a pill problem Kristi defended her son even suggesting that it had been the woman’s son not Jesse who swiped the pills She continued to make me feel compassion and empathy for the people that love addicts but didn't do anything for me about addictsWhich leads me to issue #5 Macy doesn't handle The Race Issue well When someone is black she usually makes a point of saying it and urban is often code for low class person of color She will reference 'sides' of the town What has become clear by 2016 is that now that loads of well to do white kids are dying it's an issue The one person I remember in the book as a person of color is black is in prison and who Macy seems to finger as being the person that brought 'dope' to their middle class burbs The white twenty some old that was in jail is portrayed as 'reformed' living healthy and educating others before he goes to do his time in prison for providing drugs in an OD death Issue #6 The Science this is science light I really really wanted of this “Bickel went onto scientifically uantify the indifference of the typical opioid user comparing the average non addictive person’s perception of the future – calculated to be 47 years – against an addicted users idea of the future which is just nine days I once met an addiction researcher that really educated me on brain 'wiring' and how it changes with addiction and it was really the first time I really started to appreciate how terrible trying to combat addiction is I was hoping Macy would talk about the changes in addicts and how they can actually be helped but it felt like this section was science light and hope heavy She likes to blame various aspects of the system usually lack of affordable rehab beds when an addict finally says I'm ready to uit but doesn't really address the most obvious problem that she herself notes only 50% of addicts who get into a program and on maintenance drugs stay sober for a year That's a really shitty success rate would you go to a surgeon who was only successful 50% of the time Oh we got most of your appendix but not all of it Take thyroid medication or insulin if there was only a 50% chance it would work Yeah probably not These people are desperate so they're taking what they can get but the most honest response to the addiction issue 'We don't know the best way to do it yet'TL; DR If you know nothing about what oxycodone is or why it's part of the national conversation start here But if you want investigative journalism info on Purdue or discussion on treating addiction go elsewhereOne and a half stars only because I never threw it across the roomActual semi comprehensive overview in under 20 minutes by John Oliver 3 Months to No.1: The "No-Nonsense" SEO Playbook for Getting Your Website Found on Google yard full of them Another carries around the urn of her son's ashes and caused a minor disturbance in a courtroom Does this help us understand drug abuse No Does it help stir anger against Purdue Pharmaceuticals I'd argue 'no' because it gives the reader a sad tragic death only partially from system failure Macy is trying desperately to relate the individual stories to the larger issues of economics and escape but it never gels Unlike Evicted Poverty and Profit in the American City which dispassionately used the micro stories of people to show the complexity of the issues around housing Macy seems desperate to engage the reader through emotion but without a lot of researchSurprisingly for a book about 'dopesick' Macy largely avoids the elephant of addiction It feels like she's uick to blame the system ex 'Ann' had a twisted ankle and got twenty five oxycodone before looking at individual behaviors that contribute It is clear indirectly that many of the mothers were in denial about the level of their teens' use So it kind of ignores the web of deceptions and strategies that occur before the pill takers turn into addicts She makes it sound like people are prescribed oxycodone get addicted start finding someone with extra start dealing to cover costs then turn into heroin addicts There's a loose attempt to connect that chain with economic depression but it doesn't work Mostly she makes it sound like the 'good' kids did it for fun and then 'boom' their lives end Literally For me it's the most annoying kind of journalism because it uses stereotypical images and catch phrases to capture 'tragedy' It's Hallmark Channel journalismIssue 2 Macy is not a good writer She uses adjectives for things she can't possibly know but play into preconceptions see above re Hallmark Channel and below uote about stone faced She also uotes some people saying really intriguing but largely unsupported things and then doesn't address them later When I checked her 'footnotes' in the back they aren't actually footnoted in the body of the book Dimsie Goes to School you have to skim through the notes and see if a section Sand Chronicles, Vol. 10 you are curious about is highlighted she has lame ass citations By 'lame ass' I mean one uote she uses from a guy who asserts Adderall might make the brain susceptible to addiction then she cites a book called Drug Dealer published in 2016 Why is this claim in the middle of writing about 2005 2007 I don't know Like I said terrible journalism But further research has led me to think that book has potentialIssue 3 Purdue Pharmaceuticals is an evil evil corporation As a general rule I'm pretty sure most pharmaceutical companies are greedy soul sucking entities but Purdue seems actively evil which Macy illustrates The topic gets a chapter or two but is severely hamstrung by the fact that it is a privately owned corporation by the very private Sackler family and that one of her co workers already investigated and wrote a book about how Kermit a town of 400 had enough pills to supply the US The Sackler family has doubled down by counter suing the states instead of admitting any kind of culpability The only ones that have won here are their lawyers who have made buckets defending them since 2005 or so when the internet exploded and people really started to get that Oxycontin was addictive I would have liked an expose of how Purdue built their empire; I want of the details from the whistle blowers Some of those are included but not in detail There's a woman who was terminated and filed a wrongful termination lawsuit asserting she was fired because she refused to sellpush drugs to two of her highest prescribing doctors Her district was Florida naturally I wanted to know about that they must be saying that they actually tracked prescribers and numbers and actively promoted to them Which by implication is basically admitting that they were being legal drug dealers Now that is unbelievably unethical and if Tinkle Tall Tales No. 2 you have problems with kids pushing dope in schools is because this corporation and the family that owned it ENCOURAGED IT This family has billions made from an addictive substance they repeated promoted as not Anyway Macy only briefly covers that case and largely in relation to the fact that she ended up losingIssue 4 You want compassion Talk to someone who isn't the child of police officers and a cancer nurse Macy didn't help me develop that or make me appreciate the insidious way addiction rewires the brain one dopamine burst at a time The last time I took care of an addict at my last hospital we had to call a Behavioral Emergency because we had finally gotten all the unknown drug out of his system and he was pissed we messed up his high His mother was exhausted tired of coming to the hospital and trying to talk sense into him He ripped out his IV leaking blood everywhere Hepatitis positive naturally and left It was super not fun Macy's stories barely even help me with compassion for the parents seeped as they are in denial and white privilege Kristi Remembers the first time someone in town suggested her son had a pill problem Kristi defended her son even suggesting that it had been the woman’s son not Jesse who swiped the pills She continued to make me feel compassion and empathy for the people that love addicts but didn't do anything for me about addictsWhich leads me to issue #5 Macy doesn't handle The Race Issue well When someone is black she usually makes a point of saying it and urban is often code for low class person of color She will reference 'sides' of the town What has become clear by 2016 is that now that loads of well to do white kids are dying it's an issue The one person I remember in the book as a person of color is black is in prison and who Macy seems to finger as being the person that brought 'dope' to their middle class burbs The white twenty some old that was in jail is portrayed as 'reformed' living healthy and educating others before he goes to do his time in prison for providing drugs in an OD death Issue #6 The Science this is science light I really really wanted of this “Bickel went onto scientifically uantify the indifference of the typical opioid user comparing the average non addictive person’s perception of the future – calculated to be 47 A Good Girls Guide to Murder years – against an addicted users idea of the future which is just nine days I once met an addiction researcher that really educated me on brain 'wiring' and how it changes with addiction and it was really the first time I really started to appreciate how terrible trying to combat addiction is I was hoping Macy would talk about the changes in addicts and how they can actually be helped but it felt like this section was science light and hope heavy She likes to blame various aspects of the system usually lack of affordable rehab beds when an addict finally says I'm ready to uit but doesn't really address the most obvious problem that she herself notes only 50% of addicts who get into a program and on maintenance drugs stay sober for a The Damned Lovely year That's a really shitty success rate would Handbook of Environmental and Ecological Statistics you go to a surgeon who was only successful 50% of the time Oh we got most of The Tunnel your appendix but not all of it Take thyroid medication or insulin if there was only a 50% chance it would work Yeah probably not These people are desperate so they're taking what they can get but the most honest response to the addiction issue 'We don't know the best way to do it داستان زندگی پر ثمر و با افتخار مداد قرمز yet'TL; DR If The Name Therapist you know nothing about what oxycodone is or why it's part of the national conversation start here But if Watching My Wife in Jamaica you want investigative journalism info on Purdue or discussion on treating addiction go elsewhereOne and a half stars only because I never threw it across the roomActual semi comprehensive overview in under 20 minutes by John Oliver

Beth Macy ↠ 5 Download

Become so firmly entrenched Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics Macy sets out to answer a grieving mother's uestion why her only son died and comes away with a gripping unputdownable story of greed and need From the introduction of OxyContin in 1996 Macy investigates the powerful forces that led America's doctors and patients to embrace a medical culture where overtreatment with painkillers became the norm In some of the same communities featured in her bestselling book Factory Man the unemployed use painkillers both to numb the pain of joblessness and pay their bills while privileged teens trade pills in cul de sacs and even high school standout. “The informant leaned into Lieutenant Richard Stallard’s cruiser ‘This feller up here’s got this new stuff he’s selling It’s called Oxy and he says it’s great’ he said ‘What is it again” Stallard asked‘It’s Oxy comptonsomething like that’Pill users were already misusing it to intensify their high the informant explained as well as selling it on the black market Oxy came in much higher dosages than standard painkillers and an 80 milligram tablet sold for 80 making its potential for black market sales much higher than that of Dilaudid and Lortab The increased potency made the drug a cash cow for the company that manufactured it too The informant had specifics Users had already figured out an end run around the pill’s time release mechanism a coating stamped with OC and the milligram dosage They simply popped a tablet in their mouths for a minute or two until the rubberized coating melted away then rubbed it off on their shirts Forty milligram Oxys left an orange sheen on their shirtsleeves the 80 milligrams a tinge of green The remaining tiny pearl of pure oxycodone could be crushed then snorted or mixed with water and injected The euphoria was immediate and intense with a purity similar to that of heroin” Beth Macy Dopesick Dealers Doctors and the Drug Company that Addicted AmericaEvery morning at the train station I find myself staring at the iconography of the opioid epidemic Next to me there is an advertisement for Narcan a naloxone nasal spray that can be used in case of an opioid overdose Across the tracks another ad this one for a residential treatment center focused on opioid addiction When I step on the train I am greeted with a placard that says Stop Don’t Run It is a public service announcement reminding users that they will be given prosecutorial immunity if they call 911 and stay with a person who has overdosed It is a law that is meant to stop users from running away and allowing a person to die in order to avoid a possession rap Day after day it is easy to allow such things to recede into the background To become part of normal life If you are like me you have heard the phrase “opioid epidemic” so often it has started to lose meaning Whether we pay attention or not it is happening Over the past fifteen years 300000 Americans have died from drug overdoses Seventy two thousand died just last year It is the leading cause of death for Americans under fifty and is deadlier than guns car accidents and peak HIV Beth Macy’s Dopesick tells the story of the crisis by giving it details She provides the faces and the names and the unhappy endings It is a potent at times unbearably powerful story She follows everyone cops and criminals and users; prosecutors and judges; doctors and nurses and treatment providers Mostly though this is a story of mothers A tale of mothers and their dead sons and daughters While the opioid crisis has its tentacles in every corner of the nation Macy traces it from its origin in rural America specifically western Virginia As a journalist based out of Roanoke she was there at the beginning with Perdue Pharma’s introduction of OxyContin The 1996 introduction of OxyContin coincided with the moment in medical history when doctors hospitals and accreditation boards were adopting the notion of pain as “the fifth vital sign” developing new standards of pain assessment and treatment that gave pain eual status with blood pressure heart rate respiratory rate and temperature A paradigmatic shift turned patients into health care consumers Accordingly pharmaceutical companies sent their sales reps across the country to evangelize for new medications to prescribe to these customers Macy devoted years to this story and she begins Dopesick with the story of Perdue Pharma and OxyContin She describes how this potent drug was sold to physicians who then over prescribed it to their patients And when I say “sold” I mean that in a literal sense Sales reps were buying loyalty with free lunches and junkets and swag Physicians for their parts were enjoying catered lunches and filling Oxy scripts with indefinite refills At the time Oxy hit the market unfortunately it was not tamper resistant meaning that this incredibly potent drug could be altered for an incredible high This high came at an even incredible cost “Dopesick” is the term used to describe withdrawal and it explains why opioids are so dangerous Once your body has entertained the euphoria of opioids it has a hard time going back Symptoms of withdrawal include aches diarrhea fevers profuse sweating stomach cramping nausea vomiting anxiety restlessness and irritability A person undergoing this extreme manifestation of absence becomes desperate to reverse course to feed the addiction in order to make the sickness go away An addict will do anything to get enough money for the next hit The slang junkie after all refers to a person who scrapped metal in order to support their addictionEventually the trend that began with Oxy exploded into a rebirth of heroin leading to a public health crisis that devastated rural communities filling the boneyards and the prisons Macy devotes a lot of time to following the resistance a small band of people who tried to fight City Hall even though City Hall had been purchased by Corporate America We are introduced to a small town doctor who was the canary in the coal mine warning of Oxy’s dangers as he saw his patients dying; there is a dogged ATF agent who broke one of Virginia’s largest heroin rings; there is a nurse practitioner who takes her mobile health wagon into the old coalfields where the uninsured multitudes await; and there is a no nonsense Catholic nun whose activism could help remind the moribund husk of a beleaguered Church that faith without works is dead Dopesick features beautiful black white portraits of most of these people taken specifically for the book It adds a great deal to have a face to go along with the names Perdue Pharma is an easy target It is a corporation after all a molten mass of money surrounded by the impenetrable layers of the mythic “corporate veil” endowed by the Supreme Court with all the rights of a human person but none of the moral responsibilities or potential legal conseuences Macy though does not stop with them She looks at the many other contributing factors such as an acuiescent FDA where top officials transition directly from the agency into high paying corporate positions; and physicians who failed to do their due diligence before reaching for their Perdue Pharma ballpoints to write a script; and at the potency of opioids themselves which makes recovery extremely difficult In the latter half of Dopesick Macy turns this into a furious critiue of the treatment industrial complex She advocates strongly for medication assisted treatment MAT using drugs such as Suboxone to uell cravings and subdue withdrawal symptoms without getting the person high According to Macy this is the only feasible way to break the epidemic However the legal and medical systems are extremely wary of using drugs to defeat drug addiction even though we live in a hyper medicated culture in which there is a prescription for everything Dopesick is deeply researched nicely balancing the big picture statistics with on the ground reporting But as hard as she tries this is not a work of objective journalism Macy was in the trenches a long time essentially embedding herself in fraying communities To follow these lives she became a part of those lives to the point where she would get texts from users asking her to drive them to rehab Frankly I do not see this as a problem If journalism reuires a person to put their humanity on hold then journalism is not worth a damn The surprising thing to me is that she was able to maintain her empathy Addicts are extremely frustrating I was a public defender for nine years and the number of drug users I represented who maintained their sobriety was depressingly low Addicts will – and do – steal from the people they love the most lie to the people they love the most let down the people they love the most It becomes very hard very uickly to feel sorry for them This brings us back to the mothers Mothers are the beating heart of Dopesick and we follow them closely as they try to save their kids It makes for dispiriting reading as these young people trade their futures to chase a high joining a cycle of sobriety and relapse that lasts for years and is physically and psychologically difficult to escape From the outside it is easy to say Cut them off Stop helping them Let them go Three strikes and you’re out From the outside it is easy to ask When is it enough But that is only what you say when it is not your child Because when it is your child there is never a point where you uit And maybe that is the only redemption to be found in Dopesick the mothers who keep trying to save their kidsMany of them do not succeed Macy begins her book with a fitting line from Agatha Christie “A mother’s love for her child is like nothing else in the world” Christie writes in The Last Séance “It knows no law no pity it dares all things and crushes down remorselessly all that stands in its path” Christie was describing a mother’s love but she might have been describing opioids themselves Unfortunately it does not seem that even love can triumph over the ruthless power of an insidious drug Jewellery : From Art nouveau to 3D printing you are like me Jewellery : From Art nouveau to 3D printing you have heard the phrase “opioid epidemic” so often it has started to lose meaning Whether we pay attention or not it is happening Over the past fifteen 3 Months to No.1: The "No-Nonsense" SEO Playbook for Getting Your Website Found on Google years 300000 Americans have died from drug overdoses Seventy two thousand died just last Dimsie Goes to School year It is the leading cause of death for Americans under fifty and is deadlier than guns car accidents and peak HIV Beth Macy’s Dopesick tells the story of the crisis by giving it details She provides the faces and the names and the unhappy endings It is a potent at times unbearably powerful story She follows everyone cops and criminals and users; prosecutors and judges; doctors and nurses and treatment providers Mostly though this is a story of mothers A tale of mothers and their dead sons and daughters While the opioid crisis has its tentacles in every corner of the nation Macy traces it from its origin in rural America specifically western Virginia As a journalist based out of Roanoke she was there at the beginning with Perdue Pharma’s introduction of OxyContin The 1996 introduction of OxyContin coincided with the moment in medical history when doctors hospitals and accreditation boards were adopting the notion of pain as “the fifth vital sign” developing new standards of pain assessment and treatment that gave pain eual status with blood pressure heart rate respiratory rate and temperature A paradigmatic shift turned patients into health care consumers Accordingly pharmaceutical companies sent their sales reps across the country to evangelize for new medications to prescribe to these customers Macy devoted Sand Chronicles, Vol. 10 years to this story and she begins Dopesick with the story of Perdue Pharma and OxyContin She describes how this potent drug was sold to physicians who then over prescribed it to their patients And when I say “sold” I mean that in a literal sense Sales reps were buying loyalty with free lunches and junkets and swag Physicians for their parts were enjoying catered lunches and filling Oxy scripts with indefinite refills At the time Oxy hit the market unfortunately it was not tamper resistant meaning that this incredibly potent drug could be altered for an incredible high This high came at an even incredible cost “Dopesick” is the term used to describe withdrawal and it explains why opioids are so dangerous Once Tinkle Tall Tales No. 2 your body has entertained the euphoria of opioids it has a hard time going back Symptoms of withdrawal include aches diarrhea fevers profuse sweating stomach cramping nausea vomiting anxiety restlessness and irritability A person undergoing this extreme manifestation of absence becomes desperate to reverse course to feed the addiction in order to make the sickness go away An addict will do anything to get enough money for the next hit The slang junkie after all refers to a person who scrapped metal in order to support their addictionEventually the trend that began with Oxy exploded into a rebirth of heroin leading to a public health crisis that devastated rural communities filling the boneyards and the prisons Macy devotes a lot of time to following the resistance a small band of people who tried to fight City Hall even though City Hall had been purchased by Corporate America We are introduced to a small town doctor who was the canary in the coal mine warning of Oxy’s dangers as he saw his patients dying; there is a dogged ATF agent who broke one of Virginia’s largest heroin rings; there is a nurse practitioner who takes her mobile health wagon into the old coalfields where the uninsured multitudes await; and there is a no nonsense Catholic nun whose activism could help remind the moribund husk of a beleaguered Church that faith without works is dead Dopesick features beautiful black white portraits of most of these people taken specifically for the book It adds a great deal to have a face to go along with the names Perdue Pharma is an easy target It is a corporation after all a molten mass of money surrounded by the impenetrable layers of the mythic “corporate veil” endowed by the Supreme Court with all the rights of a human person but none of the moral responsibilities or potential legal conseuences Macy though does not stop with them She looks at the many other contributing factors such as an acuiescent FDA where top officials transition directly from the agency into high paying corporate positions; and physicians who failed to do their due diligence before reaching for their Perdue Pharma ballpoints to write a script; and at the potency of opioids themselves which makes recovery extremely difficult In the latter half of Dopesick Macy turns this into a furious critiue of the treatment industrial complex She advocates strongly for medication assisted treatment MAT using drugs such as Suboxone to uell cravings and subdue withdrawal symptoms without getting the person high According to Macy this is the only feasible way to break the epidemic However the legal and medical systems are extremely wary of using drugs to defeat drug addiction even though we live in a hyper medicated culture in which there is a prescription for everything Dopesick is deeply researched nicely balancing the big picture statistics with on the ground reporting But as hard as she tries this is not a work of objective journalism Macy was in the trenches a long time essentially embedding herself in fraying communities To follow these lives she became a part of those lives to the point where she would get texts from users asking her to drive them to rehab Frankly I do not see this as a problem If journalism reuires a person to put their humanity on hold then journalism is not worth a damn The surprising thing to me is that she was able to maintain her empathy Addicts are extremely frustrating I was a public defender for nine A Good Girls Guide to Murder years and the number of drug users I represented who maintained their sobriety was depressingly low Addicts will – and do – steal from the people they love the most lie to the people they love the most let down the people they love the most It becomes very hard very uickly to feel sorry for them This brings us back to the mothers Mothers are the beating heart of Dopesick and we follow them closely as they try to save their kids It makes for dispiriting reading as these The Damned Lovely young people trade their futures to chase a high joining a cycle of sobriety and relapse that lasts for Handbook of Environmental and Ecological Statistics years and is physically and psychologically difficult to escape From the outside it is easy to say Cut them off Stop helping them Let them go Three strikes and The Tunnel you’re out From the outside it is easy to ask When is it enough But that is only what داستان زندگی پر ثمر و با افتخار مداد قرمز you say when it is not The Name Therapist your child Because when it is Watching My Wife in Jamaica your child there is never a point where Computing Across America you uit And maybe that is the only redemption to be found in Dopesick the mothers who keep trying to save their kidsMany of them do not succeed Macy begins her book with a fitting line from Agatha Christie “A mother’s love for her child is like nothing else in the world” Christie writes in The Last Séance “It knows no law no pity it dares all things and crushes down remorselessly all that stands in its path” Christie was describing a mother’s love but she might have been describing opioids themselves Unfortunately it does not seem that even love can triumph over the ruthless power of an insidious drug