Dopesick: Dealers, Doctors, and the Drug Company that Addicted America
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In sharing their experiences, these mothers hoped readers would be moved to advocate for life-saving addiction treatment and research, health care and criminal justice reform, and for political leadership capable of steering America out of the worst drug epidemic in modern history. Until then, they hoped their children’s stories would illuminate the need for patients not only to become more discerning consumers of health care but also to employ a healthy skepticism the next time a pharmaceutical company announces its latest wonder drug.
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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.”
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If they could pitch heroin as a new and nonaddictive substitute for morphine, Dreser and Bayer would both strike it rich. Presenting the drug to the German medical academy the following year, Dreser praised heroin’s sedative and respiration-depressing effects in treating asthma, bronchitis, and tuberculosis. It was a safe family drug, he explained, suitable for baby colic, colds, influenza, joint pain, and other ailments. It not only helped clear a cough, it also seemed to strengthen respiration—and it was a sure cure, Bayer claimed, for alcoholism and morphine abuse.
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To underscore such opportunities, the company planned to pass out $300,000 worth of OxyContin-branded scroll pens, $225,000 worth of OxyContin resource binders, and $290,000 worth of “Pain: The Fifth Vital Sign” wall charts and clipboards.
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Compared with the New Zealand hospitals where Davis worked earlier in his career—often prescribing physical therapy, anti-inflammatories, biofeedback, or acupuncture as a first-line measure—American insurance companies in the age of managed care were more likely to cover opioid pills, which were not only cheaper but also considered a much quicker fix. Little did Davis or the other ER docs understand that the routine practice of sending patients home with a two-week supply of oxycodone or hydrocodone would culminate by the year 2017 in a financial toll of $1 trillion as measured in lost ...more
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If a doctor was already prescribing lots of Percocet and Vicodin, a rep was sent out to deliver a pitch about OxyContin’s potency and longer-lasting action. The higher the decile—a term reps use as a predictor of a doctor’s potential for prescribing whatever drug they’re hawking—the more visits that doctor received from a rep, who often brought along “reminders” such as OxyContin-branded clocks for the exam-room walls.
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here, pairing an Oxy with a nerve pill—we call that the Cadillac high. If you’re gonna write this book, honey, you better learn the lingo.”
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To one of the region’s longtime health-department directors, Dr. Sue Cantrell, a former pharmacist, the premiere of OxyContin could not have been timed worse. With the exception of mining, production jobs in the coalfields had never paid much. Cantrell remembered setting up a mobile clinic in the parking lot of the Buster Brown apparel factory in the early 1990s because the women who worked there did piecework—they were paid by the number of sewn pieces they produced—and they had zero sick leave. “They couldn’t leave work to have a pap smear or a breast exam, so we took the clinic to them,” ...more
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Van Zee sounded the alarm about OxyContin just as its makers were on the threshold of grossing its first billion on the blockbuster drug. And though he didn’t yet know it, he would spend the remainder of his career dealing with its aftermath—lobbying policy makers, treating the addicted, and attending funerals of the overdosed dead.    But back in the early days of OxyContin, Van Zee was as puzzled as he was concerned. He told Sue Cantrell about a new condition he’d spotted among some of his older opioid addicts—skin abscesses caused by injecting the crushed-up drug. He was beginning to think ...more
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Another set of scales fell from the doctor’s eyes as a distinct possibility flashed before him: No one in federal government would take seriously the concerns of a country doctor until opioid abuse took hold in the cities and suburbs. “If it’s a bunch of poor folks up in the mountains, it doesn’t affect them personally,” he said.
Laura
sure but it wasnt like them all cared about crack neither
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It might have been easier If OxyContin swallowed the mountains, and took The promises of tens of thousands of young lives Slowly, like ever-encroaching kudzu. Instead, It engulfed us, Gently as napalm Would a school-yard.
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The Don Draper of American pharmaceutical marketing, Arthur pioneered the idea of showering doctors with favors and funding experts to back drugmakers’ claims in the 1960s. It was his marketing genius that fueled the emergence of pills as a quick fix, his marketing prowess that delivered Valium and Librium, dubbed Mother’s Little Helper by the Rolling Stones, to countless nightstands.
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“The dividends may go slightly down, but nobody cares because nobody who made the product goes to jail. If the government were serious, they’d put people in jail, and [others would be] fearful,” said Assistant U.S. Attorney Andrew Bassford, who would spend most of the next decade prosecuting heroin dealers as a direct consequence of the OxyContin epidemic, down the hall from the office where Brownlee worked. “But you can’t put a corporation in jail; you just take their money, and it’s not really their money anyway. “The corporation feels no pain.”
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“You think of heroin as seedy street slums,
Laura
just say black folk, bitch, we know what you want to say
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People you don’t even think would be using heroin are using it.”
Laura
aka white folk and poor folk; this book is kind of a complicit object lesson in innate American classism and racism
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Drug epidemics unfold “like a vector phenomenon, where you have one individual who seeds that community and then the spread begins,” said Dr. Anna Lembke, an addiction-medicine specialist at the Stanford University School of Medicine and the author of Drug Dealer, MD. People whose parents or grandparents were drug- or alcohol-addicted have dramatically increased odds of becoming addicted themselves, with genetics accounting for 50 to 60 percent of that risk, Lembke explained; she noted that the correlation between family history and depression is much lower, 30 percent. Other risk factors for ...more
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“How dare you tell the newspaper these things?” the superintendent seethed. Bassford, who also works as a brigadier general in the U.S. Army Reserve, was unmoved by the scolding. “I say these things because I know them to be true,” he said. “Your schools are a pit because your students have money, and money attracts drugs.”
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That sentiment illuminated the folly of the decades-long War on Drugs, in which drug users are arrested four times more often than those who sell the drugs.
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As journalist Sam Quinones theorized in his 2015 book, Dreamland, maybe the addiction-prone people who would have succumbed to alcohol addiction in late middle age—had opiates not appeared—were the same people who were now prematurely dying of heroin in their early adulthood.
Laura
a somewhat better book than this one sry to say
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“When work no longer becomes an option for people, what you have at the base is a structural problem, where the American dream becomes a scam.” She likened the epidemic’s spread not to crabgrass but to a wildfire: “If the economic collapse was the kindling in this epidemic, the opiates were the spark that lit the fire.” And the helicopters were nowhere in sight.
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For forty years, Baltimore had been a prime staging area for dealers moving drugs, especially heroin, along the East Coast. Its port was an entryway for international drug smuggling. Another trafficking artery was Interstate 95, which connected Baltimore to cities from Miami to Bangor, Maine, with nicknames that transitioned over time, depending on the drug of choice, from Reefer Express to Cocaine Lane to the Heroin Highway, also called the Highway to Hell.
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The night before, it had occurred to Bill Metcalf, when he was sorting through MoneyGram receipts, that he was no better than his father. The work had become its own kind of addiction. “We’re both chasing the same thing, on different sides of the law,” he said. “He enjoyed the streets and friends over family, and the pursuit of this lifestyle. And here I am, chasing those guys, and choosing that over my family.” His wife wanted to try for a boy; it would be their fifth child after four girls. “It’s one more jelly sandwich, who cares?” she argued, begging him, again, to ask for a desk job. ...more
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If OxyContin had been the economic driver in the Appalachian coalfields, then the heroin highway to Baltimore had become one of the few avenues left for America’s small-town working class. Can’t get a job in a factory? Drive to Baltimore instead. An investment of $4,000, or 50 grams of heroin, could earn a person $60,000 in a single week.
Laura
basically irresistible
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Americans, representing 4.4 percent of the world’s population, consume roughly 30 percent of its opioids.
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Among Bassford’s favorite Garfield quotes: “Most human organizations that fall short of their goals do so not because of stupidity or faulty doctrines, but because of internal decay and rigidification. They grow stiff in the joints. They get in a rut. They go to seed.”
Laura
semi questionable yet not entirely off base
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“Her addiction was so severe, I don’t think she was fighting withdrawal symptoms as much as she was fighting her mental illness demons,” including bipolar depression and probably PTSD, Cheri said. In her experience, those who have serious psychiatric problems on top of their addictions and who also use multiple drugs (not just opioids) are the very hardest cases to treat, even with MAT.
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Did a president who bragged about winning a swing state—telling the president of Mexico, “I won New Hampshire because New Hampshire is a drug-infested den”—win because voters genuinely thought he could fix it, or because too many people were too numbed out to vote?
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when his former martial-arts teacher and onetime father figure was arrested and jailed for taking indecent liberties with a teenage female student.
Laura
what is it with these martial arts fuckers??
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This book stands on the shoulders of several important works about the opioid crisis that came before it: Barry Meier’s Pain Killer, Sam Quinones’s Dreamland, Anna Lembke’s Drug Dealer, MD, and Tracey Helton Mitchell’s Big Fix.
Laura
well at least shes honest