RAISING LAZARUS

Macy follows her consequential book Dopesick with another account of big pharma’s role in killing Americans and of the frontline workers who are trying to save them.

“They say we’re going to lose a generation if we don’t do something. I say we’ve already lost that generation.” So noted a West Virginian while recounting that nearly everyone in her town has been affected by the opioid crisis. Macy hits the small towns of Appalachia and the archives to deliver another damning indictment of the Sackler family, who “willfully created the opioid crisis…a murderous rampage that has victimized hundreds of thousands of people in this country.” Via their company Purdue Pharma, the Sacklers unleashed a flood of OxyContin on the market, bribed doctors to overprescribe it, and then relied on the stigma and shame attached to addiction to ward off lawsuits. When the lawsuits finally arrived, the Sacklers were prepared. “For a quarter century,” writes Macy, “the Sacklers masterminded and micromanaged a relentless marketing campaign for their killer drug, then surgically drained the company of $10 billion when they saw trouble on the horizon.” The Sacklers have since been shamed and stigmatized, their name removed from museum halls and university buildings, but they have been able to keep their money—so far, anyway. Meanwhile, in what Macy calls the “Uneven States of America,” the drug crisis continues to grow, with future substance-dependent people beginning their drug journeys, not ending them, with heroin and fentanyl. Against this epidemic stand health workers, legal reformers, and pioneering judges who have established drug courts to dispense not punishment but treatment. Then there are the conservative politicians from, ironically, the red states most likely to be awash in a flood of drugs, who remain busy “amplifying NIMBYism” to oppose needle exchanges, free clinics, homeless shelters, and other social welfare vehicles for helping the afflicted.

A profoundly disconcerting book that, with luck, will inspire reform to aid the dopesick and punish their suppliers.