Kirkus Star


The Opioid Tragedy in Three Acts
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A deftly researched account of America’s opioid epidemic.

Guardian reporter McGreal’s book is authoritative in tone and vernacular in style. He introduces us to the voices of the epidemic—users, suppliers, family members, and others—but also to its antecedents in both medicine and drug policy. “At the time,” he writes, describing the 1970s, “American doctors regarded morphine with suspicion to the point of hostility. Whatever its qualities as a painkiller, it was regarded as so addictive and life destroying that the medical profession refused to countenance its use even for the dying.” The author’s powerful narrative has deep roots in history. In 1908, Theodore Roosevelt appointed the United States’ first opium commissioner, “who described Americans as ‘the greatest drugs fiends in the world.’ ” Then, in the 1980s, doctors began to look at the benefits of opioids in palliative care. Many of those physicians were “cavalier” in their research; some of the most disturbing testimony here comes from them, especially juxtaposed against the families that have been destroyed. The real villains, though, are the pharmaceutical companies—especially OxyContin manufacturer Purdue—and the doctors and politicians who abet them. At one point, McGreal cites a West Virginia legislator who, in the early 2000s, told the state attorney general that “one of the federal prisons was having to send a bus to pick up guards out of state because it couldn’t find enough people locally who could pass a drug test.” Even so, drug lobbyists did their best to shut down regulations. By 2009, “prescription opioid deaths…[were] three times the number of a decade earlier.” The numbers are staggering, and the author doesn’t offer a lot of hope for change. “What’s going on now is a maturing of the epidemic,” a former Food and Drug Administration official reports. “People are addicted, and that means they’re going to keep needing it. It’s going to be years that they stay on it until they finally get over it. If they don’t get killed.”

A well-rendered, harrowing book about dire circumstances.

Pub Date: Nov. 13th, 2018
ISBN: 978-1-61039-861-9
Page count: 336pp
Publisher: PublicAffairs
Review Posted Online:
Kirkus Reviews Issue: Oct. 15th, 2018


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