American overdose The opioid tragedy in three acts

Chris McGreal

Book - 2018

Journeying through lives and communities wrecked by the opioid epidemic, McGreal reveals not only how Big Pharma hooked Americans on powerfully addictive drugs, but the corrupting of medicine and public institutions that let the opioid makers get away with it. A few physicians warned of impending disaster, but the forces they were up against-- including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers-- resulted in the resurgence of heroin cartels in the American heartland. McGreal shows how its ruinous consequences will stretch years into the future. -- adapted from jacket.

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Subjects
Published
New York, NY : PublicAffairs [2018]
Language
English
Main Author
Chris McGreal (author)
Edition
First edition
Physical Description
xv, 316 pages ; 25 cm
Bibliography
Includes bibliographical references (pages 299-304) and index.
ISBN
9781610398619
  • Acknowledgments
  • Introduction: An Epidemic Foretold
  • Act I. Dealing
  • Chapter 1. The Undertaker
  • Chapter 2. Junk Science
  • Chapter 3. Pilliamson
  • Chapter 4. The Sales Pitch
  • Chapter 5. What They Knew
  • Chapter 6. Investigation
  • Chapter 7. Vital Sign
  • Act II. Hooked
  • Chapter 8. A Loaded Gun in the Suicide Ward
  • Chapter 9. Paying to Play
  • Chapter 10. Pursuit
  • Chapter 11. The Silence
  • Chapter 12. Pushback
  • Chapter 13. Sounding the Alarm
  • Chapter 14. Kermit
  • Chapter 15. A Free Pass
  • Chapter 16. The End of Days
  • Act III. Withdrawal
  • Chapter 17. The Public Health
  • Chapter 18. Russian Roulette
  • Chapter 19. Dodging Torpedoes
  • Chapter 20. The National Nightmare
  • Chapter 21. Guilt
  • Timeline
  • Notes
  • Index
Review by Booklist Review

*Starred Review* McGreal, an award-winning journalist, presents this grim cautionary tale of opioids, greed, and addiction in three acts: Dealing, Hooked, and Withdrawal. He begins with a real person, Karen Jennings, a former McDonald's manager, who took painkillers to ease her through her recovery from a broken back, and who wound up addicted and on a breadline. McGreal goes on to successfully address the question of how the greatest drug epidemic in history grew largely unchecked for nearly two decades, becoming the leading killer of Americans under age 50. Among other things, McGreal blames misguided doctors and pain specialists, the industry's false claims about the safety and effectiveness of OxyContin, and the failure to heed warnings by alarmed health officials. By 2018, overdoses were claiming more lives in a single year than the number of U.S. soldiers killed in the entire Vietnam War. Victims are everywhere, but especially in West Virginia, where pill mills dispensed opioids and got insurers to pay for them. McGreal paints an unflattering picture of the billionaire Sacklers, the family behind Purdue Pharma, the maker of OxyContin. Their heavily marketed prescription drug so severely hooked users, many continued to feed their habits with illicit drugs, including heroin. What can be done to reverse this? McGreal's powerfully stated indictment is a start.--Karen Springen Copyright 2018 Booklist

From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review

The U.S.'s opioid epidemic stems from slippery medical and corporate ethics, shoddy research, and lax government oversight, journalist McGreal reveals in his incisive debut. Opening with the story of a shady undertaker-turned-pill-purveyor, McGreal takes the reader into clinics that churned out prescriptions for painkillers like assembly-line widgets, rarely requiring follow-up appointments or other checks on patient progress when issuing refills. He tells tales of individuals whose quest for pain relief turned them into addicts and often took their lives, leaving heartbroken family and friends behind and sending thousands of children into foster care. He writes that classism played a role in the reluctance of the FDA to address the crisis; many victims came from low-income areas such as rural West Virginia, and OxyContin became known as "hillbilly heroin." Finally, the book describes in detail how lobbyists for both the pharmaceutical industry and in some cases the medical establishment, who were profiting greatly from the dangerous drugs, thwarted early efforts, in the first years of the 21st century, by doctors and others to sound the alarm to Purdue (OxyContin's manufacturer), the FDA, and the medical establishment. This urgent, readable chronicle, which names names and pulls no punches, clearly and compassionately illuminates the evolution of America's mass addiction problem. Agent: Zoe Pagnamenta, the Zoe Pagnamenta Agency. (Nov.) © Copyright PWxyz, LLC. All rights reserved.

(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review

Award-winning Guardian journalist McGreal traces the trajectory of the American opioid epidemic, and with dire conclusions. Avarice, corporate corruption, government malfeasance, and a sustained campaign of misinformation on the part of major pharmaceutical companies have all played roles in exacerbating a crisis that has claimed the lives of hundreds of thousands of people. The author interviews those who have both propagated the crisis and been victimized by it, centering his reporting on West Virginia, which, owing to an impoverished populace and a lack of well-trained physicians, is considered ground zero for the opioid epidemic. After doctors were given carte blanche in the 1990s to prescribe opioids such as Oxycontin for pain, "pill mills" began to proliferate. Patients became addicted and eventually turned to fentanyl and heroin. Efforts by some members of Congress and victims' families to lobby on behalf of more drug regulation and stricter FDA control were ignored. Ultimately, and at every level, greed has fueled the fires of this ongoing tragedy. VERDICT Although McGreal treads the same ground as Beth Macy in Dopesick: Dealers, Doctors, and the Drug Company That Addicted America (a 2018 LJ Best Book), she offers here a brisk, persuasive, and sobering account of an epidemic that is unlikely to abate any time soon.-­Barrie Olmstead, Lewiston P.L., ID © Copyright 2019. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review

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 epidemicusers, suppliers, family members, and othersbut 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 companiesespecially OxyContin manufacturer Purdueand 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. Copyright Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.