Devastating. This is a story of every day horror.
The book lays out in detail the destruction has been wrought to millions (?) of lives, the misery, in the pursuit of ever greater profits. Macy’s research is painstaking, years of meetings with and interviewing hundreds of individuals, going back month after month meeting the same people, watching as some struggle and decline, some as they successfully recover and others as they ‘get clean – relapse – get clean’ in a terrifying cycle. All the while charting the damage to communities, their battles with authority and the indifference of those who really could affect a change.
This is capitalism without a safety net: unleash a supremely addictive product on a weakened, receptive customer base, pay off the people supposed to control it, make sure people in high places are ‘indebted’ (maybe finance their political campaigns, for example) and watch your fortune grow…and ignore the suffering of people already pretty close to the bottom of the pecking order…people who are mortgaging/selling everything their (extended) family has to feed the habit…and ensure dissenting voices are sidelined. Hey presto, you’re one of the richest families in America.
Purdue Pharmaceutical company, under the wing of the Sackler family, celebrated for their sponsorship of art, art galleries, museums and friendship with the British royals, among others; the same Purdue that came up with OxyContin (Brand name for Oxycodene) the latest on long line of increasingly potent opiates used ostensibly to treat pain, especially in end of life, pain-management situations. Instead of confining use of the drug to those scenarios doctors were encouraged to prescribe the drug back up through the pain spectrum for things like wisdom tooth surgery, back pain and bronchitis, and to provide longer scripts: ie doses that were supposed to be taken over a longer period. More and more people exposed to an extremely addictive drug. In a bizarre twist where apparent racism worked in favour on non-white communities, it was found that there was a much lower incidence of OxyContin addiction amongst African Americans living in these same areas because doctors appeared to be less willing to prescribe the longer scripts to this group.
The problem escalated when the supposed ‘controlled release’ aspect of the drug was circumvented and people found they could get all of the dose, intended for a span of 10-12 hours, instantly. This immediacy and potency mixed with massive rural poverty, whole swathes of lost industry, high incidences of disability among the population led the largest drug epidemic in US history, with this drug being the leading cause of death by drug-related means by 2011. All in the name of profit.