“
America’s approach to its opioid problem is to rely on Battle of Dunkirk strategies—leaving the fight to well-meaning citizens, in their fishing vessels and private boats—when what’s really needed to win the war is a full-on Normandy Invasion.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
I'm so dopesick, my tears taste like urine. It's as if the air itself were made of broken glass. I try to stop twitching. To stay still, to stop my very breath, let the pain stay inside. The slightest movement grinds tiny shards into my pores. Breathing is like gulping from a bag of claws. I want to die. Want to pass out. Want to stop...this...fucking...feeling.
”
”
Jerry Stahl (Permanent Midnight)
“
Opioids are now on pace to kill as many Americans in a decade as HIV/AIDS has since it began, with leveling-off projections tenuously predicted in a nebulous, far-off future: sometime after 2020.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Americans, representing 4.4 percent of the world’s population, consume roughly 30 percent of its opioids.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Too many Americans go to too many prisons for far too long and for truly no good law enforcement reason.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
But you can't put a corporation in jail; you just take their money, and it's not really their money anyway.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
This tether that’s meant to attach you to something all your life, be it home or parents or safety, has been flailing around unfastened all this time, tearing at your brain’s roots, whipping around so hard it might take out an eye. All at once, that tether goes still on the floor, and you’re at rest. You start out trying to get back there, and pretty soon you’re just trying to get out of bed. It becomes your job, staving off the dopesickness for another day. Then it becomes your God. Nobody ever wanted to join that church.
”
”
Barbara Kingsolver (Demon Copperhead)
“
If my own child were turning tricks on the streets, enslaved not only by the drug but also criminal dealers and pimps, I would want her to have the benefit of maintenance drugs, even if she sometimes misused them or otherwise figured out how to glean a subtle high from the experience. If my child's fear of dopesickness was so outsized that she refused even MAT, I would want her to have access to clean needles that prevented her from getting HIV and/or hepatitis C and potentially spreading them to others.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Drug overdose had already taken the lives of 300,000 Americans over the past fifteen years, and experts now predicted that 300,000 more would die in only the next five. It is now the leading cause of death for Americans under the age of fifty, killing more people than guns or car accidents, at a rate higher than the HIV epidemic at its peak.
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
The corporation feels no pain.
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”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
When you peer into the country’s most intractable problems—homelessness, disability, domestic violence, child neglect—you see the persistence of dopesickness everywhere.
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”
Beth Macy (Raising Lazarus: Hope, Justice, and the Future of America's Overdose Crisis)
“
The more we talk about the epidemic as an individual disease phenomenon or a moral failing, the easier it is to obfuscate and ignore the social and economic conditions that predispose certain individuals to addiction. The fix isn't more Suboxone or lectures on morality but rather a reinvigorated democracy that provides a pathway for meaningful work, with a living wage, for everybody.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Whatever rules you make, you better stick to them. Your son or daughter depends on it. They will call your bluff on everything. Don't you budge. Changing the rules only confuses a young, developing mind.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
There were leaders here and elsewhere who agreed with the woman, he knew, including an Ohio sheriff who'd recently proposed taking naloxone away from his deputies, claiming that repeated overdose reversals were "sucking the taxpayers dry." Lloyd thought immediately of the answer Jesus gave when his disciple asked him to enumerate the concept of forgiveness. Should it be granted seven times, Peter wanted to know, or should a sinner be forgiven as many as seventy times? In the shadow of the church steeples, Lloyd let Jesus answer the woman's question: "Seventy times seven," he said.
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
The term “hipster,” in fact, drew from the Chinese opium smoker of the 1800s, who’d spent much of his time smoking while reclining on one hip. The hipster counterculture took inspiration from heroin-addicted jazz greats like Charlie Parker and John Coltrane.
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”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
The grueling brutality of the past two weeks’ events, no, the dysfunction of my entire life, all of it had brought me to this moment of supreme lunacy, confusing self-laceration, and pain. I faced a tidal wave of dopesickness that was going to obliterate me.
”
”
Mark Lanegan (Sing Backwards and Weep: A Memoir)
“
No more junk talk, no more lies. No more mornings in the hospital getting bad blood drained out of me. No more doctors trying to analyse what makes me a drug addict. No more futile attempts at trying to control my heroin use. No more defending myself when I know I am practically indefensible. No more police using me as practice. No more ODs, no more losses. No more trying to take an intellectual position on my heroin addiction when it takes more than it gives. No more dope-sick mornings, no more slow suicide, no more pain without end.
No more AA. No more NA. No more mind control. No more being a victim, no more looking for reasons in childhood, in God in anything but what exists in HERE. No more admitting I am powerless.
Down the dusty Los Angeles sidewalks, down the urine stained London back alleys … there goes the connection fading into the crowd like a 1960’s Polaroid.
“Business…?”
“Whachoo need…?”
“Chiva…?
”
”
Tony O'Neill (Digging the Vein)
“
Because there is no love you can throw on them, no hug big enough that will change the power of that drug; it is just beyond imagination how controlling and destructive it is.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
But there is still only one treatment bed available for every five people trying to get into rehab, and at a cost far beyond the financial reach of most heroin users.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Americans, representing 4.4 percent of the world’s population, consume roughly 30 percent of its opioids.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
If we reduced our prison population by twenty-five percent, that’s twenty billion dollars we could save. And if we invested half of that in treatment, we could really increase people’s likelihood of success.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
In a windowless nook of a downtown Roanoke funeral parlor, not far from where Tess once roamed the streets, Patricia caressed the back of the scar, as if cupping a baby's head, and told her poet goodbye. It was January 2, Tess's birthday. She would have been twenty-nine. Patricia tucked the treasures of her daughter's life inside the vest--a picture of her boy and one of his cotton onesies that was Tess's favorite, some strands of Koda's hair, and a sand dollar.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Sober for seven years, Spencer had replaced his heroin and methamphetamine addiction with martial arts even before he’d left for federal prison. The jujitsu practice had sustained him throughout his incarceration—even when his girlfriend dumped him and when his former martial-arts teacher and onetime father figure was arrested and jailed for taking indecent liberties with a teenage female student. Spencer stuck to his recovery and to his prison workouts, ignoring the copious drugs that had been smuggled inside, and he read voraciously about mixed martial arts. Using the Bureau of Prisons’ limited email system, he had Ginger copy articles about various MMA fighters—laboriously pasting in one block of text at a time—so he could memorize pro tips and workout strategies and, eventually, through her, reach out directly to fighters and studio owners for advice.
”
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
The whole system needs revamped,” said Tracey Helton Mitchell, a recovering heroin user, author, and activist. “In the United States, we are very attached to our twelve-step rehabs, which are not affordable, not standardized from one place to another, and not necessarily effective” for the opioid-addicted.
”
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
The latest research on substance use disorder from Harvard Medical School shows it takes the typical opioid-addicted user eight years—and four to five treatment attempts—to achieve remission for just a single year. And yet only about 10 percent of the addicted population manages to get access to care and treatment for a disease that has roughly the same incidence rate as diabetes.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Fewer than one-quarter of heroin addicts who receive abstinence-only counseling and support remain clean two or more years. The recovery rate is higher, roughly 40 to 60 percent, among those who get counseling, support group, and medication-assisted treatment such as methadone, buprenorphine, or naltrexone. “We know from other countries that when people stick with treatment, outcomes can be even better than fifty percent,” Lembke, the addiction specialist, told me. But most people in the United States don’t have access to good opioid-addiction treatment, she said, acknowledging the plethora of cash-only MAT clinics that resemble pill-mill pain clinics as well as rehabs that remain staunchly anti-MAT.
”
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Opioid addiction is a lifelong and typically relapse-filled disease. Forty to 60 percent of addicted opioid users can achieve remission with medication-assisted treatment, according to 2017 statistics, but sustained remission can take as long as ten or more years. Meanwhile, about 4 percent of the opioid-addicted die annually of overdose.
”
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
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.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Being wrong is a gift. We have such a fear of being wrong that we usually cling to a belief in spite of all evidence to the contrary, instead of using it as a growth experience.
”
”
Ryan Homanics (Dopesick: The American Addiction to Heroin and Profit)
“
Stigma was the real enemy of hope for the drug-addicted, Hadden decided. So to tamp it down, she decided her job was to explain the misunderstood science of addiction: Once a person becomes addicted, he loses his power of choice; his free will becomes hijacked along with the opioid receptors in his brain. When a person’s natural opioids are shut down by the deluge of synthetic ones, she told the audience at the community meeting, it creates a growing tolerance to the drug, making the brain crave ever-larger quantities of opioids just to keep from being violently ill.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
There should be meetings in church basements for people like us, virtual personas dopesick on likes, some neglecting, others avoiding, real life. "Catfishers Anonymous" they could call it. But church basements wouldn't cut it, and anonymity is not the point. Hold the meetings in football stadiums. Better yet, stream them on Facebook.
”
”
Bronson Bigelow (LA to LA)
“
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 addiction include poverty, unemployment, multigenerational trauma, and access to drugs.
”
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
A mother's love for her child is like nothing else in the world.
It knows no law, no pity, it dares all things and crushes down remorselessly all that stands in its path.
Agatha Christie, "The Last Seance" (from The Hound of Death and Other Stories)
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
The “respectable” upper- and middle-class opium and morphine addicts having died out, the remaining addicted were reclassified as criminals, not patients.
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”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
What’s funny back there?” the passenger asks.
“Just this situation,” I say. “Two weirdos and a dope-sick girl on a road trip.”
“You’re the fucking weird one, girl.”
“Because you two are the crème de la crème of normalcy, right? Two big dudes playing around in the woods together in the middle of the night.
”
”
Lauren Biel (Along for the Ride (Ride or Die Romances))
“
It is clear to us, and we hope it is clear to the government, that Giuliani would not take an assignment with a company that he felt was acting in an improper way.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
ballyhooed at a time when typical opioid consumers were
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
America will remain a country where getting addicted is far easier than securing treatment.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Portugal, which decriminalized all drugs, including cocaine and heroin, in 2001, adding housing, food, and job assistance—and now has the lowest drug-use rate in the European Union, along with significantly lowered rates of drug-related HIV and overdose deaths. In Portugal, the resources that were once devoted to prosecuting and imprisoning drug addicts were funneled into treatment instead.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
To feed yourself, you’re either going to rob somebody, or you’re going to go back to dealing or prostitution,” Schroeder said. “I’ve been there and done it myself. “The whole thing is designed for you to come back.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
There, jobs and harm-reduction measures are more plentiful, and police divert low-level drug and prostitution offenders who are addicted from prosecution before they’re booked, assisting with housing, case management, and employment services. Such a two-pronged approach not only addresses the need of former drug dealers to find legitimate work but also works to dry up the demand for drug dealing.
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Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Between 1991 and 2010, the number of prescribed stimulants increased tenfold among all ages, with prescriptions for attention-deficit-disorder drugs tripling among school-age children between 1990 and 1995 alone. “And we’re prescribing to ever- and ever-younger children, some kids as young as two years old,” said Lembke, the addiction researcher. “It’s just nuts. Because if we really believe that addiction is a result of changes in the brain due to chronic heavy drug exposure, how can we believe that stimulant exposure isn’t going to change these kids’ brains in a way that makes them more vulnerable to harder drugs?” she added.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Everywhere in America, it was painstaking to walk skeptics through the social, criminal, and medical benefits of helping the least of their brethren, but worth it—even if you had to get your ass kicked.
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”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Until we understand how we reached this place, America will remain a country where getting addicted is far easier than securing treatment.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Three hundred thousand Americans had died of overdose in the past fifteen years, and lacking dramatic interventions, the same number would die in just the next five.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
There should be meeting in church basements for people like us, virtual personas dopesick on likes, some neglecting, others avoiding, real life. "Catfishers Anonymous" they could call it. But church basements wouldn't cut it, and anonymity is not the point. Hold the meetings in football stadiums. Better yet, stream them on Facebook.
”
”
Bronson Bigelow (LA to LA)
“
We need to support this as a chronic disease the same as we support cancer and other diseases
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
An NAS baby is a portrait of dopesickness in miniature: Their limbs are typically clenched as if in agony, their cries high-pitched and inconsolable. They have a hard time latching on to either breast or bottle, and many suffer from diarrhoea and vomiting.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
The fines against Purdue and its executives accounted for about 90 percent of the company’s profits from the time the drug went on the market
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Only one in ten addicted Americans gets any treatment at all for his or her substance use disorder.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Charlie had explained to me once what heroin felt like. He said, “Imagine you’re in pain—the most excruciating pain of your life. Your skin is on fire and your thoughts are agonizing you and any inch of light or movement makes you nauseous. And you’re scared because you don’t know when or if it’s ever going to end.” He was talking about being dope-sick, but I imagined here that he was also talking about the pain of being alive. “But you know that there’s a button somewhere, and all you have to do is press that button, and that pain will vanish. It will just disappear.” He snapped his fingers. “And you will feel warm and safe and completely protected. That button is heroin.” “Jesus,” I said. “I spend every second of every day convincing myself not to press that button, even though I know exactly where it is and how easy it would be to press it, just one more time.
”
”
Hanna Halperin (I Could Live Here Forever)
“
Charlie had explained to me once what heroin felt like. He said, “Imagine you’re in pain—the most excruciating pain of your life. Your skin is on fire and your thoughts are agonizing you and any inch of light or movement makes you nauseous. And you’re scared because you don’t know when or if it’s ever going to end.” He was talking about being dope-sick, but I imagined here that he was also talking about the pain of being alive. “But you know that there’s a button somewhere, and all you have to do is press that button, and that pain will vanish. It will just disappear.” He snapped his fingers. “And you will feel warm and safe and completely protected. That button is heroin.” “Jesus,” I said. “I spend every second of every day convincing myself not to press that button, even though I know exactly where it is and how easy it would be to press it, just one more time.” “It sounds like torture,” I said. Charlie nodded. “For me, heroin is like air.
”
”
Hanna Halperin (I Could Live Here Forever)
“
Zee brought in Yale University substance abuse experts to describe the sudden physical and psychological stress caused by dopesickness, outlining a hard truth that many Americans still fail to grasp: Opioid addiction is a lifelong and typically relapse-filled disease. Forty to 60 percent of addicted opioid users can achieve remission with medication-assisted treatment, according to 2017 statistics, but sustained remission can take as long as ten or more years. Meanwhile, about 4 percent of the opioid-addicted die annually of overdose.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Charlie had explained to me once what heroin felt like. He said, "Imagine you're in pain - the most excruciating pain of your life. Your skin is on fire and your thoughts are agonizing you and any inch of light or movement makes you nauseous. And you're scared because you don't know when or if it's ever going to end." He was talking about being dope-sick, but I imagined here he was also talking about the pain of being alive. "But you know that there's a button somewhere, and all you have to do is press that button, and that pain will vanish. It will just disappear." He snapped his fingers. "And you will feel warm and safe and completely protected. That button is heroine."
"Jesus," I said.
"I spend every second of every day convincing myself not to press that button, even though I know exactly where it is and how easy it would be to press it, just one more time.
”
”
Hanna Halperin (I Could Live Here Forever)
“
The real perfect storm fueling the opioid epidemic had been the collapse of work, followed by the rise in disability and its parallel, pernicious twin: the flood of painkillers pushed by rapacious pharma companies and regulators who approved one opioid pill after another. Declining workforce participation wasn't just a rural problem anymore; it was everywhere, albeit to a lesser degree in areas with physicians who prescribed fewer opioids and higher rates of college graduates. As Monnat put it: "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 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.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Janine realized that barriers to treatment were more formidable than she'd understood, as was the epidemic's scope. It wasn't just the money and limited treatment capacity that waylaid people; it was the morphine-hijacked brain, the scrambled neurotransmitters that kept people from thinking clearly or regulating their pain with nonnarcotic substances, or imagining the possibility of feeling happy again.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
the opioid epidemic began in exactly the opposite manner, grabbing a toehold in isolated Appalachia, Midwestern rust belt counties, and rural Maine.
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”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
You whack one [dealer], and the others just pop right up, like Whac-A-Mole
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”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
He had even written a poem about one, titled “OxyContin,” published in Annals of Internal Medicine: 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. Mama said As hard as it was to bury Papa after the top fell in the mine up Caney Creek, it was harder yet to find Sis that morning cold and blue, with a needle stuck up her arm. Top of her class, with nothing but promise ahead until hi-jacked by the torment of needle and spoon.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
Facing a growing number of lawsuits and investigations, Purdue Pharma heaped praise on its American hero and new political star: “We believe that government officials are more comfortable knowing that Giuliani is advising Purdue Pharma,” Udell gushed in a promotional brochure. “It is clear to us, and we hope it is clear to the government, that Giuliani would not take an assignment with a company that he felt was acting in an improper way.
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)
“
To help burnish its image in the face of so many legal, financial, and public-relations problems, Purdue hired former New York mayor and Republican insider Rudy Giuliani and his consulting firm, Giuliani Partners. Just a few months after his lauded response to the 9/11 terrorist attacks, Giuliani’s job was to convince “public officials they could trust Purdue because they could trust him,
”
”
Beth Macy (Dopesick: Dealers, Doctors, and the Drug Company that Addicted America)