9 min · 10 chaptersNarrated in your voice
What it's about
Beth Macy traces how OxyContin, aggressively marketed by Purdue Pharma from 1996 onward, ignited an opioid epidemic that devastated Appalachian mining and mill towns before spreading nationwide. Blending investigative reporting on corporate malfeasance with intimate portraits of addicted families, dealers, and overwhelmed local officials, the book argues that the crisis was manufactured by a company that knew its product was highly addictive and sold it anyway, aided by regulators, doctors, and a justice system slow to respond.
Read a little every day
15 min a day
1 days · done Sat, Oct 31
Read together
Start a circle and share the code — everyone sees everyone's honest place in the book. Accountability, not leaderboards.
Who it's for
- Readers who want to understand how a legal pharmaceutical product became a mass-death drug - Policy makers and healthcare workers grappling with addiction treatment and harm reduction - Anyone with a family member touched by opioid addiction who wants context, not just statistics
What’s inside
- 1The Pill That Started It1 min
Purdue Pharma's 1996 launch of OxyContin succeeded because the company deliberately misrepresented the drug's addiction risk to doctors, not because opioids were suddenly in higher medical demand.
- 2Small Towns, First Casualties1 min
The epidemic hit deindustrialized, rural Appalachian communities first and hardest because economic collapse, physical labor injuries, and thin healthcare infrastructure made them uniquely vulnerable to a predatory marketing strategy.
- 3Purdue's Playbook1 min
Purdue Pharma's internal response to mounting evidence of abuse was strategic denial and legal stonewalling rather than product withdrawal or honest disclosure.
- 4From Pills to Heroin1 min
Law enforcement crackdowns on pill mills and OxyContin's 2010 abuse-deterrent reformulation pushed already-dependent users toward heroin and fentanyl, worsening rather than solving the crisis.
- 5Fighting for Treatment1 min
Effective treatment exists, medication-assisted treatment using buprenorphine or methadone, but stigma and inadequate infrastructure keep it out of reach for most people who need it.
- 6Mothers on the Front Lines1 min
Grassroots advocacy, particularly by mothers who lost children, forced local and state institutions to acknowledge the epidemic when official channels remained slow or defensive.
- 7Courts, Settlements, and Accountability1 min
Legal accountability for Purdue and the Sackler family arrived far too late and remained financially insufficient relative to the scale of harm caused.
About Beth Macy
Beth Macy is a longtime journalist based in Roanoke, Virginia, who spent over two decades covering Appalachia for The Roanoke Times. She reported on the opioid crisis for years before writing Dopesick, drawing on hundreds of interviews with families, doctors, dealers, and law enforcement in the small towns hit earliest and hardest.
