In 2012, I began reporting on the heroin epidemic as it landed in the suburbs of Roanoke, Virginia, where I had covered marginalized families for the Roanoke Times for two decades, predominantly those based in the inner city. “An impressive feat of journalism, monumental in scope and urgent in its implications.” - Jennifer Latson, The Boston Globe Read Excerpt

But even in the midst of twin crises in drug abuse and healthcare, Macy finds reason to hope and ample signs of the spirit and tenacity that are helping the countless ordinary people ensnared by addiction build a better future for themselves, their families, and their communities.

In these politically fragmented times, Beth Macy shows that one thing uniting Americans across geographic, partisan, and class lines is opioid drug abuse. Through unsparing, compelling, and unforgettably humane portraits of families and first responders determined to ameliorate this epidemic, each facet of the crisis comes into focus. In some of the same communities featured in her bestselling book Factory Man, the unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death.

From the introduction of Ox圜ontin in 1996, Macy investigates the powerful forces that led America’s doctors and patients to embrace a medical culture where overtreatment with painkillers became the norm. From the labs and marketing departments of big pharma to local doctor’s offices wealthy suburbs to distressed small communities in Central Appalachia from distant cities to once-idyllic farm towns the spread of opioid addiction follows a tortuous trajectory that illustrates how this crisis has persisted for so long and become so firmly entrenched.īeginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, Macy sets out to answer a grieving mother’s question-why her only son died-and comes away with a gripping, unputdownable story of greed and need. In this extraordinary work, Beth Macy takes us into the epicenter of a national drama that has unfolded over two decades.

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