It’s a detailed and compelling account of the spread of opioid addiction across the so-called rust belt, said to be the deadliest drug epidemic in American history. US consumers, writes McGreal, account for 80% of the world’s opioid painkillers...In many ways, McGreal’s book reads like a white-collar The Wire, with a cast of characters determined to exact as much money as possible regardless of the human cost.
McGreal has written an interview-based book, with especially vivid reporting from West Virginia, the state hit hardest by the epidemic. In the little town of Williamson, or Pilliamson as people came to call it, pharmacies were dispensing opioids at a staggering rate both to locals and to out-of-state visitors, who clogged its streets with their cars but boosted some local businesses as well as city tax revenues.
His meticulous research will make uncomfortable reading for the Sackler family, whose US company Purdue Pharma is accused by McGreal of setting off the deadliest drug crisis in history, with 350,000 Americans killed in the past 20 years...This is an engaging, cogently argued book, better than Dopesick despite a surfeit of personal testimonies that can become repetitive.
McGreal casts the net high and wide, finding a health system hijacked by corporations, complicity within the Federal Drug Administration and apathy in Congress towards victims, who are betrayed ‘to protect business interests’. He finds doctors and hospitals that resist Purdue sponsorship, and lawyers who are prepared to fight back. West Virginia attorney general Darrell McGraw filed a civil case against Purdue for aggressively marketing OxyContin, in spite of opposition from the state’s governor, Joe Manchin, and obtained an out of court settlement. But he was persuaded by Manchin not to pursue criminal charges. ‘Why?’ asks McGreal. ‘Now you’re back into politics,’ replies McGraw. Today Manchin is a senator. His wavering vote recently secured the confirmation of Brett Kavanaugh to the Supreme Court.
McGreal’s story is not about individual victims or doctors, though. It is about the “rapacious” drug industry and its “blinkered and compliant” regulators. (If you want your heart rent, read Dopesick by Beth Macy, published in August. She covers much of the same ground as McGreal but, as a journalist based in Roanoke, West Virginia, she feels closer to the heart of the crisis, geographically and emotionally...