“Appalachia was among the first places where the malaise of opioid pills hit the nation in the mid-1990s, ensnaring coal miners, loggers, furniture makers,...

“Appalachia was among the first places where the malaise of opioid pills hit the nation in the mid-1990s, ensnaring coal miners, loggers, furniture makers, and their kids.” This is how journalist Beth Macy premises her new book, Dopesick: Dealers, Doctors, and the Drug Company That Addicted America (Little, Brown, & Company, 2018). She then sets out to share a history of how and why this happened.

Macy offers readers a familiar story of industrial exploitation and economic distress in central Appalachia, only, instead of focusing on the coal industry’s role in this history, Macy describes exploitation that resulted from big pharmaceutical companies selling large quantities of prescription opioids in central Appalachia. Building on the work of authors such as Sam Quinones (Dreamland), Anna Lembke (Drug Dealer, MD), and Keith Wailoo (Pain), Macy argues that the sale and use of prescription opioids increased in part after medical professionals began to push the idea that new standards for the assessment and treatment of pain were needed in the 1990s.

The book looks critically not just at the over-prescription of opioids, but, paraphrasing Lembke, Macy also suggests that readers think critically about the “broader American narrative that promotes all pills as a quick fix” (136). As you’ll hear Macy say at the end of the podcast, she wants readers to think about “being better consumers and better listeners who are open to what’s happening on the ground.”


Chelsea Jack is a PhD student in the Anthropology Department at Yale University. She focuses on sociocultural and medical anthropology.

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