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American Overdose
'A riveting and urgent reckoning of colossal corruption.' - Philip Gourevitch
One hundred and fifty Americans are killed each day by the opioid epidemic, described by a former head of the Food and Drug Administration as 'one of the greatest mistakes of modern medicine'. But as Chris McGreal reveals in American Overdose, it was an avoidable tragedy driven by bad science, corporate greed and a corrupted medical system.
In a narrative brimming with the guilty, the victims and the unlikely heroes, Chris McGreal travels from West Virginia 'pill mills' to the corridors of Washington DC as he unravels the story of Big Pharma's hijacking of American healthcare and politics to push mass prescribing of 'heroin in a pill'.
He meets the police and FBI agents who struggled to get prosecutors to go after doctors they called 'drug dealers in white coats'; the families devastated by painkillers they thought would heal, not kill; and the physicians and scientists who took on the drug companies behind the epidemic. The result is an immensely powerful account of the terrible human cost of the crisis, and a stark warning of the consequences of a healthcare system run as a business, not a service.
One hundred and fifty Americans are killed each day by the opioid epidemic, described by a former head of the Food and Drug Administration as 'one of the greatest mistakes of modern medicine'. But as Chris McGreal reveals in American Overdose, it was an avoidable tragedy driven by bad science, corporate greed and a corrupted medical system.
In a narrative brimming with the guilty, the victims and the unlikely heroes, Chris McGreal travels from West Virginia 'pill mills' to the corridors of Washington DC as he unravels the story of Big Pharma's hijacking of American healthcare and politics to push mass prescribing of 'heroin in a pill'.
He meets the police and FBI agents who struggled to get prosecutors to go after doctors they called 'drug dealers in white coats'; the families devastated by painkillers they thought would heal, not kill; and the physicians and scientists who took on the drug companies behind the epidemic. The result is an immensely powerful account of the terrible human cost of the crisis, and a stark warning of the consequences of a healthcare system run as a business, not a service.
316 pages, Paperback
First published November 13, 2018
242 people are currently reading
6032 people want to read
About the author
Chris McGreal
3 books40 followersChris McGreal is a reporter for the Guardian. A former correspondent in Johannesburg, Jerusalem and Washington DC, he now writes from across the United States.
He has won awards for his reporting of the Rwandan genocide, Israel/Palestine, and on the impact of economic recession in America. He received the James Cameron prize for "work as a journalist that has combined moral vision and professional integrity". He was awarded the Martha Gellhorn Prize for Journalism for reporting that "penetrated the established version of events and told an unpalatable truth".
He is a former merchant seaman.
He has won awards for his reporting of the Rwandan genocide, Israel/Palestine, and on the impact of economic recession in America. He received the James Cameron prize for "work as a journalist that has combined moral vision and professional integrity". He was awarded the Martha Gellhorn Prize for Journalism for reporting that "penetrated the established version of events and told an unpalatable truth".
He is a former merchant seaman.
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Displaying 1 - 30 of 303 reviews
August 29, 2018
4.5 stars
(In 2012) "Doctors write more than 250 million prescriptions for opioids, enough to provide a bottle to every adult in America. The United States consumes more than 80 percent of the world's prescription narcotics."
- Scary, Scary statistic. That was 2012.
***Please note the information I received from the Author after writing my review. The below information concerns levels today. The new updated information will be included in the final proof of the book!:
"Around 200 million-plus opioid prescriptions were written in 2016 in the US, which is about one for every adult, although many of those prescriptions will be for fewer tablets (three or five days instead of 10 or 14 days). Also, within that there are huge disparities by state, and within those states by town and city. But Americans still use opioid painkillers at four times the rate of the UK or France, and the CDC thinks levels remain way too high."
This was a pretty scary book. The statistics were staggering. While reading this book, I highlighted huge sections as I was blown away with the information. The Author points out how "the opioid epidemic is the deadliest drug crisis in American history; it results in 90 American deaths a day and has eviscerated communities across the country."
"The Crude calculation is that prescription pain pills have claimed more than a quarter of a million of American lives."
This book is told in three acts which highlight how Opioid use and addiction came to be. In the first section, the book examines how healthcare in the U.S. is run like a business where pharmaceutical companies profit off the pain and suffering of patients, how the policies are not strict enough and the FDA was complicit in the matter. The second section of the book, addiction is addressed. In the third section of the book, drug cartels are examined and how they exploited the market for addiction.
"For years, American doctors wrote more than a quarter-million opioid prescriptions. As Congressman Harold "Hal" Rogers put it, "That's enough painkillers to medicate every American adult around the clock for a month."
The Author writes this book using staggering statistics but also shares stories ranging from addicts, doctors, family members and those in the pharmaceutical industry. Addiction has been around for a very long time. In the "1880's, more than half of those hooked on the drug (morphine) were middle and upper class white women." Cough syrups, especially those for children and teething syrups contained morphine, cannabis and alcohol. There were no regulations back then and people could use as much as they see fit.
Pain is a part of people's lives. There are those who work very physically demanding jobs which leave them in pain day after day i.e. dancers, farmers, miners, construction workers, those in the timber industry to name a few. Painkillers help them to ease the pain, recover from injury and be able to do their job day after day. That is not to mention those who require surgery and are prescribed painkillers during their healing process. But what happens when addiction occurs? What happens when clinics pop up where an individual can pay $250.00 to see a doctor to be diagnosed with an injury so that he/she can obtain a prescription to Oxycodone? When all one needs to do is come back month after month and hand the receptionist another $250.00 and you will be given another prescription no questions asked? Shocking that such places exist.
Who is to blame for the addiction to painkillers? Prescription drug manufacturers, such as Purdue, who send out drug reps to give gifts to doctors’ offices in the form of coffee mugs, pens, food, etc., so that they can talk to the doctor about prescribing oxycodone or other medications. Are they to blame? The book states how "Purdue threw out unprecedented amounts of money into promoting Oxycontin, spending several times the advertising budgets of rivals." Are doctors to blame for prescribing or over prescribing opiates, is the FDA to blame for not having more strict rules and regulations, are addicts to blame? What can be done? What is being done?
Whoever is to blame, it is scary how addiction to prescription drugs is skyrocketing. Turn on the news and there are reports of police officers and paramedics entering homes and finding children with an unconscious or deceased parent due to overdose. It's also happening in parked cars and parks as well. Is there a solution? I don't know. Pain exists, and we need treatment for it, but where do we draw the line?
This book was educational well written. Extremely well researched and laid out. The old "Knowledge is power" saying applies here. I do believe that doctors and health care providers are cracking down on what is prescribed. Some prescriptions require that an individual show a driver’s license or some form of identification when you pick up your prescriptions. But again, there are drug cartels who can and do sell the drugs on the street. It's scary. This book just addresses the opioid epidemic. There are more out there. Last year, I received a call form my son’s school. A student found his parents edibles and thought they were candy and brought them in to share with friends. Several kids were rushed to the hospital after consuming them. Anyone see the news where a young boy died when he was hungry and mistook his father’s Meth for cereal? So many frightening things going on with drugs and drug addiction. Is there a solution? What is the solution?
Thank you to Perseus Books, Public Affairs and NetGalley who provided me with a copy of this book in exchange for an honest review. All the thoughts and opinions expressed in this review are my own.
Read more of my reviews at www.openbookpost.com
(In 2012) "Doctors write more than 250 million prescriptions for opioids, enough to provide a bottle to every adult in America. The United States consumes more than 80 percent of the world's prescription narcotics."
- Scary, Scary statistic. That was 2012.
***Please note the information I received from the Author after writing my review. The below information concerns levels today. The new updated information will be included in the final proof of the book!:
"Around 200 million-plus opioid prescriptions were written in 2016 in the US, which is about one for every adult, although many of those prescriptions will be for fewer tablets (three or five days instead of 10 or 14 days). Also, within that there are huge disparities by state, and within those states by town and city. But Americans still use opioid painkillers at four times the rate of the UK or France, and the CDC thinks levels remain way too high."
This was a pretty scary book. The statistics were staggering. While reading this book, I highlighted huge sections as I was blown away with the information. The Author points out how "the opioid epidemic is the deadliest drug crisis in American history; it results in 90 American deaths a day and has eviscerated communities across the country."
"The Crude calculation is that prescription pain pills have claimed more than a quarter of a million of American lives."
This book is told in three acts which highlight how Opioid use and addiction came to be. In the first section, the book examines how healthcare in the U.S. is run like a business where pharmaceutical companies profit off the pain and suffering of patients, how the policies are not strict enough and the FDA was complicit in the matter. The second section of the book, addiction is addressed. In the third section of the book, drug cartels are examined and how they exploited the market for addiction.
"For years, American doctors wrote more than a quarter-million opioid prescriptions. As Congressman Harold "Hal" Rogers put it, "That's enough painkillers to medicate every American adult around the clock for a month."
The Author writes this book using staggering statistics but also shares stories ranging from addicts, doctors, family members and those in the pharmaceutical industry. Addiction has been around for a very long time. In the "1880's, more than half of those hooked on the drug (morphine) were middle and upper class white women." Cough syrups, especially those for children and teething syrups contained morphine, cannabis and alcohol. There were no regulations back then and people could use as much as they see fit.
Pain is a part of people's lives. There are those who work very physically demanding jobs which leave them in pain day after day i.e. dancers, farmers, miners, construction workers, those in the timber industry to name a few. Painkillers help them to ease the pain, recover from injury and be able to do their job day after day. That is not to mention those who require surgery and are prescribed painkillers during their healing process. But what happens when addiction occurs? What happens when clinics pop up where an individual can pay $250.00 to see a doctor to be diagnosed with an injury so that he/she can obtain a prescription to Oxycodone? When all one needs to do is come back month after month and hand the receptionist another $250.00 and you will be given another prescription no questions asked? Shocking that such places exist.
Who is to blame for the addiction to painkillers? Prescription drug manufacturers, such as Purdue, who send out drug reps to give gifts to doctors’ offices in the form of coffee mugs, pens, food, etc., so that they can talk to the doctor about prescribing oxycodone or other medications. Are they to blame? The book states how "Purdue threw out unprecedented amounts of money into promoting Oxycontin, spending several times the advertising budgets of rivals." Are doctors to blame for prescribing or over prescribing opiates, is the FDA to blame for not having more strict rules and regulations, are addicts to blame? What can be done? What is being done?
Whoever is to blame, it is scary how addiction to prescription drugs is skyrocketing. Turn on the news and there are reports of police officers and paramedics entering homes and finding children with an unconscious or deceased parent due to overdose. It's also happening in parked cars and parks as well. Is there a solution? I don't know. Pain exists, and we need treatment for it, but where do we draw the line?
This book was educational well written. Extremely well researched and laid out. The old "Knowledge is power" saying applies here. I do believe that doctors and health care providers are cracking down on what is prescribed. Some prescriptions require that an individual show a driver’s license or some form of identification when you pick up your prescriptions. But again, there are drug cartels who can and do sell the drugs on the street. It's scary. This book just addresses the opioid epidemic. There are more out there. Last year, I received a call form my son’s school. A student found his parents edibles and thought they were candy and brought them in to share with friends. Several kids were rushed to the hospital after consuming them. Anyone see the news where a young boy died when he was hungry and mistook his father’s Meth for cereal? So many frightening things going on with drugs and drug addiction. Is there a solution? What is the solution?
Thank you to Perseus Books, Public Affairs and NetGalley who provided me with a copy of this book in exchange for an honest review. All the thoughts and opinions expressed in this review are my own.
Read more of my reviews at www.openbookpost.com
September 15, 2018
Unconsciousable, if there is one word I would use to describe the greed I read about in this book, this would be the word. One would have to be completely out of touch to have not heard on the news, or read in the papers, about the opoid epidemic striking our nation. Untold deaths, families, lives ruined. A documentary about West Virginia, which was literally a opoid mill, was shown a few months back, towns completely taken over by addiction. What I didn't realize was how this was accomplished. A literal pill mill.
This book explains how this happened, how it was allowed to happen. The greed of drug companies, basically pushing to doctors, what they tooted as the newest pill in pain relief, from cooked doctors, clinics, and pharmscies. Taking advantage of the pain those with injuries or previous trauma experienced,to addict them to a pill that they needed more and more of I increasing dosages. Hard to believe this is happening in my country, but it is and it is deplorable.
So many lives ruined, even those who had seen this becoming a problem seen what it did to people, find themselves after an accidental addicted. This book explains in three separate sections how this was done, how greed and the love of money, addicted so many. A very important read and one that is easy to read but explains things very well.
ARC from Netgalley.
This book explains how this happened, how it was allowed to happen. The greed of drug companies, basically pushing to doctors, what they tooted as the newest pill in pain relief, from cooked doctors, clinics, and pharmscies. Taking advantage of the pain those with injuries or previous trauma experienced,to addict them to a pill that they needed more and more of I increasing dosages. Hard to believe this is happening in my country, but it is and it is deplorable.
So many lives ruined, even those who had seen this becoming a problem seen what it did to people, find themselves after an accidental addicted. This book explains in three separate sections how this was done, how greed and the love of money, addicted so many. A very important read and one that is easy to read but explains things very well.
ARC from Netgalley.
November 26, 2018
American Overdose: The Opioid Tragedy in Three Acts (2018) is a devastating and shocking expose of the chain of events that defines the worst drug epidemic in American history, authored by notable journalist for the Guardian Chris McGreal. As ordinary American’s use and abuse substance, suppliers/dealers of illicit drugs were included in the same category as the wellness clinics, “pill mills” (of West Virginia, North Carolina, Ohio, Florida) and the doctor’s that prescribed “astronomical” amounts of opioid’s--while keeping poor records, phoning in prescriptions, with few questions and/or never meeting patients. The chain continued up, the pharmacies that received and filled orders dispensing millions of pills without question or notifying authorities; the pharmaceutical industry responsible for the manufacture and peddling of pills in the “Disease of Despair” realizing billions of dollars in sales and profits. There were “user friendly policies and procedures” needed to keep the lucrative gravy train rolling— enter Big Pharma’s buddies in the FDA, lobbyists, experts in the medical field, and the shameless politicians that received millions of dollars in campaign donations supporting the greedy agenda of the pharmaceutical industry (names were included)! The connection of these forces that conspired together with too many government officials and policy makers looking the other way, have created a corrupt for profit medical industry that dangerously fails to serve the American people in a responsible accountable manner.
According to McGreal and other investigative journalists including Beth Macy with her informative book “Dopesick” (2018) many northeastern cities and the American Appalachia were seemingly targeted and hardest hit in this unfolding tragedy. By 2005, Big Pharma had spent billions in marketing direct to consumer advertising and education—as patients self-diagnosed and demanded prescription medication. It is now known that the probability of addiction was discounted and downplayed as “The Balanced Approach” was aggressively promoted by industry executives: suggesting the FDA make opioid’s available without restriction, and went as far to copyright “pain” as the 5th vital sign. The Veteran’s Administration was the first to accept this (outrageous) policy.
The Balanced Approach also separated “good patients” who were the real “victims” suffering pain and in dire need of treatment. Big Pharma would always deflect their responsibility and role for the drug epidemic— shifting the blame of addiction solely on the individual user rather than the drug that caused it.
Over a decade later, smug industry executives would claim that “playing the blame game would not end the epidemic.” In hearings pharma executives were blasted as “offensive” by West Virginia Rep. David McKinley (GOP) for flooding a local Mingo County pharmacy with 5.6 million opioid pills in a two year period. By this time, individual doctors and pharmacists had already been charged, medical licenses revoked, some were serving prison sentences. McKission paid a 150 million fine for failure to report suspicious drug shipments. However, with billions a year in profits the fine was labeled as merely the cost of doing business.
The accountability of Big Pharma executives continued at an all-time low for their role in the drug epidemic that led to drug related deaths of over 72,000 Americans (2017). While McGreal doesn’t offer solutions to the vast problems created by the epidemic, his book offers an urgent message related to education and understanding of powerful forces that shape American society and medical structure; and the lasting profound impact on humanity. ** With thanks and appreciation to Hachette Book Group via NetGalley for the DDC for the purpose of review
According to McGreal and other investigative journalists including Beth Macy with her informative book “Dopesick” (2018) many northeastern cities and the American Appalachia were seemingly targeted and hardest hit in this unfolding tragedy. By 2005, Big Pharma had spent billions in marketing direct to consumer advertising and education—as patients self-diagnosed and demanded prescription medication. It is now known that the probability of addiction was discounted and downplayed as “The Balanced Approach” was aggressively promoted by industry executives: suggesting the FDA make opioid’s available without restriction, and went as far to copyright “pain” as the 5th vital sign. The Veteran’s Administration was the first to accept this (outrageous) policy.
The Balanced Approach also separated “good patients” who were the real “victims” suffering pain and in dire need of treatment. Big Pharma would always deflect their responsibility and role for the drug epidemic— shifting the blame of addiction solely on the individual user rather than the drug that caused it.
Over a decade later, smug industry executives would claim that “playing the blame game would not end the epidemic.” In hearings pharma executives were blasted as “offensive” by West Virginia Rep. David McKinley (GOP) for flooding a local Mingo County pharmacy with 5.6 million opioid pills in a two year period. By this time, individual doctors and pharmacists had already been charged, medical licenses revoked, some were serving prison sentences. McKission paid a 150 million fine for failure to report suspicious drug shipments. However, with billions a year in profits the fine was labeled as merely the cost of doing business.
The accountability of Big Pharma executives continued at an all-time low for their role in the drug epidemic that led to drug related deaths of over 72,000 Americans (2017). While McGreal doesn’t offer solutions to the vast problems created by the epidemic, his book offers an urgent message related to education and understanding of powerful forces that shape American society and medical structure; and the lasting profound impact on humanity. ** With thanks and appreciation to Hachette Book Group via NetGalley for the DDC for the purpose of review
April 29, 2019
This is a very informative book on the opioid crisis in the US. Had I not recently read another, I'm sure I would have rated this 5 stars. However, there was a lot of overlap with the other book Dopesick: Dealers, Doctors, and the Drug Company that Addicted America and I found myself bored part of the time with this one. If you're looking for a book on the crisis, I recommend American Overdose more than the other. It's very well-researched and written and contains much more information than the other.
December 27, 2018
I was riveted by this account of the start and spread of the opioid epidemic and how it has helped fuel the rise of heroin and fentanyl. McGreal deftly deals with the complicated mix of players from the pharma companies to unscrupulous physicians, corrupt police and politicians, and failed government oversight. He highlights the hazards of a government that bends more to corporate interests instead of protecting the public health. A fascinating read.
February 20, 2019
3.5 Stars
If you want to be infuriated with pharmaceutical companies, the government, and doctors, then read this book. The blatant way that they ignore or twist data and warnings and succumb to greed is largely the reason there’s an opioid epidemic in America. Those few doctors who stood up to them (and their patients) and pointed out the harm and addictiveness of opioids were quickly dismissed and sometimes had active smear campaigns against them. This book looks largely at the crisis in W. Virginia and takes you pretty much to present.
If you want to be infuriated with pharmaceutical companies, the government, and doctors, then read this book. The blatant way that they ignore or twist data and warnings and succumb to greed is largely the reason there’s an opioid epidemic in America. Those few doctors who stood up to them (and their patients) and pointed out the harm and addictiveness of opioids were quickly dismissed and sometimes had active smear campaigns against them. This book looks largely at the crisis in W. Virginia and takes you pretty much to present.
February 23, 2020
Every time I read anything on the topic, I get furiously, uncontrollably angry. This book is fairly new (2018?) and already feels out of date. The war rages on with no end in sight. Sure, Purdue Pharma and Sacklers have been forced to account for their sins, but their billions are safe and secure. And the failure on the part of our government to address the issue in the face of the obvious is truly disheartening.
July 30, 2018
Interesting and illuminating do not even come close to describing this book! This is the devastating narrative of how the opiate crisis came to pass in America. Written in a unique, comprehensive and educational manner, I found myself wishing that this book was a reading requirement for all high school students to help them avoid the pitfalls of the current addiction culture. I then found myself wishing it was a requirement for ALL Americans to read. Several years ago an individual remarked to me that soon not a person on the US would be left untouched by the opiate crisis. She insisted that soon everyone would have a friend or family member suffering from addiction. I remember thinking that this woman was quite mistaken. Three years on, I believe her prediction has come to pass.
In American Overdose, Chris McGreal sets the framework for what would lead to arguably the biggest addiction crisis in America, founded on misguided policies, trust, corruption, booming profits and, of course, big pharma. Have other authors tackled this same topic? Sure; but not with the finesse and meticulousness of Chris McGreal. This book not only provides the “hows” and “whys” behind the crisis, it also provides up-close and personal glimpses into the lives of real people affected by pill mills, dishonorable doctors and a healthcare system off its tracks. Gripping, enthralling and informative. I rate this book a solid five stars.
In American Overdose, Chris McGreal sets the framework for what would lead to arguably the biggest addiction crisis in America, founded on misguided policies, trust, corruption, booming profits and, of course, big pharma. Have other authors tackled this same topic? Sure; but not with the finesse and meticulousness of Chris McGreal. This book not only provides the “hows” and “whys” behind the crisis, it also provides up-close and personal glimpses into the lives of real people affected by pill mills, dishonorable doctors and a healthcare system off its tracks. Gripping, enthralling and informative. I rate this book a solid five stars.
June 29, 2019
A book that stars my least favourite people - drug companies, corrupt/lazy/dumb government officials and greedy people. I was hoping there would be an ending of some hope but instead the drugs keep on coming, the doctors keep prescribing, people find ways around any laws or regulations and the users die, go broke, or go to jail.
As a book it is well researched but I found the structure a little repetitive and the writing a little devoid of empathy. Maybe the author was just hollowed out after seeing all the tragedy.
The opioid crisis seems to be a symptom of America the broken nation.
As a book it is well researched but I found the structure a little repetitive and the writing a little devoid of empathy. Maybe the author was just hollowed out after seeing all the tragedy.
The opioid crisis seems to be a symptom of America the broken nation.
November 22, 2020
American Overdose documents the tragedy that is the Opioid Crisis in America.
I do not think anybody debates the issue---during the early part of the 21st century, opioids became the leading cause of death in America. For a period, opioids contributed to more deaths than guns, car accidents, heart disease, etc.
But how did this happen?
Let’s keep it simple, many of the players who kept the tobacco industry alive re-appear in this book.
Pharmacies had a vested interest in selling the drug. Doctors had a vested interest in selling the drug.
Doctors and 'Pain Clinics' literally made millions in prescribing opioids. Some doctors supposedly saw hundreds of patients a day---and prescribed maximum dosages to these patients. Certain clinics prescribed millions of pills in clinics in communities with a few thousand people. People literally travelled to these drug dealers, I mean clinics on a weekly basis to get new prescriptions.
The CDC tried to fight it---but was scorned by big pharma and politicians. The FDA, whose jurisdication it fell, refused to do anything. The DEA didn't want to act because it didn't want to impede upon the 'practice of medicine.'
Thus, there were literally no guidelines or regulations affecting what types of medicines or how much a doctor could prescribe. Opiods were legal. Certain clincs in West Virginia, Florida, and Kentucky literally garnered loyal clients who were willing to pay cash (or sex) to doctors who prescribed pain medicines to them.
Most of these doctors who were punished, were not convicted of medical crimes, but of money laundering or tax evasion.
Doctors argued for the freedom to "practice" as they saw fit. Law enforcement was reluctant to prosecute doctors who clearly pushed decency because the doctore MIGHT be acting benign and prescribing from a good intent.
Again, the drugs were legal, so it was a short coming of the victim, I mean patient, if they became addicted or it ruined their life---then it was the victim's fault.
Fast forward to 2020... many of these same arguments have been made over the past few months from "America's Frontline Doctors" and "Association of American Physicians and Surgeons". Both of these groups argue against government oversight and believe that the individual doctor knows best. That the individual doctor, by definition, has the patients best interests in mind and should be free to prescribe whatever medicine they wish in whatever quantity they wish.
These doctors, who constitute an extremely small number of medical professionals, have captured the attention of right wing media and President Trump who advocate the use of experimental or unproven techniques for the treatment of COVID.
Just as certain clinics became known during the Opiod heyday, these doctors would profit by offering solutions to which people would travel across the country for their prescriptions.
I could not read the stories about opiod clinics and not think about doctors prescribing HCQ as a magical cure-all.
I also wondered how much of the war against the CDC over the past year stemmed from opioid proponents extracting revenge?
I do not think anybody debates the issue---during the early part of the 21st century, opioids became the leading cause of death in America. For a period, opioids contributed to more deaths than guns, car accidents, heart disease, etc.
But how did this happen?
Let’s keep it simple, many of the players who kept the tobacco industry alive re-appear in this book.
Pharmacies had a vested interest in selling the drug. Doctors had a vested interest in selling the drug.
Doctors and 'Pain Clinics' literally made millions in prescribing opioids. Some doctors supposedly saw hundreds of patients a day---and prescribed maximum dosages to these patients. Certain clinics prescribed millions of pills in clinics in communities with a few thousand people. People literally travelled to these drug dealers, I mean clinics on a weekly basis to get new prescriptions.
The CDC tried to fight it---but was scorned by big pharma and politicians. The FDA, whose jurisdication it fell, refused to do anything. The DEA didn't want to act because it didn't want to impede upon the 'practice of medicine.'
Thus, there were literally no guidelines or regulations affecting what types of medicines or how much a doctor could prescribe. Opiods were legal. Certain clincs in West Virginia, Florida, and Kentucky literally garnered loyal clients who were willing to pay cash (or sex) to doctors who prescribed pain medicines to them.
Most of these doctors who were punished, were not convicted of medical crimes, but of money laundering or tax evasion.
Doctors argued for the freedom to "practice" as they saw fit. Law enforcement was reluctant to prosecute doctors who clearly pushed decency because the doctore MIGHT be acting benign and prescribing from a good intent.
Again, the drugs were legal, so it was a short coming of the victim, I mean patient, if they became addicted or it ruined their life---then it was the victim's fault.
Fast forward to 2020... many of these same arguments have been made over the past few months from "America's Frontline Doctors" and "Association of American Physicians and Surgeons". Both of these groups argue against government oversight and believe that the individual doctor knows best. That the individual doctor, by definition, has the patients best interests in mind and should be free to prescribe whatever medicine they wish in whatever quantity they wish.
These doctors, who constitute an extremely small number of medical professionals, have captured the attention of right wing media and President Trump who advocate the use of experimental or unproven techniques for the treatment of COVID.
Just as certain clinics became known during the Opiod heyday, these doctors would profit by offering solutions to which people would travel across the country for their prescriptions.
I could not read the stories about opiod clinics and not think about doctors prescribing HCQ as a magical cure-all.
I also wondered how much of the war against the CDC over the past year stemmed from opioid proponents extracting revenge?
February 14, 2019
I read this book to help understand this question-"How was the greatest drug epidemic in American history allowed to grow virtually unchecked for nearly two decades with no end in sight?" Epidemic sounds like fear mongering but when the word is right, we must use it. More people dying of opioid overdose than car crashes!?!
Turns out there's lots of blame to go around. Apparently that old adage "follow the money" still works "Nine out of ten members of the House of Representatives and all but a handful of US Senators have taken campaign contributions from drug manufacturers..". Big fails by Federal Agencies tasked with public welfare as well as physicians unwilling to accept extra education and oversight. Upsetting and infuriating. Also as a proud Purdue Univ. graduate, I'm sad that the worst provider , Purdue Pharm (no relation to the University) is mentioned like every other page
Turns out there's lots of blame to go around. Apparently that old adage "follow the money" still works "Nine out of ten members of the House of Representatives and all but a handful of US Senators have taken campaign contributions from drug manufacturers..". Big fails by Federal Agencies tasked with public welfare as well as physicians unwilling to accept extra education and oversight. Upsetting and infuriating. Also as a proud Purdue Univ. graduate, I'm sad that the worst provider , Purdue Pharm (no relation to the University) is mentioned like every other page
July 30, 2018
A received an ARC of this book via NetGalley in exchange for my honest opinion.
A fascinating read about how the opioid epidemic arose. Through meticulous research, McGreal is about to identify the various factors and individuals responsible for this epidemic. McGreal explores the epidemic from all angles, and presents perfect representation of each subject and how it contributed to the epidemic. Even those readers already well versed in this subject will gain a greater knowledge of the opioid epidemic. Greed, corruption, hubris, ineptitude, denial, and deceit all contribute to the crisis we are facing today. Much of this crisis could have been avoided, or at a minimum, reduced, but now much of the damage has been done, and reversing these trends will not be an easy task. This is a must read for anyone with at least a passing interest in the opioid crisis in America wanting to gain a greater understanding of its inception.
A fascinating read about how the opioid epidemic arose. Through meticulous research, McGreal is about to identify the various factors and individuals responsible for this epidemic. McGreal explores the epidemic from all angles, and presents perfect representation of each subject and how it contributed to the epidemic. Even those readers already well versed in this subject will gain a greater knowledge of the opioid epidemic. Greed, corruption, hubris, ineptitude, denial, and deceit all contribute to the crisis we are facing today. Much of this crisis could have been avoided, or at a minimum, reduced, but now much of the damage has been done, and reversing these trends will not be an easy task. This is a must read for anyone with at least a passing interest in the opioid crisis in America wanting to gain a greater understanding of its inception.
June 16, 2022
A hard-hitting look at the opioid epidemic that big pharmaceutical companies, primarily Purdue Pharma, pushed on the country starting in the 1990s in Appalachia. When patients got addicted to OxyContin, many moved on to street heroin and now, lately, fentanyl, which is an artificial, highly concentrated opiate that is killing a lot of people.
This is an American tragedy, as Americans consume 80% of the world's opioids. I saw a documentary about this but the book is more complete.
Highly recommended!
This is an American tragedy, as Americans consume 80% of the world's opioids. I saw a documentary about this but the book is more complete.
Highly recommended!
September 10, 2020
Wow- this book contains tons of information and has blown my mind. I know greed is bad- but holy cow is it intentional and intense. I've heard/seen a lot of this information on TV, New Amsterdam, CSI, & Claws come to mind.
September 30, 2019
Excellent reporting. The title is misleading however insofar as what this book demonstrates is that the opioid epidemic is not so much a tragedy (sad but unavoidable fate) but a completely preventable, deliberate crime with one main culprit and many co-conspirators with varying degrees of responsibility. Appalling and gripping story of corruption and incompetence.
I liked this much better than the recent Dopesick: Dealers, Doctors, and the Drug Company that Addicted America, which focused more on the emotional impact on victims, vs. the underlying preventable causes.
I liked this much better than the recent Dopesick: Dealers, Doctors, and the Drug Company that Addicted America, which focused more on the emotional impact on victims, vs. the underlying preventable causes.
April 6, 2024
As someone who has read a lot on this topic, there wasn't a lot new here, but if you want straight-forward, just the facts, Opioid Crisis 101, you won't go wrong with this book. It has a little of everything: the Saklers, pill mills, the prescription pills to heroin to fentanyl path, crooked doctors, frustrated doctors, greed, grieving families, not-our-fault distributors, small West Virginia towns selling more pills than big cities, missed opportunities, political influence, investigations...
November 1, 2018
OxyContin: “Industrial-Scale Delivery of Death”
Opioids came to my attention a few years ago when a report came out that New York State doctors had written more than 24 million prescriptions for opioids the previous year. Unstated in the story, but obvious to me, was that there are only 19 million people in the state, total. Doctors were flooding the state with narcotics. That can’t be right. Chris McGreal’s American Overdose details how very wrong it was and continues to be. It’s capitalism, greed and amorality at their finest.
Opioids are narcotics. The big three, Vicodin, Percocet and OxyContin are the most prescribed. A movement began in the 1980s to free up narcotics for any kind of pain relief at all. Doctors began prescribing them for the slightest pain, on the basis that they hadn’t been doing enough to relieve pain in general. And, incredibly, that opioids weren’t really addictive after all.
The story of OxyContin and the opiate crisis is the story of one family’s quest to provide unfettered freedom for narcotics in the USA. The Sacklers, with a long history of hustle and living just over the edge of legitimacy, built an empire in Purdue Pharma, making narcotics available to all, addicting them for life, shortened though it would be. Chris McGreal investigates the players, the history and the fallout in the thorough, gripping and excellent American Overdose. He spoke to all the key players and plugged in all the missing parts. The timeline at the end is invaluable – for some Congressional hearing that will never take place. At some point, this has to stop.
“OxyContin was not the result of good science or laboratory experiment. OxyContin was the child of marketers and bottom-line financial decision-making,” says John Brownlee, then a southwestern Virginia federal prosecutor. He considers Purdue Pharma a criminal enterprise.
In 1999, deaths from legal drugs overtook deaths from illegal drugs, and have not looked back. Deaths are increasing 18% a year, and the average age of death keeps declining. It’s the number one cause of death for those under 50. Ironically, the old and dying are the only group where opioids are not increasing the death rate. Mass prescribing was driving the epidemic. Addicts ravaged savings, relatives, homes – anything – to keep renewing prescriptions. The pain of withdrawal is that fearsome. Death can come suddenly in an instant, or drag out over days of agony. Even the most drug averse can find themselves hooked without knowing it.
American Overdose is a litany of failures. McGreal has chapters focused on doctors, on the police, on politicians, on drug distributors, and of course, on the manufacturers. Each is as bad as the next. It is astonishing how deeply criminal it was, and how little was done to stop it. Those who tried were squashed like bugs. Judges and police were purchased. Doctors became Mafiosi. Roadkill in this story are the children of addicts. Hundreds of thousands across the country have fallen into state care, because their parents were incapacitated, imprisoned or dead from opioids. Babies of addicted mothers are born addicted.
The relentless pressure from big pharma had the desired effect. Uniquely in America, doctors all over the country firmly believe that narcotics are necessary and appropriate for any kind of pain, for any age of person, in any kind of need. They believe that OxyContin is not addictive, because someone declared the resurgence of pain as the drug wears off is proof there is no addiction. And of course, they believe they need no educating on narcotics and that no one can tell them what to do. They’re doctors, after all. The result is a nationwide epidemic, where overdose deaths have bypassed illegal drugs, alcohol, auto collisions and gunshot fatalities. The grand total long ago eclipsed the number of deaths in the Vietnam war, and it is the only area of mortality that is skyrocketing. By itself, it has lowered the life expectancy of Americans.
Through it all, Purdue Pharma continued to lie. Its training video for doctors states there is “no evidence that addiction is a significant when persons are given opioids for pain control.” It got the Food and Drug Administration to label OxyContin as actually reducing the risk of addiction. Its reps guilted doctors into prescribing more because their competitors were. It bribed them with pizza and swag. It paid some of them for papers or speeches. It produced millions of pills to saturate small localities where people would drive for hours to get instant prescriptions, only fillable at co-opted pharmacies that would not report them.
-Doctors could make $20,000 a day writing scrips. They did them in advance, so receptionists could just fill in a name. No checkup necessary. Just $150-$250. Cash.
-Florida permits doctors to both prescribe and sell narcotics, saving a step in spreading narcotics to all. So hundreds of dispensaries popped up to take advantage of the flood of cash. By the end of the 2000s, Florida was number one in opioid prescriptions.
-As for Washington, its first act to tame the epidemic was to pass a law in 2016 handcuffing the Drug Enforcement Agency, basically preventing it from enforcing existing narcotics laws on distributors.
The Mexican drug cartels are entrepreneurial enough to know a good thing when they see one, and promoted heroin as a far cheaper substitute for OxyContin. Then an artificial opioid, Fentanyl, solved the import problem. Fentanyl is 50 times as powerful per gram, so far less of it has to be made or shipped or delivered. Fentanyl has overtaken heroin and OxyContin in the death race, but heroin and OxyContin are not fading either. A single badly mixed Fentanyl pill can kill by itself, without all the agony of addiction.
In 2018, Purdue Pharma finally said it would no longer promote OxyContin to doctors, and laid off all its sales staff. But the snowball is still rolling down the hill. The Centers for Disease Control estimates it will take another 15 years for the OxyContin epidemic to run its course. Purdue Pharma is all but guaranteed billions of dollars annually until that time. The current estimate of opioid addicts in the USA is at least two million.
McGreal ends with the whistleblowers finally making some progress. They are nibbling away at the edifice of prescription narcotics. A law here, a prosecution there, a help service, a publicity campaign. Incredibly, there is still a narcotics lobby working Washington for all its worth. Because it’s worth billions.
David Wineberg
Opioids came to my attention a few years ago when a report came out that New York State doctors had written more than 24 million prescriptions for opioids the previous year. Unstated in the story, but obvious to me, was that there are only 19 million people in the state, total. Doctors were flooding the state with narcotics. That can’t be right. Chris McGreal’s American Overdose details how very wrong it was and continues to be. It’s capitalism, greed and amorality at their finest.
Opioids are narcotics. The big three, Vicodin, Percocet and OxyContin are the most prescribed. A movement began in the 1980s to free up narcotics for any kind of pain relief at all. Doctors began prescribing them for the slightest pain, on the basis that they hadn’t been doing enough to relieve pain in general. And, incredibly, that opioids weren’t really addictive after all.
The story of OxyContin and the opiate crisis is the story of one family’s quest to provide unfettered freedom for narcotics in the USA. The Sacklers, with a long history of hustle and living just over the edge of legitimacy, built an empire in Purdue Pharma, making narcotics available to all, addicting them for life, shortened though it would be. Chris McGreal investigates the players, the history and the fallout in the thorough, gripping and excellent American Overdose. He spoke to all the key players and plugged in all the missing parts. The timeline at the end is invaluable – for some Congressional hearing that will never take place. At some point, this has to stop.
“OxyContin was not the result of good science or laboratory experiment. OxyContin was the child of marketers and bottom-line financial decision-making,” says John Brownlee, then a southwestern Virginia federal prosecutor. He considers Purdue Pharma a criminal enterprise.
In 1999, deaths from legal drugs overtook deaths from illegal drugs, and have not looked back. Deaths are increasing 18% a year, and the average age of death keeps declining. It’s the number one cause of death for those under 50. Ironically, the old and dying are the only group where opioids are not increasing the death rate. Mass prescribing was driving the epidemic. Addicts ravaged savings, relatives, homes – anything – to keep renewing prescriptions. The pain of withdrawal is that fearsome. Death can come suddenly in an instant, or drag out over days of agony. Even the most drug averse can find themselves hooked without knowing it.
American Overdose is a litany of failures. McGreal has chapters focused on doctors, on the police, on politicians, on drug distributors, and of course, on the manufacturers. Each is as bad as the next. It is astonishing how deeply criminal it was, and how little was done to stop it. Those who tried were squashed like bugs. Judges and police were purchased. Doctors became Mafiosi. Roadkill in this story are the children of addicts. Hundreds of thousands across the country have fallen into state care, because their parents were incapacitated, imprisoned or dead from opioids. Babies of addicted mothers are born addicted.
The relentless pressure from big pharma had the desired effect. Uniquely in America, doctors all over the country firmly believe that narcotics are necessary and appropriate for any kind of pain, for any age of person, in any kind of need. They believe that OxyContin is not addictive, because someone declared the resurgence of pain as the drug wears off is proof there is no addiction. And of course, they believe they need no educating on narcotics and that no one can tell them what to do. They’re doctors, after all. The result is a nationwide epidemic, where overdose deaths have bypassed illegal drugs, alcohol, auto collisions and gunshot fatalities. The grand total long ago eclipsed the number of deaths in the Vietnam war, and it is the only area of mortality that is skyrocketing. By itself, it has lowered the life expectancy of Americans.
Through it all, Purdue Pharma continued to lie. Its training video for doctors states there is “no evidence that addiction is a significant when persons are given opioids for pain control.” It got the Food and Drug Administration to label OxyContin as actually reducing the risk of addiction. Its reps guilted doctors into prescribing more because their competitors were. It bribed them with pizza and swag. It paid some of them for papers or speeches. It produced millions of pills to saturate small localities where people would drive for hours to get instant prescriptions, only fillable at co-opted pharmacies that would not report them.
-Doctors could make $20,000 a day writing scrips. They did them in advance, so receptionists could just fill in a name. No checkup necessary. Just $150-$250. Cash.
-Florida permits doctors to both prescribe and sell narcotics, saving a step in spreading narcotics to all. So hundreds of dispensaries popped up to take advantage of the flood of cash. By the end of the 2000s, Florida was number one in opioid prescriptions.
-As for Washington, its first act to tame the epidemic was to pass a law in 2016 handcuffing the Drug Enforcement Agency, basically preventing it from enforcing existing narcotics laws on distributors.
The Mexican drug cartels are entrepreneurial enough to know a good thing when they see one, and promoted heroin as a far cheaper substitute for OxyContin. Then an artificial opioid, Fentanyl, solved the import problem. Fentanyl is 50 times as powerful per gram, so far less of it has to be made or shipped or delivered. Fentanyl has overtaken heroin and OxyContin in the death race, but heroin and OxyContin are not fading either. A single badly mixed Fentanyl pill can kill by itself, without all the agony of addiction.
In 2018, Purdue Pharma finally said it would no longer promote OxyContin to doctors, and laid off all its sales staff. But the snowball is still rolling down the hill. The Centers for Disease Control estimates it will take another 15 years for the OxyContin epidemic to run its course. Purdue Pharma is all but guaranteed billions of dollars annually until that time. The current estimate of opioid addicts in the USA is at least two million.
McGreal ends with the whistleblowers finally making some progress. They are nibbling away at the edifice of prescription narcotics. A law here, a prosecution there, a help service, a publicity campaign. Incredibly, there is still a narcotics lobby working Washington for all its worth. Because it’s worth billions.
David Wineberg
March 18, 2025
A must-read 🚨What I originally expected to be a boring and depressing story turned out to be one of my favorite non-fiction books! The author weaves in facts and statistics seamlessly with well-told stories of unbelievable corruption and corporate greed. It’s also a great reminder that addiction can happen to anyone and affects broader public health.
One question I had while reading the book was why Oxy got so much of the blame when it had only 10% market share of opioids at its peak. This was comprehensively addressed in the epilogue with interesting examples of other opioid-pharmaceutical companies following the path to “success” that Purdue Pharma paved.
One question I had while reading the book was why Oxy got so much of the blame when it had only 10% market share of opioids at its peak. This was comprehensively addressed in the epilogue with interesting examples of other opioid-pharmaceutical companies following the path to “success” that Purdue Pharma paved.
February 16, 2019
Reading this book was personal to me, and it broke my heart. I'm originally from the Appalachian foothills, and Appalachia (particularly the tri-state area of West Virginia, eastern Kentucky, and southern Ohio) is ground zero for the opioid epidemic.
I first remember hearing about opioids back in the early 2000s - and I'd even heard about the loose standards in Williamson. But it didn't spread very fast in my part of Ohio - or, if it did, I didn't notice. I mean, they were prescriptions from a doctor, you know? I'm pretty sure most of us thought, at least at the time, that that meant they were safe, that they were regulated, that the doctors wouldn't give us things that would get people hooked.
I left Ohio in 2010, and although I visited, it was easy to block out the blight that was overtaking my hometown. Things had never been "good" there as long as I could remember - the factories and big coal companies left when I was a little kid - but my sister, who stayed, told me that it was getting worse. The murder rate was getting higher. Driveby shootings not only happened, but were becoming increasingly common. Drugs were running rampant through the streets. The sidewalks downtown were covered with sleeping homeless people every night.
But when I returned briefly in 2015, I was shocked, absolutely SHOCKED, at what I saw. What had happened in the five years that I was gone? Like I said, opioids weren't a new story to me - I'd heard about them for years - but the occasional overdose was now a literal epidemic. I worked for six months in a hospital in Columbus Ohio, and I was just appalled. There aren't even words to describe what I saw while there. Countless people came into the ER every night overdosing on opioids, heroin, and fentanyl (they're all related, by the way - the book explains how). People were passed out on the streets or in their cars from overdosing. Grandparents were struggling to take care of their drug-addicted adult children and their grandchildren. Our NICU was full of babies in various stages of detox, all born incredibly prematurely (I'm talking 22-24 weeks gestation, for the most part) and with numerous health problems (birth deformities, drug dependencies, brain bleeds from their early births, etc). Women handed you their babies and walked away because they were so strung out on drugs they knew they couldn't care for them. I saw fetuses having literal seizures in the womb because of drugs. And I didn't understand. What the hell had HAPPENED?
Well, opioids happened, and this book spells out clearly the string of events that led to this epidemic. It's full of drug companies whose only concern was profits and didn't care that "dumb hillbillies" were getting hooked on their pills because we are expendable people to them. This book shows how all of the safeguards that should have helped prevent this - the FDA, the AMA, Congress, etc - failed us all, and spectacularly. Purdue Pharma was allowed to push through a drug that was incredibly addictive (OxyContin) and say the whole time that it wasn't, and few people said a damned thing about it. Purdue Pharma was allowed to amass HUGE sales forces that pushed doctors to prescribe drugs, and even got JCAHO to support them in the process. And while alarm bells were going off all over the place, Purdue Pharma (along with other opioid manufacturers) had enough money and clout to encourage Congress to pass laws that favored them and made it even EASIER to make people addicted to their products (and all the while blaming the addicts for being bad eggs).
My blood is boiling just writing this review. If anyone needs any evidence showing that the American "healthcare" system is broken, just read this book. You'll see all that you need and more.
I wish that I could force those who made billions (or even millions) of dollars from peddling opioids to come to Appalachia with me for one week. Just one day, even. Hell, I could get my point across in five minutes. I'd love to take them through the NICU at my former job and show them all of the babies they have fucked up for life because they were so driven by profits that they unleashed a largely untested drug onto a community already suffering from grinding poverty and despair. These are the lives their wealth is built upon, and I sincerely hope they dream of nothing but dying babies every night in their mansions.
I first remember hearing about opioids back in the early 2000s - and I'd even heard about the loose standards in Williamson. But it didn't spread very fast in my part of Ohio - or, if it did, I didn't notice. I mean, they were prescriptions from a doctor, you know? I'm pretty sure most of us thought, at least at the time, that that meant they were safe, that they were regulated, that the doctors wouldn't give us things that would get people hooked.
I left Ohio in 2010, and although I visited, it was easy to block out the blight that was overtaking my hometown. Things had never been "good" there as long as I could remember - the factories and big coal companies left when I was a little kid - but my sister, who stayed, told me that it was getting worse. The murder rate was getting higher. Driveby shootings not only happened, but were becoming increasingly common. Drugs were running rampant through the streets. The sidewalks downtown were covered with sleeping homeless people every night.
But when I returned briefly in 2015, I was shocked, absolutely SHOCKED, at what I saw. What had happened in the five years that I was gone? Like I said, opioids weren't a new story to me - I'd heard about them for years - but the occasional overdose was now a literal epidemic. I worked for six months in a hospital in Columbus Ohio, and I was just appalled. There aren't even words to describe what I saw while there. Countless people came into the ER every night overdosing on opioids, heroin, and fentanyl (they're all related, by the way - the book explains how). People were passed out on the streets or in their cars from overdosing. Grandparents were struggling to take care of their drug-addicted adult children and their grandchildren. Our NICU was full of babies in various stages of detox, all born incredibly prematurely (I'm talking 22-24 weeks gestation, for the most part) and with numerous health problems (birth deformities, drug dependencies, brain bleeds from their early births, etc). Women handed you their babies and walked away because they were so strung out on drugs they knew they couldn't care for them. I saw fetuses having literal seizures in the womb because of drugs. And I didn't understand. What the hell had HAPPENED?
Well, opioids happened, and this book spells out clearly the string of events that led to this epidemic. It's full of drug companies whose only concern was profits and didn't care that "dumb hillbillies" were getting hooked on their pills because we are expendable people to them. This book shows how all of the safeguards that should have helped prevent this - the FDA, the AMA, Congress, etc - failed us all, and spectacularly. Purdue Pharma was allowed to push through a drug that was incredibly addictive (OxyContin) and say the whole time that it wasn't, and few people said a damned thing about it. Purdue Pharma was allowed to amass HUGE sales forces that pushed doctors to prescribe drugs, and even got JCAHO to support them in the process. And while alarm bells were going off all over the place, Purdue Pharma (along with other opioid manufacturers) had enough money and clout to encourage Congress to pass laws that favored them and made it even EASIER to make people addicted to their products (and all the while blaming the addicts for being bad eggs).
My blood is boiling just writing this review. If anyone needs any evidence showing that the American "healthcare" system is broken, just read this book. You'll see all that you need and more.
I wish that I could force those who made billions (or even millions) of dollars from peddling opioids to come to Appalachia with me for one week. Just one day, even. Hell, I could get my point across in five minutes. I'd love to take them through the NICU at my former job and show them all of the babies they have fucked up for life because they were so driven by profits that they unleashed a largely untested drug onto a community already suffering from grinding poverty and despair. These are the lives their wealth is built upon, and I sincerely hope they dream of nothing but dying babies every night in their mansions.
July 31, 2019
American Overdose by Chris McGreal - 5/5 stars
From time to time, I read a book that keeps me angry from beginning to end. Two other books that did this for me were Catastrophic Care by David Goldhill and Bad Blood by John Carreyrou. The book American Overdose by Chris McGreal completely blew me away. Much of the American public heard about the opioid crisis for the first time when it was addressed by Trump when he came into office. A big part of me wondered why he was the first to mention and address an epidemic that has been recognized by the CDC, and is killing 130 Americans a day. I know the answer now. The pharmaceutical industry is a full-blown drug cartel, with the full backing of the FDA, and their reach into the American political system is deep.
This book read like a crime thriller, and was reminiscent to me of two of my favourite TV shows - Narcos and Ozark. It was hard to believe the events outlined in this book are real. The opioid epidemic is destroying this country from the inside. It is that much more dangerous than other drug epidemics because the drug in question is completely legal, and is dispensed readily and easily by physicians. The dearth of research into the safety of the various narcotics currently on the market is astounding, and instead of doing more studies, the pharmaceutical industry is busy formulating stronger and more dangerous narcotics to administer to the American public.
I work as a registered nurse, and what stood out to me in this book is that certain concepts that I have taken for granted since nursing school are based on completely false premises lacking any evidence. For example, I had it hammered into my brain throughout nursing school that “pain is the fifth vital sign.” The first question we ask any patient is “are you in pain?”. It turns out that the idea of pain as a fifth vital sign was pushed hard by the pharmaceutical industry, and is not backed up by evidence. Hospital surveys which determine Medicare and Medicaid reimbursement ask the patient how well their pain was controlled. This is another initiative that was pushed by the pharmaceutical industry, to highlight the idea of pain in patients’ minds as abnormal or completely avoidable, when this is obviously not the case. The American Pain Society, which pushed the above mentioned policies and is supposed to be a patient advocacy group, is basically a subsidiary of Purdue Pharma, the manufacturer of Oxycontin. It was all part of an agenda to get dangerous and addictive drugs into the hands of people who would have never otherwise considered taking them.
This is a book about greed, corruption, tragedy, and the broken system that allowed this travesty to happen. Hundreds of thousands of Americans have died from overdosing on opioids. Babies in the Appalachia and other parts of this country are born every day addicted to opioids. Families have been destroyed, and this problem has been largely ignored thanks to the far-reaching tentacles of Big Pharma. Read this book, you won’t regret it!
From time to time, I read a book that keeps me angry from beginning to end. Two other books that did this for me were Catastrophic Care by David Goldhill and Bad Blood by John Carreyrou. The book American Overdose by Chris McGreal completely blew me away. Much of the American public heard about the opioid crisis for the first time when it was addressed by Trump when he came into office. A big part of me wondered why he was the first to mention and address an epidemic that has been recognized by the CDC, and is killing 130 Americans a day. I know the answer now. The pharmaceutical industry is a full-blown drug cartel, with the full backing of the FDA, and their reach into the American political system is deep.
This book read like a crime thriller, and was reminiscent to me of two of my favourite TV shows - Narcos and Ozark. It was hard to believe the events outlined in this book are real. The opioid epidemic is destroying this country from the inside. It is that much more dangerous than other drug epidemics because the drug in question is completely legal, and is dispensed readily and easily by physicians. The dearth of research into the safety of the various narcotics currently on the market is astounding, and instead of doing more studies, the pharmaceutical industry is busy formulating stronger and more dangerous narcotics to administer to the American public.
I work as a registered nurse, and what stood out to me in this book is that certain concepts that I have taken for granted since nursing school are based on completely false premises lacking any evidence. For example, I had it hammered into my brain throughout nursing school that “pain is the fifth vital sign.” The first question we ask any patient is “are you in pain?”. It turns out that the idea of pain as a fifth vital sign was pushed hard by the pharmaceutical industry, and is not backed up by evidence. Hospital surveys which determine Medicare and Medicaid reimbursement ask the patient how well their pain was controlled. This is another initiative that was pushed by the pharmaceutical industry, to highlight the idea of pain in patients’ minds as abnormal or completely avoidable, when this is obviously not the case. The American Pain Society, which pushed the above mentioned policies and is supposed to be a patient advocacy group, is basically a subsidiary of Purdue Pharma, the manufacturer of Oxycontin. It was all part of an agenda to get dangerous and addictive drugs into the hands of people who would have never otherwise considered taking them.
This is a book about greed, corruption, tragedy, and the broken system that allowed this travesty to happen. Hundreds of thousands of Americans have died from overdosing on opioids. Babies in the Appalachia and other parts of this country are born every day addicted to opioids. Families have been destroyed, and this problem has been largely ignored thanks to the far-reaching tentacles of Big Pharma. Read this book, you won’t regret it!
November 5, 2018
This book makes an attempt, in three acts, to sum up the current opioid crisis in America. It’s long long form journalism. This is a heavy topic, although I have to say, the weight of this book for me was more about the often unparsable reams of info about big pharma, the FDA, and all of the legal issues with the mainstream prescribing of opiates for moderate pain, than to do with the astounding death tolls. I think the facts shared were well researched, but this book was short of qualitative interviews with those impacted by the overdoses (I remain baffled that he didn’t include one interview with a grandparent raising grandchildren after they were orphaned by overdoses - that is the aftermath of the crisis in a nutshell). I get that this issue is born in the whitest areas of America, so this book mostly looked at whiteness, but even within that there were some major issues with what was researched and what was taken for granted. How McGreal could painstakingly track down every FDA staffer or disgruntled doctor or whoever, to make sure that his points were supported, and then just be like “fentanyl comes from China and then Mexican drug cartels” and “heroin comes from the inner cities” is baffling to me. Where is the evidence to support this? How can you write a book whose whole statement is that you can’t trust what you are told, then regurgitate tired stereotypes without indicating that he even tried to verify the information? Also! It was a total cop out to quote one person saying that addiction only became a disease when white people started dying, and just leave it at that as your full explanation of racism, but also to take that a step further and be like “but anyways it’s a better approach so maybe everyone will be better off with this change in perspective” as if that’s what’s going to happen. That felt very lazy to me. Also, the third act in the book felt super rushed. Fentanyl deaths are huge and whole communities are suffering. The third act needed more research or to be cut entirely. This book skims the surface on an important topic, how capitalism fails as medicine in particular, but more is needed. Thank you netgalley for this ARC, opinions are my own.
November 30, 2018
I haven't read Dreamland or Dope Sick yet (on the TBR, I swear) but my first dive into books about the opioid crisis made me Very Angry. All the systems that are supposed to prevent problems like this failed us because Capitalism and Political Lobbying (like, WTF, do people not understand what a Conflict of Interest is???). Also, an extremely concerning disregard of actual science by scientists and physicians.
September 22, 2019
A really thorough, if intensely depressing, account of the opioid crisis and how we got to where we are. I came away with a really good understanding of the roles played by each of the parties - the medical community, big pharma, regulators, local and national officials, dealers, and the addicted and their families. Understanding, and a deep sense of frustration and mistrust.
I read this at the same time as What the Eyes Don’t See, and there were a lot of parallels. One, that it very much depends on who is dying (ie: what color they are and how much they money they have) for a crisis to gain any kind of traction. It took loads of white people dying for addiction to be classified as an epidemic and a public health emergency, but even then, the opioid crisis only got attention once it started affecting people outside of Appalachia. And poor, minority children still apparently come in at the bottom of the list of things anyone cares about. Shame on us.
The second is that greater regulatory vigilance would have prevented both crises. This is, of course, why industries like pharma shun regulation. It makes it difficult to profit from ruining people’s lives. Even where institutions and regulations are present, the banality of evil and the tyranny of bureaucracy create a stifling inertia until someone finds the guts to stand up and shout, “hey, this is really fucked up, no?” And even then all the people who should have been protecting everyone double down in denial, because to admit mistakes would mean admitting culpability. Precious time, and lives, are wasted.
This was a real double whammy. I don’t think I’ll ever trust anyone or anything ever again.
I read this at the same time as What the Eyes Don’t See, and there were a lot of parallels. One, that it very much depends on who is dying (ie: what color they are and how much they money they have) for a crisis to gain any kind of traction. It took loads of white people dying for addiction to be classified as an epidemic and a public health emergency, but even then, the opioid crisis only got attention once it started affecting people outside of Appalachia. And poor, minority children still apparently come in at the bottom of the list of things anyone cares about. Shame on us.
The second is that greater regulatory vigilance would have prevented both crises. This is, of course, why industries like pharma shun regulation. It makes it difficult to profit from ruining people’s lives. Even where institutions and regulations are present, the banality of evil and the tyranny of bureaucracy create a stifling inertia until someone finds the guts to stand up and shout, “hey, this is really fucked up, no?” And even then all the people who should have been protecting everyone double down in denial, because to admit mistakes would mean admitting culpability. Precious time, and lives, are wasted.
This was a real double whammy. I don’t think I’ll ever trust anyone or anything ever again.
November 9, 2018
"Tragedy" is an apt word for the way opioids have been managed by pharmaceutical companies, doctors, and our government. I've read several books on this topic, and American Overdose is right up there with the best.
One aspect that makes this a standout read is that Chris McGreal addresses the FDA's absolute failure in oversight, and perhaps even complicity in the false and dangerous claims about a prescription drug that led to nationwide addiction. If you happen to come to this book with the belief that the FDA works to protect the public, you'll find it difficult to hold on to that belief by the end.
American Overdose is an exceptionally well written and researched narrative. McGreal takes us through the madness of the pharmaceutical company's lies, doctors' ignorance and arrogance, FDA's negligence, and, ultimately, the human tragedy caused by a drug that should never have been allowed for such broad use. We're given an inside view on all counts, keeping us invested and making the story feel personal.
Ultimately, the financial penalty imposed on a handful of those responsible means nothing to the millions of people whose lives were ruined by or lost to opioid addiction. The best we can do is arm ourselves with knowledge and question everything, so that maybe we can keep anything like this from ever happening again. Reading American Overdose is a great place to start.
*The publisher provided me with an advance copy, via NetGalley, in exchange for my honest review.*
One aspect that makes this a standout read is that Chris McGreal addresses the FDA's absolute failure in oversight, and perhaps even complicity in the false and dangerous claims about a prescription drug that led to nationwide addiction. If you happen to come to this book with the belief that the FDA works to protect the public, you'll find it difficult to hold on to that belief by the end.
American Overdose is an exceptionally well written and researched narrative. McGreal takes us through the madness of the pharmaceutical company's lies, doctors' ignorance and arrogance, FDA's negligence, and, ultimately, the human tragedy caused by a drug that should never have been allowed for such broad use. We're given an inside view on all counts, keeping us invested and making the story feel personal.
Ultimately, the financial penalty imposed on a handful of those responsible means nothing to the millions of people whose lives were ruined by or lost to opioid addiction. The best we can do is arm ourselves with knowledge and question everything, so that maybe we can keep anything like this from ever happening again. Reading American Overdose is a great place to start.
*The publisher provided me with an advance copy, via NetGalley, in exchange for my honest review.*
February 3, 2020
This book was an eyeopener for me. I always wondered what was meant by "the opioid crisis". This is surprising because I have been working as a nurse in the hospital system for 15 yrs and 20 yrs in home health and hospice. I thought the crisis was related to the problems for diversion of prescribed narcotics to family members forefather abuse by them or sales for abuse. I have been aware of changes in thinking about treatment of pain, but was not aware of the push to use narcotics as treatment for chronic pain. In my practice, I am used to narcotics being prescribed for pain related to cancer and mostly for terminally ill patients. What a shock to discover the organized and concerted effort by pharmaceutical companies to prescribe more for chronic pain and the pop up of "pill mills" in many states without much oversight and for profits without the thought to problems of overdose.
I have seen more education of both medical care workers and by extension to the public, to encourage prescribing for the specific type of pain and using what works best for that, with only using narcotics when it is indicated and not for chronic pain. This book reinforced my thoughts that advertising medications on TV is not a good thing and mostly benefits Big Pharma.
I have seen more education of both medical care workers and by extension to the public, to encourage prescribing for the specific type of pain and using what works best for that, with only using narcotics when it is indicated and not for chronic pain. This book reinforced my thoughts that advertising medications on TV is not a good thing and mostly benefits Big Pharma.
January 3, 2021
Some parts dragged on with more detail than necessary, but overall a very good overview of the origins and profession of the opioid epidemic, and how it evolved into the larger heroin/fentanyl epidemic. McGreal focuses more on the pharmaceutical companies, interest groups, and government agencies that played a role in our current crisis. McGreal does a good job of appointing blame as necessary, but also in showing how widespread the failings were in order to lead to repeated warnings being ignored. Lots of lessons to be learned, highly recommended for anyone that wants a comprehensive start to understanding this topic, and future healthcare/public policy folks.
February 10, 2019
This was a hard read. Not by quality of reporting (excellent) or length (290 pages). But by the heartbreaking cost of it all. McGreal highlights how so many segments of the medical and social systems failed the American public. Not failure through incompetence or fortune. But failure under the pressure of greed from pharma companies, distributors, medical associations, and regulators. The book is rife with stories of the human cost of such greed. As more people in America die per day from opioids than were from AIDS during its deadliest, this book is essential reading for a look at how we got here, and just how much work remains to fix it.
November 20, 2018
I received an ARC from Netgalley in exchange for an honest review. My first Netgalley!
This book made me so mad. As a substance abuse counselor the personal stories are not new to me, but how Oxycontin was pushed on doctors from the drug companies and marketed as safe was ridiculous. This went on for so many years before enough people stepped up and said enough. Unfortunately the damage has been done in so many says. I highly recommend this book to everyone.
This book made me so mad. As a substance abuse counselor the personal stories are not new to me, but how Oxycontin was pushed on doctors from the drug companies and marketed as safe was ridiculous. This went on for so many years before enough people stepped up and said enough. Unfortunately the damage has been done in so many says. I highly recommend this book to everyone.
March 9, 2023
I've read a couple of books on the opioid crisis, and while this book was still interesting, it jumped around a lot and I found parts of it hard to follow. I think the other books were just better, but I liked how this book looked more closely at the federal and state government's role in the current epidemic.
January 10, 2019
How many books will I read about the opioid crisis? Apparently as many as people will write. I found this book more engaging than Dopesick in many ways. However, there were still long passages that were pretty boring. The worst for me was the lack of copy editing- a single dropped ‘the’ or ‘an’ is one thing but there were so many errors in this book, I almost stopped reading it. Overall this book is thoroughly researched and an informative, if infuriating, read.
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