Death in Mud Lick: A True Story of Corporate Pill Pushers in Small Town America

by Eric Eyre

From a Pulitzer Prize–winning reporter from the smallest newspaper ever to win the prize for investigative reporting, an urgent, riveting, and heartbreaking investigation into the corporate and governmental greed that pumped millions of pain pills into small Appalachian towns, decimating communities.

Death in Mud Lick is the story of a pharmacy in Kermit, West Virginia, that distributed 12 million opioid pain pills in three years to a town with a population of 382 people—and of one woman, desperate for justice, after losing her brother to overdose. Debbie Preece’s fight for accountability for her brother’s death took her well beyond the Sav-Rite Pharmacy in coal country, ultimately leading to three of the biggest drug wholesalers in the country. She was joined by a crusading lawyer and by local journalist, Eric Eyre, who uncovered a massive opioid pill-dumping scandal that shook the foundation of America’s largest drug companies—and won him a Pulitzer Prize.

Part Erin Brockovich, part Spotlight, Death in Mud Lick details the clandestine meetings with whistleblowers; a court fight to unseal filings that the drug distributors tried to keep hidden, a push to secure the DEA pill-shipment data, and the fallout after Eyre’s local paper, the Gazette-Mail, the smallest newspaper ever to win a Pulitzer Prize for investigative reporting, broke the story.

Eyre follows the opioid shipments into individual counties, pharmacies, and homes in West Virginia and explains how they hooked thousands on prescription drugs—resulting in the highest overdose rates in the country. But despite the tragedy, there is also hope as citizens banded together to create positive change—and won. A work of deep reporting and personal conviction, Eric Eyre’s intimate portrayal of a national public health crisis illuminates the shocking pattern of corporate greed and its repercussions for the citizens of West Virginia—and the nation—to this day.

Genres: Nonfiction, History, True Crime, Politics, Crime, Audiobook, Journalism

320 pages, Hardcover

First published March 31, 2020

Reviews

[Sharon Orlopp · Rating 5 out of 5]

The first sentence in the preface grabbed me and wouldn't let go. "In two years, out-of-state drug companies shipped nearly 9 million opioid pain pills to Kermit, West Virginia, a town with 382 people." It continues to describe a town 20 miles away from Kermit with 1700 people that received over 16 million opioids within a decade. WTH!!???

Couldn't. Put. It. Down.

Death in Mud Lick: A Coal Country Fight against the Drug Companies That Delivered the Opioid Epidemic is an incredible David vs Goliath story written by investigative journalist Eric Eyre. Eyre worked for the Charleston Gazette-Mail which was a small, local newspaper that believed in keeping sustained outrage alive and covering state news without fear or favor.

Some of the incredulous statistics from the book include 780 million opioid pills sent to the state of West Virginia during a six year period for a total state population of 1.8 million. West Virginia had 1,728 overdoses during those six years. During that same six year period, 76 BILLION opioid pills were distributed in the U.S.

Eyer's newspaper article was titled, "Follow the pills and you'll find the overdose deaths." He was doggedly determined to get information to the citizens of towns and states so that they knew the magnitude of the opioid problem.

Several memorable passages from the book:

* Democracies die behind closed doors.

* Keep sustained outrage alive.

* Newspapers should be an undeniable check on power.

* Intrusive journalistic nose is a badge of honor

The book opens with a quote from Mother Jones that sums up the book's purpose well: Pray for the dead, and fight like hell for the living.

Highly, highly recommend!

[Ron S · Rating 4 out of 5]

There's been so much discussion of "Fake News" over the last four years, along with the widespread demise of daily newspapers across North America, it's somewhat easy to forget that there are still dogged, undaunted, dare I say heroic investigative journalists still out there digging for the truth about the most important issues facing us today. Eric Eyre is one of these, and presents solid facts here that drug distributors, politicians, lobbyists, the DEA and a lot of greedy pharmacists and doctors would prefer had remained in the dark.

[Ed · Rating 5 out of 5]

Earnest report of Big Pharma dumping their opioid pills in rural West Virginia. The author won a Pulitzer Prize for his newspaper coverage while he battled Parkinson's Disease. Lots of finger-pointing and evasion goes on. The investigative reporting methods are interesting.

[Nancy Oakes · Rating 5 out of 5]

4.5 rounded up (read in May)
full post here:
http://www.nonfictionrealstuff.com/20...


Even after being diagnosed with and beginning treatment for Parkinson's in the midst of it all, the author of Death in Mud Lick, Eric Eyre, stuck to his guiding principle of "sustained outrage" as he continued to investigate and to report on the flooding of opioids into West Virginia, ultimately winning a Pulitzer in 2017 for his hard work. The word dogged doesn't even begin to describe his determination to get to the truth. At the same time, this is not just another book on the opioid epidemic -- here we are provided with an intense scrutiny of what goes on behind the scenes of a number agencies which are supposed to be regulating the flow of these powerful drugs to safeguard the population. What happens here is real, it is not at all pretty, and if you had to choose only one book on the topic, this would be the one.

This work of investigative journalism puts an eagle-eyed focus on Eyre's efforts to gain information from not only the huge and powerful drug distribution firms, but also from various government officials and government agencies, and reveals how an elected official in West Virginia set out to "derail" Eyre's investigation, most likely in retaliation. Just reading this book frustrated me to no end -- not because it is bad (because it is most certainly not), but because, as Eyre writes in the preface,

"As the addiction crisis spread across the country, some health advocates sounded the alarm, but industry lobbyists snuffed out policymakers' efforts to stop the scourge. They found politicians willing to do their bidding. The regulators -- the DEA, the pharmacy board -- failed to do their jobs. Pablo Escobar and El Chapo couldn't have set things up any better."

I am a natural cynic and even I was shocked at what goes on behind the scenes to protect not the citizens of this nation but rather the ultra-lucrative pharmaceuticals industry. I am a huge believer in the power of investigative journalism done the right way, and I have to say that Death in Mud Lick is one of the best books I've read on this subject. After what he went through during the course of his investigations, Mr. Eyre deserves all accolades this book may receive.

very highly recommended

[Amy · Rating 2 out of 5]

If you like stories about entities refusing to turn over paperwork to other entities, you will like this book. Not to downplay the issue at hand, but, the main takeaway is how difficult it is to get any legal action on anything once everybody gets lawyered up. I found it difficult to keep track of all the lawyers involved, who was working for who in what capacity, and etc., but it almost didn't matter to understanding the story, which was: nobody wants to say they knew what is going on.

[Alan · Rating 4 out of 5]

The Hallmark of Crusading Journalism Is Sustained Outrage
—Title of an editorial by W.E. 'Ned' Chilton in the Charleston, WV Gazette, November 18, 1983, from p.81 of Death in Mud Lick

What's the difference between a legal drug and a drug that's illegal? You might think there'd be some objective, scientific criterion—how addictive it is; the level of danger from taking it; the physical effects of the drug; the social damage it causes—but no, none of those really make a difference to the law.

The primary legal difference is this: who profits from the trade? (Or, in Latin: cui bono? )

Death in Mud Lick, by crusading journalist Eric Eyre, was not at all my usual thing, but it's forcefully written and meticulously researched, and it concerns places very near where I grew up—Eyre's work literally strikes very close to (what was, at least) my home.

The Preface of Death in Mud Lick is an effective executive summary—in those few short pages, Eyre lays out all you really need to know about the destruction wreaked by the trade in addictive painkillers (primarily hydrocodone and oxycodone) in southern West Virginia. The rest of the book is narrative and backup: detailed evidence, corroborating citations, and names. Lots and lots of names. Eyre's extensive research and documentation are exhaustive and thorough. Sometimes, even, a bit too thorough—for example, I don't think we needed to know exactly what Eyre ordered from Burger King (p.100).

*

"If you're not angry, you're not paying attention."

If you're not already angry after the first page or two of Death in Mud Lick, I think you will be by the end. So many organizations—and people—weren't paying attention. The drug companies actually used this legal theory to defend themselves, contending that the multitude of guilty parties diluted their responsibility, but I rather think it compounds culpability. There's more than enough blame to, as it were, distribute. Are the addicts themselves responsible? Yes, to some extent—although most of them received their first doses in traditional drug-pusher fashion, "for free," as legitimately-prescribed analgesics for injuries they received on the job. Are the local pharmacists who blindly filled hundreds and thousands of prescriptions a day at fault? Yes, for sure. Are the regional distributors who brought truckloads of pills to these tiny towns week after week to blame? Them, too. The transnational manufacturers of those pills? Yup. The state's politicians—men like Patrick Morrisey, the state's Attorney General through much of the period Eyre covers, and then-Governor Joe Manchin, who comes across as a DINO then as now? Oh hell yeah. And does the oblivious Drug Enforcement Agency, focusing on Florida while ignoring the ongoing traffic much closer to D.C., bear some responsibility too? Absolutely.

Eric Eyre's analysis lets no one off the hook.

The law, on the other hand...

*

Throughout Death in Mud Lick, Eyre exhibits a journalist's faith in the power of the Word to redeem the world (or at least his neglected corner of the world). And, indeed, the sustained outrage of Eyre and crusading investigators like him did have some positive effects on the prescription-drug crisis in my home state.

Whether that's enough to save West Virginia in the long run... well, we'll see.

[Kayla · Rating 4 out of 5]

I think it proper to begin my review of Eric Eyre's "Death in Mud Lick" with a disclaimer. I am a native West Virginian, so the issues within were familiar and visceral for me and that may contribute to a slight bias! Bias aside, I think this is an important work for any reader interested in the culture of Appalachia. It shows how the rest of the United States views this area of the country and focuses an investigative eye on the flood of prescription pills that rolled over the region and led to so many deaths. The stories of pharmacies entertaining crowds so large they brought in popcorn makers and a food truck seem like something out of fiction, but the consequences Eyre's charts are very real and their effects are still being dealt with today. The book does end with hopes for justice, but as a native daughter of the state notes in the book, it's difficult to "trust that the money [will] go where it's needed." Hopefully a work like this will lead to more treatment centers and less abuse from the "painkiller profiteers."

[Nancy · Rating 5 out of 5]

Newspaper journalists were my heroes as a girl. My ten-year-old girlfriend and I spent hours planning to turn a falling down chicken coup into an office where we would write and publish our own newspaper. I was on the school newspaper in high school. I follow a number of journalists on social media who are my heroes, and now I have one more to add to my list.

You reminded me of how much a community depends on its newspaper to tell the truth and follow through finding the truth even if it's a little scary.~from Death in Mud Lick by Eric Eyre

Charleston Gazette-Mail reporter Eric Eyre won a Pulitzer Prize for his investigation into the massive opioid shipments to West Virginia. That story is presented in the book Death in Mud Lick.

I will admit this was one of those books I requested that looked interesting but when I received it I almost regretted it. I don't need to read another tragedy. We are in a pandemic already!

But I don't shirk my responsibilities and I sat down and read. I was soon immersed in the twisted history of how every safeguard failed to alert and stop the massive inflow of opioids into small towns, resulting in record overdose deaths. I looked forward to picking it up every day.

Everybody was making money--the pharmacies, doctors, patients, distributors, manufacturers. And nobody had the power to stop them.~ from Death in Mud Lick by Eric Eyre

This is one more story about people's lives sacrificed for money and governing authorities complicity in cover-ups. It is also the story of how a small town newspaper and one reporter prevailed to disclose the papertrail detailing responsibility.

Eyre does an amazing job marrying the personal side of the crisis and the struggle of the newspaper to keep afloat with his documentation of events. During the time of his investigation, Eyre was diagnosed with Parkinson's. It didn't stop him.

Today a Facebook friend shared a quip about shutting down the national media and watching 80% of the world's problems go away. Another Facebook friend responded, "It's your right to stay ignorant."

I am with that second friend. The media--particularly newspapers still employing investigative reporters--are essential to a democratic society. We may not like what we are reading, we may find the news disheartening and frightening, but our alternative is ignorance.

I received a free ebook from the publisher on a Goodreads giveaway. My review is fair and unbiased.

[Audra · Rating 4 out of 5]

3.5 stars. Overall, the book infuriates me because it very clearly shows the greed, corruption, dishonesty, and total lack of concern for other people that exists today. At times it was tedious to read because there are a lot of people to keep track of, the timeline was hard to follow at times, and it's primarily about investigative journalism and legal battles. But, the investigative journalism was amazing and it was interesting to learn how this reporter exposed the opioid problem and was relentless in his efforts.

[Renee · Rating 5 out of 5]

First Five Star book of the year!

[Sue · Rating 5 out of 5]

There’s more than one tragedy in Eric Eyre’s book. He is a gifted journalist, capable of pursuing a story until it’s complete. But he worked for a regional newspaper that is bleeding money, and he does the kind of journalism that has come to seem impossible as newspapers can barely stay alive. The Charleston Gazette-Mail has had a reputation as a journalistic watchdog. It’s a role they may not be able to continue. This book is about opioids, but it is also the story of how important investigative journalism is.

West Virginia could be considered Ground Zero for the Opioid epidemic. Overdoses and addictions ravaged many communities, but this story of the fight to expose the sources of easy availability began with the death of one man, William Preece, in the town of Mud Lick. His sister, Debbie, was determined that he would not be just another number in the drug overdose statistics.

Debbie traced William Preece’s pills to the Sav-Rite Pharmacy in Kermit, West Virginia. She and her lawyer uncovered the pharmacy’s delivery data for the year following Preece’s death: 2.2 million hydrocodone and 78,5000 oxycodone pills. This in a tiny town.

This enormous quantity was delivered to the pharmacy by a single distributor, a middleman company that purchases prescription pills from the manufacturers, stores them, and distributes to hospitals and pharmacies. From 2006 to 2012, distributors – seemingly benign middlemen – delivered 780 million hydrocodone and oxycodone pills to West Virginia, while 1728 residents of the state fatally overdosed on the two painkillers.

There are plenty of culprits in this story: Doctors who wrote prescriptions without even seeing the patient. Official agencies like the Drug Enforcement Agency and the West Virginia Board of Pharmacy that failed to follow up on “suspicious orders.” Pharmaceutical companies which promoted dangerous and addictive drugs. The drug users themselves, often addicted before they began to get prescriptions. A state attorney general with conflicts of interest.

Yet it is the action of distributors that is at the core of this story. Journalist Eric Eyre’s pursuit of the story asks the question, “How did 780 million painkillers spew into West Virginia and nobody said a word?” Eyre found his years-long story when Debbie Preece’s battle with the distributors came to his attention. Eyre won the Pulitzer Prize, and this book is the account of his investigation.

When there are so many blame-worthy layers, it is easy for any of the culprits to downplay their own roles. Chief executives of the distributors, notably McKesson, Cardinal Health, and AmerisourceBergen, denied contributing to the opioid crisis, but the House of Representatives Committee on Energy and Commerce ultimately found that they failed to conduct proper oversight by not questioning or monitoring the rampant flow of addictive painkillers. When a legal battle finally resulted in the release of DEA data, the full magnitude of their negligence became clear.

Eric Eyre, we need you. This one reporter trained his eye on greed and corruption that caused so much human misery. May our society find ways to reward and keep these “essential workers.”

[Jennifer DeMarco · Rating 5 out of 5]

Being from this area, it is insane to hear the numbers of pain pills that were sent to these small towns. The attorney general's wife was a lobbyist for these big pharma companies, and the AG did not formally recuse himself from the case suing these same companies (not to mention they also contributed financially to his campaign). This is a must read for anyone interested in the opioid crisis, corrupt politics, and addiction. 10/10 recommend. It is hard to fathom the destruction these companies caused rural communities.

[Joanne · Rating 4 out of 5]

In two years time, one small town pharmacy sold 9 million opioid pills. The population of the town was 382 people. One woman, who lost her brother to an overdose, along with Eric Eyre and a crusading attorney took on the 3 largest distributor's of the drugs. Eyre uncovered a pill dumping scandal that reverberated through the entire U.S.

It is an eye opening piece of investigative journalism. From Big Pharma, to the drug distributor's , to the politicians and the DEA, there is more than enough shame and blame to cover them all.

I think the pharmaceutical industry has got so much money coming in with the lobbyists and the money that's generated from sales, that nobody wants to take on these people. It's a cartel. They're protected. And you can't--it's just too big Sargent Mike Smith, W.V. State Police.

GR's recommended this book to me because I have Empire of Pain: The Secret History of the Sackler Dynasty on my shelf. I am glad I picked it up and am now ready to move on to The Sackler Family and how this crisis all began.

[Rosemary · Rating 5 out of 5]

Eric Eyre, author of Death in Mudlick, is the reporter who wrote a series of articles for the Charleston (WV) Gazette Mail about the opioid crisis in Southern West Virginia that won the newspaper the Pulitzer Prize for Investigative Reporting in 2018. The Gazette Mail is the smallest newspaper ever to win the prize.

This book tells how Eyre got onto the story and how he pursued it despite the wily tactics of drug companies, the DEA, the Board of Pharmacy, doctors that were writing prescriptions for money, pharmacies that were filling hundreds of prescriptions for opioids daily, and lawyers, judges, and politicians, all trying to protect themselves. On his side were other reporters, a terrific editor, lawyers, politicians, and people who had lost loved ones to opioid overdoses and people who were tired of seeing their communities devastated by drugs.

The story is complex but Eyre's recounting is easy to follow and a highly readable story. The accounts of individuals who overdosed are heartbreaking, with some families losing two or three members to drugs. The story rarely gets bogged down in the details of pill numbers and legal maneuvers, though that information is included. The politicians involved are mainly of interest to West Virginians like me (may Patrick Morrisey rot in hell) but they serve as exemplars of how politicians wriggle out of things and shift blame and outright lie. So do drug companies and government officials.

The important thing is that Eyre's articles and persistence brought to light what was happening and caused the regulation of opioid drugs to change nationwide. He tells his story very matter of factly when he could be taking bows all over the place. He is a reporter through and through, just following the story where it leads. (And completing this book as Parkinson's disease makes it increasingly more difficult for him to type because of tremors.)

Death in Mudlick came out just as the country was going into lockdown because of the Covid-19 pandemic, so Eyre didn't get to do book tours to publicize it. I'm hoping my review will let people know about this important publication. Please pass the word along.

[Agne · Rating 4 out of 5]

Small town intrigue and a national tragedy. A revealing account of how blame can be avoided for a long time if several things contribute to a problem. A story of local journalism at its absolute highest peak. I was amazed at the kind of digging, begging and suing that had to happen to bring the whole prescription drug epidemic to light. Redemption for a former drug dealer. And most of all, I understood better what such pain killer addiction can be like for a community - regular people, injuries from blue collar jobs, easy access to prescriptions.

“For the first time, we could calculate the six-year total for the entire state. There were two ways to do it. Simply add up all the pills the pharmacies bought. Or add up each distributor’s deliveries to every county. Both methods produced the same number—780 million. That was just hydrocodone and oxycodone—in a state with fewer than 1.8 million people.”

[Matt Vargo · Rating 5 out of 5]

The epic story of West Virginia fighting off the opioid epidemic even while republicans were sleeping with the drug companies (literally, in the case of the WV attorney general). This is what you love to see - the press pressuring the government and corporations to behave responsibly. Fortunately they were able to avoid the buzz saw of fascism that is Moscow Mitch aka Old Fuck Face.

This is a book by a Pulitzer prize winning reporter on this topic - winning the Pulitzer from the smallest newspaper to ever win it. This is also the best book on the opioid epidemic I've read so far......in contention for best book I read in 2020. I have filed it in the ever growing section of my library for the genre: "Republicans really don't give a fuck about human beings they just want your money". There seems to be infinite content in this genre.

[Emma · Rating 3 out of 5]

I've really been enjoying nonfiction that broadens my knowledge about various topics. This book gave a lot of information and I found it interesting (although I'm still not completely sure how courts and lawsuits work, so those parts were a bit muddled for me). I liked that there was a plenty of info but also a lot that had my emotions going--I was sad when the author revealed his Parkinson's diagnosis, and I was nervous throughout to see how various lawsuits would end up.

[Kirsti · Rating 5 out of 5]

Devastating, infuriating account of how small, poor communities had literally millions of addictive pills dumped in them each year for years on end—and hundreds of people looked the other way because the money was so good and it wasn't their families or friends who suffered. I've read about opiate addiction and pill mills before, but this account is really something special.

[Alex Gerling · Rating 4 out of 5]

Listened on audio. Really interesting perspective on the opioid crisis

[Katie · Rating 4 out of 5]

Summary: A great work of investigative journalism that benefited from the author's depth of local knowledge.

So far, the two books I'd heard the least about have been the best books I've read on the opioid crisis. In Pain, a memoir by a bioethicist who was addicted to opioids, included both personal experience and some of the most thoughtful analysis I've read. This book, Death in Mudlick, is by a reporter who received a Pulitzer Prize for his role reporting on opioid distributor sales data in West Virginia. It really delivered everything I want in narrative nonfiction.

I think the main reason I enjoyed this book more than other popular takes on the topic is that we joined the author in discovering what opioid manufacturers and distributors were up to. We also learned in real time with him about connections between state officials and the distributors. Although I didn't feel that the people who caused the opioid crisis had really been brought to justice by the end, even the revelation of what they were up to felt like a victory.

The author also brought a real depth of knowledge about place and local politics to his reporting. Other books I've read have felt well reported, but they simply lack the depth of knowledge and personal concern that come from living in a place for years. I both felt more invested in this story and more like there was a satisfactory payoff in terms of the good guys accomplishing something. I realize that isn't something that nonfiction can always deliver, but I certainly enjoy a story where it does!This review was originally posted on Doing Dewey

[SoulSurvivor · Rating 3 out of 5]

I heard on the news today that a West Virginia pharmacy was hit with a $610M judgement for the dispensing of millions of opiates over the course of 5 years. This in a holler town with less than 500 people. This book describes the sordid story of how drug manufacturers, wholesaleers, pharmacies and crooked doctors made that state #1 target for adiction despite its small population. Lawyers, politicos, lobbyists and state, county and local officials were complicit, pocketing wealth while fellow citizens were dying all around them. An eye-opening look at the down-fall of a state that has dealth with poverty for generations . 3.45 stars.

[Neil Griffin · Rating 5 out of 5]

We live in a hilariously corrupt country. Just now, as I sit down to write this, our orange boy has fired an inspector general for investigating Pompeo. And it's a random day. Like tomorrow or whenever you, dear reader, read this, there will be some other hilariously corrupt thing that happens.

This book documents the corruption in our country, basically the nexus where right-wing politics meets vulture capitalism under the guise of an American Eagle, and does it with tenacity and heart. It's an inspiring book showing small-town journalism at it's best in how it holds truth to power for the citizens that it represents. It reads elegiac at times, because these small papers are dying, since Facebook and Google have totally eviscerated this industry, which makes this sometimes quite sad to read. In a future without journalists like Eric Eyre the shit corporations in league with our shit politicians, mostly republicans who are cartoonishly greedy and cynical at this point in our national journey, would have free rein to poison the country for profits without any comeuppance.

I mean, for Christ's sake, the Attorney General of West Virginia and his wife were lobbyists for the drug companies that he was supposed to prosecute for plundering his state. And that reads as normal in these times.

In any case, Eyre writes with conviction and heart and if we all had journalists uncovering these crimes in our community, we'd live in a much better society.

[Lara Ryd · Rating 3 out of 5]

Eyre’s retelling of his investigation of the West Virginia opioid crisis is compelling not only as a courtroom drama but also as a story about a struggling small-town newspaper and its determination to tell the truth. Eyre weaves together the personal stories of the people of Kermit, WV with the dramatic legal battle against the pharmaceutical companies in a way that clearly depicts what’s at stake in the investigation. The story is quite slow-going due to all the red tape the journalists and lawyers had to wade through in order to get information, but Eyre still manages to build tension and suspense despite all the bureaucratic barriers. Reminded me of All the President’s Men, or an earthier, less elitist Sorkin film.

[Robyn · Rating 5 out of 5]

DEATH IN MUD LICK:
Eric Eyre

OMG, this was an amazing read and super informative. I am going to put it on my suggested reading list for my CJ students. I used the numbers in several of my classes to show white-collar crime and students actually were interested. Don't get too excited I also show Zootopia because of its sociological theory value.

Just a great read that will enlighten you about this serious problem facing our country.

5 stars

Happy Reading!

[Ken Heard · Rating 5 out of 5]

This is a stunning look at the rampant opioid abuse in West Virginia, Kentucky and Ohio brought on, not by drug dealers trying to make a quick buck, but the pharmaceutical companies, physicians and pharmacies that dispense millions of hydrocodone, oxycodine, Oxycontin and other pain killers.

Eric Eyre does an amazing job of tracking down the offenders all while working at a newspaper that is in economic trouble (as most papers are) and while battling Parkinson's Disease. The story shows the dedication Eyre has to getting the story despite all the obstacles placed in front of him.

And it is quite a story. One small pharmacy in Kentucky would sell hot dogs and used cars to people who waited in line to get their pain meds filled, it was that much of a rush. At one point, Eyre wrote, the amount of pills dispensed in a year would result in every West Virginia resident getting more than 1,000 pills each.

There are a lot of characters, attorneys and defendants in the book and at times it becomes confusing to sort everyone out if you read the book in bits and pieces like I did. Best to dive into it in a weekend and read it through. It's well written, informative and almost plot-driven like a thriller in events leading to courtroom hearings. Eyre also did the newspaper feature writing 101 technique. He opened with a person who lost her brother to an overdose and then ended the story with her at another funeral. It looped the tale around and put a more human side to the courtroom brawls and staggering numbers of overdoses in the region.

[Leslie · Rating 5 out of 5]

Is there any entity or institution, public or private, that has not been rendered unfit for purpose by the for-profit health care (non)system, out-of-control economic and social disparities, the gutting of the public sector and regulatory agencies that are supposed to serve the people, the demolition of media capable of investigative journalism, and the political control of the judicial system that's supposed be a check on corruption and elite control? What a mess. A mess that's killing people and destroying communities. Journalists like Eric Eyre are a necessary but fragile bulwark against it all.

[Bookphile · Rating 5 out of 5]

I'm sure it comes as no surprise to say that these days, I don't really need anything more to stir me up. There's more than enough going on to feed my anxiety and outrage 24/7. Yet this is a book that definitely deserves to be read, because it goes into detail about an issue that I sincerely hope does not get buried in the aftermath of COVID-19. It would be far too convenient for the many offenders--drug companies, distributors, the DEA, corrupt pharmacies, deplorable doctors, politicians drowning in their own self-interest--if this issue did fade from the public consciousness. I was outraged after the tobacco industry was exposed, and I am no less outraged at the machines that kept churning out opioids in mass quantities. At least COVID-19 is a creation of indifferent nature, unlike tobacco and opioids, both of which were produced by humans who seemingly didn't care about the people they were killing with their products.

The other thing this book exposes is how critical independent journalism and journalists are to a free society. There is a reason freedom of the press is enshrined in the very first amendment to our Constitution, and this book provides ample proof of why, particularly in this day and age, when the powerful have honed the weapons they have long used to try to suppress and silence those who would speak truth to power. Our government may be formally comprised of three parts, the judicial branch, the legislative branch, and the executive branch, but the press is every bit as important to our democracy as these other three pillars of America. Were it not for journalists like Eyre, corporations would simply continue to buy off politicians in order to conceal their malfeasance from the public. Reading this book isn't the first time I've wondered who politicians truly represent, and I'm sure it won't be the last, but it did drive home for me why the public needs a watchdog to keep politicians in line. I shudder to think of what might have happened with the opioid crisis had Eyre and other journalists not exposed the dirty secrets of all involved in pushing billions of pills on Americans, and I shudder to think of what might happen if the relentless barrage perpetrated against the media by the powerful is successful. There is a war for access to the truth going on in this country, and it looks alarmingly like American citizens are destined to lose.

If this review hasn't yet made clear why I think this book is so important, let me make another attempt. In clear, lucid, compelling prose, Eyre lays out his battle against West Virginia's powerful in his attempts to unveil the truth, and he makes clear the human cost of the opioid epidemic. Of course drug companies and the politicians in their pockets want to lay the blame on addicts, all the while denying the role they played in creating those addictions. Like the tobacco industry, the opioid industry lied again and again about the dangers of their products, products that have not only killed Americans, but that have devastated entire swathes of the country. Serious as the death toll is, it's hard to quantify the damage done because the scope is so enormous. Children are growing up on the brink because their parents can't escape their addictions, industries are suffering because they can't find employees who pass their drug tests, and the already fragile health care system has been unable to keep up with and offer meaningful care to those who want to break free of their addictions.

This book makes clear why government oversight and regulation are important. America is a culture that worships capitalism and because it does, it has become very good at waving away the ills of unfettered capitalism. This book lays bare the speciousness of the argument that corporations can regulate themselves because taking care of their customers is in their own best interests. As any psychology researcher can tell you, humans excel at justifying away all kinds of reprehensible behavior when they're benefiting from that behavior, and it cannot be clearer that the billions of dollars in profits corporations were raking in led to a whole lot of willful blindness when it came to the effect their product was having on their consumers. Like most people, I love a good David and Goliath story, love the idea that the powerful can be toppled by the unlikeliest of combatants. But this book made me wonder why America is a country that not only tolerates the creation of those Goliaths, but that actively seeks to protect them at all cost. A country that is supposedly of the people, for the people, and by the people has become a dark reflection of itself.

[Karyl · Rating 5 out of 5]

In two years, out-of-state drug companies shipped nearly 9 million opioid pain pills to Kermit, West Virginia, a town with 382 people.

Read that statistic. Then read it again. Read it one more time for good measure.

I know it’s easier to blame the addict. They’re the ones breaking the law, right? They’re doctor shopping to get their pills prescribed, and they’re finding shady pharmacies that fill those prescriptions no questions asked, or they’re buying the pills on the street.

But how did those people get to be addicts to begin with? Pill manufacturers encouraged doctors to prescribe these highly addictive painkillers while maintaining they weren’t all that addictive if taken properly. Once on these painkillers, many patients needed higher and higher doses to keep the pain at bay, especially if it was emotional pain in addition to their physical pain they were medicating. The distributors loved how easy it was to rake in money, and even though they were supposed to be keeping track of the areas that were ordering an inordinate amount of pills, the almighty dollar took over and the pills were shipped.

Americans were consuming more than 80 percent of the world’s supply of oxycodone, and 99 percent of its hydrocodone.

And hardest hit was West Virginia. Eyre’s reporting on the opioid crisis was instrumental in bringing this epidemic into the light, to try to place the blame at the feet of those responsible, though their money and their Washington lobbyists tried their best to shuffle it off. This is an important book, and it’s even more amazing that Eyre so doggedly kept to the story even as his newspaper was sold and his health declined because of Parkinson’s disease.

Democracy dies in darkness (to borrow the tag line of the Washington Post). Thank you, Mr Eyre, for continuing to shine a light.

[Jill Diamond · Rating 3 out of 5]

3.5 stars. Compelling, important story. Extensively researched, well-written by Pulitzer Prize winning reporter. I had some lags in interest (editing?) but the facts speak for themselves.

[Kayla · Rating 4 out of 5]

First audiobook