Genre: Adult Nonfiction
Year Release: 2022
Source: Audible

Listened to the audiobook
Content/trigger warnings: COVID-19, overdose, vomiting, prison, drug abuse, structural inequality, death of relatives

This book is a kind of sequel to Dopesick, in that it is a continuation of Beth Macy’s research and investigation into the impact and extent of the devastation left behind by the Sackler’s mismarketing and straight-up lying about the acute and long-term effects of their so-called miracle drug. There is some follow-up with the activists, doctors, and caregivers from the initial investigation, with several new key players in the movement to curb overdose deaths both within Appalachia and nationwide.

Though “hope” is in the subtitle, this volume reckons with the fact that the COVID-19 pandemic has slowed down many of the boots-on-the-ground work with regards to harm reduction and further stigmatization and rethinking addiction as a disease rather than a personal failing. It does end, however, with action items that the reader can take on personal, political, and local levels.

This book is not a feel-good story. The details within follow-up on the situations and people featured in Dopesick, and, in many cases, things have not gotten better. Especially with COVID-19 disrupting availability of hospital beds, personal protective equipment, and the ability to gather in close quarters. Macy does not shy away from the grittier details, but it’s not designed to put off people from reality; in fact, her depiction and narration serve to elicit compassion and empathy. The word is hard, both from a standpoint of being able to handle the work and navigating those who get in the way. In some ways, the roadblocks to treatment are more harrowing than coming down with substance use disorder to begin with. Macy takes great care in showing all the people and steps involved in helping those affected survive, especially when the treatment and approaches defy past research and recovery theory for addiction as a whole. It’s all presented in a way that asks the reader to recognize and reconsider their own biases. It’s effective, and it’s left me with much food for thought.

While not coddling at all, the book does end with a list of action items to help those in one’s immediate community, political actions, supporting harm reduction locally and nationally, and more. I’ve already subscribed to the newsletter for the Texas Harm Reduction Alliance, and encourage readers to do the same for their state and local municipalities.