Many of the casualties have been young adults. In a poignant early scene, Macy joins a mother at the grave of her 19-year-old son. Kristi Fernandez wants to know “how Jesse went from being a high school football hunk and burly construction worker to a heroin-overdose statistic, slumped on someone else’s bathroom floor.” That question — and its larger implications — becomes an engine for the entire investigation, driving it forward with plain-spoken moral force.
In the sprawling cast of “Dopesick,” parents like Fernandez stand out. They have been galvanized by loss. Ed Bisch, an I.T. worker in Philadelphia, hadn’t even heard of OxyContin when it killed his 18-year-old son in 2001. He went on to build a message board, OxyKills.com, that became a parental support network and information clearinghouse. It attracted the attention of Lee Nuss, a grieving mother in Palm Coast, Fla., and together they started a grass-roots protest group: Relatives Against Purdue Pharma. One of the most memorable images of their work together formed during a civil trial against Purdue in Tampa, where Nuss came to a courtroom bearing the urn with her son’s ashes. Lawyers complained. The judge ordered it removed. “My son is not here in body, but he is definitely here in spirit,” Nuss told her friends. “He might have left the building, but he will be back!”
Macy introduces so many remarkable people that, midway through “Dopesick,” readers may find it challenging to keep track of them. (Imagine the writer as the literary equivalent of a triage doctor, with more patients to stabilize than she can linger on.) Taken as a whole, however, this gripping book is a feat of reporting, research and synthesis. Among myriad sources, Macy cites the influence of two earlier works on the crisis: Sam Quinones’s “Dreamland,” which followed the heroin trail back to the Mexican county of Xalisco, and Barry Meier’s “Pain Killer,” published in 2003, which first brought Van Zee’s heroic work to light.
The final third of “Dopesick” is dedicated to recovery — the steep uphill climb facing former addicts and, more broadly, the nation. Here, Macy follows the struggle of Tess Henry, a former honor-roll student, athlete and poet, who tries to stay sober while raising a young son. Macy spends months driving Tess to Narcotics Anonymous meetings, charts her relationship with her mother and hopes for the best when Tess disappears, falling out of communication and into sex work.
This is the place where a traditional storytelling arc tells us to seek redemption. Macy advocates for medical-assisted therapies to help victims of the crisis and notes some pockets of progress. But the epidemic continues to grow, aided by a legal system that criminalizes victims and a health care framework that treats patients as consumers.
While Macy offers some glimmers of hope — chief among them the will of parents and advocates to keep fighting — what echoes long after one closes this book are the unsettling words of Tess Henry’s mother about her daughter: “There is no love you can throw on them, no hug big enough that will change the power of that drug.”