Ep. 164 Breaking a Story with Patrick Radden Keefe

Our guest today is staff writer at The New Yorker, and award winning author Patrick Radden Keefe. We talk about his newest book Empire of Pain: The Secret History of the Sackler Dynasty, and the ways the opioid crisis was directly connected to their drug OxyContin. We also discuss Patrick’s thinking around breaking a story, writing after the success of his bestselling book Say Nothing: A True Story of Murder and Memory in Northern Ireland, and his foray into podcasting with his show Wind of Change.

The Stacks Book Club selection for May is Anna Karenina by Leo Tolstoy . We will discuss the book with Jenny Lee on Wednesday May 26th.


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Everything we talk about on today’s episode can be found below in the show notes. You can also find everything we talked about on Amazon.

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Dopesick: Dealers, Doctors, and the Drug Company that Addicted America by Beth Macy

The Stacks received this book from the publisher in exchange for an honest review. For more information click here

When I heard about Dopesick by Beth Macy, I was so excited. This is the kind of book I just love, investigative journalism meets profiles of drug abusers meets cover up by big business, meets politics meets the healthcare system meets current events. This book has all the things I love reading about. If you’re not familiar with this book here is a quick blurb:

Beth Macy takes us into the epicenter of America’s twenty-plus year struggle with opioid addiction. From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once-idyllic farm towns; it’s a heartbreaking trajectory that illustrates how this national crisis has persisted for so long and become so firmly entrenched.

Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, Macy endeavors to answer a grieving mother’s question-why her only son died-and comes away with a harrowing story of greed and need. From the introduction of OxyContin in 1996, Macy parses how America embraced a medical culture where over treatment with painkillers became the norm. In some of the same distressed communities featured in her bestselling book Factory Man, the unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death.

This book is telling the story of the heroin/opiate addiction that runs rampant in this country, and in this book specifically in Virginia. It is a compassionate look at the individual lives touched by these drugs and a also a searing indictment on the big pharma companies and government agencies that allowed it to get out of control. I think this book is important in the stories it tells, and only wish that other drug addicts and families got the same compassion and understanding the the victims of the opioid epidemic invariably seem to get.

Macy’s writing style is verbose to say the least, there are sentences that are filled with so many commas and dashes that I found myself having to reread them to figure out what she was talking about. As far as investigative journalism goes, this style is not what you tend to see. Macy inserts herself in the book, which is a trend I’ve noticed in two other works of investigative journalism published this year (Bad Blood by John Carreyrou and To The Bridge by Nancy Rommelmann). I don’t feel that Macy needed to be an outright voice in this book, nor do I understand her choice to be one. It didn’t take away from Dopesick, nor did it add anything.

I learned a lot about OxyContin, heroin, methadone, fentanyl, a slew of other opiate drugs and the effects they have on a human body while reading Dopesick. I found myself constantly looking up from the book and asking my husband (who is a doctor) if he knew this or that, if he’d ever prescribed OxyContin, if he’d dealt with babies born addicted to opiates. The book excited my love of learning. Like most addictions, the stigma around heroin/opiate use prevents a lot of information from getting out to the world, and Macy’s work exposes the dark secrets we don’t hear about. Like the mother who takes the doors of the hinges to prevent her son from doing drugs in the house. All the things that people who aren’t connected to this kind of addiction would never see.

Macy is thorough in her research and reporting on this drug crisis. Her politics and perspectives are very much present in the book, and she even shares some of her opinions point blank (around drug treatment policy, the current President and his administration). I wish she would have pushed back on some of the racism and racial double standards we find through out the book and on the topic of drug use in America, in general. There was certainly more room for questioning and dissecting the politics around a book like this. Why is the main drug dealer in this story Black? Why is he described as a predator?

As I read the book, I kept asking myself, if we know that drug addiction alters brains, and changes humans, how come we’re only willing to extend the benefit of understanding to White kids and their families? Where are the compassionate profiles that examine addiction in theBlack and Brown communities? The book isn’t to blame for this, but it does highlight the second chances that White heroin addicts are given by law enforcement, the courts, doctors, and the community at large. That is what frustrates me most about the opioid epidemic and the way it has been prioritized in American political and popular culture.

Overall I suggest this book, if you’re OK with some of the more graphic and emotional details that come with drug addiction and overdoses. The book is a pretty heavy read, and the subject is upsetting. There is a lot to learn from reading this book. Trigger warning for those who are dealing with opiate addiction in their own life in any capacity.

  • Hardcover: 384 pages
  • Publisher: Little, Brown and Company; 1st Edition edition (August 7, 2018)
  • 4/5 stars
  • Buy Dopesick on Amazon

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The Stacks participates in affiliate programs in which we receive a small commission when products are purchased through some links on this website. This does not effect my opinions on books and products. For more information click here.