Raising Lazarus: Hope Justice, and the Future of America’s Overdose Crisis by Beth Macy. 

3/5 rating. 293 pages.

Book #4 of 2024. Finished January 25, 2024.

This is the follow-up to the incredible book (and later Hulu series) about the opioid crisis, “Dopesick”.

Beth is a great writer who covers a vast swath of happenings around the overdose crisis and opioids. The book focuses a lot on the ongoing court battles between countless localities and individuals hurt by OxyContin, and the criminals who ran Purdue Pharma, the Sacklers. Along with this struggle is a ton of stories of people fighting to help the addicted drug users.

This book was heart-wrenching because of the absolute callousness by officials and people creating stigma around those hurt most by the opioid epidemic. Meanwhile, the stories of the heroes trying to help those in need get their lives back was beautiful.

I think the biggest detractor from the book’s rating was just that there was not that large of a throughline, it just viewed a whole bunch of people and the work they are doing as well as the Sackler court battle.

Some of my favorite quotes:

– “But for two decades, regulatory watchdogs stood by as pharmaceutical and health-products corporations plied lobbyists, political campaigns, and Capitol Hill politicians with $4.7 billion to smooth the pathway so they could sell, sell, sell.”

– “When you treat marginalized groups like human beings instead of objects, they begin to trust you, eventually they get better and help others get better, too.”

– “‘If you don’t believe in evidence and you don’t believe in humanity, at least look at the costs,’ said Smith, eighty-three. ‘Every dollar spent on treatment saves nine dollars in public health and social costs.’”

– “What matters to the Sacklers? Money. So what do we want back from them? Money. I want that money. I don’t care if they go to jail, I don’t care if they go to prison. I want their money. You know what else I want? I want that fucking patent [awarded to Richard Sackler in 2018] to the new Suboxone. And I want that Suboxone free for every single person who needs it…How dare they try to profit off this epidemic that they created?” – Alexis Pleus, Truth Pharm founder

Additional Quotes:

“The Centers for Disease Control and Prevention estimates that more than a million Americans have died from drug overdose since 1996, the largest factor in decreasing life expectancy for Americans. In the past two decades, overdose deaths have quintupled.”

“For a quarter century, the Sacklers masterminded and micro-managed a relentless marketing campaign for their killer drug [OxyContin], then surgically drained the company of $10 billion when they saw trouble on the horizon.”

“In recent years the opioid lobby has spent eight times more than the gun lobby to curry favor with lawmakers.”

“Just don’t disappear, okay?”

“CAVEs – short for Citizens Against Virtually Everything.”

“People who go to needle programs are five times more likely to enter treatment – because their needs are triaged by trusted workers who can help them enter treatment if an when they are ready. They’re also three times more likely to reduce or stop IV drug use.”

“‘Part of the divide is amongst ourselves, and it has to do both with class and race, as in, “This county used to be so great, but then these +urban+ problems came in.”‘ They wrongly blame immigrants for taking their jobs when it was greedy corporate executives beholden to greedy shareholders who offshored the jobs, keeping more profit for themselves and treating the working class like a coal seam in Appalachia – a resource to mine, no matter the human or environmental cost.”

“Heartache, not data, was the best prompter of public-policy change.”

“When [Richard] Sackler pressed his lieutenants to lobby for over-the-counter status for OxyContin in Germany in 1997, one worried whether such lax German controls would lead to widespread abuse. To which Richard stunningly responded: ‘How substantially would it improve your sales?’”

“The AMA remains an opponent of single-payer health care, or Medicare for All, even as it enjoys widespread public support today.”

“If Medicare were, [Ronald Reagan] warned, ‘you and I are going to spend our sunset years telling our children and our children’s children what it was like when men were free.’”

“When I shared my son’s drug-war near-misses with the historian Herzberg, he said, ‘You just described a system that prevented a young person being foolish from being screwed forever. Everybody should have that. You want the kind of society where young people can fuck up and still come out okay on the other side.’”

“People living in distressed rural communities are ‘so suspicious of government; they don’t think anything’s really going to help them, and generally they don’t see their futures as being very bright.’”

“A 2019 study by economists at the Wharton School and elsewhere suggested that, in the few states with unusually stringent prescription monitoring practices – so-called triplicate programs – overdose deaths from both illicit and prescribed OxyContin remained significantly lower two decades after it was introduced. Purdue had avoided spending as much on marketing in Illinois, New York, California, Idaho, and Texas precisely because company executives understood that their hard-sell tactics wouldn’t pay off where prescription oversight was highest. Regulation, where it was employed, worked.”

“I always start with, ‘We’re so glad to see you. We’re so glad you’re here.’”

“As an aside, Watson told me that the professional most critical to a person’s initiation into recovery wasn’t their doctor or even their nurse. It was the attitude of the person running the front desk.”

“‘When people are driven by fear, facts don’t matter,’ O’Connell said. ‘We cannot scare people into a public health approach.’”

#opioidcrisis #harmreduction #raisinglazarus #bethmacy #dopesick

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