American Overdose: The Opioid Tragedy in Three Acts

American Overdose: The Opioid Tragedy in Three Acts

A comprehensive portrait of a uniquely American epidemic--devastating in its findings and damning in its conclusionsThe opioid epidemic has been described as "one of the greatest mistakes of modern medicine." But calling it a mistake is a generous rewriting of the history of greed, corruption, and indifference that pushed the US into consuming more than 80 percent of the w...

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Title:American Overdose: The Opioid Tragedy in Three Acts
Author:Chris McGreal
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American Overdose: The Opioid Tragedy in Three Acts Reviews

  • Janet

    received a DIGITAL Advance Reader Copy of this book from #NetGalley in exchange for an honest review.

    From the publisher ---

    A devastating portrait of the opioid epidemic, a uniquely American and catastrophically lethal tragedy born of Congressional neglect, amplified by corporate greed, and brutally exploited by illegal drug cartels.

    The opioid epidemic is the deadliest drug crisis in American history; it results in 90 American deaths a day and has eviscerated communities across the country. It

    received a DIGITAL Advance Reader Copy of this book from #NetGalley in exchange for an honest review.

    From the publisher ---

    A devastating portrait of the opioid epidemic, a uniquely American and catastrophically lethal tragedy born of Congressional neglect, amplified by corporate greed, and brutally exploited by illegal drug cartels.

    The opioid epidemic is the deadliest drug crisis in American history; it results in 90 American deaths a day and has eviscerated communities across the country. It is a consequence of a healthcare system run as a business, one that prescribed drugs with unprecedented amounts of oxycodone to patients experiencing everything from toothaches to severe chronic pain. The practice created a culture of addiction in towns and cities from Florida to Maine and throughout Appalachia and the American West.

    In American Overdose, Chris McGreal outlines the three main stories of the opioid epidemic: first, the negligent policies that allowed the greed and corruption of big pharma to profit off the suffering of their patients and new evidence on the FDA's complicity in the matter; second, the widespread addiction that ravaged American towns and cities; and finally, the even more devastating arrival of the drug cartels who deliberately and catastrophically exploited the market for addiction that has been created.

    Through the lives of doctors, addicts, policy-makers, pharmaceutical reps, and family members, McGreal tells two parallel stories: that of the rise of opioids in the healthcare system and the personal stories of those affected on the ground, joined in what a former member of the FDA has called "one of the greatest mistakes of modern medicine."

    Aside from crazy politics, whenever you read the news it seems that another set of parents are found passed out with their kids in the car or some other crazy, neglectful place as mom and dad are “out” if not dead. (I often wonder if more of the dead-kid-left-in-a-hot-car has to due to opioids as well!) My father is a retired pharmacist who is devastated by all these happenings and grateful that he doesn’t have to worry about armed robberies at his dispensary.

    I had to put MY ideology/view/opinion that addiction is a choice NOT A DISEASE (I feel that it is a choice) to read this book as I don’t understand why people want to “get high”. All three of the stories in this book are frightening and prove that more and more, the opioid crisis is only going to get worse to the point where massive, violent gangs like in Mexico move into the urban landscape.

    How do we fix this? Not easily, for sure.

    This book is a mastery of the non-fiction book: immaculate research and easy explanations will make it be enjoyed by all levels of readers and their interests. Turn off the fake news and read this book! In fact, make it a #bookclubpick !!

  • Shelly

    Interesting and illuminating do not even come close to describing this book! This is the devastating narrative of how the opiate crisis came to pass in America. Written in a unique, comprehensive and educational manner, I found myself wishing that this book was a reading requirement for all high school students to help them avoid the pitfalls of the current addiction culture. I then found myself wishing it was a requirement for ALL Americans to read. Several years ago an individual remarked to m

    Interesting and illuminating do not even come close to describing this book! This is the devastating narrative of how the opiate crisis came to pass in America. Written in a unique, comprehensive and educational manner, I found myself wishing that this book was a reading requirement for all high school students to help them avoid the pitfalls of the current addiction culture. I then found myself wishing it was a requirement for ALL Americans to read. Several years ago an individual remarked to me that soon not a person on the US would be left untouched by the opiate crisis. She insisted that soon everyone would have a friend or family member suffering from addiction. I remember thinking that this woman was quite mistaken. Three years on, I believe her prediction has come to pass.

    In American Overdose, Chris McGreal sets the framework for what would lead to arguably the biggest addiction crisis in America, founded on misguided policies, trust, corruption, booming profits and, of course, big pharma. Have other authors tackled this same topic? Sure; but not with the finesse and meticulousness of Chris McGreal. This book not only provides the “hows” and “whys” behind the crisis, it also provides up-close and personal glimpses into the lives of real people affected by pill mills, dishonorable doctors and a healthcare system off its tracks. Gripping, enthralling and informative. I rate this book a solid five stars.

  • Kyle

    A received an ARC of this book via NetGalley in exchange for my honest opinion.

    A fascinating read about how the opioid epidemic arose. Through meticulous research, McGreal is about to identify the various factors and individuals responsible for this epidemic. McGreal explores the epidemic from all angles, and presents perfect representation of each subject and how it contributed to the epidemic. Even those readers already well versed in this subject will gain a greater knowledge of the opioid e

    A received an ARC of this book via NetGalley in exchange for my honest opinion.

    A fascinating read about how the opioid epidemic arose. Through meticulous research, McGreal is about to identify the various factors and individuals responsible for this epidemic. McGreal explores the epidemic from all angles, and presents perfect representation of each subject and how it contributed to the epidemic. Even those readers already well versed in this subject will gain a greater knowledge of the opioid epidemic. Greed, corruption, hubris, ineptitude, denial, and deceit all contribute to the crisis we are facing today. Much of this crisis could have been avoided, or at a minimum, reduced, but now much of the damage has been done, and reversing these trends will not be an easy task. This is a must read for anyone with at least a passing interest in the opioid crisis in America wanting to gain a greater understanding of its inception.

  • Debra

    4.5 stars

    (In 2012) "Doctors write more than 250 million prescriptions for opioids, enough to provide a bottle to every adult in America. The United States consumes more than 80 percent of the world's prescription narcotics."

    - Scary, Scary statistic. That was 2012.

    ***Please note the information I received from the Author after writing my review. The below information concerns levels today. The new updated information will be included in the final proof of the book!:

    "Around 200 million-plus opi

    4.5 stars

    (In 2012) "Doctors write more than 250 million prescriptions for opioids, enough to provide a bottle to every adult in America. The United States consumes more than 80 percent of the world's prescription narcotics."

    - Scary, Scary statistic. That was 2012.

    ***Please note the information I received from the Author after writing my review. The below information concerns levels today. The new updated information will be included in the final proof of the book!:

    "Around 200 million-plus opioid prescriptions were written in 2016 in the US, which is about one for every adult, although many of those prescriptions will be for fewer tablets (three or five days instead of 10 or 14 days). Also, within that there are huge disparities by state, and within those states by town and city. But Americans still use opioid painkillers at four times the rate of the UK or France, and the CDC thinks levels remain way too high."

    This was a pretty scary book. The statistics were staggering. While reading this book, I highlighted huge sections as I was blown away with the information. The Author points out how "the opioid epidemic is the deadliest drug crisis in American history; it results in 90 American deaths a day and has eviscerated communities across the country."

    "The Crude calculation is that prescription pain pills have claimed more than a quarter of a million of American lives."

    This book is told in three acts which highlight how Opioid use and addiction came to be. In the first section, the book examines how healthcare in the U.S. is run like a business where pharmaceutical companies profit off the pain and suffering of patients, how the policies are not strict enough and the FDA was complicit in the matter. The second section of the book, addiction is addressed. In the third section of the book, drug cartels are examined and how they exploited the market for addiction.

    "For years, American doctors wrote more than a quarter-million opioid prescriptions. As Congressman Harold "Hal" Rogers put it, "That's enough painkillers to medicate every American adult around the clock for a month."

    The Author writes this book using staggering statistics but also shares stories ranging from addicts, doctors, family members and those in the pharmaceutical industry. Addiction has been around for a very long time. In the "1880's, more than half of those hooked on the drug (morphine) were middle and upper class white women." Cough syrups, especially those for children and teething syrups contained morphine, cannabis and alcohol. There were no regulations back then and people could use as much as they see fit.

    Pain is a part of people's lives. There are those who work very physically demanding jobs which leave them in pain day after day i.e. dancers, farmers, miners, construction workers, those in the timber industry to name a few. Painkillers help them to ease the pain, recover from injury and be able to do their job day after day. That is not to mention those who require surgery and are prescribed painkillers during their healing process. But what happens when addiction occurs? What happens when clinics pop up where an individual can pay $250.00 to see a doctor to be diagnosed with an injury so that he/she can obtain a prescription to Oxycodone? When all one needs to do is come back month after month and hand the receptionist another $250.00 and you will be given another prescription no questions asked? Shocking that such places exist.

    Who is to blame for the addiction to painkillers? Prescription drug manufacturers, such as Purdue, who send out drug reps to give gifts to doctors’ offices in the form of coffee mugs, pens, food, etc., so that they can talk to the doctor about prescribing oxycodone or other medications. Are they to blame? The book states how "Purdue threw out unprecedented amounts of money into promoting Oxycontin, spending several times the advertising budgets of rivals." Are doctors to blame for prescribing or over prescribing opiates, is the FDA to blame for not having more strict rules and regulations, are addicts to blame? What can be done? What is being done?

    Whoever is to blame, it is scary how addiction to prescription drugs is skyrocketing. Turn on the news and there are reports of police officers and paramedics entering homes and finding children with an unconscious or deceased parent due to overdose. It's also happening in parked cars and parks as well. Is there a solution? I don't know. Pain exists, and we need treatment for it, but where do we draw the line?

    This book was educational well written. Extremely well researched and laid out. The old "Knowledge is power" saying applies here. I do believe that doctors and health care providers are cracking down on what is prescribed. Some prescriptions require that an individual show a driver’s license or some form of identification when you pick up your prescriptions. But again, there are drug cartels who can and do sell the drugs on the street. It's scary. This book just addresses the opioid epidemic. There are more out there. Last year, I received a call form my son’s school. A student found his parents edibles and thought they were candy and brought them in to share with friends. Several kids were rushed to the hospital after consuming them. Anyone see the news where a young boy died when he was hungry and mistook his father’s Meth for cereal? So many frightening things going on with drugs and drug addiction. Is there a solution? What is the solution?

    Thank you to Perseus Books, Public Affairs and NetGalley who provided me with a copy of this book in exchange for an honest review. All the thoughts and opinions expressed in this review are my own.

    Read more of my reviews at

  • Michelle

    American Overdose: The Opioid Tragedy in Three Acts (2018) is a devastating and shocking expose of the chain of events that defines the worst drug epidemic in American history, authored by notable journalist for the Guardian Chris McGreal. As ordinary American’s use and abuse substance, suppliers/dealers of illicit drugs were included in the same category as the wellness clinics, “pill mills” (of West Virginia, North Carolina, Ohio, Florida) and the doctor’s that prescribed “astronomical” amount

    American Overdose: The Opioid Tragedy in Three Acts (2018) is a devastating and shocking expose of the chain of events that defines the worst drug epidemic in American history, authored by notable journalist for the Guardian Chris McGreal. As ordinary American’s use and abuse substance, suppliers/dealers of illicit drugs were included in the same category as the wellness clinics, “pill mills” (of West Virginia, North Carolina, Ohio, Florida) and the doctor’s that prescribed “astronomical” amounts of opioid’s--while keeping poor records, phoning in prescriptions, with few questions and/or never meeting patients. The chain continued up, the pharmacies that received and filled orders dispensing millions of pills without question or notifying authorities; the pharmaceutical industry responsible for the manufacture and peddling of pills in the “Disease of Despair” realizing billions of dollars in sales and profits. There were “user friendly policies and procedures” needed to keep the lucrative gravy train rolling— enter Big Pharma’s buddies in the FDA, lobbyists, experts in the medical field, and the shameless politicians that received millions of dollars in campaign donations supporting the greedy agenda of the pharmaceutical industry (names were included)! The connection of these forces that conspired together with too many government officials and policy makers looking the other way, have created a corrupt for profit medical industry that dangerously fails to serve the American people in a responsible accountable manner.

    According to McGreal and other investigative journalists including Beth Macy with her informative book “Dopesick” (2018) many northeastern cities and the American Appalachia were seemingly targeted and hardest hit in this unfolding tragedy. By 2005, Big Pharma had spent billions in marketing direct to consumer advertising and education—as patients self-diagnosed and demanded prescription medication. It is now known that the probability of addiction was discounted and downplayed as “The Balanced Approach” was aggressively promoted by industry executives: suggesting the FDA make opioid’s available without restriction, and went as far to copyright “pain” as the 5th vital sign. The Veteran’s Administration was the first to accept this (outrageous) policy.

    The Balanced Approach also separated “good patients” who were the real “victims” suffering pain and in dire need of treatment. Big Pharma would always deflect their responsibility and role for the drug epidemic— shifting the blame of addiction solely on the individual user rather than the drug that caused it.

    Over a decade later, smug industry executives would claim that “playing the blame game would not end the epidemic.” In hearings pharma executives were blasted as “offensive” by West Virginia Rep. David McKinley (GOP) for flooding a local Mingo County pharmacy with 5.6 million opioid pills in a two year period. By this time, individual doctors and pharmacists had already been charged, medical licenses revoked, some were serving prison sentences. McKission paid a 150 million fine for failure to report suspicious drug shipments. However, with billions a year in profits the fine was labeled as merely the cost of doing business.

    The accountability of Big Pharma executives continued at an all-time low for their role in the drug epidemic that led to drug related deaths of over 72,000 Americans (2017). While McGreal doesn’t offer solutions to the vast problems created by the epidemic, his book offers an urgent message related to education and understanding of powerful forces that shape American society and medical structure; and the lasting profound impact on humanity. ** With thanks and appreciation to Hachette Book Group via NetGalley for the DDC for the purpose of review

  • Margaret Sankey

    McGreal chases the string of events via which Purdue pharma got doctors to start thinking of pain as a "fifth vital sign" and, with relaxed advertising rules, started convincing people that pain was an unendurable blight, even after surgery or as part of aging. Once the market was primed, FDA labeling lobbied for by the company, and sales people armed with big data targeting specific communities and doctors flooded the medical community with Oxycontin, Oxycodone and promises that time release wo

    McGreal chases the string of events via which Purdue pharma got doctors to start thinking of pain as a "fifth vital sign" and, with relaxed advertising rules, started convincing people that pain was an unendurable blight, even after surgery or as part of aging. Once the market was primed, FDA labeling lobbied for by the company, and sales people armed with big data targeting specific communities and doctors flooded the medical community with Oxycontin, Oxycodone and promises that time release would prevent abuse and addiction. As this spiraled into rural communities, like Kermit and Williamson in Appalachia, social fabric, already strained by deindustrialization and the 2008 financial crash, shredded as people flocked to pill mills run by disgraced doctors with cash in hand gained from theft, prostitution and other crimes. As overdoses mounted, people organized in vain to demand political response. Some curtailing came in 2010, swinging many people from prescription abuse to the more affordable heroin supplied by savvy cartels. Ultimately, and very depressingly, the complex means of addressing this epidemic are exactly what the current administration is least likely to do.

  • Diane S ☔

    Unconsciousable, if there is one word I would use to describe the greed I read about in this book, this would be the word. One would have to be completely out of touch to have not heard on the news, or read in the papers, about the opoid epidemic striking our nation. Untold deaths, families, lives ruined. A documentary about West Virginia, which was literally a opoid mill, was shown a few months back, towns completely taken over by addiction. What I didn't realize was how this was accomplished.

    Unconsciousable, if there is one word I would use to describe the greed I read about in this book, this would be the word. One would have to be completely out of touch to have not heard on the news, or read in the papers, about the opoid epidemic striking our nation. Untold deaths, families, lives ruined. A documentary about West Virginia, which was literally a opoid mill, was shown a few months back, towns completely taken over by addiction. What I didn't realize was how this was accomplished. A literal pill mill.

    This book explains how this happened, how it was allowed to happen. The greed of drug companies, basically pushing to doctors, what they tooted as the newest pill in pain relief, from cooked doctors, clinics, and pharmscies. Taking advantage of the pain those with injuries or previous trauma experienced,to addict them to a pill that they needed more and more of I increasing dosages. Hard to believe this is happening in my country, but it is and it is deplorable.

    So many lives ruined, even those who had seen this becoming a problem seen what it did to people, find themselves after an accidental addicted. This book explains in three separate sections how this was done, how greed and the love of money, addicted so many. A very important read and one that is easy to read but explains things very well.

    ARC from Netgalley.

  • Caidyn (SEMI-HIATUS; BW Reviews; he/him/his)

    Where I am for my social work practicum is a place very different than this book’s stance. Every day — well, Mondays and Tuesdays — I listen to opioid use and the people who use them to make themselves better. The angle I’m coming at this topic from is very different than what McGreal is comme

    Where I am for my social work practicum is a place very different than this book’s stance. Every day — well, Mondays and Tuesdays — I listen to opioid use and the people who use them to make themselves better. The angle I’m coming at this topic from is very different than what McGreal is commenting on. I’m coming at it from hospice. And, that’s an important part of hospice since the whole thinking is to make their last days/weeks/months easy. Get rid of the pain.

    So, generally, I look at opioids as something positive for these people.

    For me? Nope. I can count on one hand how many times I’ve had to use opioids and, each time, I got off of them as soon as possible. I wasn’t even on them for a week after top surgery before I started substituting them and getting myself off of them.

    And, this book is just scary. It’s a fitting October read just from how frightening it is to see the way pharmaceutical companies, doctors, and the government all worked together to let this current mess we’re in get to this point. It was just terrifying to see how it all went down and happened, laid out in detail by McGreal.

    Coming at this topic as a layperson, I found this book very easy to understand and track. McGreal is a great author. He knows how to tell the story and to do so simply. There were a lot of names that I couldn’t keep track of and sometimes I forgot about some things while I went along, but it was still a very solid, well-done book on a huge topic.

    I loved how McGreal incorporated so many real voices into this. Not just the “experts,” but also the people affected by this epidemic. Those who have lost children, spouses, and even themselves to it. It was horrifyingly sad to see all the people who suffered and suffer from what’s happened.

    If anything, this cements this in my head as a huge problem that needs to be fixed in the future or we’re going to suffer more than we already do as a society.

  • Jess

    Thank you to NetGalley and Perseus Books/PublicAffairs for providing me with an ARC in exchange for an honest review. Chris McGreal's American Overdose is a must-read for anyone concerned with the current opioid crisis in the United States. And who should be concerned? Everyone.

    Having read another opioid crisis expose, Dopesick by Beth Macy, already this year, I was interested to see what new material McGreal could bring to the table. This book provides more of a structural overview of the topic

    Thank you to NetGalley and Perseus Books/PublicAffairs for providing me with an ARC in exchange for an honest review. Chris McGreal's American Overdose is a must-read for anyone concerned with the current opioid crisis in the United States. And who should be concerned? Everyone.

    Having read another opioid crisis expose, Dopesick by Beth Macy, already this year, I was interested to see what new material McGreal could bring to the table. This book provides more of a structural overview of the topic than Dopesick and then dives into specific pieces to flesh out the narrative. The investigation is split into three parts, Dealing, Hooked, and Withdrawal. Though the two books understandably share many central characters, they are not repetitive and McGreal's work dovetails perfectly with other research studies already completed on the topic.

    Overdose is the leading cause of death for people under the age of fifty, McGreal writes. Poor, rural people are not manufacturing these drugs. This crisis is not due to street heroin or cocaine or meth, though people turn there when their prescriptions run out. These drugs are being funneled into the hands of a vulnerable American public through the greed of big pharma and the negligence of the FDA. Doctors have been brought into the fray through money and gifts, with others doctors fighting against their medical brothers and sisters to save patients.

    Pills have been peddled to Americans as the panacea for every ill and now generations of Americans are growing up thinking that relative pain is a vital sign and pills are magic. We are in a dangerous zone and people are dying daily because of it. McGreal makes a great case that while pain should be taken seriously and is certainly real for many people, opioids are not the answer; just the cause of more pain. He has thoroughly convinced me that pharmaceutical companies should not be allowed to advertise on television. It is a recipe for disaster.

    Written in an engaging style with thorough research and clear stances, American Overdose is highly recommended.

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