51 pages • 1 hour read
Beth MacyDopesick: Dealers, Doctors, and the Drug Company that Addicted America
Nonfiction | Book | Adult | Published in 2018A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Part 2, Chapters 7-8Chapter Summaries & Analyses
Chapter 7 Summary: “FUBI”
Macy returns to the story of Jones’s role in bringing heroin to suburban and small-town Virginia. Woodstock, Virginia, was the home of George’s Chicken processing plant, which provided employment to nonviolent felon offenders in place of prison. Jones came to Woodstock as a part of that program. In 2012, drug detectives Brent Lutz and Bill Metcalf gained insight from an informant who told them that someone known only as “D.C.” (the street name of Ronnie Jones, it turns out) was importing bulk heroin from New York City and selling it in town.
By 2012, places like Woodstock that were dependent on agriculture or processing plants were catching up to more rural communities when it came to the loss of jobs due to shifts in the economy. Macy quotes Syracuse University professor Shannon Monnat, who saw the loss of jobs in these communities as a “structural problem, where the American dream becomes a scam” (152)—an argument supported by three credible sources according to the note on page 336.
When DC began bringing heroin to town in bulk, he found a ready market. People no longer had to be commuter-dealers (people who bought drugs in cities like Baltimore, then came back to town with a stash and some to sell to pay their supplier). Heroin overdoses, drug-seeking behavior in medical facilities, and crime related to addiction skyrocketed.
Lutz and Metcalf uncovered a wide-reaching drug ring that they drew out on a board labeled FUBI (after a defiant informer’s profane refusal to cooperate with law enforcement to take down the ring). The word from Eric Holder, President Obama’s attorney general, was that agents like Metz and Metcalf should be focusing on top-level dealers, not street-level dealers. The two detectives found DC elusive, however. Their difficulties showed that simply arresting the dealers they could find wouldn’t be enough to stem the flow of drugs into their community.
Chapter 8 Summary: “‘Shit Don’t Stop’”
Lutz and Metcalf finally arrested Jones in 2013 using tips from informants and his girlfriend. Metcalf himself came from a family in which his father both used and sold heroin. His stake in busting Jones was personal, a way of “atoning for the sins of his father” (169). Lutz was so committed to his work that he neglected his wife and children, whom he rarely saw as he pursued Jones and his supplier in Harlem. Jones was relentless as well; the title of this chapter comes from a recorded conversation between one of Jones’s girlfriends and Jones, who continued arranging drug deals while incarcerated. For the agents involved, the pursuit of Jones reminded them of The Wire, a gritty television drama about the drug trade in Baltimore, Maryland.
Addiction took a greater toll on families. The story of Kristi Fernandez is illustrative. A mother of modest means, Fernandez expended her financial and emotional resources to help her son Jesse Bolstridge kick his heroin addiction. Jesse did numerous stints in rehabilitation. He experienced some success with medication-assisted treatment (MAT), which relies on behavioral interventions but also medications like methadone and Suboxone to dampen cravings.
Jesse and his mother were unable to afford MAT over the long term, and Jesse ended up in an abstinence program that relied on behavioral interventions only; most rehabilitation programs rely on abstinence and peer support programs modeled on “Alcoholics” Anonymous, a 12-step, structured approach that encourages people to rely on spirituality and group connections to become sober.
Macy contends that there is not enough evidence to show that abstinence programs are effective, but there is evidence that medication-assisted ones likely are. It takes many attempts for people to reach recovery from substance abuse; medication-assisted treatment, perhaps for life, may be the only way for people to get to recovery. She includes information from reputable agencies “NIDA [National Institute on Drug Abuse], the world Health Organization, and the White House drug czar’s office” (174) to back up her claim.
Jesse was weaned off the drug once he left rehabilitation. He lived in a sober living house for a while but relapsed into smoking marijuana, then oxycodone, and finally back to heroin. He died in 2013 after a binge on the night before he was scheduled to go to a new program.
An insert with black and white photos of the parents of young adults who died of overdoses, law enforcement officers who pursued Jones, and people on the forefront of fighting opioid addiction in their communities is included between pages 178 and 179.
In 2013, Purdue Pharma finally changed their OxyContin formulation when the original patent that gave them the exclusive right to manufacture it expired. By then, however, the FDA had approved even more addictive drugs of this type.
Part 2, Chapters 7-8 Analysis
Macy traces the evolution of the epidemic from OxyContin to heroin addiction. She uses the stories of individuals—law enforcement officers, people with addictions, and their families—to show the toll of the War on Drugs.
One of Macy’s major claims is that the War on Drugs, with its emphasis on law enforcement of urban communities where people of color live, was a failure. She systematically examines the stakeholders that contributed to those failures, despite the good intentions of many involved. The stories of Lutz and Metcalf show the two agents attempting to enact the directive of the Obama Justice Department, which told them to pursue higher-level dealers. Lutz and Metcalf’s pursuit of Jones expended many resources—and strained the agents’ personal relationships—to catch one dealer, but the trade persisted despite their best efforts. Macy also takes care to show that even as the two agents pursued drug dealers on the ground in Virginia, the FDA was approving drugs that would create even more addiction, which in turn would create even more potential consumers of heroin. That government agencies could be at such odds in their policy implementation shows that government dysfunction contributes to the opioid epidemic. Without addressing the source of the problem, addressing its consequences became a game of Whac-a-mole.
The same kind of dysfunction exists within the treatment community. Here and elsewhere, Macy explores the tension between abstinence programs like “Narcotics” Anonymous and programs that rely on medication-assisted treatment for addiction. Macy includes specific case studies to show the real-life impact of relying on the abstinence model over more evidence-based models, including the story of Jesse Bolstridge. Her evidence supports the idea that the disconnect between the bulk of recovery programs and the science on recovery contributed to the failure of the response to the epidemic.
Though Macy makes a balanced case for unwinding the effort to stem drug use via the criminal justice system by using appeals to both emotion and reason, she tends to rely on the human stories at the heart of her own research. Readers accustomed to seeing the drug trade through a dramatic lens (e.g., celebrated crime shows like The Wire) are likely to expect dramatic anecdotes about dealers, agents, and people dying from their addictions; Macy’s evidence meets those expectations. The candid photos in the insert—many of them with blurs and shadows that make them look like personal photos—are portraits of real despair, overwork, and grief. Macy also chooses to tuck her substantial research references into notes on pages 313-363 of the book; that rhetorical choice is another effort to lead with human interest stories rather than the overwhelming sociological research that supports the claim that the War on Drugs is a failure.
