Pharmageddon

A new book about America’s OxyContin crisis suggests it could be heading to our shores

If anyone needed any further convincing about the merits of the National Health Service, or rather, the relative demerits of America’s healthcare system (if system isn’t too grand a word), they might be well advised to pick up American Overdose: the Opioid Tragedy in Three Acts by Chris McGreal. The Guardian writer, who won the Martha Gellhorn Prize in 2003 for his reporting on Israel and Palestine, picks apart the astonishing circumstances that have led to opioids now killing more people in the United States per year than Aids at the height of that epidemic.

What is almost as astonishing is how it started. As villains go, they don’t come much more far-fetched than Henry Vinson. A former coroner and male escort who served five years in jail for corruption and racketeering, in 1995 he noticed the queues outside the office of a doctor in Williamson, West Virginia, who had a reputation for being quick to dole out prescription painkillers to injured loggers or miners. Not one to pass up an opportunity, he recruited more doctors and set up the Williamson Wellness Center, which by 2000 was one of the busiest “pill mills” in the state.

What started as an Appalachian phenomenon — OxyContin, with potency and addictive qualities that have made it the biggest culprit, was known initially as “hillbilly heroin” — has quickly spread. The causes are various: doctors proving naive, if not amoral, about prescribing painkillers; drugs firms making poorly supported, if not misleading, claims for products; and government bodies proving slow, if not unwilling, to intervene. It has affected not only miners and loggers, but teens, young professionals, middle-aged parents and the children whose families have been ruined.

McGreal’s book is forensic in its detailing and turns up some eye-popping examples: the clinic in Fort Lauderdale, Florida, set up by twin brothers with no medical training where doctors carried guns and the pharmacy was run by former strippers; the town of Kermit, West Virginia, which doled out 9m pills in two years, despite having a population of around 400. But is this a purely American phenomenon? Another case of that country’s maximalist capitalism wrecking lives? Not exactly, says McGreal: in the UK, opioid prescriptions have doubled in a decade, with a surge in heroin use in England and Wales since 2012. Let’s hope Britain has better infrastructure and governing principles with which to tackle it. —

American Overdose: the Opioid Tragedy in Three Acts (Faber) is out on 15 November

Opioids now kill more people in the US than Aids at its height