Phar­maged­don

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

Esquire (UK) - - Culture -

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

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