This Is Public Health Book Club discussion

Summary: In these chapters, the author continues to shed light on the opioid epidemic and the impact that it has had on the American people, both rural and suburban alike. Throughout these chapters, the narrative explores the expansion and spread of opioid addiction beyond rural areas and into suburban communities. These chapters highlight the shift in demographics affected by the opioid crisis and reveals the devastating impact that it has had on families and communities. Chapter 8, Shit Don’t Stop, provides insight into how difficult it can be to receive treatment and furthermore, stay in treatment. It also touches on the complex relationship that the dealers, users, and police play in these situations. Furthermore, it demonstrates the level of poverty and desperation that some people may feel when they are unable to earn a livable wage and feel that dealing drugs is more profitable, even if it is more dangerous. The photos within chapter 8 add a personal effect to this book, placing faces to a name.

1. The author provides many personal stories of individuals that were affected by opioid addiction. Did any stand out to you in particular? How do these personal narratives enhance your/our understanding of the broader societal impact of the opioid epidemic?

2. How has the opioid crisis exacerbated existing socioeconomic challenges within these communities, both rural and suburban?

3. Throughout these chapters, various stakeholders are implicated in the opioid crisis, including pharmaceutical companies, healthcare providers, and policymakers. Who do you think bears the most responsibility for addressing the opioid epidemic and what actions should they take?
Furthermore, the author does not mention McKinsey’s role in the opioid epidemic, specifically as they served as consultants for Purdue Pharma. Why do you think the author does not mention the firm? What accountability should the firm have in addressing the society impacts of their clients’ actions, based on their involvement in advising Purdue Pharma on opioid marketing strategies?

4. What factors do you believe contributed to the spread of opioid addictions from rural to suburban areas? What implication does this have for addressing the crisis on a national scale?

5. The book portrays addiction as a complex issue, with social, economic, and psychological roots. How does this perspective challenge the traditional notions of addiction, as solely a personal failing?

6. Throughout the book, but highlighted mostly in these chapters, are the concept of being “dope sick”, describing the physical and emotional withdrawal symptoms. Does the understanding of these symptoms change your view of individuals struggling with addiction?
Furthermore, does the personal narrative approach enhance your understanding of the opioid crisis?