This is a fantastically well researched book. It covers the opioid epidemic from the invention of morphine and heroin to present day, focusing on Roanoke and rural Virginia. She also tells the story of a few families in the area who she got to know, with kids who were addicted, dealers, or died of heroin overdoses. It's a great book.

My only real criticism is that it is a little too disjointed for me. It jumps between stories in a way that works really well in a lengthy news article or essay, but I struggled with a little bit in a whole book. With all the different people involved, I sometimes lost the thread of the narrative and couldn't quite follow. It wasn't too bad and it was really well done in general, but I did struggle just the littlest bit with that.

I loved hearing from the people personally involved, especially when she talked to the addicted young people. One woman who was my age had me tearing up at the end of the book, even though I already knew where it was going. I couldn't stop myself from crying. All the situations were so heartbreaking, from addicted teenagers to doctors who don't know what would happen to their patients if they died, to parents fighting pharmacy corporations in court. All of it brings the human element so well and paints such a vivid picture.

I do think Macy is a lot more drug negative than I am. She touched ever so briefly on how the crackdown on prescriptions for opioids affected those with chronic pain, but only about twice that I noticed and so very briefly. She also spoke very negatively of doctors prescribing Adderall or Ritalin for kids with no discussion on why that might be important for some kids (and adults) to live life. Over prescription is a massive problem, but in a book that focused so much on the dangers of prescription drugs, I really wish there had been discussion on the importance of those same drugs for people who need them to function.

Overall, a really great and informative book. I'd highly recommend this if you're interested in the subject. It's definitely made me want to read her other books as well.