Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, journalist Beth Macy endeavors to answer a grieving mother's question--why her only son died--and comes away with a harrowing story of greed and need. From the introduction of OxyContin in 1996, Macy parses how America embraced a medical culture where overtreatment with painkillers became the norm. The unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death. Through unsparing, yet deeply human portraits of the families and first responders struggling to ameliorate this epidemic, each facet of the crisis comes into focus.

"August 2018"--Title page verso.

Prologue -- Part one. The People v. Purdue. The United States of Amnesia -- Swag 'n' dash -- Message board memorial -- "The corporation feels no pain" -- Part two. Objects in mirror are closer than they appear. Suburban sprawl -- "Like shooting Jesus" -- FUBI -- "Shit don't stop" -- Part three. "A broken system". Whack-a-mole -- Liminality -- Hope on a spreadsheet -- "Brother, wrong or right" -- Outcasts and inroads -- Epilogue : soldier's disease.