Raising Lazarus: Beth Macy’s Follow-Up Reporting on the Opioid Epidemic

Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis, by Beth Macy
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Journalist Beth Macy, who has been on the forefront of chronicling the opioid epidemic in the US for years, recently released her follow-up to 2018’s Dopesick. I haven’t really seen this new book get as much attention yet as I think it deserves, so I hope that changes soon.

The tack Macy takes in Raising Lazarus is to focus on harm reduction methods; the scientific research that supports their use and successful outcomes as opposed to previously used methods, like abstinence rehabs, prison, or just ignoring the problem; and the people who are doing that work in their communities, often illegally. This is shocking:

In the richest country in the world, treatment of the sickest, neediest people fell to volunteers risking arrest to give out homemade tinctures discovered in the Middle Ages.

The title refers to the biblical act of raising Lazarus from the dead: Jesus did it, but it was Lazarus’s friends and family who did the tough, unpleasant work of removing his burial shroud and wrappings, helping to usher him back into life.

Macy uses this as a metaphor for the difficult but necessary work that many — but not nearly enough — people are performing of harm reduction on local, community levels. Macy identifies harm reduction as opposed to previous governmental stances or policies as being the tactics backed by science to have the most impact in helping Americans overcome the still-crippling opioid epidemic, which has been back-burnered in the Covid era.

This is also quite a thorough study, weaving in a vast range of economic and social aspects around addiction and treatment as well as some of the legal battles to hold the Sackler family responsible for their role in knowingly pushing Oxycontin despite awareness of its dangers.

And as in Dopesick, Macy’s puts human faces on this epidemic, of both users and the people doing the exhausting, thankless work mitigate harm, to intense emotional affect. She acknowledges how tough it is, showing how many people have been affected by it, not only due to their own addiction but through family members and loved ones who have fallen victim, or those who have been victimized through theft, for example. That makes it difficult sometimes to have sympathy, but Macy shows exactly why empathy matters in ultimately conquering this epidemic. She addresses the widespread misunderstandings that we still hold about addiction thanks in part to Reagan-era War on Drugs policies, likening the social media comment sections on mugshot posts to “an updated version of Shirley Jackson’s “The Lottery”.

This is an incredible work of compassion, on Macy’s part to chronicle it and of all the people who are doing what they can in harm reduction work to help community members who have been horribly failed by medical professionals, big pharma, the government, law enforcement, and anyone else who could’ve pointed this in a different direction any earlier.

If I live to be 100, I will never forget the image of Brooke Parker, sitting at the infected feet of a calmly weeping man while police officers went about the business of stapling up eviction notices. It was like we weren’t even there, like the earth that we, too, walked on belonged solely to the politicians and bureaucrats and people who were still falling for Richard Sackler’s “hammer the abusers” scam.

A helpful companion read is Brian Alexander’s The Hospital: Life, Death, and Dollars in a Small American Town, a book I haven’t reviewed but really appreciated. A thread running throughout Raising Lazarus is the responsibility that the US for-profit healthcare system has in not better mitigating the epidemic, and The Hospital makes abundantly clear how dangerous, overbloated, and unwieldy this system is, to the detriment of all of us.

I agree with economist Paul Krugman, quoted in Macy’s book, that “I still run into people who are sure that we have the world’s highest life expectancy, when we actually die a lot younger than people in other rich countries.” This is American exceptionalism at its worst: we do continue to believe our healthcare system is vastly superior to other countries, particularly looking down on those with universal socialized medicine, when the reality is that the opioid epidemic would’ve never played out as it did without our healthcare industry prioritizing profit and pharmaceutical money over patients themselves.

As per economists Anne Case and Angus Deaton: “Other countries have a range of other ways of organizing healthcare, all have their strengths and weaknesses, but none are killing people. None are supporting the brazen subordination of human need to human profit.”

This is hard-hitting and emotional — I get tearful even remembering one section where several newly-in-treatment opioid users shared their short-term goals — but it’s outstanding: excellently written, even page-turning, and such an important journalistic work. Please read this if you still think that the “they have to be allowed to hit rock bottom” approach to drug use is correct.

published August 16, 2022 by Little, Brown. I received an advance copy courtesy of the publisher for unbiased review.


16 thoughts on “Raising Lazarus: Beth Macy’s Follow-Up Reporting on the Opioid Epidemic

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    1. So glad I could bring it to your attention! It’s an outstanding book and such an important topic that’s definitely been taking a backseat over the last years with Covid the more dominating problem. But this one’s not getting any better and ignoring it is to our detriment. I hope you can read it soon!

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    1. This actually is that sequel book 🙂 It’s excellent, but of course also very difficult. I haven’t watched the show yet, I’m always less into scripted shows but I heard it’s really good.


  1. This sounds very informative and well-written. I’ve actually been looking for a good book to read about this subject, so I’m going to be picking up Dopesick first, and then this book. You mentioned that she focuses on individual people, and that’s something that I think is really important and humane. Thank you for sharing your thoughts on it!

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    1. This + Dopesick are definitely some of the best you can find on the topic. She really does an amazing job of showing the human tragedy of all this, and clearly explaining the economics and politics around it as well. We’ve been conditioned to chalk addiction up to personal responsibility and ignore this but she tells individual stories in such a humane, compassionate way. I’m in awe of her, it clearly wasn’t an easy task. Hope you find these meaningful reads when you pick them up!

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    1. Unfortunately these both are definitely going to depress you, there’s no way around that. But I learned so much from them, it was really worthwhile. This one can be read on its own and felt more hopeful than Dopesick, in case that helps!

      Liked by 1 person

  2. You review all the best books ! I noticed this book does not seem to have garnered much attention so far. I thought Dopesick was a really important book.

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    1. Oh thank you! I think you’d like this one. I really don’t know why it’s not getting more attention, as Dopesick was huge and the TV series made from it is pretty popular at the moment. This really deserves to be wider read, it’s so good and so important!


  3. I’ve been waiting to read your review until I read this book, but I’m giving up on getting to it anytime soon! I just couldn’t bring myself to read it without reading the first book and would actually really like to do a deep dive into the topic of the opioid crisis, since I have a bunch of related books on my to-read list. Your review makes me realize what I’m missing out on though. This sounds like such a good book. It seems like the author does a great job including both solid research and personal stories to paint a complete picture of the situation. I’m also interested by your reference to The Hospital, which does seem very relevant.

    I actually only recently learned that substantially more women die during child birth than die of abortions, so I’m not surprised to hear that a lot of people don’t know we have a lower life expectancy than many other countries. I’m concerned by how much people distrust experts these days, but I also feel like the media is really failing us when it comes to how people perceive the US – and not just hacky places like fox news.

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    1. I did a deep dive on opioid crisis books a few years ago and weird as it may sound, I really recommend it. It changed a lot of my thinking around how addiction works (although I feel like you probably have a better understanding of that going in) and really gave me a new understanding of what exactly happened to bring us to this point. I read Dopesick, American Overdose, and Dreamland, and maybe another but I need to check my Goodreads! It’s of course a really tough and depressing topic though, so make sure you keep some particularly sunny books nearby to change off with!! I’d love to hear your thoughts on this one, I think you would really appreciate it. I thought it was truly excellent, if utterly heartbreaking, and I think although it helps to read Dopesick first, she’s structured it well enough that it can be a standalone.

      I completely agree with you about how Americans perceive ourselves vs the reality. As you know my husband is a new immigrant and he’s started watching/reading US news more than he ever did abroad, and he says now he understands exactly why we’re like this: You have to actively seek out anything beyond just the major headline stories from anyplace else, otherwise we’re just bombarded with our own stuff and it’s very navel-gazing. Reading takes of what’s going on in the US from other countries is sobering. I agree that our media is absolutely failing us on this and giving a very skewed perspective. I sometimes can’t believe the conversations I have with Americans about our perception abroad. Healthcare is such a big one. I think a lot of people are completely unaware that our maternal mortality rate is egregiously high, of course even worse for non-white women, and this should absolutely be common knowledge by now and sadly isn’t. Although I think like you I’m not sure if I knew that it’s substantially higher death rates in childbirth than abortion…but I wonder if that will remain true over the coming years with our removal of access to safe abortions in so many places. Sigh.


      1. I also feel a little weird saying this, but I’ve just read my first book on the topic (Pain Killer by Barry Meir) and I’m really excited for this reading project. I know it’s going to be a dark topic and I will definitely follow your advice to mix in some happier books, but I do love good investigative journalism and there seems to be a lot on this topic. I definitely think I could still learn more about addiction and challenge my own assumptions more in general and I also know very little about the opioid crisis specifically, so I expect I’ll learn a lot.

        Currently, I get most of my news from The Atlantic. Sometimes they publish pieces on cancel culture, trans rights, etc that I think are egregiously conservative, but I agree with their perspectives often enough to continue to read their work. They do some great pieces on science and culture. I occasionally stumble across something on The Guardian, but otherwise, I really don’t read any international news sources myself. It’s really helpful to get your and your husband’s perspective on that! It seems like seeking out more international news might be a good use of my time 🙂

        Liked by 1 person

      2. I heard Pain Killer was really good too! I’m looking forward to your review of that one 🙂 The other one that’s seeming a must-read is Empire of Pain (although I don’t feel ready to tackle that one yet). Macy references it frequently in this book too and it does seem very comprehensive for understanding the legal aspects. Curious to see what else you’ll read on it!

        I love The Atlantic for a lot of its journalism , particularly on science and culture too. But yeah, I have noticed them taking some unusually conservative stances too! The Guardian is usually my go-to, and DW (Deutsche Welle) is a great German media outlet that also publishes in English (and many other languages – their goal is just to get world news to as many people internationally as possible!) That one might be worth your time 🙂


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