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In this extraordinary work, Beth Macy takes us into the epicenter of a national drama that has unfolded over two decades. From the labs and marketing departments of big pharma to local doctor's offices; wealthy suburbs to distressed small communities in Central Appalachia; from distant cities to once-idyllic farm towns; the spread of opioid addiction follows a tortuous trajectory that illustrates how this crisis has persisted for so long and become so firmly entrenched.

On Christmas Eve, 2017, Tess Henry was found dead in a dumpster in Las Vegas. Tess was a 28-year-old new mother, a former honor roll student, and a high school basketball player from suburban Roanoke, Virginia, a place ravaged by the national opioid crisis. The New York Times best-selling author Beth Macy chronicled Tess and her mom, Patricia, through Tess' harrowing, years-long battle to recover from heroin addiction in her award-winning book Dopesick: Dealers, Doctors, and the Drug Company That Addicted America.

In her gripping, necessary, and deeply humane follow-up to the New York Times bestseller Dopesick, journalist Beth Macy brings us to the next frontier of the opioid crisis, telling the story of the everyday heroes fighting to stem the tide of drug overdose in communities that are too often left to fend for themselves, and of the activists and relatives of the dead who are still struggling for accountability in America’s courts. Like the treatment innovators she profiles, Beth Macy meets the opioid crisis where it is—not where we think it should be or wish it was.

The year was 1899, as the old people told the story, the place a sweltering tobacco farm in Truevine, Virginia, the heart of the Jim Crow South, where everyone they knew was either a former slave or a child or grandchild of slaves. The Muse brothers, George and Willie, were just six and nine years old, but they worked the fields from dawn to dark. Until a white man offered them candy and stole them away to become circus freaks. For the next 28 years, their distraught mother struggled to get them back.

With over $500 million a year in sales, the Bassett Furniture Company was once the world's biggest wood furniture manufacturer. But beginning in the 1980s, the Bassett company suffered from an influx of cheap Chinese furniture as the first waves of Asian competition hit, and ultimately was forced to send its production offshore to Asia. Only one man fought back. That man is John Bassett III, a descendant of the Bassetts who is now chairman of Vaughan-Bassett Furniture Co, which employs more than 700 Virginians and has sales of over $90 million.