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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.

Urbana, Ohio, was not a utopia when Beth Macy grew up there in the ’70s and ’80s—certainly not for her family. Her dad was known as the town drunk, which hurt, as did their poverty. But Urbana had a healthy economy and thriving schools, and Macy had middle-class schoolmates whose families became her role models. Though she left for college on a Pell Grant and then a faraway career in journalism, she still clung gratefully to the place that had helped raise her.

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.

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.