Race, Healthcare, and Criminal Justice Theme Analysis

Although the opioid crisis is most commonly associated with rural, predominantly white regions of the U.S., Beth Macy shows in Dopesick how it eventually went on to affect Americans of all races. Macy builds on the work of previous writers like Michelle Alexander and Bryan Stevenson (both of whom she references in Dopesick) to explore how the so-called War on Drugs that took off during Ronald Reagan’s administration had a disproportionate effect on Black Americans, leaving them overrepresented in prison populations. Somewhat ironically, however, although people of color were the main victims of opioids in the United States for much of the middle of the 20th century (when heroin remained a largely urban phenomenon), they have been less affected by the recent opioid epidemic. Macy argues that this is because, due to biases, doctors hesitated to give out stronger painkiller prescriptions to patients of color. In Dopesick, Macy depicts how powerful opioids are addictive to people of all races, but she also shows how biases in the American healthcare and criminal justice systems have led to very different experiences of the epidemic for Black and white Americans.

As the dealer who provides heroin to Woodstock, Virginia, where many people die of overdoses, Ronnie “D.C.” Jones may seem at first like the villain of Dopesick. But the situation is more complicated, and while Macy lets readers draw their own conclusions, she shows that many of Jones’s actions were informed by the biases he faced as a Black man, particularly in the criminal justice system. Ronnie’s brother Thomas recalls that Ronnie wasn’t a bad kid, just stubborn, but this was enough to get him in trouble. Ronnie first went to prison at age 17, for allegedly stealing a car from his girlfriend. Once Ronnie was in the prison system, he found it hard to get out. Even when he was out of prison and technically free, he found it hard to do necessary things like get a job and find stable housing, raising the question of how free he truly was. Macy cites authors Michelle Alexander and Bryan Stevenson who confirm that Ronnie’s experience is typical and that many people who have supposedly served their time—particularly Black men—continue to face problems like the ones Ronnie does. Ronnie soon finds out that he can make more money in a single drug deal than he can in many days of working the terrible jobs available to him as an ex-convict. He knows that drug dealing is unsustainable and that he’ll likely be caught within months, but even still, he decides that he prefers it over the alternative. Though his decisions arguably lead to the loss of many lives in Woodstock, Virginia, Macy raises the question of how much personal responsibility Ronnie bears for his actions versus how much his actions should be blamed on his circumstances. Ronnie’s brother Thomas, who grew up in similar circumstances to Ronnie, goes on to become an internationally famous rapper. This suggests that had he been luckier, or had he been given more support, Ronnie, too, may have been able to achieve great things.

Macy compares and contrasts the life of Ronnie Jones to the life of Bill Metcalf, a white agent for the Bureau of Alcohol, Tobacco, Firearms, and Explosives who is responsible for tracking down and arresting drug dealers like Ronnie. The two men, whose lives take very different courses, are also very similar in some ways, and Macy explores the role that race may have played in determining their different life paths. Like Jones, Metcalf is the son of addicts, and also like Jones, he’s known for being stubborn. Instead of ending up in prison, however, Metcalf ends up with a job in law enforcement where his hard-headedness is rewarded and even encouraged. Both Metcalf and Jones try to escape the fates of their addicted families by avoiding personal drug use and instead dedicating themselves to their work. The difference is that Jones has far fewer job opportunities and the “job” he ends up dedicating himself to is illegal heroin dealing, which has dire consequences for him and for those he sells to. Metcalf and Jones find themselves pitted against each other, and when they finally meet in person, each despises the other. The irony, Macy shows, is that the two enemies actually have a lot in common. The racial bias (or lack of bias) that Jones and Metcalf each experienced helped to put them on different sides of the law, unable to see their common ground.

Though Dopesick focuses on predominantly white communities in Virginia, Macy convincingly argues that it’s impossible to fully understand the opioid crisis without looking at race. While many white addicts, like Spencer Mumpower, also faced consequences from the criminal justice system, it’s impossible to understand the full scope of the crisis without looking specifically at how men like Ronnie Jones had a different experience in the system because of their race. Macy interviews Jones hoping for answers and closure but just comes away with more questions. While Macy doesn’t attempt to justify Jones’s actions, she argues that greater support for men like Jones and a more equitable criminal justice system could have wide-ranging benefits, showing how race, health, and economics intersect in the opioid crisis.