Historical amnesia about addiction

Historical amnesia about addiction describes the recurring failure to connect present-day opioid crises with the nation’s earlier experience of opiate use, dependence, and drug control. In Dopesick, that forgetting is more than a gap in public knowledge: it appears in shifting assumptions about who uses drugs, in families’ difficulty speaking openly, and in the distance between criminal justice and health care. The book’s framing title, “The United States of Amnesia,” names a central problem of its investigation: the present crisis is treated as unprecedented even as the historical record reveals earlier episodes and recurring patterns.

Meaning and Historical Frame

The book places contemporary addiction within a longer history rather than treating it as a sudden or isolated event. Its first chapter is titled “The United States of Amnesia,” while the epilogue returns to the historical expression “Soldier’s disease.” Together, these bookends frame forgetting as a repeated loss of context: the language and settings change, but the country has confronted opiate dependence before.

That historical perspective also changes the questions posed by the narrative. The account begins with families seeking explanations for what happened to their children, then widens into an inquiry across geography and time. The personal search for an answer and the public failure to remember earlier drug history become related problems: a single family may lack a complete account of a death, while a nation may fail to recognize the larger history in which such deaths occur.

An Older Record, and Its Uncertainties

The discussion of “Soldier’s disease” draws attention to opiate addiction after the Civil War and to uncertainty in the historical record. One estimate cited for the number of addicted veterans is 400,000, while historians who consider that figure too high have pointed instead to Horace Day’s estimate of 80,000 to 100,000 Americans addicted in 1868. David F. Musto’s estimate for 1900 is 250,000. These figures are not presented as interchangeable certainties; their disagreement itself demonstrates how difficult it can be to establish the scale of earlier addiction.

The book also invokes historian David Courtwright in considering how a new drug can sweep through the country, and notes that Paul Tough’s 2001 account of OxyContin helped chronicle the advent of the modern opioid epidemic. This historical framing counters the impression that the crisis has no precedent. It also shows that knowledge can exist in research and reporting without necessarily becoming a durable part of public understanding.

Reporting, Grief, and Family Silence

The narrator began reporting on heroin in 2012 as the epidemic reached the suburbs of Roanoke, Virginia. After two decades covering marginalized families for the Roanoke Times, the narrator found that many of the families first interviewed were too ashamed to speak publicly. Five years later, as the book was being completed, nearly everyone agreed to be identified; a few still feared consequences for their jobs or safety. The change records a partial movement from secrecy toward testimony, but not the disappearance of risk or stigma.

Kristi Fernandez’s search for an account of her son Jesse Bolstridge’s death gives that uncertainty a specific human form. She wanted to understand the rapid progression from his life as a high-school football player and construction worker to his death from an overdose, partly so that she could help other parents. The investigation could not supply a complete timeline: Jesse’s friend Dennis Painter bought heroin about eighteen hours before Jesse died, and other people and unknown circumstances lay between the purchase and the death. The unresolved interval is not filled with certainty. It illustrates why a family’s need for explanation can persist even when reporting and investigation establish some parts of a story but cannot prove all of them.

The book also records how isolation changed over time. In 2012, there were not yet Facebook groups connecting suffering parents across the state to exchange rehabilitation information, coping strategies, and material support. Robin Roth described feeling marked as a failed parent and carried a framed portrait of her son Scott to Spencer Mumpower’s sentencing. These accounts show how shame could keep families separated even as they were confronting related losses.

Uneven Memory in Institutions and Communities

For years, heroin in Roanoke was widely understood as an inner-city, Black drug and was largely left to police and court reporters. Don Wolthuis recalled that in the 1980s and 1990s only a few dozen people in the area were believed to use heroin, an isolated population that could remain largely unseen. When heroin use appeared among suburban users, the book describes how the older assumptions obscured the scale and changing character of the problem. The contrast is not simply between one group and another: it reveals how racialized ideas about drug use shaped what received attention and what remained overlooked.

The divide between criminal justice and health care is another form of institutional forgetting. At a Families Anonymous meeting near Hidden Valley, the chance meeting of two mothers exposed the gaps families had to navigate while trying to keep addicted relatives alive. The book depicts those gaps as environments in which shame can conceal need and in which different actors—including some doctors, dealers, and pharmaceutical companies—may benefit from the disconnection. In Tess Henry’s experience, even though Narcotics Anonymous officially accepted medication-assisted treatment, longtime members declined requests to sponsor her because she was taking buprenorphine. The distance between formal policy and local practice shows how a treatment option can be accepted in principle yet stigmatized in a recovery community.

The same unevenness appears in public responses. Janine Underwood described telling school-board members and county officials about the local problem and meeting silence; the school board declined to support the prevention program, and the county provided its usual $2,000. At the same time, the book contrasts calls to avoid relying on arrests for mostly white opioid users with the continued imprisonment of people such as Ronnie Jones, a Black man serving time for heroin distribution. It also reports that, in 2014, young white people were dying of overdose at three times their 2002 rate while the death rate among people of color was relatively unchanged, and presents lower opioid prescribing to people of color as one factor in that difference. Remembering the crisis therefore requires attention not only to addiction but also to unequal medical and criminal-justice responses.

Narrative Significance

Historical amnesia about addiction organizes the book’s movement between individual stories, historical evidence, and institutional analysis. Jesse Bolstridge’s unresolved timeline, parents’ earlier reluctance to speak, contested estimates of past addiction, and disparities in treatment and punishment are distinct kinds of evidence; together, they resist a simple account in which the crisis appeared without warning or affects everyone in the same way.

The book’s alternative to forgetting is sustained attention: following families through rehabilitation, prison, recovery, and relapse; acknowledging what remains unknown; and placing contemporary experience beside earlier histories and public policies. Its argument does not depend on claiming that every episode is identical. Rather, the record makes it possible to recognize recurring failures while preserving the differences in who is seen, who receives care, and who is punished.