I’d been thinking that while the opioid epidemic is most definitely a tragedy, it’s naturally occurring, the product primarily of human frailty. But Macy’s book reveals a more complex truth of an epidemic that has been manufactured by the players of her subtitle, fueled by greed and indifference to human suffering. People have been sounding the alarm about the dangers of these drugs for two decades, but drug companies have been fighting in court to prevent regulation that would protect people.