Van Zee’s prophecy and other early warnings haunt the pages of “Dopesick: Dealers, Doctors, and the Drug Company That Addicted America,” a harrowing, deeply compassionate dispatch from the heart of a national emergency. The third book by Beth Macy — the author, previously, of “Factory Man” and “Truevine” — is a masterwork of narrative journalism, interlacing stories of communities in crisis with dark histories of corporate greed and regulatory indifference.

Macy began investigating the drug epidemic in 2012, as it seeped into the suburbs around her adopted hometown, Roanoke, Va., where she worked for 20 years as a reporter at The Roanoke Times. From there, she set out to map the local onto the national. “If I could retrace the epidemic as it shape-shifted across the spine of the Appalachians, roughly paralleling I-81 as it fanned out from the coalfields and crept north up the Shenandoah Valley, I could understand how prescription pill and heroin abuse was allowed to fester, moving quietly and stealthily across this country, cloaked in stigma and shame,” she writes.

[Read Beth Macy on the life and death of an addict]

The word “allowed” is a quiet curse. The further Macy wades into the wreckage of addiction, the more damning her indictment becomes. The opioid epidemic didn’t have to happen. It was a human-made disaster, predictable and tremendously lucrative. At every stage, powerful figures permitted its progress, waving off warnings from people like Van Zee, participating in what would become, in essence, a for-profit slaughter. Or as Macy puts it: “From a distance of almost two decades, it was easier now to see that we had invited into our country our own demise.”

Particularly grotesque is the enthusiasm with which Purdue peddled its pills. In the first five years OxyContin was on the market, total bonuses for the company’s sales staff grew from $1 million to $40 million. Zealous reps could earn quarterly bonuses as high as $100,000, one former salesperson told Macy, adding, “It behooved them to have the pill mills writing high doses.” Doctors were plied with all-expense-paid resort trips, free tanks of gas and deliveries of Christmas trees and Thanksgiving turkeys. There were even “starter coupons” offering new patients a free 30-day supply. As sales rocketed into the billions, noxious side effects began to emerge. Chief among them was the creation of a legion of addicts who, desperate to stave off withdrawal, made the leap to cheap heroin and, later, fentanyl. (“Four out of five heroin addicts come to the drugs … through prescribed opioids,” Macy notes pointedly.)