Macy’s primary motivation for writing Dopesick is to explain why Purdue Pharma marketed OxyContin despite knowledge that the drug was addictive and destructive. She identifies greed as the company’s primary motivation. At the time of her research and publication of the book, Purdue Pharma was a business in which the Sackler family had a controlling interest, but the family’s use of limited-liability corporations allowed them to avoid personal legal responsibility for the many lives ruined by opioid addiction. Macy examines the company’s involvement in the epidemic to prove that pro-business, pro-corporate attitudes among government agencies combined with corporate greed to create the conditions for the opioid epidemic. In other words, the Sacklers, are part of a larger capitalistic system in which corporate profits trump responsibility to ordinary people who provide the labor and consumer markets within that system.

Macy makes her case, in part, by exploring the many economic dimensions of the epidemic. The economic context that created the epidemic came about because of decisions by government and companies. Politicians who signed global trade agreements in the 1990s promised that new markets would allow American businesses to do this: