Twenty-two years later, that oath became evidence in a criminal investigation.
In May 2023, Thompson's partner of four years, Dustin Maxwell, died of a fentanyl overdose. Seven months after finding Dustin's body, Thompson stood in Travis County Courthouse and pled guilty to felony drug distribution-for the pharmaceutical pills he'd provided to prevent withdrawal, pills that weren't what killed his partner.
First, Do No Harm is the story of what happens when love, medical training, and America's war on drugs collide-and when the choice between watching someone suffer and risking imprisonment becomes impossible to navigate.
Thompson writes with the clinical precision of a trained medic and the devastating honesty of someone who has lost everything. This memoir explores the impossible decisions facing American families navigating addiction: Do you watch someone you love endure agonizing withdrawal? Do you provide pharmaceutical alternatives to deadly street drugs and risk criminal prosecution? Do you call 911 knowing it might result in arrest rather than help?
Through alternating perspectives-Thompson's voice as the partner and caregiver, and Dustin's own chapters revealing the internal logic of addiction that families rarely see-readers witness the full complexity of loving someone whose brain chemistry is working against them. There are no heroes or villains here, only two people trying to survive a system that treats medical emergencies as criminal conspiracies.
This is also the story of generational patterns that repeat with brutal precision. Thompson's brother Michael died of an overdose in 1998 at age eighteen. His Uncle Robert followed three years later. Dustin lost his Uncle Pete and cousin Bryan the same way. The memoir examines how addiction moves through families like a curse-and what it takes to break cycles of shame that span decades.
First, Do No Harm arrives at a critical moment in America's conversation about harm reduction, criminal justice reform, and how we treat people struggling with substance use disorders. Thompson doesn't offer easy answers or redemptive arcs. Instead, he provides unflinching witness to a healthcare crisis that has been criminalized, to grief without closure, and to the cost of choosing integrity over self-preservation.
Written with literary precision and raw emotional power, this memoir speaks to families navigating addiction who feel criminalized for caring, LGBTQ+ readers seeking representation in recovery narratives, medical professionals facing ethical dilemmas around patient care, advocates for criminal justice reform, and anyone who has loved someone the world decided wasn't worth saving.
Thompson's voice is intimate without being sentimental, clinical without being cold. He holds contradictions with grace: love and enabling, hope and despair, the oath to heal and the reality of harm. The result is a memoir that refuses to let shame silence truth-and that demands better from systems designed to punish families for loving the wrong way.
This book is for anyone who has faced impossible choices in the face of addiction. For anyone who has been told that caring makes them complicit. For anyone who refuses to believe that the people we lose to overdose were somehow less deserving of compassion, treatment, and life.
First, Do No Harm is proof that breaking cycles requires witness, that policy reform begins with personal testimony, and that sometimes the most radical act is simply refusing to stay silent.
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