Macy, Beth. Dopesick: Dealers, Doctors, and the Drug Company that Addicted America. Little, Brown. Aug. 2018. 384p. photos. notes. index. ISBN 9780316551243. $28; ebk. ISBN 9780316551281. HEALTH
“Americans, representing 5 percent of the world’s population, consume 80 percent of its opioids.” Macy (Factory Man; Truevine) brings that statistic down to the personal level as she relates individual stories of OxyContin use in the United States, while also tracing its regulatory history and legal, medical, and social ramifications. The intertwined factors that have led to today’s opioid epidemic play out in stories of health-care providers, patients, pharmaceutical companies, politicians, drug dealers, users, and family members. Starting with her own community of Roanoke, VA, Macy effectively shows how opioid abuse plays no favorites as it works its way into all socioeconomic levels, races, and ethnicities. The accounts of addicts and their families leave no doubt about the power the chemicals hold over the brains they alter. Addicts soon begin using to avoid the symptoms of withdrawal (dopesick) rather than gaining any pleasurable high. Controversies abound over what treatments work. Abstinence versus medication-assisted therapy is an ongoing debate, while profit motives and insurance problems are also factors. VERDICT Macy’s use of current research by various experts makes clear how complex the opioid problem is, but the strength of this narrative comes from the people in the day-to-day battle.
Sederer, Lloyd. The Addiction Solution: Treating Our Dependence on Opioids and Other Drugs. Scribner. May 2018. 224p. notes. index. ISBN 9781501179440. $26; ebk. ISBN 9781501179464. HEALTH
Sederer (chief medical officer, New York Office of Mental Health) argues that the United States is failing to control an addiction epidemic through “a dogged attachment to ideas and efforts that have not worked” rather than an evidence-based, public health approach. In this brief, readable overview, the author discusses factors that contribute to addiction, failed approaches, prevention, current treatments, and future directions. He portrays addiction as a complex illness—not a moral failing—that responds best to a combination of treatments tailored to an individual patient. Modalities discussed include (but are not limited to) medication, 12-step programs, mindfulness, and even LSD as an experimental treatment. He declares punitive or judgmental methods ineffective and advocates instead for “prevention, early intervention, [and] effective and comprehensive treatment programs,” as well as “a cultural shift” toward understanding addiction’s medical, psychological, and social aspects. Most of the writing is accessible to an educated lay audience, but the level of detail and extensive references make this useful for medical professionals needing further education on the subject. VERDICT Enriched with patient case studies that illustrate the complex nature of this disease, Sederer’s balanced and compassionate approach makes this a valuable addition to the conversation on this timely topic.
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