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3 Books Take a Deeper Look at the Opioid Epidemic

Drug overdoses are now the leading cause of death among Americans under 50. Here are three books that explore the opioid epidemic and how to help those afflicted by addiction.

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DREAMLAND
The True Tale of America’s Opiate Epidemic
By Sam Quinones
384 pp. Bloomsbury Press. (2015)

In this National Book Critics Circle Award-winning book, the investigative journalist Sam Quinones looks at two phenomena — the overprescription of pain medication in the 1990s and the influx of black-tar heroin from Mexico to the United States — to explain how opiate addiction has come to plague hundreds of towns across the country. In the 1990s, many doctors freely prescribed powerful analgesics, including the highly addictive OxyContin, resulting in widespread pain-pill abuse. Black-tar heroin, delivered primarily by Mexican drug dealers from the municipality of Xalisco, was introduced around the same time and became a cheaper alternative with similar effects. Quinones weaves together the roles of a cast of characters, including pharmaceutical executives, narcotics investigators, recovered addicts and the dealers who set up a system that Quinones compares to pizza delivery.

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CLEAN
Overcoming Addiction and Ending America’s Greatest Tragedy
By David Sheff
374 pp. Eamon Dolan/Houghton Mifflin Harcourt. (2013)

This book examines the available research on prevention and treatment to argue that “addiction isn’t a criminal problem, but a health problem.” David Sheff (who also wrote a memoir, “Beautiful Boy,” about living with the addiction of his son, Nic) argues that the “war on drugs” was a failure; we now have more addicts and more types of drugs than we did 40 years ago. Sheff emphasizes that adolescents are a particularly vulnerable group, as drug use can stunt their emotional growth. Though he presents models of “evidence-based treatment,” he concedes that the medical specialty of addiction medicine is a new and inexact science, and that the potential for relapse is a persistent “hallmark of addiction” that requires lifelong vigilance.

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MARLENA
By Julie Buntin
274 pp. Henry Holt & Company. (2017)

The story in “Marlena” is told retrospectively by a woman named Cat, as a 30-something adult; she recounts her yearlong friendship with the title character as a teenager in Northern Michigan. The telling is so intimate that one can miss, at first, that Marlena is addicted to the pills she carries around inside a pin on her chest. Marlena takes them openly — once, in class, she feigns a headache as she pops one in her mouth. Only later does Cat begin to understand what the pills are and call them by name: “Oxys and benzos and Addys.” There is a moment when Marlena drops her pin and the pills scatter all over the floor; Cat’s description of the desperation with which Marlena scrambles across the floor to gather them is gut-wrenching. The book is ostensibly about friendship and the indelible mark the troubled Marlena left on Cat, but it is also a quiet, powerful look at addiction.

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