Health care in America

DREAMLAND by Sam Quinones is now available as a Young Adult edition which is great news given students’ concerns about this health-related topic. Clearly more accessible, this YA version of DREAMLAND will pair beautifully with the recent set of articles and graphics in the Washington Post’s series called Opioid Files. Quinones divides his newest edition into three parts; for example, he discusses the Pills, OxyContin, and the Oxy Trade in separate chapters contained in Part 1. Then he looks at Heroin and the drug cartels in the mid-1990s in Part 2. Some of the profiles there focus on Colorado or New Mexico.  The final section again discusses Ohio and looks specifically at Corporate Crimes.  Quinones includes a link to his website (with audio and videos interviews), plus photographs, a reading guide, and source notes in this excellent and timely resource. Look for the young adult version of DREAMLAND to be on our shelves soon along with Quinones’ original version and other books on this topic, including Macy’s Dopesick and Sederer’s The Addiction Solution.

For another look at America’s health care system and the problems with which it is associated, see CODE BLUE by Mike Magee. This non-fiction work unabashedly addresses “profit over health: the fascinating, infuriating story of how we built the world’s most expensive, least equitable health care system - and what we can do to fix it.” Magee, who is a medical doctor and historian on the faculty at the University of Hartford, has also worked for Pfizer and edits his own blog, HealthCommentary.org. His biases and frustrations are evident there as well as in CODE BLUE (a title selected to convey his sense that “the American health care system is in critical condition”) where he notes, “Americans spend from 50 percent to 100 percent more on health care as a share of GDP than people in other industrialized countries do, and for all our high expenditure we get collective outcomes that are demonstrably worse.” Clearly, this is an extremely complex topic, and one that will continue to be debated publicly, especially with respect to basic universal coverage proposals. Magee devotes roughly a fourth of this text to an appendix, notes and an index.  He also includes several lists, including “Some Basic Steps to Reform the Medical Industrial Complex,” looking at education, clinical research, publications and marketing. Overall, his pressing sense of urgency seemed to negatively impact his objectivity even though CODE BLUE received a starred review from Kirkus.

Dopesick by Beth Macy

DOPESICK by Beth Macy is a fascinating work of non-fiction that deals with “Dealers, Doctors, and the Drug Company that Addicted America.” Macy, an award-winning journalist and author of Factory Man, explores the opioid crisis through the lives of four families whose teenage children’s addiction resulted in devastating emotional and economic costs. As she tells it, this is a story of rehab and prison, of recovery and relapse, of “the crushing and sometime contradictory facets of an inadequate criminal justice system often working at cross-purposes against medical science.” Macy argues that “the flood of painkillers pushed by rapacious pharma companies,” particularly Purdue Pharma, began in isolated and politically unimportant places. A resident of Roanoke, Virginia, she attempts to “retrace the epidemic as it shape-shifted across the spine of the Appalachians, roughly paralleling Interstate 81 as it fanned out from the coalfields and crept north up the Shenandoah Valley.” In addition to the collapse of work, she points to denial coupled with fear and ready stereotypes (“affliction of jobless hillbillies”) plus the lack of resources for local papers to cover the enfolding story as several reasons for why it took so long for this epidemic to be widely recognized. 

The abuse of opioids is a high interest topic for our students, both in Health classes and for Junior Theme and they will find much valuable information in Macy’s work, as well as other titles such as Sederer’s The Addiction Solution and Quinones’ Dreamland (to which Macy refers). DOPESICK is extensively researched, with more than twenty percent of the book devoted to notes. Chosen as an Amazon Best Book of August 2018, DOPESICK also received starred reviews from Booklist, Kirkus and Publishers Weekly.

The Addiction Solution by Lloyd Sederer

THE ADDICTION SOLUTION by Lloyd Sederer is subtitled “Treating Our Dependence on Opioids and Other Drugs” and it certainly addresses a timely and concerning topic. In fact, I had several students who crafted major research papers on opioid abuse and over-prescription issues this year. They often turned to full length texts like Quinones’ Dreamland for information and compelling details.  

THE ADDICTION SOLUTION will be an important addition to our collection, especially given the compassionate manner in which Sederer approaches treatment options. He argues for "a cultural shift" away from punishment and towards prevention by promoting understanding of addiction as disease with individualized impacts due to its complex medical, psychological, and social aspects.  As Chief Medical Officer for the New York State Office of Mental Health, Sederer is able to draw on his own vast clinical knowledge and to combine disguised patient case studies with recent scientific research and some shocking statistics. For example, he notes the 4-fold increase in prescriptions between 1999 and 2010, with Cardinal Health allegedly shipping 241 million opioid pills to West Virginia alone (population less than 2 million) between 2007 and 2012. 

THE ADDICTION SOLUTION is a very accessible, practical text which received starred reviews from both Booklist and Library Journal.