I had a high level of frustration as I read this book. By the halfway point, I was becoming eager for it to end. I don’t usually feel that way about books, so this was a bit of a surprise for me.
There are always good points to a book, and this one is no exception. The quality of the writing is very good, and there is very clear information about medical treatments for addiction. The authors made a very clear case for using medication instead of relying on 12 step treatment for people who must withdraw from opioids. Medical terms are explained well.
So why did I give it a poor rating and feel so frustrated with it? I have found that a lot of books about addiction or mental illness to be lopsided in that they either focus strictly on the medical aspect, or are they strictly focus on the emotional aspect of the mental illness or addiction. There is no balance. This book spent four chapters describing the need for medical maintenance for people who are addicted to opioids medications. I don’t have a problem with that in general, but they did not spend much time discussing why people choose to get high in the first place, how people can handle the return of the initial reason for wanting to get high, or the emotional feelings that a person will experience during withdrawal. It seems as if they were describing the medical treatment in a vacuum as if it were the only factor that would stabilize or D stabilize a person who is addicted.
I see this same lopsided treatment of bipolar disorder where there is a high focus on taking a persons medications rather than discussing how to manage aspects of living with bipolar disorder beyond taking pills a couple of times a day. I want to make it clear that I do not dispute the reasons and needs for taking medication either with bipolar disorder or opioid addiction. My point is that medication seems to be the primary focus, and that is not reality for people living with those disorders.
The other issue I have is that it does not appear that anyone in the authoring team of this book has personally dealt with addiction. Neither did they include comments or direct quotations from people who are living with this new medical approach. They tell us that it works very well, and their criteria is that overdoses are reduced. That approach would be OK if the title of this book or its description says that it is written specifically for medical professionals. However, since this book is supposed to be for families and addicts as well, it is sad that they chose not to represent any addicts or family members themselves. Instead, they used composite cases with made up names to describe situations. Unfortunately, the situations they described in the stories made a tight fit for their reasoning for their medical model. They didn’t discuss or really acknowledge other factors that are part of long-term recovery. They did mention in several places that people need psychosocial support, but they never really described what that support could be like or even define psychosocial support.
The sad part of this for me is that I agree with much of what this book says. However, I have a major problem with how it is presented and that people dealing with addiction or who have had a past addiction are not part of this process. If we want doctors, nurses, and other people who come into contact with attics frequently to understand what’s going on, I think they need to understand the full dimension of why a person chooses to get high, why they might choose to relapse, why they might unconsciously choose to relapse. They also need to hear what types of things help a person maintain recovery, and that is not just to take their medication. It goes beyond taking some pills a couple of times a day or showing up for a methadone injection once a day. They still have to decide to stay abstinent.