Heroin is a worldwide scourge and a seemingly intractable one. The Life of the Heroin User: Typical Beginnings, Trajectories and Outcomes is the first book to apply a biographical approach to the lifecycle of the heroin user from birth until death. Chapters address each stage of the user's life, including childhood, routes to use, the development of dependence, problems arising from addiction, death and options for treatment and prevention. Drawing on over two decades of experience in the field of opiate research, Shane Darke examines major theoretical approaches to the development of opiate dependence and the efficacy of treatment options for opiate dependence. Key points are presented at the end of each chapter. The most detailed review available of what is likely to happen to the dependent heroin user, this is an important book for clinicians, researchers and students in the fields of drug and alcohol studies and public health.
“Hart’s argument that we need to drastically revise our current view of illegal drugs is both powerful and timely . . . when it comes to the legacy of this country’s war on drugs, we should all share his outrage.” —The New York Times Book Review From one of the world's foremost experts on the subject, a powerful argument that the greatest damage from drugs flows from their being illegal, and a hopeful reckoning with the possibility of their use as part of a responsible and happy life Dr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, is one of the world's preeminent experts on the effects of so-called recreational drugs on the human mind and body. Dr. Hart is open about the fact that he uses drugs himself, in a happy balance with the rest of his full and productive life as a researcher and professor, husband, father, and friend. In Drug Use for Grown-Ups, he draws on decades of research and his own personal experience to argue definitively that the criminalization and demonization of drug use--not drugs themselves--have been a tremendous scourge on America, not least in reinforcing this country's enduring structural racism. Dr. Hart did not always have this view. He came of age in one of Miami's most troubled neighborhoods at a time when many ills were being laid at the door of crack cocaine. His initial work as a researcher was aimed at proving that drug use caused bad outcomes. But one problem kept cropping up: the evidence from his research did not support his hypothesis. From inside the massively well-funded research arm of the American war on drugs, he saw how the facts did not support the ideology. The truth was dismissed and distorted in order to keep fear and outrage stoked, the funds rolling in, and Black and brown bodies behind bars. Drug Use for Grown-Ups will be controversial, to be sure: the propaganda war, Dr. Hart argues, has been tremendously effective. Imagine if the only subject of any discussion about driving automobiles was fatal car crashes. Drug Use for Grown-Ups offers a radically different vision: when used responsibly, drugs can enrich and enhance our lives. We have a long way to go, but the vital conversation this book will generate is an extraordinarily important step.
Heroin is a fascinating drug to most people.It is often referred to as the “hardest drug.” By this logic, people might start with alcohol, work up to marijuana and maybe LSD. Then they reach to cocaine or methamphetamine. And finally, at the end of the journey is heroin. But like most things about heroin, this is more myth than reality. For non-users, this mythic power is exciting. And writers for the last century have been more than willing to pander to such readers in pulp and art novels all the way up to television crime novels. But it is rare for the most people to get a real look at what is, after all, the very core of what heroin is about for its users. To users, the interest is obvious. But ignorance of the the details of drug use among heroin users is rife — usually based on what the author calls “old junkie tales.” The difference between such folklore and the truth is often the difference between life and death. The Heroin User’s Handbook reveals the largely hidden world of heroin use based upon actual work with users and countless scholarly books and articles. And it does it in an extremely readable, non-technical manner — even while providing detained and accurate information. The book discusses all aspects of heroin use: the acquisition of drugs, the administration of them, health risks, legal issues, social aspects, and addiction and detox. It provides the non-heroin world with a detailed look inside a very rarefied subculture. But it also provides the those in the heroin using world life-saving information.
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
Introduction: a theory of abuse -- Intimate apartheid -- Falling in love -- A community of addicted bodies -- Childhoods -- Making money -- Parenting -- Male love -- Everyday addicts -- Treatment -- Conclusion: critically applied public anthropology.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
The authors employ the techniques of oral history to penetrate the nether world of the drug user, giving us an engrossing portrait of life in the drug subculture during the "classic" era of strict narcotic control. Praise for the hardcover edition: "A momentous book which I feel is destined to become a classic in the category of scholarly narcotic books." —Claude Brown, author of the bestseller, Manchild in the Promised Land. "The drug literature is filled with the stereotyped opinions of non-addicted, middle-class pundits who have had little direct contact with addicts. These stories are reality. Narcotic addicts of the inner cities are both tough and gentle, deceptive when necessary and yet often generous--above all, shrewd judges of character. While judging them, the clinician is also being judged." —Vincent P. Dole, M.D., The Rockefeller Institute. "What was it like to be a narcotic addict during the Anslinger era? No book will probably ever appear that gives a better picture than this one. . . . a singularly readable and informative work on a subject ordinarily buried in clichés and stereotypes." —Donald W. Goodwin, Journal of the American Medical Association " . . . an important contribution to the growing body of literature that attempts to more clearly define the nature of drug addiction. . . . [This book] will appeal to a diverse audience. Academicians, politicians, and the general reader will find this approach to drug addiction extremely beneficial, insightful, and instructive. . . . Without qualification anyone wishing to acquire a better understanding of drug addicts and addiction will benefit from reading this book." —John C. McWilliams, Pennsylvania Magazine of History and Biography "This study has much to say to a general audience, as well as those involved in drug control." —Publishers Weekly "The authors' comments are perceptive and the interviews make interesting reading." —John Duffy, Journal of American History "This book adds a vital and often compelling human dimension to the story of drug use and law enforcement. The material will be of great value to other specialists, such as those interested in the history of organized crime and of outsiders in general." —H. Wayne Morgan, Journal of Southern History "This book represents a significant and valuable addition to the contemporary substance abuse literature. . . . this book presents findings from a novel and remarkably imaginative research approach in a cogent and exceptionally informative manner." —William M. Harvey, Journal of Psychoactive Drugs "This is a good and important book filled with new information containing provocative elements usually brought forth through the touching details of personal experience. . . . There isn't a recollection which isn't of intrinsic value and many point to issues hardly ever broached in more conventional studies." —Alan Block, Journal of Social History
Why do the vast majority of heroin users live in cities? In his provocative history of heroin in the United States, Eric C. Schneider explains what is distinctively urban about this undisputed king of underworld drugs. During the twentieth century, New York City was the nation's heroin capital—over half of all known addicts lived there, and underworld bosses like Vito Genovese, Nicky Barnes, and Frank Lucas used their international networks to import and distribute the drug to cities throughout the country, generating vast sums of capital in return. Schneider uncovers how New York, as the principal distribution hub, organized the global trade in heroin and sustained the subcultures that supported its use. Through interviews with former junkies and clinic workers and in-depth archival research, Schneider also chronicles the dramatically shifting demographic profile of heroin users. Originally popular among working-class whites in the 1920s, heroin became associated with jazz musicians and Beat writers in the 1940s. Musician Red Rodney called heroin the trademark of the bebop generation. "It was the thing that gave us membership in a unique club," he proclaimed. Smack takes readers through the typical haunts of heroin users—52nd Street jazz clubs, Times Square cafeterias, Chicago's South Side street corners—to explain how young people were initiated into the drug culture. Smack recounts the explosion of heroin use among middle-class young people in the 1960s and 1970s. It became the drug of choice among a wide swath of youth, from hippies in Haight-Ashbury and soldiers in Vietnam to punks on the Lower East Side. Panics over the drug led to the passage of increasingly severe legislation that entrapped heroin users in the criminal justice system without addressing the issues that led to its use in the first place. The book ends with a meditation on the evolution of the war on drugs and addresses why efforts to solve the drug problem must go beyond eliminating supply.
After surviving nearly a decade of heroin abuse and hard living on the streets of San Francisco’s Tenderloin District, Tracey Helton Mitchell decided to get clean for good. With raw honesty and a poignant perspective on life that only comes from starting at rock bottom, The Big Fix tells her story of transformation from homeless heroin addict to stable mother of three—and the hard work and hard lessons that got her there. Rather than dwelling on the pain of addiction, Tracey focuses on her journey of recovery and rebuilding her life, while exposing the failings of the American rehab system and laying out a path for change. Starting with the first step in her recovery, Tracey re-learns how to interact with men, build new friendships, handle money, and rekindle her relationship with her mother, all while staying sober, sharp, and dedicated to her future. A decidedly female story of addiction, The Big Fix describes the unique challenges faced by women caught in the grip of substance abuse, such as the toxic connection between drug addition and prostitution. Tracey’s story of hope, hard work, and rehabilitation will inspire anyone who has been affected by substance abuse while offering hope for a better future.
