Book Review- Addiction Nation Offers a Path to Those in Need

Tom Houseman Harm Reduction

Addiction Nation opens with a deeply personal story told in visceral detail. It describes  the weeks that author Timothy McMahon King spent in an intensive care unit, suffering from pancreatitis, on the verge of organ failure and death. He describes the agonizing pain he suffered, as well as the only resource that brought him any relief: opioids, specifically fentanyl.

Addiction Nation is my story,” he writes, “but it is our story too.” The subtitle of the book is What the Opioid Crisis Reveals About Us. King is not a journalist, nor is Addiction Nation a PhD thesis. The opioid crisis, and the challenges of treating substance use disorder, have been examined by several authors, from Gabor Maté to Beth Macy to Sam Quinones. King references their writing, as well as the mountain of research done on the spread of opioid use disorder, but his approach is unique.

Instead it is King’s personal experience, and his faith-driven approach to recovery, that power Addiction Nation. King experienced opioid use disorder, describing his addiction to opioids that began with his time in the hospital. He is extremely lucky, and he understands that. “My story is one of early detection,” he explains, “of things that went right. It is a story that should be more common than it is… If everyone had what I had, the opioid crisis would not be what it is today.”

King grew up in a religious household, and he has spent his life pondering and understanding the role that faith plays in his life. Few authors have explored the relationship between faith and addiction as deeply as King, or in a way that is as accessible to a Christian audience. Those who do not share this perspective may find the biblical allegories and quotes off-putting, as if King’s religious background detracts from the seriousness of his writing. But for those who share this worldview, it offers fascinating insight into how people treat both themselves and others.

“Addiction is a kind of faith gone wrong,” King posits. King explains how he was able to come to terms with his own addiction and gain control of it. He needed to reckon with his own shame, fueled by the stigma that addiction was a “moral failing,” a sign of a weak will and a weak mind. Using his own experience as a jumping-off point, he tries to explain how complex addiction is, how universal an experience it is, and how shame and “tough love” are often the worst ways to handle it.

King’s goal is loftier than garnering sympathy for people who use drugs, or pushing policy proposals that will save lives, although he does both. He wants to diagnose all of us, and help us understand how our lives have become steeped in addiction. “The idea of addiction as a disease,” he writes, ‘allowed me to let down my defenses and accept help.”

But he also explores the idea of the so-called Disease Model of addiction and finds it imperfect and lacking. King argues that the opioid crisis, and addiction in general, is “more than a disease.” It is a complex hydra of impulses and emotions, a mobius strip of blame, shame, need, and fear, a vicious, self-reinforcing cycle. In order to defeat it, we must first untangle it and understand it.

The drug addictions plaguing communities, cocaine and meth and heroin, have been exacerbated by politicians who, rather than trying to help people in need, choose to “wage war on our citizens.” These “tough on crime” policies have fed on racial stereotypes of “super predators” and “welfare queens,” but they hid the growing problem of drug addiction surging in affluent white communities as well as poor rural communities.

King believes that addiction “reveals something about our culture, our economy, and our world that is very much considered ‘normal’ but is actually destroying what is human.” Opioids, he explains, “are not the cause of addiction, even though they are addictive.” Instead, addiction is driven by a desire to escape pain. For some that pain is physical, as it was for King, but for others it is emotional, psychological, even spiritual. Poverty, isolation, and hopelessness are all types of pain from which addiction offers a momentary escape at a great cost.

There are no easy answers to the addiction crisis, because King explains that addiction itself is the easy answer. Instead, he promotes the idea of slow, deliberate changes made on both the personal and the systemic level. That is what King means when he writes about faith: that faith in ourselves, each other, and the slow process of growth are the only way to overcome addiction. We must grapple with our own shame and fear in order to promote positivity, rather than condemning addicts out of a misplaced superiority.

“To struggle with control of our own actions is at the heart of what it means to be human.” As the opioid epidemic rages, more and more people either struggle with their own substance use disorders or know and love someone mired in addiction. These are the people for whom Addiction Nation is written: people who are afraid, who don’t know what to do, who know that the old answers won’t work and are looking for new solutions.

For Christian audiences, and people who find strength in their faith, King’s story and perspective are inspiring and enlightening. For  anyone scared or ashamed, the ideas explored in Addiction Nation will help them remember the most important message in overcoming addiction: You are not alone. We are all in this together.

Tom Houseman, Policy Director