A CDC doctor’s insider account of the opioid crisis.
LeBaron comes to the subject of the 21st century’s war on opioids as a seasoned professional—he’s a graduate of Princeton University and Harvard Medical School, and has been a medical epidemiologist for over 28 years at the Centers for Disease Control and Prevention (CDC)—but he opens his book with his personal connection to the subject. In disastrous succession, the author experienced meningitis, disseminated shingles, and spinal abscesses. This put him in a position to need opioids himself and brought him into a collision with the escalating and highly politicized war on drugs. “Beset on every side by these virtuous prime-time crusaders,” he asks, “how was I going to get my little oxycodone pill?” In 1980, 41,000 people in the U.S. were imprisoned for drug offenses, and as LeBaron points out, that number is now ten times as high. The author’s experiences have put him on the front lines of this “opioid epidemic,” working for the CDC but also serving stints as a prison doctor and as a visiting physician for an Indian Health Service hospital in Appalachia that was a “pill mill” for many of its patients—the author found himself in the position of dispensing “narcs” on a regular basis. This combination of personal and professional vantage points is elevated by LeBaron’s vivid and fast-paced writing style (quotes from Mary Tyler Moore and Rickey Henderson jostle against allusions to Plato) and gives his insights added weight. “What if rigid opioid prescription controls, prompted by the CDC Guideline, were provoking and even promoting addict-like behavior among those who had nothing but severe pain?” he asks, noting that “exaggerated narratives of fear tend to be counter-productive.” The U.S. has 5% of the world’s population but consumes 80% of the world’s opioids; LeBaron here details both the worst of the country’s dysfunctional system and some working models that might actually improve the situation in gripping, sometimes searing prose.
A powerful, important expert’s analysis of the opioid epidemic.