THIS IS OHIO

Another alarming report from the front lines of the opioid epidemic.

Shuler, who teaches journalism at Denison University, focuses his on-the-ground study in nearby Newark, Ohio, “a microcosm of the U.S. economy—a once-prosperous industrial city that has felt the effects of neoliberal free-trade policies.” Though not far from Columbus, Newark is also perched on the edge of Appalachia; it suffers from all the troubles of a Rust Belt city, including a populace that is largely unprepared for this long-term economic shift and has not been quick to reeducate itself. Thus begins a kind of self-fulfilling prophecy—as Shuler points out, the toll that opioids take on the under- or uneducated means more than four times the death rate as compared to those with even some college. This speaks to the current notion, propounded by economists Anne Case and Angus Deaton, of “deaths of despair.” As Shuler further notes, although the opioid crisis is indisputably a matter of public health and “a form of collective trauma on par with the HIV/AIDS crisis,” it is generally treated as a criminal matter, which only exacerbates the problem. Some of Shuler’s informants have had it a little better in life but still fall victim: a woman of a comparatively privileged background who turned to drugs to self-medicate for bipolar disorder and who deems the current overdose crisis—“since 2000, the accidental overdose rate in Ohio has more than tripled”—a human rights crisis as well. The author ventures some eminently practical measures, including making lifesaving medications widely available; more users, he urges, “could be saved from an opioid overdose death if more people had naloxone.” Furthermore, we blame drugs too readily when “they’re just a symptom” of a greater social crisis we continually fail to address. Though not quite on par, this book should be shelved next to Beth Macy’s Dopesick and Sam Quinones’ Dreamland.

Full of grim yet important statistics and vignettes as well as a few sensible solutions.