A valuable but overlong overview of an underappreciated drug crisis.

THE LEAST OF US

TRUE TALES OF AMERICA AND HOPE IN THE AGE OF FENTANYL AND METH

Quinones sounds an alarm about a rapidly spreading form of meth in a follow-up to his award-winning Dreamland.

Buried in this overstuffed book lies an urgent story the author sees as overshadowed by the opioid crisis: the explosive growth of the potentially lethal form of synthetic methamphetamine known as P2P (phenyl-2-propanone). Through extensive but rambling interviews with people ranging from dealers to Drug Enforcement Administration agents, Quinones found that unlike earlier types of meth, made with hard-to-get ephedrine, P2P meth could be more easily made from “legal, cheap, and toxic” chemicals in Mexican labs and shipped north by traffickers. P2P, he learned, could cause intense paranoia and terrifying hallucinations and faster and worse harm than ephedrine-based forms: The new meth “was quickly, intensely damaging people’s brains.” Quinones maps the wreckage nationwide, including that it drew Black dealers to what had been “a working-class white drug.” What he learned is genuinely alarming but embedded in background material on topics that have been extensively covered elsewhere: the neuroscience behind addiction, the pre–P2P shifts from prescription painkillers to heroin to fentanyl, the toll opioids have taken in West Virginia, and the Sackler family’s disastrous stewardship of Purdue Pharma. The author also describes effective community-based responses to the crisis, such as church shelters for homeless addicts and “drug courts” that offer substance abusers an alternative to prison. Quinones concludes that the nation has forsaken “what has made America great” and that “when drug traffickers act like corporations and corporations like drug traffickers, our best defense, perhaps our only defense, lies in bolstering community.” After his account of the corporate missteps of the Sacklers and others, readers may be unpersuaded that the “best defense” might come from hard-hit communities themselves rather than from remedies such as tighter government regulation of rapacious corporations like Purdue Pharma.

A valuable but overlong overview of an underappreciated drug crisis.

Pub Date: Oct. 12, 2021

ISBN: 978-1-63557-435-7

Page Count: 432

Publisher: Bloomsbury

Review Posted Online: July 18, 2021

Kirkus Reviews Issue: Aug. 15, 2021

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A solid work of investigation that, while treading well-covered ground, offers plenty of surprises.

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PERIL

An account of the last gasps of the Trump administration, completing a trilogy begun with Fear (2018) and Rage (2020).

One of Woodward and fellow Washington Post reporter Costa’s most memorable revelations comes right away: Gen. Mark Milley, chairman of the Joint Chiefs of Staff, calling his counterpart in Beijing to assure him that even after Jan. 6 and what Milley saw as an unmistakable attempt at a coup d’état, he would keep Trump from picking a war with China. This depiction has earned much attention on the talking-heads news channels, but more significant is its follow-up: Milley did so because he was concerned that Trump “might still be looking for what Milley called a ‘Reichstag moment.’ ” Milley emerges as a stalwart protector of the Constitution who constantly courted Trump’s ire and yet somehow survived without being fired. No less concerned about Trump’s erratic behavior was Paul Ryan, the former Speaker of the House, who studied the psychiatric literature for a big takeaway: “Do not humiliate Trump in public. Humiliating a narcissist risked real danger, a frantic lashing out if he felt threatened or criticized.” Losing the 2020 election was one such humiliation, and Woodward and Costa closely track the trajectory of Trump’s reaction, from depression to howling rage to the stubborn belief that the election was rigged. There are a few other modest revelations in the book, including the fact that Trump loyalist William Barr warned him that the electorate didn’t like him. “They just think you’re a fucking asshole,” Barr told his boss. That was true enough, and the civil war that the authors recount among various offices in the White House and government reveals that Trump’s people were only ever tentatively his. All the same, the authors note, having drawn on scores of “deep background” interviews, Trump still has his base, still intends vengeance by way of a comeback, and still constitutes the peril of their title.

A solid work of investigation that, while treading well-covered ground, offers plenty of surprises.

Pub Date: Sept. 21, 2021

ISBN: 978-1-982182-91-5

Page Count: 512

Publisher: Simon & Schuster

Review Posted Online: Sept. 24, 2021

Kirkus Reviews Issue: Oct. 15, 2021

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An oft-ignored but fully convincing argument that “we cannot prevent the next pandemic without creating a healthy world.”

THE CONTAGION NEXT TIME

The Covid-19 pandemic is not a one-off catastrophe. An epidemiologist presents a cogent argument for a fundamental refocusing of resources on “the foundational forces that shape health.”

In this passionate and instructive book, Galea, dean of the Boston University School of Public Health, writes that Covid emerged because we have long neglected basic preventative measures. “We invest vast amounts of money in healthcare,” he writes, “but comparatively little in health.” Readers looking to learn how governments (mainly the U.S.) mishandled the pandemic have a flood of books to choose from, but Galea has bigger issues to raise. Better medical care will not stop the next epidemic, he warns. We must structure a world “that is resilient to contagions.” He begins by describing the current state of world health, where progress has been spectacular. Global life expectancy has more than doubled since 1900. Malnutrition, poverty, and child mortality have dropped. However, as the author stresses repeatedly, medical progress contributed far less to the current situation than better food, clean water, hygiene, education, and prosperity. That’s the good news. More problematic is that money is a powerful determinant of health; those who have it live longer. Galea begins the bad news by pointing out the misleading statistic that Covid-19 kills less than 1% of those infected; that applies to young people in good health. For those over 60, it kills 6%, for diabetics, over 7%, and those with heart disease, over 10%. It also kills more Blacks than Whites, more poor than middle-class people, and more people without health insurance. The author is clearly not just interested in Covid. He attacks racism, sexism, and poverty in equal measure, making a plea for compassion toward stigmatized conditions such as obesity and addiction. He consistently urges the U.S. government, which has spared no expense and effort to defeat the pandemic, to do the same for social injustice.

An oft-ignored but fully convincing argument that “we cannot prevent the next pandemic without creating a healthy world.”

Pub Date: Nov. 1, 2021

ISBN: 978-0-19-757642-7

Page Count: 280

Publisher: Oxford Univ.

Review Posted Online: Aug. 28, 2021

Kirkus Reviews Issue: Sept. 15, 2021

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