Book Review: “The Opioid Epidemic: What Everyone Needs to Know,” by Yngvild Olsen and Joshua Sharfstein

This is The Book. This is the one you need to read for evidence-based information on opioid use disorder, its treatment with medications, and what we can do to address the epidemic.

The prose is lean and easy to understand without talking down to readers. Published by Oxford University Press in 2019, it’s still relatively up to date. It’s a substantial read, at 344 information-packed pages.

I know of one of the authors, Dr. Olsen, from presentations she’s given at national ASAM meetings (American Society of Addiction Medicine). In fact, I just listened to a recorded presentation from spring of 2022 where she was one of the main presenters about how treatment regulations changed both before and after COVID 19. She’s been a leader in the field of Addiction Medicine, holding key positions in both federal and state organizations.

She knows what she’s talking about.

Her co-author, Dr. Sharfstein, is also a standout in the field. He teaches courses at Johns Hopkins’ Bloomberg School of Public Health, giving this book a depth of information not seen in others on the same topic.

The book, written in a question-and-answer format, starts at the first chapter by defining what opioids are and how they work. The authors make clear the difference between addiction and physical dependence, which is so often misunderstood. In that first chapter, the book also answers another common misperception: why using methadone or buprenorphine is not “just replacing one addiction with another.” The authors accomplished this so deftly that I knew the book was a winner.

In the second chapter, they describe how opioids are used for pain, and in the third chapter describe how misuse of opioids can start. Chapter 4 discusses what opioid addiction (opioid use disorder) is.

Chapter 5 covers what opioid overdose is and how it can be treated with naloxone. The authors dispel more myths in the chapter, like the one that says people using opioids will use more if they know naloxone is available to save them.

Chapter 6 does the heavily lifting of describing what is and is not effective treatment for opioid use disorder. The authors do a great job of describing treatment both in office-based practices and at opioid treatment programs. They cover methadone, buprenorphine, and naltrexone. They even touch on use of kratom and ibogaine as purported treatments with little information to recommend their use.

Chapter 7 covers treatment for pregnant patients. I was so happy to see their discouragement of the use of the phrase “addicted babies” as an outdated and improper term. Chapter 8 discusses use of opioids in teens and recommended treatments for this age group.

Chapter 9 focuses on questions that families of people with opioid use disorder often have. The book encourages the families while still warning them that opioid use disorder is a chronic illness. They discuss the term “enabling” and why allowing a family member to “hit rock bottom” may not be the best thing to do.

Chapter 10 talks about the supports people in recovery need, specifically housing and other essentials. They talk some about peer supports as well, and about 12-step meetings and how in some cases, 12-step meetings can be confusing for people new to recovery on MOUD.

Chapter 11 gives the historical perspective of the opioid epidemic in the U.S., going all the way back to just after the Civil War, and up to the age of fentanyl.

Chapters 12 through 16 are possibly the most helpful sections of this book, describing evidence-based policies that can help us in the areas of prevention, treatment, and harm reduction of opioid use disorder. There’s also a chapter about our failed war on drugs, explaining how we could better use law enforcement to help people enter treatment instead of jail.

I found myself in the “Amen!” corner while reading this book, excited to see evidence-based treatment options discussed so eloquently in a book.

I would recommend this book to any person who wants scientific information about opioid use disorder and its treatment. It’s an appropriate book for public health officials on all levels: federal, state, local, counties, etc.

It is as up to date as possible given its 2019 publication date, and I hope this is the first of many editions of this book. Things change quickly in the arena of opioid use disorder and its treatment, so we should be ready for a second edition soon.

2 responses to this post.

  1. Guess I should ask, in case people like me are acknowledged by expects in book(?) What are the odds..
    The clinic I had been in treatment with with for 17 years is a reputable facility. They technically admitted patients (including myself) under the criteria required legally. And technically since I did have a brief history of abusing my prescription Vicodin, i could be accepted into their program. They didn’t offer anything other than long term Methadone maintenance. I didn’t know what other options were available. I didn’t fully understand the benefits or the possible risks. It’s the most difficult aspect of researching. I don’t want to admit that I may have not needed the maintenance Methadone. 17 years is a long time to merely be involved in a potential error. Do you believe all level of opioid addictions can benefit medically from methadone? If so, I’m hoping someone can explain what I could have done to help make my treatment a success? Or at the very least not harmful. You don’t need me telling you that you’re a wonderful doctor, and person. But you are. How do patients stand up for themselves without doing all other methadone patients a disservice? Basically, what went wrong?

    Reply

  2. Figured your opinion is probably more valuable

    Reply

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