This was a challenging listen. On one hand, "On Opium" is set to showcase an array of experiences of people who use opioids. And there are both--those for whom this is the only way to be able to function normally, but also those who got prescribed/self-medicated to the point of addiction, even though their conditions could have been managed differently.

On the other hand, this audiobook gets a bit monotone after a while and the stories--repetitive. I applaud the author for taking on such a challenging, and close to her heart topic, but towards the end I felt overwhelmed with the amount of information and details that probably would make a harder entry point for many readers.

On opium is a vitally important book and Carlyn Zwarenstein's mediation on the costs and the often unspoken benefits of the magical poppy seed syrup is compelling throughout.

Zwarenstein begins, with literature and the life and laudanum of Thomas De Quincy, and from there spreads her net to capture a world of pain, relief and sometimes, in her most taboo moments, even pleasure associated with the consumption of opium.

This books makes a superb partner to Beth Macy's heart-breaking 'Dopesick' and the excellent TV Drama it spawned starring Michael Keaton. In Macy's tale of the opioid crisis and the unbridled pursuit of profit by the Sackler family but here Zwarenstein persuasively argues that for some, for those in chronic pain both physically and mentally, a clean, legal source of opium in whatever form can give not only relief but structure and control to lives that have become undone not through the drug itself but through their inability to access what they need.

Zwarenstein, herself a sufferer from chronic pain from the effects of Ankylosing spondylitis is incredibly convincing in her treatise. Her personal story and her tales of the others she has met on her way, those whose use of opium of has criminalised and 'othered' them are sympathetic and engaging. The debate is perhaps not as simple as she claims and recalling the appalling death toll of Macy's book one is left with more questions than answers but at least as a reader one feels like the debate has more dimensions to be considered. Indeed my biggest takeaway from this excellent treatise is that nothing is ever simply black and white and the the complexity of human existence leaves almost all our absolutes in softer shades of grey,

On Opium in an interesting series of essays discussing the use of opium and other hard drugs, both for recreational and medical/pain relieving purposes. Some sections were eye-opening, such as how the decriminalisation of these drugs, as with the alcohol prohibition in 1920s America, causes unwanted consequences and forces otherwise good people into crime and dangerous street drugs, and how misdemeanours are more heavily prosecuted against minority populations.

Worth a listen, but my criticism is that this comes across as a series of essays, with many of the core points repeated throughout. This is a huge audiobook - 18 hours in total, I felt the narrator was losing interest at some points - and could've easily been edited down to half its length to have a greater punch.

Thanks to NetGalley for the audiobook ARC!

On Opium is an exhaustive look at the use of morphine derivatives for both legal and illegal use. It's also rather exhausting. As a pharmacist, I found the in-depth nature of the book to be fascinating and insightful, but I feel like it is probably about twice as long as a member of the general public would remain interested in the subject matter. Which is partly a downfall of the book and a sad commentary on our society's ability to ignore problems that are staring us in the face.

Opioid use is an epidemic in North America, killing thousands of people each year, with millions more using them on a regular basis. A user of prescribed opioids to deal with a chronic condition, Carlyn Zwarenstein is able to write from a position of authority due to her first hand experience. She does not limit the book to her own experiences, though. She reaches out to many other opioid experts and users to add their experiences to the book as well. Some use street drugs daily; some are leading recovery sessions at local centers, and some are doctors who provide legal prescriptions to their patients. These stories are all interwoven with history on opioids, a look into why people use them, the effects on users and those around them, an analysis into how the crisis rose to the level where it is today, and what could be done to ameliorate the crisis.

The threads of this book were beautifully woven together to provide a book that is both informative and compelling. I highly recommend it to anyone who wants to know more about opioids, our current crisis, and where we go from here. Christine Horne did a wonderful job narrating the audiobook.

Many thanks to NetGalley for providing me an audio ARC of this book.

Thank you to NetGalley and Goose Lane Editions for granting me free access to the audiobook recording of On Opium: Pain, Pleasure, and Other Matters of Substance by Carlyn Zwarenstein in exchange for an honest review. Wow. What an extensive look at the opioid epidemic that has plagued North America for the past thirty years. The careful analysis of the opioid crisis from a harm-reduction perspective paired with the narrative of Carlyn's own experience with opioid use made this book both strikingly intellectual and incredibly empathetic. I would highly recommend this book to anyone who would like to learn more about the opioid crisis, but has never been challenged to see the nuances of drug use and addiction. Carlyn bravely fights for justice for those who are most marginalized in the drug using community and poignantly outlines the necessity of harm reduction health care.

What an informative read!

On Opium is filled with so much information and stories from real people. I feel like we need to start having a reality check when it comes to opioid use and hearing about others experience is just the beginning. There are so many misconceptions out there and I feel like Carlyn was able to address them all.

I recommend this book to any one and everyone, especially those who are looking to do further research on this topic because it is filled with great references.

Thank you to Carlyn Zwarenstein and Bespeak Audio Editions for the audio-digital ARC provided through NetGalley in exchange for an honest review!

This was interesting read looking at opium in a different way, I felt it could have been shorter as did get abit board listening in areas,
It did make you think about things in a different light though which was good