WEIGHING RISK IN USE OF CONTROLLED OPIOIDS
One in six Canadians use prescribed opioids. Canada is the world’s second-largest prescriber of opioids, while in the United States the increasing use of the substances make almost daily headlines. Writer and journalist Carlyn Zwarenstein explores our obsession with opioids in her new book, Opium Eater, in which she describes her own use to cope with debilitating chronic pain.
Q Opium Eater is described as a 21st-century take on the classic Confessions of an English Opium-Eater. How did De Quincey’s book influence your own?
A When I discovered — with a Google search — that the drug I was taking was an opioid, I remembered vaguely that there was this book called Confessions of an English Opium-Eater. I looked it up and was just stunned at the beauty of some of the language, and also at how closely it reflected my emerging experiences. I tried to match the lyricism of De Quincey’s best passages, to avoid the stultifying detail of his worst, and to use his model of an ambiguous confessional to say the things that were of most interest to me.
Q You describe the debilitating pain you experience and the anticipation, relief and sometimes joy you feel when taking opioids to alleviate the pain. Was it challenging to write about such personal experiences, especially those with stigma attached to them? Did you feel exposed?
A It was a joy to write about these experiences, but I certainly felt and feel exposed. At my launch, I stumbled over my first sentence to an audience that included my childhood neighbour, former and current employers and clients, high school friends and my mom: “This is a book about how I take small, regular doses of a drug related to heroin.” I decided a very long time ago that I could write about anything, and I tried to be true to that, but it has made me feel very vulnerable and exposed indeed, and it is scary to find that people feel like they know me after reading the book. On the other hand, I don’t see writing as a form of psychotherapy — rather, I see it as my work. And it’s art — I do get to choose what I tell and how I tell it. That provides a bit of emotional protection.
Q What can the average reader learn from someone who regularly takes opioids that they may not learn from the more mainstream reporting of usage?
A That pain, which can be tolerated for a few hours, is an absolutely devastating thing to live with in the long term. That it is important to consider whether the medication a person is taking is in fact improving or diminishing their life. That there are actually limits to every single one of the alternatives that have been proposed — and that should be fully explored by patients and their doctors — and that the very real situation of irresponsible prescription could be dramatically improved simply with better patient education about what they are actually taking, the expected effects and side effects (which should really just be called effects), the risks involved, the proper way to store the drugs, the alternatives or adjuncts that are possible and preferable, and the importance of keeping one’s dose as low and short-term as feasible.
Q The book is an amalgamation of your own story, that of De Quincey, and recent research about opioid consumption. Tell us about the writing process and how you interwove these elements.
A To justify my proposal, I started with the idea of a challenge — will this be the story of my sad but topical spiral into addiction? That’s a very superficial, magazine-y, exploitive and very conventional way of dealing with a complex issue, and I was glad that my editor, Tyee Bridge, picked up on the romantic elements I held onto for dear life enough to help me (he is a magician) to allow me to make it more of a timeless meditation on pain and drugs and meaning, with a suitably magical structure.
Q The format for Opium Eater is an unusual one: a “Nonvella” — a book which can be read in a single sitting and which takes inspiration from the long-form journalism that can be overlooked in today’s click-heavy world. How did this book length influence how you created the book? Was it hampering or enabling?
A I love the intensity and frugality of the novella form, and I actually approached this particular small press after seeing an article about how they were trying to promote this sort of single-sitting (or almost) writing in book form. The length functions as a wonderfully enabling constraint. It’s long enough to say quite a lot — and I managed to fit just about everything I could have wanted in there — but it is short enough that every word has to be beautiful and perfectly fit together. No one’s time is going to be wasted. I hope to keep this in mind to prevent things from getting bloated and boring in future books.