On Opium

By Carlyn Zwarenstein

On Opium
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A groundbreaking meditation on pain, painkillers, and dependence from a prescription opioid user.


Her writing has been described as "measured," "sensuous," and "compelling. " In 2016, Carlyn Zwarenstein’s short narrative on pain made the Globe and Mail’s Top 100 Books. ... Read more


A groundbreaking meditation on pain, painkillers, and dependence from a prescription opioid user.


Her writing has been described as "measured," "sensuous," and "compelling. " In 2016, Carlyn Zwarenstein’s short narrative on pain made the Globe and Mail’s Top 100 Books. Now, she returns with a seductive dive into opioids and the nature of dependence.

North Americans are the world’s most prolific users of opioid painkillers. In On Opium, Zwarenstein describes her own use of opioid-inspired medicines to cope with a painful disease. Evoking both Thomas De Quincey and Frida Kahlo, she travels from the decadence of recreational drug use in past eras to the misery and privation of the overdose crisis today.

Speaking with users of prescribed morphine, illicit fentanyl, and smoked opium, Zwarenstein investigates uncomfortable questions about why people use substances and when substance use becomes addiction. And she exposes causes of drug-related harms: the debilitating effects of poverty, isolation, and trauma; the role of race, class, and gender in addressing pain; and a system of prohibition that has converted age-old medicines into taboo substances.

Through all of this, Zwarenstein finds hope. Drawing on solidarity between illicit drug users and people in pain; in a wise understanding of what humans need to be well; and in radical drug policies like legalization and safe supply, she lays out a vision of a world where suffering is no longer lauded, and opioids are no longer demonized.

Carlyn Zwarenstein

Carlyn Zwarenstein is a writer based in Toronto. Her writing has appeared in the Guardian, the Toronto Star, and Vice. She is also the author of Opium Eater: The New Confessions.


“Zwarenstein not only plumbs the depths of pain and relief and dependence on relief but traces the blurred lines between writer and subject on that — perhaps needlessly — charged question: What do we do for pain and its wily life-thieving-or-enabling remedy? What would happen if we turned our focus to the prevention and elimination of suffering, rather than the demonization and criminalization of sufferers?”

Anna Mehler Paperny, author of <i>Hello I Want to Die Please Fix Me</i>

“Zwarenstein puts drug users at the centre of this conversation, a location from which they are far too often pushed away, and forces us to reconsider everything we’ve ever thought about opioids. ”

Nora Loreto

“A beautifully written meditation on opioids, addiction, joy, and pain — and the cruel and rigid policies we devise that mainly serve to make suffering worse. ”

Maia Szalavitz, author of <i>Undoing Drugs</i>

“Carlyn Zwarenstein provides a voice previously missing from the overdose crisis. With empathy and urgency, she takes us inside the world of people who use opioids at a time when they are dying in record numbers. On Opium captures people’s pain, hope, and resilience, and in sharing their stories, provides a blueprint to end the crisis. ”

Travis Lupick, author of <i>Fighting for Space</i>

“Captivating, rage-inducing, and most important of all, helpful. In On Opium, Zwarenstein challenges us to imagine a world in which we toss out our antiquated, actively harmful ideas about substance use, stop thinking of addicts versus 'legitimate' users, and embrace harm reduction in a meaningful way. ”

Alison Manley

“Zwarenstein’s volume is a valuable tool for the promotion of harm reduction. When so much conservative rhetoric is based on an ideology of stoicism, it’s bracing to learn that Roman emperor and Stoic philosopher Marcus Aurelius was also an opium user. ”

“Rarely have I felt so trusted as a reader. Zwarenstein is disarmingly transparent about her process, casual in her tone, and honest about her limitations. . .. What we should all be thinking of more, Zwarenstein seems to be saying, is suffering itself, and how we can help ourselves and others surmount it. ”

Viviane Fairbank

“We need to legalize and regulate non-medical use of drugs. . .. On Opium shows us that, after too much suffering, too much delay, that change will come. ”

W.A. Bogart

“Zwarenstein weaves her personal narrative of using prescription opioid medication to manage spinal arthritis with a deeply reported look at why people use substances and the causes of drug-related harms. ”

Tabassum Siddiqui

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