Missouri Life June 2023

BOOKS

How to Blow Up a Pipeline A new book examines and deconstructs the criminalization of prescription drugs. REVIEW Evan Allen Wood

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or Shaun, the trouble started with his knees. He hurt them playing football in high school and college and was prescribed opioids to treat the chronic pain that resulted from years of injuries. But oftentimes the doctors Shaun, a Black man, went to for pain management

A word of advice to readers: Forget what you think you know about institutions such as the prison system and the health care system before you pick up this book. Smirnova makes a compelling case in this text that outcomes within these institutions vary wildly based on a variety of factors including class and race. Each story told within the book tends to feature a person looking for solutions to chronic pain or psychological issues stemming from childhood trauma (often parental abuse) and subsequently being failed by these institutions. One point Smirnova illustrates particularly well is how in American society we tend to frame each person’s life as a matter of individual success or failure. We view criminal behavior or poverty as failures of morality and motivation. Stories in the book like that of Walter, a 65-year old Black man, ask us to revisit these internalized notions. According to the book, Walter was landscaping and home remodeling by day and going to school for computer programming by night, which he saw as a path both toward upward class mobility and a way to continue to make a living when he aged out of manual labor. Then he was diagnosed with a degenerative eye condition which forced him to abandon his education. “Walter did not want to be a patient or a victim,” Smirnova writes. “He wanted to take his future into his own hands, but during the course of his struggles, he became a prisoner instead.” Smirnova asks us to suspend the idea that her interview subjects are guilty individuals who made negative choices and instead to question the extent to which structures outside the control of any individual influenced the course of their lives. Smirnova is writing about a system that is political in its nature, and therefore her perspective is political, which inherently means some readers may not agree with it. It’s worth noting that this text is academic in its construction—the tone of its writing is comprehensible but formal. These interviews were conducted as a part of an academic study, and the book includes methodological notes and citations. If you object to Smirnova’s conclusions, you can at least verify her sources.

doubted his intentions and under-prescribed medication, assuming he was using them to get high. In a cruel irony, this led to Shaun using illicit options to treat his pain, which eventually resulted in his incarceration. Shaun grew up in rural Missouri, and he is one of 80 incarcerated individuals interviewed by Michelle Smirnova for her book, The Prescription-to Prison Pipeline , published in March of this year through Duke University Press. Each interview was conducted at a Missouri prison, and the stories that Smirnova relays from these conversations may be tragically familiar to readers from the region. In the book, Smirnova,

a sociology professor at the University of Missouri Kansas City, posits the idea that our current system of managing pain and psychological issues is highly stratified based on socioeconomic class, among other factors. The result is that those who can afford it receive quality care, which helps orient them toward healing, while the poor tend to be treated with the prescription pad only, setting them off on a journey that all too often ends, as in Shaun’s case, in the carceral system. Smirnova argues this pipeline is entrenched within American society to the deleterious effect of all involved.

THE PRESCRIPTION- TO-PRISON PIPELINE Michelle Smirnova, 176 pages, nonfiction, Duke University Press, softcover, (6 by 9 inches), $24.95

THE PUBLISHER

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