Host Kate Carpenter is joined by drug historian Dr. Emily Dufton to talk about Emily’s newest book, Addiction, Inc.: Medication-Assisted Treatment and America’s Forgotten War on Drugs.
Emily holds a PhD in American studies and works full-time as a writer. Her first book was Grass Roots: The Rise and Fall and Rise of Marijuana in America. Thanks to her expertise in drug history, she regularly serves as a commentator on cannabis history and news, and she also writes essays and op eds for public outlets.
Addiction, Inc. tells the history of medication-assisted treatment for illicit drug addiction, beginning with its emergence during President Richard Nixon’s war on drugs in the 1970s as a radical approach to public health. From there she traces the controversies, missed opportunities, and privatization that have scrambled access to what is considered the gold standard of addiction treatment, even as America wrestles with an opioid overdose epidemic. Emily is the recipient of multiple awards that supported the book’s creation, including a J. Anthony Lukas Works-in-Progress Award, a Robert B. Silvers Grant, and a Whiting Creative Nonfiction Grant.
We spoke about the process of applying for those awards and why writers should try for grants, the home disaster that derailed the beginnings of this project, and how she balances feedback with her own vision for her book—even when there is A LOT of feedback. You’ll also hear about whether she finds it lonely to write outside of an institution, and why she suggests that more historians pick up the phone and call their sources.
Note that bookshop.org links are affiliate links that generate a small commission to support the show if you purchase books using these links.
Mentioned in this episode
- Emily Dufton’s website
- Emily Dufton, Addiction, Inc: Medication-Assisted Treatment and America’s Forgotten War on Drugs
- Emily Dufton, Grass Roots: The Rise and Fall and Rise of Marijuana in America
- J. Anthony Lukas Prize
- Robert B. Silvers Foundation Works-in-Progress grants
- Whiting Creative Nonfiction Grant Pauline Kael’s work at the New Yorker
Transcript
Kate Carpenter 0:01
Welcome back to Drafting the Past. This is a podcast about the craft of writing history, and I'm Kate Carpenter. I'm delighted to be joined today by Dr Emily Dufton.
Emily Dufton 0:11
Thank you so much for having me. I'm really happy to be here.
Kate Carpenter 0:14
Emily holds a PhD in American Studies and works full time as a writer. She is the author of two books. Her first was Grass Roots: The Rise and Fall and Rise of Marijuana in America. Thanks to her expertise in drug history, she regularly serves as a commentator on cannabis history and news, and she also writes essays and op eds for public outlets. Her newly released book is Addiction, Inc.: Medication Assisted Treatment and America's Forgotten War on Drugs. In it, she tells the history of medication assisted treatment for illicit drug addiction, beginning with its emergence during President Richard Nixon's war on drugs in the 1970s as a radical approach to public health. From there, she traces the controversies, missed opportunities, and privatization that have scrambled access to what is considered the gold standard of addiction treatment, even as America wrestles with an opioid overdose epidemic. As she worked on Addiction, Inc., Emily won multiple prestigious awards to support its creation, including a J. Anthony Lukas works-in-progress award, a Robert B. Silvers grant and a Whiting Creative Nonfiction grant. We talked about the process of applying for those awards and why writers should try for grants. We also talked about the home disaster that derailed the beginnings of this project, and how Emily balances feedback with her own vision for her book, even when there is a lot of feedback. First, though, I asked her to tell me about the trajectory of her career as a writer.
Emily Dufton 1:42
Oh, the trajectory of my career for what it is. I've actually been thinking about that myself lately, because with this book coming out next month, I've been starting to think, Well, what kind of trajectory have I been on? Because it has been a hot minute since I published my last book. That was nine years ago. That was back in 2017 and so this book took about eight years, all told, kind of from the beginning when I started thinking about the topic in 2018 to now, when it's finally coming out. Because for a long time, I kind of felt like everything was conspiring against me to actually get this book out there. I sold the proposal in December of 2019, two weeks before my daughter was born. And so I had this beautiful little baby and a three year old boy with the agreement with the University of Chicago Press that I would, you know, have my little baby and then get her into some kind of care, and I would start writing full time, maybe when she was three, four or five months old. But of course, Covid-19 had other plans in March of 2020 so that threw me off a bit, when I was suddenly home with my baby and toddler. And then when my daughter finally entered full time daycare when she was 18 months old, the night after her first day, when I was awaking to the promise of full time work and being able to really focus because I had been working in fits and starts for the past couple of months and getting nowhere. I thought, This is it. Like, I'm really going to start on this book. This is going to be great. And that morning, our neighbor's tree fell in a storm onto our property, destroyed our car, brought down the power lines and inspired our circuit breaker in our basement to burst from the explosion of energy that came through, which would have burned down our entire basement, but it was so hot, it melted a water main, which burst and subsequently put out the fire, but then proceeded to flood our basement, which is where my office is located. And my office was the most damaged room. I lost a good chunk of my research from my first book, Grass Roots. I lost all the research, preliminary research such as it was for this book, and it set us back for about six months having everything rebuilt and the mold remediation and all this other stuff. So by December, January of 2022, over four years ago, I was finally starting to work on this book, and then it was just simply the process of actually researching it and writing it, and then through the process of that darling of academia, peer review, through the University of Chicago Press. But the trajectory felt sisyphean, for a long time, but I am very pleased that the book is coming out. It does exist, and I have a rebuilt office, and I was able to put everything together, but I have felt that the trajectory of my career as a writer has been moderately stunted by what our insurance company called acts of God. And I sort of wondered karmically, who I upset that made it so difficult to get this book finished. But lo and behold, it is here, and perhaps my trajectory will move slightly more quickly after, after this is over, maybe I burned off that karma.
Kate Carpenter 4:56
Oh, boy, I hope so. I need a minute just after hearing that.
Emily Dufton 5:03
Tip to your listeners, don't store important documents on the floor. You never know when your basement might flood. That's my advice to your listeners. Don't repeat my mistake.
Kate Carpenter 5:13
Most practical writing advice, oh, my goodness. Well, so did you, did you plan to focus on a career as a writer after graduate school?
Emily Dufton 5:24
I did. I did because I went to George Washington University here in DC, and I was very interested in writing, and I was also very interested in academia. But the time I graduated, but by the time I graduated, rather, my husband had really established himself here in DC as a speech writer. He was actually the chief speech writer for President Obama's Secretary of Transportation, Anthony Foxx, by the time I graduated. So it was very clear that we were going to have to make our life in DC, because as a speech writer, there's not so many cities you can live in where you're going to find consistent work. DC is a great one. So he had found his position in communications, and I really loved the idea of teaching, but I also saw academia somewhat collapsing in on itself, especially in the humanities, and this is even 10 years ago, a process that I fear has only accelerated. So I knew there was probably a lot of options for me to make my way outside of the traditional academic path and forging a way forward with writing being more centered here in the city as well, and that's pretty much what I've been doing. I did a postdoc that was a lot of fun at an investigative newsroom. I've worked on podcasts. I have my own little writing shop where I take on contract jobs. I've done book proposals for people, speeches, op eds, things like that. So I've kept that going to sort of, you know, pay the bills while I work on my own writing on the side. And that was, that was what, that was sort of how Addiction, Inc., got to to come out into the world. Was me scratching away at it when I wasn't taking on jobs that actually paid me real, live American dollars.
Kate Carpenter 6:59
Well, I'm going to start with my practical questions. Now that you have a rebuilt office, when and where do you like to do your writing?
Emily Dufton 7:07
I like to do it here. I am a standing desk devotee. I stand all the time. My legs actually get pretty tired by the end of the day. But I am a pretty, pretty hard core, like, I just get into it the moment I get home from dropping off the kids at school. I'm down here, and I'm very focused, until, pretty much the moment I have to leave and go pick them up, I take breaks to walk the dog and, like, eat some food. But I've never been someone who struggles with focus, especially when it comes to writing. I prefer a quiet room. I prefer to be surrounded by the materials I need, but I have no problem with grinding it out. You know, from from nine to five, I feel like that's one of the things I can offer my potential clients. Is like, don't worry. I don't get tired or bored. I'm very masochistic in that way.
Kate Carpenter 7:57
How do you like to organize yourself?
Emily Dufton 7:59
In a very chaotic way that I think only I understand according to the faces of anyone who comes into my office. It doesn't look entirely organized, but strangely, I know where everything is. So that is my non-organization organization is how I like to organize myself.
Kate Carpenter 8:16
So do you like then to keep, as evidenced by the flood, do you like to keep sources in paper form, or do you organize them digitally somehow?
Emily Dufton 8:23
I'm a very, I'm like very old school. I love, I love paper. I recognize the value of digital resources. I love like a control F, and you find exactly the term you're looking for, or the statistic or the number or whatever. And I can't over overstate the value of that enough, but I read better, and I observe, absorb more when I read on paper, and when I take notes on paper, and when I write on paper, I'll oftentimes remember exactly like the marginalia on which page, on which side of the page, and what I wrote and like in what color ink, and that will help me find it faster than, obviously, not a control F, but if you're looking at the, you know, a physical document, I really do prefer that. I have several filing cabinets throughout my office where I keep things together and I compile, basically, files on individuals or organizations slowly over time. And so some of those files, you know, were useful for my first project, but then I went--which was about cannabis and, you know, kind of basically grassroots cannabis, cannabis activism, something relatively different from from what I'm writing about in Addiction, Inc.--but a lot of the material was still helpful, and it was good to go back and kind of have that physical copy, rather than saying, like, well, which drive did I save that on? Or where is this thing? Because, like, technology keeps changing. I can't find a lot of the stuff that I wrote in grad school, but my papers, assuming they don't get destroyed in floods, my papers live on and so, you know, shout out. Shout out for the analog. Shout out for the analog sources.
Kate Carpenter 9:56
Where in your research process do you like to start writing?
Emily Dufton 9:59
So it sort of depends, because it's a bit of a catch 22 because I don't know what I'm really researching or what I need to research until I start writing, but I cannot write until I've started to research. But I do feel like once I actually get into the process of writing, it becomes much more clear which research I've done is actually helpful and will push the narrative forward, and which was probably a rabbit hole that sucked up a few hours of my life, and I'll never get that time back. But, but now I know a lot about Eugene O'Neill, right? Didn't get into the final manuscript, but I went down a really big rabbit hole on him, so I feel like the two kind of have to exist neck and neck. But of course, ideally, the writing process comes into play a bit more when I have done a sufficient amount of research where I know what, like the sort of the starting point of the story is, and I can kind of see the basic narrative thread from there. But that doesn't always necessarily happen at the beginning of research. So sometimes you gotta, sometimes you gotta waste your life on Eugene O'Neill for a while before you realize you've gone the wrong direction.
Kate Carpenter 11:05
Do you ever then end up making an outline and kind of planning where you're going? Or do you just, do you just start writing?
Emily Dufton 11:10
I've been more into outlines lately. I really do love an outline. It can be very basic, maybe just a term or two, but I like to know which stone I have to jump to next to get across the river. I didn't always used to do that. I wasn't always such an outline person, but I now feel like it organizes my thoughts much better, where I can see where I'm going, and I can see which paths will lead me there most directly. And I also like an outline, and it'll usually just be in, like, the Word doc or the Google Doc that I'm working in, you know, but I'll, but I'll kind of know the next step. I also like it, because it can also serve as that messy first draft. And I'm not so hung up on it, because it's just an outline, like the sentences don't have to be perfect, they don't have to sound good. It's just an outline, but I love a messy first draft, and I so much appreciate and respect and value a messy first draft these days, especially as I get older, because it's like for me, it's not until I have a messy first draft that I can even begin to figure out what it is that I'm actually saying. For me, writing is so much a process of revision, but you need to have something to exist to revise before you can get to that point. And sometimes an outline plays that role quite beautifully. So, you know, hooray for analog sources and hooray for outlines. This is, I guess, these are the conclusions I've come to.
Kate Carpenter 12:35
How do you approach tackling that revision?
Emily Dufton 12:37
Oh, I will read a paragraph over and over and over and over until it is smooth and it feels right. And then I will do that for every paragraph, and then I will do that for the chapter as many times as I possibly can. Usually I need to start when I'm revising something, when I'm reading, and I really need to start at the beginning always, and go through and if I'm reading it and it feels smooth, I feel like I can move on. But if there's anything that trips me up, like just language wise or sound wise, or if I feel like the meaning is unclear, I'll go back and I'll work it and I'll work it and I'll work it, and then I can move on and do the next thing. Now, I'm not always successful in this revision and clarification. There's, I just finished reading the audio book of Addiction, Inc., and there's definitely moments where I'm like, Ooh, I could have done better on that, but I I'm a non stop revisor. I do it over and over and over again until I feel like it's right. Because if I get hung up on something when I'm reading it through, I can't I cannot comfortably move on until, until you know it does. It's not the same way with cleaning up messes, obviously, as my as my office shows, but if I feel like there's a mess on the page, it just drives me nuts, and I have to keep working at it until it's finally clean.
Kate Carpenter 13:49
I know that really, for all writers, writing can be a lonely process, but especially when you're not in the academy and you don't kind of have that institutional environment, it can be especially isolating. Well, of course, it has bonuses also, but are there ways that you maintain a writerly community?
Emily Dufton 14:07
That's a great question. And it can be lonely, but I feel like it's lonely, you know, writing is lonely no matter what kind of institutional you support you have or don't have, right? It's, it's a, it's a journey with yourself, in your brain, in your soul, in your heart. It's a journey that one can only take alone, usually, unless you have a collaborator. But I feel very lucky that I've had a lot of communities around me. Living in DC is great for people who love books. We've got so many great bookstores, and they host so many great events. So I love going to book talks like Politics and Prose, or Barnes and Noble or East City Books or Solid State Books or People's Book here in Tacoma Park, like you can just keep going. There's so many. So I feel like I have a community there where I can go see like writers I really respect and adore and listen to them get questions and see how they answer it. So that's been really great. I have communities with some of the organizations that I've won awards from. They actually have really thriving communities. They bring us together a lot. So I feel really supported in that. And I get to see other people working on narrative nonfiction, and sort of see how they're, how they're going, and then I'm just lucky that I have like, you know, family and friends who are like, we know you're doing this weird thing, and we support you in it anyway. And, like, when I'm feeling blue and I'm like, oh, writing is the worst. This is so terrible. They, they're happy to, they're happy to support me. And, you know, there's just this benefit of, like, living in DC, there's so many smart people, and, like, lots of them have written books. So they all get it, they're like, Oh yeah, writing. So yeah, it's a great, it's a wonderful, there's, there's many environments and many communities around me, and I'm deeply grateful to all of them. So shout out. Shout out to the people who have supported me.
Kate Carpenter 15:56
I wanted to talk a little bit more about those prizes. So you won several really prestigious, really awesome prizes to support writing this book. And I was wondering, can you talk a little bit more about the process of applying for those grants, kind of, how, how you, how you balance applying for grants with doing the work of the book and and how those experiences shaped the book?
Emily Dufton 16:16
Yeah, the prizes were great. So, I mean, free money, like it's a wonderful thing. It's great. So I, it's a couple of years ago now, actually, that I won those. This was sort of deep in the whole like, pandemic, house fire and flood, lost everything, and so that's why I had the time to fill them out, because it was that and working with insurance, you know. But it also really pushed me to apply for these because, you know, I wasn't able to kind of do any other work. I wasn't really able to do anything, but with the promise that this money would be used exclusively to work on the book. But I'll get to that in a second. So the awards were, and I highly recommend anybody listening to this to check them out, because these are great awards with great organizations that really want to support important ideas and and the people who are who are out there to make them real. So these are great, great organizations. So in 2021 I won the J. Anthony Lukas Work-in-Progress award. Great award, it was $25,000 for the completion of a nonfiction work. It's through Columbia and Harvard universities. Highly recommend checking them out. And then in 2022 I won a work in progress grant from the Robert B. Silvers Foundation, which is great. They offer up to $10,000 for people working on nonfiction works. And in 2022 I won the Whiting Creative Nonfiction Grant, which is $40,000 like like no holds barred money to use for your book project. And that's just incredible that these organizations are willing to support writers in this way, and I really applaud them for it. But the applications, and I've led a few like grant writing workshops and everything, the applications are demanding in a certain way. You really do kind of need to be further along in your project, which, of course, I wasn't, but I was able to lie enough to make it seem like I was further along. Like, sure they wanted, you know, I think like 25 pages of of sample chapters, and I hadn't written a word, so I had to write a sample chapter just for the Whiting Foundation, which is in, which is, in large part, actually still in the book. But, you know, they're asking for a lot of things. You have to have a very clear idea of what your project is and how you're going to use this money to specifically achieve the objectives that you lay out for yourself. But, but all the writers I've ever met are really wonderful, professional, competent people, and all you have to do in these applications is be that same competent, professional person, and, you know, make a case for yourself that I'm going to use this money to accomplish these things. For example, for me, it was covering, you know, daycare payments. It was covering office supplies and subscriptions to research services. And it paid for a research trip I took to Switzerland for a week in 2023 to analyze other addiction, addiction treatment clinics. But if you have like, all of this laid out, and here's the budget, and I'm going to use this money for this, and I think it's um, you can present yourself in such a way that you make yourself an appealing candidate, you just have to really know your work and present yourself in that most kind of compelling and professional way.
Kate Carpenter 19:21
Let's take a closer look at Emily's new book, Addiction, Inc. She agreed to read a short excerpt from Chapter Two about methadone. Here's Dr Emily Dufton reading from Addiction, Inc.
Emily Dufton 19:33
“Methadone had always been controversial. The synthetic opioid, three times stronger than morphine, was developed in Germany in 1938 by the Nazi-aligned pharmaceutical company I. G. Farben Industrie, which also developed the gas chamber drug Zyklon B. In 1946, methadone was brought to America, along with Volkswagens and the aerospace engineer Wernher von Braun, via federal programs designed to transfer German technologies to American industry as a spoil of war. Scientists first tested methadone at the Addiction Research Center (ARC) at the US Public Health Service Hospital in Lexington, Kentucky. There, doctors were impressed by its potency, but skeptical that it was any less addictive than traditional opiates. Dr. Harris Isbell, the ARC’s research director, said methadone made the volunteers who used it to detoxify from street drugs talkative and euphoric; they likened it to heroin and attempted to get more. Because of this, Isbell dismissed the drug and concluded that it should not be made widely available. In a 1947 report, he warned that methadone was an ‘addiction-causing drug’ and that ‘narcotic drug addicts would abuse and would become habituated to it if it were freely available and not controlled.’ Despite Isbell’s warnings, however, in 1947 the US Food and Drug Administration (FDA) approved methadone’s use as an analgesic and cough suppressant, and several pharmaceutical companies, including Eli Lilly, were licensed to manufacture it for pain treatment under the brand name Dolophine. It was never a big seller, though, either legally or underground. With its delayed onset of effects, methadone was unpopular as a painkiller, and Herbert Huncke, the writer best known for introducing heroin to the Beat Generation, argued that ‘Dollies’ (Dolophine) were only useful during a panic, when a sudden shortage made heroin unavailable in the streets. But methadone was never a proper way to maintain an addiction, Huncke said. The pills were a last resort, ‘merely a way to get straight’ so users wouldn’t get sick. Methadone then languished for nearly twenty years—until the summer of 1965 when the drug began making headlines again, this time in a positive way. In two lengthy New Yorker articles published in June and July, Nat Hentoff profiled Nyswander, the doctor who was using methadone to treat heroin addiction at the Rockefeller Institute’s clinical hospital in New York. There, Nyswander and her partner, Dole, were doing something new. They weren’t using methadone to detoxify patients like at the ARC, or periodically, like Huncke, to get through a scare. Instead, they were giving large doses of methadone to know heroin users daily, and then watching as the drug transformer their patients’ lives. ‘From two slugabeds,’ Nyswander said, her volunteers were now ‘dynamos of activity.’ ‘One began to paint, and to paint industriously and well. The other started urging us to let him get his high school-equivalency diploma.”
Kate Carpenter 22:48
So I want to talk to you a little bit about style and voice. I feel like I could have chosen basically any passage to talk about this, because they all are representative. But your subject here is, is quite complicated. It's, it's confusing. Sometimes there are a lot of people and agencies involved. There's sort of the politics where not everything actually makes logical sense for why it's proceeding the way it is, because that's how politics goes. Your style, though, is really light, it's straightforward, it's easy to read. You make it look easy, which I know that it is not. How do you do that? How do you achieve that? Is that something that you work on as you're writing?
Emily Dufton 23:30
Oh, well, thank you. That's very kind of you to say. Oh, yeah, I worked on it. I worked on it. Yeah, it kind of goes back to what I was saying before when I reread things. You know, sometimes, like, it's hard to see, right? It's very forest for the trees. Sometimes I have to come back to a section weeks later or months later. Sometimes it's really lovely to have, like, super fresh eyes, and that's where you can see the faults and the places that are that are working much more clearly. But it is important to me to to kind of make it as clear as possible, to make it really clear. Because, as you said, and which I certainly agree, this is a complicated story, like, it's really hard to kind of explain. And you know, like, I have-- my neighbor's like, you need to have a social media presence, and you need to be able to, like, explain all of MAT in 60 seconds, and that'll be great for Tiktok. And I'm like, I don't know how. It took me four hundred and thirty-some pages--
Emily Dufton 24:23
If I could do that I wouldn't have written a book!
Speaker 1 24:32
But there are ways to explain, like, sort of little tidbits. And I feel really, really happy when I come across a quote from, you know, like that, that great quote from Nyswander, like, "from two slugabeds they're now dynamos of activity." Dynamos of activity, like, I find those quotes, and I'm like, Oh, yeah. Like, I'm building a passage around this. This is, this is gold, right? But it is like, I, I feel like my greatest, my greatest sort of responsibility, is to the reader. And to try to make something that is complicated, that does involve a lot of people, that involves a lot of agencies, that involves a lot of political infighting, to make it understandable and relatable, because otherwise, like we'll never understand this history, this deeply complicated history that really has impacted us over the past 50 years, and one might argue, and indeed I do, has had such negative effects that we have the world's leading number of overdoses and the world's largest problem with opioids, right? This has had real, visible and tangible effects on our society. And so I feel like, if we understand it better, perhaps we can do a little bit more to actually counteract the most negative effects. And so if, like, a, you know, a section about Marie Nyswander where people are like, Oh, I get it now. Like, if that helps, I feel like I've done my service.
Kate Carpenter 25:48
You interviewed a lot of people for this book, as I understand it. How did those conversations shape the book? I am particularly interested because, as I look through the notes, you're not necessarily directly quoting from those interviews all that often, but I know they must sort of form the bedrock of of what you're writing. So how did those, yeah, how did those interviews shape what you what you ended up writing?
Emily Dufton 26:12
Oh, I like that term. I like the term bedrock, and I agree with it very much. I did talk to a lot of people. I really, like, this project, and actually my first book as well, it really got me over my fear of just like emailing someone or calling someone, like, just do it. Just do it. I cannot encourage your listeners to just like, contact people enough. If you're writing about someone and they're still alive, get in touch. They will be so happy to talk to you. They are thrilled. They're like, Oh my god, someone cares about what I did 50 years ago. But those conversations were fundamental, and in shaping the book, a lot of the leading figures who created this field, the field of medication assisted treatment, they were based in DC, which made that convenient for me, and they're also still kind of around here. They are very much getting older. Jerome Jaffe, Nixon's first drug czar, who's a key figure in the book, he's turning 93 this year, but he and I became very close, and I think I felt like I knew this project had legs when I would call Jerry Jaffe. And I think the first six times I spoke to him, he was so mean to me that I would cry, like I would hang up the phone and cry, but I kept trying to convince him that I was serious, that I was a historian. I had a PhD, I knew what I was doing, and I was really committed to telling the story in a way that used primary sources, in a way that relied on the evidence, in a way that gave like a fairly I mean, obviously everything is subjective, but I was trying to be as historically objective as possible. And I feel like I finally won him over when he, when I went through all of his papers at the Library of Congress, he's like, Oh, you went through 40 boxes. You're committed. And that's when the conversations changed, and he started letting me in on more and more of the background and the insights. And then he would put me in touch with other people, and they would talk to me, I became, like, accepted among this field of, like, former federal officials who, I mean, there's, and there's really not that many of them who are instrumental in creating the entire industry that we now live with. What was also particularly helpful was that once Jaffe had hazed me sufficiently, and he then brought me into the circle of trust, he gave me the remaining boxes of material that were in his basement that he had donated to the Library of Congress. He didn't give all of them. There are about seven boxes left over, and he gave those to me, and I was able to bring them home to my office, where I did not store them on the floor, because I learned my lesson. But I went through that, and that's actually where the entire history of LAAM, L alpha acetyl methadol, which was the fourth medication assisted treatment that the federal government tried to develop, and they botched it up so badly, it's it's not available anymore, but that history was hiding in Jerry Jaffe's basement outside of Baltimore for 50 years, but he finally gave me those those boxes, and I was able to go through them and found that information, and then I donated all of it to the Library of Congress, and now it's there, and other people can research it. But it was, it was the conversations, and it was the human connections that I had made with these people, it opened up all of the doors that allowed for a lot of that hidden history to be told. So, like, immense gratitude and appreciation to them for for letting me in and for trusting me with all this material, but without without those conversations and without those people, it just wouldn't have happened. It wouldn't or it would be a considerably shorter and crappier book, I guess.
Kate Carpenter 29:46
Man, six times. I'm stuck on that. Your persistence is impressive, I want to talk a little bit about narrative structure, because this is largely a chronological story. But of course, no book is as simple as just day one, day two, day three. How did you think about the structure of this book?
Emily Dufton 30:02
It actually, it did take me a little bit to figure out exactly how to dive into the story, you know, because there's kind of, like, there's sort of, you're right. I do tell it ultimately chronologically, and I really do need to do that. I think it's like, my my historian hang up. I love a chrono, chronological story. It's like, oh, this context, and everything's building on each other. And like, this is how time passes, and this is, this is how things evolve. Like, to me, that's a really great way to tell a story. And I know some people are like, boring, like, spice it up. But I love a chronological story. But I knew that like to get into the chronology, to understand the chronology, like there had to be that moment that sort of crystallizes what's at stake and and sort of what happened. And so I felt like there were two moments, which one do I start with? And ultimately, I kind of went chronologically with that as well. So there's the introduction where I sort of give the reason for why I'm writing this book, which is about the passing of my friend Dana, who died in 2016 after 15 years of steady and escalating opioid use, and I wanted to know what could have helped him. Doctors and researchers all said, MAT, medication assisted treatment. And I was like, what's that? And they were like, oh, and they explained it. And then I was like, Where'd it come from? And they're like, We don't know. So I wrote a book, but that wasn't really the way to get into the history. That was just sort of setting it up. The history really begins both in the 1920s and then squarely on June 17, 1971, so I have my introduction, and I'm like, Dana died, terrible, research problem. This is what I found. And then I have a prologue, because too much is never enough when it comes to introductory sections and my prologue takes place in the 1920s when America had a brief, but rather wild experiment with morphine clinics, which was the first time we had medication assisted treatment, where we were giving known opiate users a steady supply of legal, unadulterated and inexpensive opiates to keep them out of withdrawal and, quote, unquote, satisfy their habits. Obviously, they did not last very long, but they were instrumental. And because they launched basically the next 50 years of the classic era of narcotic control, that brought us to my next key moment, which was June 17, 1971. I was like, well, gotta have it. So there's the prologue, and then the book really begins. 500 pages into it. It really begins on June 17, 1971 with Nixon giving the press conference in the White House, saying that he is going to launch a new war against public enemy number one, or new, wage a new all out offensive. I have to get the quotes right, new, wage a new all out offensive against heroin. Public Enemy Number One. And that moment is extremely important, because it's probably the most misremembered date in drug history. Everyone's like, oh, that's when Nixon started his war on drugs, and that's when arrests skyrocketed, and it became this very racist carceral, controlling and punitive battle. But when I looked at it, I was like, oh no, it wasn't that at all. He started a nationalized addiction treatment clinic system that day with Jerry Jaffe, in charge of something called the Special Action Office for Drug Abuse Prevention, which was ultimately responsible for opening hundreds of clinics, getting tens of thousands of people into treatment, not only with methadone, which was the new technology and medication at the time, but in abstinence based programs as well. Arrests dropped, persecution for drug use dropped, overdoses dropped, the spread of blood-borne diseases from needle sharing, like hepatitis, dropped from 71 to 73. I was like, Oh my God, we've completely misremembered this period of history. I'll spend the next eight years writing a book about it, and then once people finally get to chapter three, basically they can, they can see that that's what it's been all about. That's how I approached the narrative. It took me a minute, but I do get there.
Emily Dufton 30:50
I like that. I'm curious. This is a somewhat selfish question, because I'm working on a project, on a wildly different topic. but that also sort of doesn't end, you know, it continues to the present. And I was curious that, this is a history, but it's definitely explicitly linked to the present. You started out wanting to know how we got here, and there's very much an understanding that a lot of what we are coping with now is still rooted in the things that you write about in this book. How did you handle that transition from writing about past to present? Was that difficult? How did you build that link?
Emily Dufton 33:24
It wasn't terribly difficult, because in writing the chronological history of MAT, of MAT, it brought me up to the present. Because basically what the Special Action Office for Drug Abuse Prevention, or SAODAP did, which is what the office Jerry Jaffe was leading, was not only did they fund a bunch of addiction treatment clinics nationwide, but they were also congressionally mandated to pursue research into new and improved treatment drugs, and from this initial congressional mandate in the early 1970s that's where the rest of MAT drugs come from. So they started with methadone, but then federal researchers were instrumental in developing naltrexone in the 1980s, LAAM in the 1970s and then again in the 1990s and most recently, buprenorphine, which your listeners might know better as Suboxone. That's its brand name, and this drug is still available today. It's still widely used. It was sued successfully, or like criminal, criminal prosecutions were successfully brought against it by 2020 from the Department of Justice when it accused Suboxone's manufacturer of the exact same shady pharmaceutical dealings that Purdue Pharmaceuticals had done back in the early 2000s with Oxycontin. So it was very easy to track this journey, this evolution that MAT has gone on, from like early methadone clinics in 19, in the early 1970s to the situation we have today, where we do have methadone clinics, still. Naltrexone is somewhat available, and now we have Suboxone, which became such a huge commercial success and public health failure, up to just a few years ago. And of course, it's quite something to write about Washington today, when the organization's, sort of the fragments of that original SAODAP office, which today are NIDA, the National Institute on Drug Abuse, which is mostly a research organization based in the National Institutes of Health, and SAMHSA, the Substance Abuse and Mental Health Services Administration, which is located in Health and Human Services. They were both very much under attack a year ago as I was finishing up the manuscript. So it was real easy to tie Nixon's drug war from 55 years ago to the ongoing battle and struggle that we continue to have today. It was almost like, oh, just thanks for giving me my concluding thoughts there. This is great. From the news headlines, just pulled right from it. I don't know if that will work for every topic I pursue from now on, you know, but it was, it was great for this book, and also it worked out quite well for my first book as well, because that came out in 2017 when the first wave of states were legalizing. And I was like, oh, this is great. Thanks for giving me my conclusion. You know, it's, I appreciate it when, whenever news, news headlines, grant me what I need.
Kate Carpenter 33:24
Does that make it challenging to stop? The sense that this is still ongoing, that there's, there's breaking news happening all the time?
Emily Dufton 33:24
It makes it very hard to stop. But at some point, my editor was just like, give me the manuscript.
Kate Carpenter 33:24
Fair enough.
Emily Dufton 33:24
At some point you've gotta hand it in!
Kate Carpenter 33:24
In our last bit of time, I want to talk a little bit more about your influences. I'm curious, first of all, who do you, if anyone, who do you rely on for feedback about your writing?
Emily Dufton 33:24
With this book, I had a lot of feedback, to the point where almost I was like, how many cooks are in this kitchen? This is wild. But, you know, I went through the traditional academic peer review process. So I had two very thorough peer reviewers who who did a great job. And then my editor at University of Chicago Press read it. I had a very intensive copy editor who, you know, held my feet to the fire for a number of things, and then Jerry Jaffe read the whole thing, and caught a lot of boo boos. And actually my mentor, David Courtright, professor emeritus from the University of North Florida, and really the godfather of drug history, if we can, if we can say such a thing, he read through it as well. I'm very grateful to all these individuals, because there's just sometimes like silly mistakes that I made, like I was referring to the Marshall Plan. But for some reason, I called it the MacArthur plan, and no one corrected it, until like the fourth or fifth review. I was like, I guess people are into the MacArthur plan. Whatever that is, no one knows. But then there are other things where you know, like, because Jerry Jaffe was there he corrected it, or because David Courtwright is such a well renowned scholar of like, 19th century opiate use and early 20th century opiate use, he was really good about correcting me on some of my early history. So I had a lot of people taking care of me and and helping me out and reviewing the book very, very closely, to the point where I was like, maybe you could be nicer and just let these things slide. But I had, I had a lot of eyes and a lot of help. And so, you know, the whole like Malcolm X caveat that he put on his autobiography, I will put on on mine as well. You know, if there are any mistakes left in the manuscript, they are entirely because of me, because I had an awful lot of assistance in this too.
Kate Carpenter 33:24
Is that, I mean, I can see where it's challenging just from the sheer volume of input. But was it, was it ever hard to sort of maintain your vision and voice in the wake of all of that feedback?
Emily Dufton 33:32
Yes, it was extremely hard. One of my peer reviewers just really wasn't convinced that I needed the sections on methadone, or, excuse me, on naltrexone or LAAM at all. I really had to fight for that. And there were other parts where it just, you know, there was, you know, kind of like fighting for naltrexone and LAAM was sort of like the biggest battle I had to wage, as far as keeping my vision, because I really felt like they're integral to understanding how we get from methadone to buprenorphine. If you don't have those two steps, you don't understand why buprenorphine was allowed to be privatized and went with private physicians and pharmacies rather than these quarantine methadone clinics. You can't understand that trajectory without the two failed attempts of trying to get outside of the clinic with with naltrexone and LAAM, and I was able to keep that in. So I was really pleased about that, but for the most part, like, my copy editor really wanted to change a lot of my language and stuff like that. And I, you know, like, I think maybe if I were younger, I would have gone with all of their suggestions. Like, oh, sure, of course, you know better than me, but now that I'm older and more disgruntled, I'm like, no, this is my book, and I like the way I wrote that, and I'm going to keep it. So I do feel like I viewed the multi step review process, not so much as like this is my boss or my supervisor saying this is the way it has to be, but more as a collaborative process and taking the advice that I felt was really useful and that that strengthened the book and made it better. And there was a lot of that, that I received, and you know, if there was advice that I did not necessarily agree with, I'd just kind of be like, you know, a lot of people don't take my advice either on everything. So we're just going to move on.
Kate Carpenter 41:36
Speaking of advice that you may or may not take. What is the most influential writing advice you've ever gotten?
Emily Dufton 41:43
It's funny, like when I when I heard that question, I was like, huh. And it took me back to this creative writing class I had when I was an undergrad at NYU. The woman who led it was named Viola Lee. She was a poet, and she was a great teacher, really, really great person, and we focused on poetry and short stories. But during the poetry section, I remember she would have us do this exercise, and I still think about that exercise a lot where, like, you'd have your poem, and you would read it once, and then you would hand it to the person next to you, and they would read it, and then the class would discuss it. And that was the most interesting thing to me, was like, the person's presentation of their own work, and then someone else's presentation of the exact same work, but, you know, they read it differently, and they emphasize different things. And like, as soon as you hear your words out of someone else's mouth, it's so enlightening about sometimes about the quality of the work, you're like, Oh no, that's what it sounds like? That's what you think it sounds like? Oh my God. And so I really keep that in mind when I'm writing, which is that someone else can read this and they can read it very, very differently. And that's why I really try to, like, if I have a point that I'm really trying to make, clearly, that's why it's important to me to work with the sentences and kind of massage them in such a way where I feel like, if I read it, it would sound the way I want it to. And if the person next to me, I just handed them the sheet, they would read it, and it would still sound the way I kind of wanted it to. And that's where I'm like, Okay, I always have Viola Lee's class in my head.
Kate Carpenter 43:17
What an amazing experience.
Emily Dufton 43:19
And the other piece of writing is, you know, Kurt Vonnegut's kill your darlings, right? Just like get rid of excessive--and boy, reading the audio book, I was like, oh, I should have listened to Kurt Vonnegut more. I should kill off a lot of these darlings. But they're, they're in it now.
Kate Carpenter 43:33
What other writers or books do you like to read or turn to for inspiration?
Emily Dufton 43:37
Man, I I love to read, and I wish I could read more working from home. I don't have, like, a commute, and that's where I would do all my reading. Like, I love reading on the metro. I love reading on a plane, train, car, bus. I will read on a train. I will read on a plane. Dr Seuss. But I read, I read as much as possible. I read pretty much like every word of the New Yorker and the Atlantic as well. But who do I follow for inspiration? Actually, it's funny. Lately I've been listening. I've been like hearing my my dissertation advisor's voice in my head, Leo Ribuffo, who was at George Washington in the history department for a long, long time. He passed away in 2018 but he would always tell all of his students to read books that are over 30 years old. And it's so true to kind of re familiarize myself with earlier voices. A lot of times, political writing is really interesting from that time, and that helps me, sort of, it gives me a lot of inspiration for how to present something in a way that will still feel timely no matter how many decades go by, like when you can read, and it's not just like Ernest Hemingway and F. Scott Fitzgerald, but if you can read, even like Pauline Kael's journalism from the 1970s you're like, God, she really knew what she was doing. I take a lot of inspiration from that. And because I have small children, I take a lot of inspiration from from classic children's literature. Because, man, there's a lot that children's writers can do with such short sentences and short books and the emotion and the values and oftentimes, like the gravity of things that they convey in this in this short way. You know, chef's kiss. Love that stuff. So, yeah, that's kind of what I've been-- that's, you know, I can't wait to, like, take a take a flight in June, and I can read a couple books.
Kate Carpenter 45:29
Absolutely. Well, I know that Addiction, Inc, was a while in coming, and that you're focused, probably right now, on helping to publicize it and getting excited for its release. Is there another project that you're starting to noodle with, or something you are working on next?
Emily Dufton 45:47
There's a couple things, one of which that really excites me is, I'm going back to my first love, which is cannabis history. The 2018 Farm Bill championed by Republican Kentucky Senator Mitch McConnell had the unanticipated outcome of legalizing intoxicating hemp products nationwide. Now this is why you can buy quote, unquote cannabis gummies and flour and tincture and drinks everywhere in sometimes gas stations or smoke shops or online, and these things are completely unregulated, oftentimes extremely potent, and are technically kind of going to be criminalized again this November, because in November of 2025 Congress signed legislation reopening the government, and Mitch McConnell slipped in this rider that said, okay, those hemp products that I allowed to be decriminalized in the 2018 Farm Bill. Oopsie, I'm going to take that back. But this sort of like eight year period where we have had the most potent and unregulated cannabis products available to anyone for, like, really cheap, that seems like it deserves some analysis. So I've been working on some articles and potentially a book project about, about the hemp revolution. And, you know, it's, again, it's gonna involve a lot of conversations. There's so many people involved with the field who support it, who don't support it. It's revitalized Kentucky's agricultural system, right? Like, after the after tobacco cratered, after the master settlement agreement, they really needed something, and they're like, Well, how about weed? You know? Why not? Until Mitch McConnell was like, no, no more. So there's this massive period of chaos happening in the legal cannabis market, and I'd love to write about it. So once I once I stopped writing about opioid addiction, I'm going back to, I'm going back to weed. It's the opposite of a gateway drug.
Kate Carpenter 47:39
Wow, that's fascinating.
Emily Dufton 47:40
Don't buy things online, by the way. Don't buy these products. Do not put them in your human body. They're very, they're very gross.
Kate Carpenter 47:46
Is it interesting to think about a project that's really much more sort of journalism in many ways, that it's the past eight years?
Emily Dufton 47:55
It is, but it's so inspired by historical influences, right? Like that 1998 master settlement agreement, which cratered, you know, a lot of Kentucky's tobacco farming industry, like that was the impetus behind the 2018 Farm Bill. So we're actually going back to things that were happening 30, 40 years ago. I still feel like having a more, like I and like the idea of doing journalism excites me, but I can't go into it without my historian brain, where I'm like, well, I could also explain all the context, right? Like, this could be kind of fun. Could have several more chapters on history of Kentucky farming or something like that. So I think even now, it's like, I just can't turn it off, like, I'll look at anything that's happening in the news, and I'm like, I could probably write a book about the history of that. You know?
Kate Carpenter 48:40
I love that. I'm here for the journalistic history hybrids always.
Emily Dufton 48:45
Right? Why not?
Kate Carpenter 48:46
Dr. Emily Dufton, thanks so much for joining me on Drafting the Past and talking about your writing process with me.
Emily Dufton 48:52
Oh, thank you so much. It's been a joy. Thanks again.
Kate Carpenter 48:54
Thanks again to Emily for joining me and to you for listening. Check out the show notes for links to her books and visit draftingthepast.com to find notes and transcripts for all of our episodes. While you're there, sign up for the email newsletter for reminders about new episodes, other bits of writing advice I find to pass along and more. This week, I'll be sharing some of what I learned from the recent listener survey in the newsletter. Until then, remember that friends don't let friends write boring history.
