book review

Book Review: What Are Drugs For? An Exploration of Stolen Fire

/ bs king / Leave a comment

It’s always a bit nerve-wracking when a family member tells you they’ve written a book.

You know you’re going to have to read it, and give a reaction, regardless of what you actually think, and that’s a harrowing thought when you don’t know what’s actually sitting on those pages. What if it’s terrible? What if you can’t finish it? What if you disagree? Maybe some people are savvy enough to navigate these questions easily, but as an ultra-opinionated person who tends to talk a lot, people tend to notice if I go quiet. So I am never getting out of giving an opinion.

This is all a way of leading in to the fact that my brother has written a second book, and I want to thank him, truly, profoundly, from the bottom of my heart, for not putting me in a bind with this one. Because I think this book is great. I don’t have to have any awkward discussions with ChatGPT about how to phrase this or anything, I just genuinely loved the book. I’d say it if he wasn’t my brother. It was interesting and got me thinking about the world a little differently, and that’s always been the highest compliment I can give a book. Well done, brother of mine.

So with that out of the way, let’s back up and give you the information I probably should have started with.

What are Drugs For? An Exploration of Stolen Fire is a new book (available Tuesday 9/15) by Timothy McMahan King, who yes, is related to me. This is his second book, after 2019s Addiction Nation, which I also discussed here on the blog.

The book itself takes an interesting approach to the discussion of drugs, one that seems obvious once you start reading but I realized I hadn’t seen before: it takes a step back and tries to look at the big picture of why we have drugs at all and what our relationship is with them as a species. When I said it made me think about the world differently, this was what I meant. I realized that most of our discussions around drugs are extremely reactive: what new drug has hit the market, who is dying of what overdose, what drug should be legal, etc, etc, etc. But this book steps back and asks us to look at the big picture, going back thousands of years. What are drugs for? Why do we have these problems at all? Why do humans get addicted to anything? And how have both drugs and addiction been treated throughout time and history? Or to put it more succinctly…what are drugs for?

Along the way it makes a compelling case that our viewpoints on individual drugs are not static: drugs that are seen as awful today were previously seen as benign and vice versa. The statistician in me loved this part, because of course if you don’t have solid definition of something it’s hard to get a handle on it. With drugs it’s clear we’ve had a tremendously difficult time doing just that. We treat it as a given that a drug like opioids has one categorization (bad) but this book repeatedly points out this has actually fluctuated quite a bit over time. I don’t think his goal here is one of moral relativism, but rather pointing out that early anti-alcohol activists literally were just focused on hard liquor rather than beer, or that opium was introduced as an exotic drug and was considered less concerning than other substances that had been around for longer.

As King builds his case, perhaps one of the most interesting side roads he takes is a deep dive (and deeply researched) in to the idea that there are specific and repeated drug references in the Bible. He makes this case in large part to support the points above, that the history of humanity is full of interesting relationships with drugs, and the Bible-as-historical-document captures that. Whether currently religious or not, I think anyone raised with the Bible will find this part interesting, particularly since the conventional wisdom is that the Bible contains no specific drug references. It is extremely hard to get through the “Bible chapters” in King’s book and to continue to believe this is true.

Anyway, I enjoyed the book and while there wasn’t a lot of science in this one for me to proofread, I did listen to a “rough draft” of the audiobook. That format is available on Tuesday as well if you’re so inclined, and makes a fun listen.

Well done brother, I love it. I learned something. What more could I ask for?

My Favorite Book of the Year: The Age of Diagnosis

/ bs king

As 2025 comes to a close and we careen towards Christmas and giving season, I wanted to put in a plug for my favorite book of the year. The book is The Age of Diagnosis: How Our Obsession with Medical Labels Is Making Us Sicker, and I enjoyed it immensely. I found it originally when Jesse Singal did a Substack post called “Long Covid can be both Psychosomatic and Real”, and immediately forwarded it to my sister (an NP), who promptly got the book and then immediately called me to talk about it. She was annoyed I hadn’t actually read it yet, so I got the book and could see why she was calling. This is a book you want to talk about with people.

The author is a UK neurologist and a skilled writer, and she dares to ask the question “what is the point of diagnosing people with things”. She points out that diagnosis is supposed to be used strictly to inform treatment options, but we’ve completely overlooked the psychological impact a diagnosis can have. She starts with the example of Huntington’s disease, a fatal genetic disease that you can test for and diagnose, but for which there is currently no cure. Prior to the advent of testing, 90% of patients and their families said they would love to have a test. Once one was developed however, the decision to test or not proved a lot harder for people than they had expected.

She goes on to cover many other areas of medicine: COVID, chronic Lyme, autism, ADHD, cancer screenings, and points out repeatedly that there are two ways to be wrong. Missing a diagnosis you could have treated is obviously bad, but giving someone a diagnosis they may not have also carries a risk. It’s that second risk she explores for both physical and psychological illnesses. What does happen if you think you have a disorder that you don’t? Does disorder creep carry a cost? If your diagnosis makes you feel better about yourself but actually doesn’t improve your objective functioning or even worsens it, should it really have been given? Shouldn’t we be, you know, studying some of these questions?

I liked this book because I’ve spent a lot of time in the last 7 years or so thinking about the purpose of diagnoses and what they’re good for. Back in 2019 I wrote about my lengthy journey to getting diagnosed with chronic migraines (they had an atypical presentation at first), and it was a great relief to finally getting a name to my issue. However, it still took years to get a treatment regimen that worked, and I still have problems. I also have a new appreciation for psychosomatic illness because the migraines have messed up my sense of pain quite a bit. I now have to let every health care provider I have know that my sense of pain is not a great guiding light, in either direction. I have felt pain in places that appeared to have nothing actually wrong with them, and failed to recognize pain in other places because I thought it was part of the regular pain I have. Not having your senses work predictably is a huge disadvantage in diagnosis, but there are more people this happens to than you think. One highlight of the book was when she notes many people experience psychological pain as physical pain, and get slapped with every escalating numbers of diagnoses while trying to treat it. This isn’t good for anyone.

A related read this week was Accommodation Nation in the Atlantic, which points out that now over 20% of students at elite universities have a disability on file. This is a rate far higher than less elite universities, and the disabilities are primarily autism, ADHD and anxiety, and again makes us wonder what a diagnosis is really for. If the best and brightest are claiming to be disproportionately impaired, what are we really looking at here?

What The Age of Diagnosis highlights, sometimes uncomfortably, is that our institutions haven’t caught up to the psychological and social power of a label. In an era where traditional communities seem to be shrinking, we run the risk of allowing diagnoses to take a disproportionate role in the way we define ourselves. Books like this don’t offer easy answers, but they do give us the vocabulary to ask better questions about how we allocate care, how we define impairment, and what we actually want our diagnostic categories to accomplish in a world where they shape so much of public and private life.