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Power and addiction.

Orford, J. (2013).

Power, powerlessness and addiction.

Cambridge: Cambridge University Press

[ISBN 978-1-107-61009-5; paperback; 261 pages; $22.49]

Jim Orford, the author of this book, is an Emeritus Professor of Clinical and Community Psychology at the University of Birmingham and brings in his vast experience in the addiction field in presenting this book. He is also the recipient of the E. M. Jellinek Award for his contribution to alcohol and addiction studies and has written 14 other books. The book brings in the concepts of power and powerlessness to addiction which is a unique contribution.

The book is organized into seven chapters. The first chapter is entitled, "Powerful connections: three examples of addiction." The chapter consists of three hypothetical case studies, one of alcohol addiction involving a middle-aged man; a second one of drug addiction involving a young woman; and a third one of gambling addiction involving a woman. The cases are hypothetical but they mimic real life situations and are pretty in-depth. These are the three types of addiction that the book talks about in the remaining chapters. The case studies have been written well. However, inclusion of a chapter summary at the end of the chapter would have been nice to see. Also, in the case studies some questions for reflection would have been a useful addition.

The second chapter is about how addiction erodes free agency or increases powerlessness. The chapter begins with a discussion on how power and its distortion in relationships leads to addiction and is the primary theme of the chapter. The chapter explains how addiction undermines personal agency and how mood modification is a source of power for those addicted. Various theories of psychological addiction are also discussed in this chapter.

The third chapter is about how addiction subordinates the interests of family members and friends. The chapter opens up with a discussion on how family members and friends were affected in the three hypothetical cases studies presented in Chapter 1. Then the chapter discusses how the husbands' addiction affected the wives of two famous poets, Samuel Taylor Coleridge and Dylan Thomas. The issue of subordination of family members' interests by an addict is the theme of this chapter. How the addiction of parents and husbands poses a challenge to authority is also discussed in this chapter. The chapter concludes by discussing constraints on rebelling against the illegitimacy of addiction.

The fourth chapter is about inequality in the power to resist addiction and discusses how addiction is unequally distributed within social groups. The case of alcohol is presented where the harmful effects in terms of hospitalizations and mortality are higher among low-socioeconomic stratum, while the consumption is higher among those with higher socio-economic status. Risky drug injecting environments are presented. The powerless position of women, indigenous, and minority populations with regard to problems associated with drug addiction are also discussed.

The fifth chapter is about power and powerlessness in the addiction supply industries. This chapter refers to the network of people and organizations through whom the merchandises to which people are addicted, are delivered. The author presents how the alcohol industry, which is the legal addiction-creating industry, is all powerful as evident by its size and reach. The powerful use of lobbying, free trade and corporate social responsibility are also discussed. The power relationships in the illicit drug trading are also delineated in this chapter.

The penultimate chapter is about reasserting power and control in the process of change and treatment. The chapter emphasizes that effective addiction management involves both social influence and individual cognitive change. The role of power exercised by others to support recovery from addiction, the role of higher authority as is common in Alcoholics Anonymous programs, and the role of expert power are the modalities discussed in this chapter.

The final concluding chapter is entitled, "Facing up to the power of addiction and those who benefit from it." This chapter draws examples from preceding chapters to discuss the issue of free will being undermined in addiction, responsibility being decreased, and sovereignty being forfeited. The chapter concludes by discussing some case examples. It would have been great to see a chapter on prevention of addiction and how it is related to the issues of power.

The book is well referenced and indexed to help in location of the topics discussed within the chapters. On the whole I enjoyed reading this book that provides a unique perspective relating to power and addiction. I would recommend this book to researchers who may be interested in the construct of power as it relates to addiction. Thanks to this book, I would imagine that the construct of power would be operationalized more in addiction research studies. This book would also be of interest to policy makers who would look at the relationship between power and addiction from fresh eyes.

Review by Manoj Sharma, University of Cincinnati
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Title Annotation:Power, Powerlessness and Addiction
Author:Sharma, Manoj
Publication:Journal of Alcohol & Drug Education
Article Type:Book review
Date:Apr 1, 2014
Words:812
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