If It Knocked on Your Door

Empathy involves placing oneself in the shoes of another and taking in their perspective, seeing as they do and feeling with them. Sympathy requires us only to feel for another from the outside. But even that is lacking in cultural conversations when it comes to addiction. At best, we have pity and compassion for those others who use drugs. At worst, these feelings transform into resentment and blame (most often in the form of op‑eds about strung-out zombies haunting safe-consumption sites and lowering property values in desirable neighbourhoods).

Theory and practice can be hard to square, even for a bioethicist like Hanna Pickard, who has spent much of her academic career also doing clinical work. She was especially shaped by her decade assisting in therapeutic communities where clinicians work non-hierarchically with patients with personality disorders. “Where ideas come from matters,” she writes. “My understanding of addiction is both anchored...