A Fine Line: Painkillers and Pleasure in the Age of Anxiety GEORGE C. DERTADIAN Singapore: Palgrave Macmillan, 2019 ISBN: 978-981-13-1974-7, 285 pp. Hardback. Price: $89.99 The double meaning of this text’s primary title—A Fine Line—says much about its contents. At first glance, it refers to an arresting image on the cover: geometrically arranged lines of crushed white powder. As an evocation of intranasal ingestion (snorting), it signals the text’s concern with drug use beyond the bounds of medical authority, and gestures towards the ‘fine’ pleasures such practices might afford. However, it is a second meaning of A Fine Line–that of a precarious or fragile distinction—which emerges as the primary concern of the text. It can be said that the ‘critical’ part of critical drug scholarship is the troubling of orthodox binaries and the conceptual frameworks of dominant disciplines. In this tradition, Dertadian sets about blurring three distinctions: recreational pleasure and therapeutic analgesia; defiance of medical authority and neoliberal biological citizenship; and safety and risk. He also demonstrates how these distinctions order dominant responses to the ‘diversion’ of pharmaceutical pain killers, with implications for supply policy and regulation, clinical responses to pain, and harm minimisation services for people who use opiates. In an era of heightened anxiety about pain medication—especially around the increased penetration of pharmaceuticals within the illicit opiate market; concerns around over-prescription; and increased data-sharing across the health system, including the introduction Electronic Recording and Reporting of Controlled Drugs scheme—interrogating these boundaries is important work. The book is presented in two sections: Part one, The way we think about non-medical use and Part two, The way people experience non-medical use. Part one troubles the three binaries via analysis of relevant literature, policy and the historical development of relevant concepts, while Part two troubles them through the analysis of qualitative data. Recreational pleasure vs. therapeutic analgesia Focussing on an Australian context, Part one gives an historical account of how ‘good’ and ‘bad’ drug use have been contrasted in political discourse, policy and medicine. Chapter 3 looks behind the scenes at how public health research methodologically constructs non-medical opiate use and identifies the political stakes of survey instrument design, including the Australian IDRS and DUMA. While ambiguities between recreational use and analgesia are identified within these figures, a closer engagement with the mechanics of survey instruments—such as in the analysis performed by Dwyer and Fraser [1]—may have delivered a more forceful critique of the elisions and silences. In Chapters 5 and 6, young adult drinkers’ accounts of analgesic use to enhance intoxication and to manage hangovers blur distinctions between recreation and therapy. In Chapters 7 and 8, the line between pleasure and pain relief fades as chronic pain sufferers describe the pleasures of daily functioning afforded by opiates, and dependent users describe therapeutic relief from debilitating This article is protected by copyright. All rights reserved. This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/dar.12926