[A] fascinating new book...[which views] our history from a pharmaceutical perspective...Kandall's approach is sober, thoughtful--and passionately critical of the carelessness of doctors who have been so quick to prescribe narcotics for their female patients.

In his book, Dr. Kandall traces the woeful history of women's treatment for drug dependence over the past century and a half and, in the process, reveals the roots and costs of today's oftentimes punitive policies toward addicted women.

This book pursues several main themes and statements: women have always made up a significant proportion of drug users and addicts; to an important but largely hushed-up extent, their addiction experiences have been supported by inappropriate and excessive medication by physicians and pharmacists, and attention to these problems have only come late in the day; women as childbearers and the relationships between female sexuality and drug use are central to the story...[This is a] much-needed antidote to other books that equate drug addiction with male experiences.

As a historical account, the book succeeds. It is a well-researched chronology of women's use of and dependence on drugs, starting with the 19th century, when the majority of opium addicts were women who obtained the drugs legally from physicians, druggists, or charlatans. For readers interested in the development of federal treatment and research programs for women or personal accounts by addicted women, Substance and Shadow is an excellent source of references. Particularly rich are the early chapters, which document the major role of iatrogenesis in drug abuse and dependence among women at the turn of the century...Substance and Shadow offers a solid, useful chronology of women's involvement with drugs and society's response to it; I will use it often for reference purposes.

This careful, well-documented survey will be of special interest to anyone seeking a historical perspective on the complex problems of women and drugs.

Although the historical literature is replete with references to drug use by males, female drug-users have remained largely invisible. This book reduces that discrepancy by providing a comprehensive historical examination of women, drug use, and addition. The book is not simply an epidemiology essay; rather, it exposes the interrelationship of women, drug use, medicine, and politics. It is all the more impressive because of the dearth of historical information on the subject.

A thoroughly researched and accessible book on one of the most important women's issues of our time. For decades women addicts have been demonized and punished rather than helped. Kandall examines the cultural, economic, and social forces that both draw women into drug addiction and then deny them treatment. His book is a powerful and welcome call for change.

Stephen Kandall's Substance and Shadow is a clearly written, comprehensive history of women and addiction. Beginning with the mid-1800s, Kandall carefully traces women's use of psychoactive substances as well as society's reaction to that use, including physician prescribing practices, treatment, and punishment. Substance and Shadow is sure to become a classic in the drug field, and I look forward to having this comprehensive work in my library to be used again and again as a reference.