Paperback and audiobook editions coming in May 2026
Doctors and pharmacists make critical decisions every day about whether to dispense opioids that alleviate pain but fuel addiction. Faced with a drug crisis that has already claimed more than a million lives, legislatures, courts and policymakers have enlisted the help of technology in the hopes of curtailing prescriptions and preventing deaths. This book reveals how this “Trojan horse” technology embeds the logics of surveillance in the practice of medicine, forcing care providers to police their patients while undermining public trust and doing untold damage to those at risk.
Elizabeth Chiarello draws on hundreds of in-depth interviews with physicians, pharmacists and enforcement agents across the United States to take readers to the frontlines of the opioid crisis, where medical providers must make difficult choices between treating and punishing the people in their care. States now employ prescription drug monitoring programs capable of tracking all controlled substances within a state and across state lines. Chiarello describes how the reliance on these databases blurs the line between medicine and criminal justice and pits pain sufferers against people with substance-use disorders in a zero-sum game.
Shedding critical light on this brave new world of healthcare, “Policing Patients” urges medical providers to reaffirm their roles as healers and proposes invaluable policy solutions centered on treatment, prevention and harm reduction.
Awards and Recognition
Winner of the Herbert Jacob Book Prize, Law and Society Association
Winner of the Donald Light Book Award, Medical Sociology Section of the American Sociological Association
Winner of the Foundation for the Sociology of Health and Book Prize, British Sociological Association Medical Sociology Section
Winner of the Senior Faculty Scholarly Works Book Award, Saint Louis University
Honorable Mention for the Best Book Award, Law Section of the American Sociological Association
Honorable Mention for the Robert K. Merton Award, Science Knowledge and Technology Section of the American Sociological Association
About the author
Liz Chiarello is an associate professor of sociology in Arts & Sciences at Washington University in St. Louis. She is a medical sociologist and socio-legal scholar who conducts research at the intersection of healthcare and law. Her research centers on how cultural forces such as law, politics and organizational policy influence decision-making in healthcare and the criminal-legal system and how blurred boundaries between these fields affects patient care.
Additional media coverage
“Conflict at the Drugstore: When Pharmacists’ and Patients’ Values Collide.” Op-ed for The Conversation, Oct. 6, 2025.
“Caring for Patients or Policing Them?” Interview with the On Becoming a Healer podcast, March 18, 2025.
“How drug monitoring programs route patients out of health care and into the legal system.” Interview, St. Louis on the Air, KWMU/St. Louis Public Radio, March 5, 2024.
Quicktake Charge, Bloomberg News. Interview, 21 minute mark, Oct. 6, 2021.
“Opioid settlements are imminent. Spend the money on proven treatments that save lives.” Op-ed with Allan M. Brandt, USA Today, July 23, 2021.
“This Is Your Country on Drugs.” Cover story, Radcliffe Magazine. Winter 2020.