Without going into too much detail, what I was apprehensive about was it could trivialize certain events by just being way to powerful. What worked out really well was the fact that the others around the table didn't just endorse the addiction and strangeness: Some tried to stop it, some tried to direct it. It added both an incredibly personal story to the development of the maelstrom, while at the same time allowed a bad-guy type of vibe from the players that felt uncontrolled, and therefore less personally aggressive. Some people don't like it when another guy at the table shoots some NPC they care about, and if it happens a few times, they might take it personally. In this case, the contamination was really the thing in control, and it really brought the threat home to the group.
It's like when we did barter in AW1, people really didn't use barter very much, it was almost a background living expense or a plot device. Either way the players didn't struggle themselves, so the suffering was a step removed. In this case, it really took the threats in the world, a disease crippling a people, a strangeness of drug-addiction clawing its way through... and brought that into the game in the same way. Suddenly the PC's were personally confronted with a contamination that was fun enough to have around, but in the same way, was corrupting them and their agendas.
All that said, I probably won't be running a full game with the playbook in the immediate future, I just wanted to try it out, and then give some feedback. I have a long-running game atm and won't be seeing this until the next one rolls around probably.