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The Urge: Our History of Addiction

Carl Erik Fisher

Start date: January 1, 2025

Finish date: January 31, 2025

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Jan 25, 2025 aPriL does feral sometimes rated it liked it · review of another edition

Shelves: why-does-everyone-love-this-ick-ick, nonfiction-cozy, history, puffy-fluffy, too-sensitive-to-live-cuz-im-artist

‘The Urge: Our History of Addiction’ by Carl Erik Fisher disappointed me. It certainly is focused telescopically, and thus seemed myopic to me, on a history of the use of the word addiction, basically. His sources are mostly from what has been written in America about addiction. Most of the book is quotes and restatements of documents and articles from science and psychological research papers and academic newspaper/magazine interviews. They reveal social attitudes and sympathies have been the m ‘The Urge: Our History of Addiction’ by Carl Erik Fisher disappointed me. It certainly is focused telescopically, and thus seemed myopic to me, on a history of the use of the word addiction, basically. His sources are mostly from what has been written in America about addiction. Most of the book is quotes and restatements of documents and articles from science and psychological research papers and academic newspaper/magazine interviews. They reveal social attitudes and sympathies have been the main driving forces in thinking about addiction, which have tainted scientific theories and medical/religious treatments for addictions through hundreds of years. I think the author has a bias to see addiction sympathetically, and it affected his book as well, a case of not seeing the speck in his own eye while pointing out the specks obscuring the vision of other researchers. There ARE a lot of different specks in the atmosphere surrounding addictions, though! I read more than a hundred books a year, and I have thought sometimes I am an addict of reading, probably to escape real life, which might be why some people drink or use drugs to excess, right? Shut up.

I have copied the book blurb:

”Named a Best Book of the Year by The New Yorker and The Boston Globe -An authoritative, illuminating, and deeply humane history of addiction—a phenomenon that remains baffling and deeply misunderstood despite having touched countless lives—by an addiction psychiatrist striving to understand his own family and himself

“Carl Erik Fisher’s The Urge is the best-written and most incisive book I’ve read on the history of addiction. In the midst of an overdose crisis that grows worse by the hour and has vexed America for centuries, Fisher has given us the best prescription of understanding. He seamlessly blends a gripping historical narrative with memoir that doesn’t self-aggrandize; the result is a full-throated argument against blaming people with substance use disorder. The Urge is a propulsive tour de force that is as healing as it is enjoyable to read.” —Beth Macy, author of Dopesick

As a psychiatrist in training fresh from medical school, Carl Erik Fisher found himself face-to-face with an addiction crisis that nearly cost him everything. Desperate to make sense of his condition, he turned to the history of addiction, learning that our society’s current quagmire is only part of a centuries-old struggle to treat addictive behavior. A rich, sweeping account that probes not only medicine and science but also literature, religion, philosophy, and public policy, The Urge introduces us to those who have endeavored to address addiction through the ages and examines the treatments that have produced relief for many people, the author included. Only by reckoning with our history of addiction, Fisher argues, can we light the way forward for those whose lives remain threatened by its hold.The Urge is at once an eye-opening history of ideas, a riveting personal story of addiction and recovery, and a clinician’s urgent call for a more nuanced and compassionate view of one of society’s most intractable challenges.”

This was a non-fiction cozy in my opinion. For instance, the author describes his addiction to alcohol as a problem for him throughout the book because he was often late in showing up at work or remembering where he had been in his off-hours. The biggest mental block he seemingly had to deal with was admitting he was drinking too much alcohol too often that was causing him to be late for work. If he kept showing up late at the hospital for his shifts, or failed any drug tests, he couldn’t be a doctor. He finally permitted himself to be involuntarily committed when he had a couple of days of delusions that scared him and his family and friends. This is seemingly as deep as his bottom was before he finally admitted he was an alcoholic. Maybe it was his bottom because he is an upper-class white guy with a lot of financial and networking privileges while training to be a doctor. What was the bottom for him seems like a mildly wild Spring break to me. At least, this is the impression from what he is willing to reveal in these pages.

The entire book appeared very genteel, keeping the tone at a quiet level. Fisher walks down a very narrow road of explanations and history focused on philosophical/medical ideas pro and con about the changing meaning of and feelings of shame about addiction. The medical or psychological ‘cures’ (apparently cures are very very rare indeed) throughout history reflect either supportive or punitive fixes to the problems of addiction. It is all described in severely censored or obfuscating academic-speak.

The fixes for addiction were dependent more on social/religious mores of whatever decade where solutions were being tried out in approaching the problem of addiction, and nothing else, based on the documentation, papers and articles the author has researched and quoted from. Politics and religion obviously does not make for good science.

I know people really like this book. I liked the history, especially in reading about those decades I personally lived through. There is no question the author is accurate about the history because of the academic sources he has used. I did not have a problem with the author mixing academic information in with his own and others’ personal experiences with addiction. However, because of the genteel high-end philosophical academic manner in which the book is written I felt the author’s was seemingly trying to sooth anxious fears of sensitive readers of his book. The doctor describes how addiction throughout history is defined whenever there is apparently a problem of not being able to stop using drugs or alcohol. But he does so with an airbrushing out of any disturbing details, sticking the landing to pinpoint precision on the meaning of addiction and how political and medical society handled it in academic philosophical ideas. Although he does generally mention addiction is a problem because people are unable to stop taking drugs despite the ongoing degrading of their quality of life, causing terrible shame, he really really really avoids getting into any explicit reasons why people have shame or why being unable to stop despite growing degradation is a problem. From how he has approached writing about the subject of addiction with academic-speak full of euphemisms, apparently to veil the uglier aspects of an addicted person’s life, if one had absolutely no awareness of the fallout from being addicted to drugs and alcohol, it actually could cause an ignorant reader to feel it was silly to be very upset about addiction. Such an ignorant reader would gasp at the brief descriptions of the inadequate and sometimes cruel solutions to force people to stop drinking or using drugs, although censored carefully in description by the author. Of course, the author does describe finally the delusions he had had, publicly acting out under the influence of mixing drugs and alcohol one night, finally an explicit explanation of why he felt shame, although he could not accept that he was an addict at that moment. The ignorant reader might wonder if personal psychotic delusions are the reason drugs and alcohol abuse is bad from what can be gleaned in the book, causing the shame (as well as being late for work too much). But except for being unable to stop using drugs, and that one mention of delusions, and being late for work a lot, there is nothing else in this book about symptoms, or damages, such as the permanent physical effects on the body from long-time abuse of drugs. Or about how relationships are destroyed, or financial stability disappears, or senseless beatings of children and animals occur, and other forms of extreme violence and uncontrolled general mayhem are set loose by drunken sprees which never seem to end for years, particular the horrors of vehicle crashes while driving drunk. I liked the history, but not the genteel airbrushing about the actual effects of alcohol and drugs on people’s lives, using academic-speak about what the fuss is all about if someone is addicted to using drugs and alcohol too much. After all, isn’t it the behavior of people under the influence of alcohol and drugs the first clue that something is wrong? So why avoid describing behaviors which cause concern about an individual in the first place?

The book has photographs and illustrations, as well as extensive Notes and Index sections. ...more

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