In a book sure to inspire controversy, Gene Heyman argues that conventional wisdom about addiction—that it is a disease, a compulsion beyond conscious control—is wrong.
Drawing on psychiatric epidemiology, addicts’ autobiographies, treatment studies, and advances in behavioral economics, Heyman makes a powerful case that addiction is voluntary. He shows that drug use, like all choices, is influenced by preferences and goals. But just as there are successful dieters, there are successful ex-addicts. In fact, addiction is the psychiatric disorder with the highest rate of recovery. But what ends an addiction?
At the heart of Heyman’s analysis is a startling view of choice and motivation that applies to all choices, not just the choice to use drugs. The conditions that promote quitting a drug addiction include new information, cultural values, and, of course, the costs and benefits of further drug use. Most of us avoid becoming drug dependent, not because we are especially rational, but because we loathe the idea of being an addict.
Heyman’s analysis of well-established but frequently ignored research leads to unexpected insights into how we make choices—from obesity to McMansionization—all rooted in our deep-seated tendency to consume too much of whatever we like best. As wealth increases and technology advances, the dilemma posed by addictive drugs spreads to new products. However, this remarkable and radical book points to a solution. If drug addicts typically beat addiction, then non-addicts can learn to control their natural tendency to take too much.
“A mind-blowing tour de force that unwraps the myriad objects of addiction that surround us…Intelligent, incisive, and sometimes grimly entertaining.”
—Rod Phillips, author of Alcohol: A History
“A fascinating history of corporate America’s efforts to shape our habits and desires.”
—Vox
We live in an age of addiction, from compulsive gaming and shopping to binge eating and opioid abuse. Sugar can be as habit-forming as cocaine, researchers tell us, and social media apps are deliberately hooking our kids. But what can we do to resist temptations that insidiously rewire our brains? A renowned expert on addiction, David Courtwright reveals how global enterprises have both created and catered to our addictions. The Age of Addiction chronicles the triumph of what he calls “limbic capitalism,” the growing network of competitive businesses targeting the brain pathways responsible for feeling, motivation, and long-term memory.
“Compulsively readable…In crisp and playful prose and with plenty of needed humor, Courtwright has written a fascinating history of what we like and why we like it, from the first taste of beer in the ancient Middle East to opioids in West Virginia.”
—American Conservative
“A sweeping, ambitious account of the evolution of addiction…This bold, thought-provoking synthesis will appeal to fans of ‘big history’ in the tradition of Guns, Germs, and Steel.”
—Publishers Weekly
The drug war that has turned Juárez, Mexico, into a killing field that has claimed more than 7,000 lives since 2008 captures headlines almost daily. But few accounts go all the way down to the streets to investigate the lives of individual drug users. One of those users, Scott Comar, survived years of heroin addiction and failed attempts at detox and finally cleaned up in 2003. Now a graduate student at the University of Texas at El Paso in the history department's borderlands doctoral program, Comar has written Border Junkies, a searingly honest account of his spiraling descent into heroin addiction, surrender, change, and recovery on the U.S.-Mexico border.
Border Junkies is the first book ever written about the lifestyle of active addiction on the streets of Juárez. Comar vividly describes living between the disparate Mexican and American cultures and among the fellow junkies, drug dealers, hookers, coyote smugglers, thieves, and killers who were his friends and neighbors in addiction—and the social workers, missionaries, shelter workers, and doctors who tried to help him escape. With the perspective of his anthropological training, he shows how homelessness, poverty, and addiction all fuel the use of narcotics and the rise in their consumption on the streets of Juárez and contribute to the societal decay of this Mexican urban landscape. Comar also offers significant insights into the U.S.-Mexico borderland's underground and peripheral economy and the ways in which the region's inhabitants adapt to the local economic terrain.
It inspired written testimonials from William McKinley, Thomas Edison, and Sarah Bernhardt; merited a medal from Pope Leo XIII; produced "exhilaration and lasting euphoria" in Sigmund Freud. Once the stimulant of choice of the enlightened and the elite, cocaine has become, a century later, a plague, ravaging the lives of millions. This book is the first to draw together all the facts about this pervasive drug--from its natural occurrence in a tea-like native South American plant to its devastating appearance as crack in the inner cities of the United States.
Drawing on the latest work in medicine, psychiatry, neuroscience, pharmacology, epidemiology, social work, and sociology, the volume is a highly accessible reference on the history and use of cocaine, its physical and psychological effects, and the etiology and epidemiology of cocaine addiction. It also provides a critical evaluation of the pharmaceutical agents and psychosocial interventions that have been used to treat this addiction. Author Jerome J. Platt answers such basic questions as: What is cocaine? What forms does it come in? How is it administered? What does it do? What are the medical complications of cocaine addiction? What are the treatments, and how successful are they?
Uniquely comprehensive, Cocaine Addiction makes all the latest information on this urgent subject readily available to medical professionals and practitioners, social workers and scholars, and anyone who cares to know more about this perennially troubling drug.
Discovering Addiction brings the history of human and animal experimentation in addiction science into the present with a wealth of archival research and dozens of oral-history interviews with addiction researchers. Professor Campbell examines the birth of addiction science---the National Academy of Sciences's project to find a pharmacological fix for narcotics addiction in the late 1930s---and then explores the human and primate experimentation involved in the succeeding studies of the "opium problem," revealing how addiction science became "brain science" by the 1990s.
Psychoactive drugs have always had multiple personalities---some cause social problems; others solve them---and the study of these drugs involves similar contradictions. Discovering Addiction enriches discussions of bioethics by exploring controversial topics, including the federal prison research that took place in the 1970s---a still unresolved debate that continues to divide the research community---and the effect of new rules regarding informed consent and the calculus of risk and benefit. This fascinating volume is both an informative history and a thought-provoking guide that asks whether it is possible to differentiate between ethical and unethical research by looking closely at how science is made.
Nancy D. Campbell is Associate Professor of Science and Technology Studies at Rensselaer Polytechnic Institute and the author of Using Women: Gender, Drug Policy, and Social Justice.
"Compelling and original, lively and engaging---Discovering Addiction opens up new ways of thinking about drug policy as well as the historical discourses of addiction."
---Carol Stabile, University of Wisconsin--Milwaukee
Also available:
Student Bodies: The Influence of Student Health Services in American Society and Medicine, by Heather Munro Prescott
Illness and the Limits of Expression, by Kathlyn Conway
White Coat, Clenched Fist: The Political Education of an American Physician, by Fitzhugh Mullan
Throughout the African American community, individuals and organizations ranging from churches to schools to drug treatment centers are fighting the widespread use of crack cocaine. To put that fight in a larger cultural context, Doin' Drugs explores historical patterns of alcohol and drug use from pre-slavery Africa to present-day urban America.
William Henry James and Stephen Lloyd Johnson document the role of alcohol and other drugs in traditional African cultures, among African slaves before the American Civil War, and in contemporary African American society, which has experienced the epidemics of marijuana, heroin, crack cocaine, and gangs since the beginning of this century. The authors zero in on the interplay of addiction and race to uncover the social and psychological factors that underlie addiction.
James and Johnson also highlight many culturally informed programs, particularly those sponsored by African American churches, that are successfully breaking the patterns of addiction. The authors hope that the information in this book will be used to train a new generation of counselors, ministers, social workers, nurses, and physicians to be better prepared to face the epidemic of drug addiction in African American communities.
The recorded use of deadly force against unarmed suspects and sustained protest from the Black Lives Matter movement, among others, have ignited a national debate about excessive violence in American policing. Missing from the debate, however, is any discussion of a factor that is almost certainly contributing to the violence—the use of anabolic steroids by police officers. Mounting evidence from a wide range of credible sources suggests that many cops are abusing testosterone and its synthetic derivatives. This drug use is illegal and encourages a “steroidal” policing style based on aggressive behaviors and hulking physiques that diminishes public trust in law enforcement.
Dopers in Uniform offers the first assessment of the dimensions and consequences of the felony use of anabolic steroids in major urban police departments. Marshalling an array of evidence, John Hoberman refutes the frequent claim that police steroid use is limited to a few “bad apples,” explains how the “Blue Wall of Silence” stymies the collection of data, and introduces readers to the broader marketplace for androgenic drugs. He then turns his attention to the people and organizations at the heart of police culture: the police chiefs who often see scandals involving steroid use as a distraction from dealing with more dramatic forms of misconduct and the police unions that fight against steroid testing by claiming an officer’s “right to privacy” is of greater importance. Hoberman’s findings clearly demonstrate the crucial need to analyze and expose the police steroid culture for the purpose of formulating a public policy to deal with its dysfunctional effects.
"I started out snorting a couple of lines a night and ended up injecting and snorting about three grams a day."--That could be your dentist talking.
"I worked a lot with hangovers and made lots of mistakes when coming down off acid."--That might be your nurse.
"The patient was waking up and I was out cold."--And that was some unlucky patient's anesthesiologist.
Professionals trusted with our well-being are the last people we suspect of drug addiction. And yet they are at least as likely as anyone else to abuse alcohol and other drugs--a well-kept secret finally aired and fully examined in this powerful book. Drawing on more than 120 personal interviews with addicted physicians, dentists, nurses, pharmacists, attorneys, and airline pilots and those who treat them, Robert Coombs gives us a startling picture of drug abuse among "pedestal professionals." He discusses addiction as an occupational hazard for those with the easiest access to drugs, the greatest sense of immunity to their perils, and the most extensive means (and reasons) for hiding their problems. Throughout, the interviewees' eloquent and often harrowing testimony reminds us of the human drama behind the exhaustive research and analysis presented here. Their bittersweet stories bear out Coombs's contention that recovering addicts, free of their magical elixirs, can become more complete people than they were before addiction.
From the biological, psychosocial, and spiritual roots of addiction to the equally diverse approaches to recovery, to the merits and failures of government drug policy, Drug-Impaired Professionals offers a clear and complete overview of a complex problem that affects nearly every family in America.
When The Natural History of Alcoholism was first published in 1983, it was acclaimed in the press as the single most important contribution to the literature on alcoholism since the first edition of Alcoholic Anonymous’s Big Book. George Vaillant took on the crucial questions of whether alcoholism is a symptom or a disease, whether it is progressive, whether alcoholics differ from others before the onset of their alcoholism, and whether alcoholics can safely drink. Based on an evaluation of more than 600 individuals followed for over forty years, Vaillant’s monumental study offered new and authoritative answers to all of these questions.
In this updated version of his classic book, Vaillant returns to the same subjects with the perspective gained from fifteen years of further follow-up. Alcoholics who had been studied to age 50 in the earlier book have now reached age 65 and beyond, and Vaillant reassesses what we know about alcoholism in light of both their experiences and the many new studies of the disease by other researchers. The result is a sharper focus on the nature and course of this devastating disorder as well as a sounder foundation for the assessment of various treatments.
2025 Coral Horton Tullis Memorial Prize, Texas State Historical Association
The first study of the Fort Worth Narcotic Farm, an institution that played a critical role in fusing the War on Drugs, mass incarceration, and public health in the American West.
In 1929, the United States government approved two ground-breaking and controversial drug addiction treatment programs. At a time when fears about a supposed rise in drug use reached a fevered pitch, the emergence of the nation’s first “narcotic farms” in Fort Worth, Texas, and Lexington, Kentucky, marked a watershed moment in the treatment of addiction. Rehab on the Range is the first in-depth history of the Fort Worth Narcotic Farm and its impacts on the American West. Throughout its operation from the 1930s to the 1970s, the institution was the only federally funded drug treatment center west of the Mississippi River. Designed to blend psychiatric treatment, physical rehabilitation, and vocational training, the Narcotic Farm, its proponents argued, would transform American treatment policies for the better. The reality was decidedly more complicated.
Holly M. Karibo tells the story of how this institution—once framed as revolutionary for addiction care—ultimately contributed to the turn towards incarceration as the solution to the nation’s drug problem. Blending an intellectual history of addiction and imprisonment with a social history of addicts’ experiences, Rehab on the Range provides a nuanced picture of the Narcotic Farm and its cultural impacts. In doing so, it offers crucial historical context that can help us better understand our current debates over addiction, drug policy, and the rise of mass incarceration.
In 1989 Jennifer Johnson was convicted of delivering a controlled substance to a minor. That the minor happened to be Johnson's unborn child made her case all the more complex, controversial, and ultimately, historical. Stephen R. Kandall, a neonatologist and pediatrician, testified as an expert witness on Johnson's behalf. The experience caused him to wonder how one disadvantaged black woman's case became a prosecutorial battlefield in the war on drugs. This book is the product of Kandall's search through the annals of medicine and history to learn how women have fared in this conflict and how drug-dependent women have been treated for the past century and a half.
Kandall's sleuthing uncovers an intriguing and troubling story. Opium, laudanum, and morphine were primary ingredients in the curative "powders" and strengthening "tonics" that physicians freely prescribed and pharmacists dispensed to women a hundred and fifty years ago. Or a woman could easily dose herself with narcotics and alcohol in the readily available form of "patent" medicines sold in every town and touted in popular magazines ("Over a million bottles sold and in every one a cure!"). For the most part unaware of their dangers, women turned to these remedies for "female complaints," such as "womb disease" and "congestion of the ovaries," as well as for "neurasthenia," a widespread but vague nervous malady attributed to women's weaker, more sensitive natures. Not surprisingly, by the latter half of the nineteenth century the majority of America's opiate addicts were women.
The more things change, the more they remain the same: Substance and Shadow shows how, though attitudes and drugs may vary over time--from the laudanum of yesteryear to the heroin of the thirties and forties, the tranquilizers of the fifties, the consciousness-raising or prescription drugs of the sixties, and the ascendance of crack use in the eighties--dependency remains an issue for women. Kandall traces the history of questionable treatment that has followed this trend. From the maintenance clinics of the early twenties to the "federal farms" of mid-century to the detoxification efforts and methadone maintenance that flourished in the wake of the Women's Movement, attempts to treat drug-dependent women have been far from adequate. As he describes current policies that put money into drug interdiction and prisons, but offer little in the way of treatment or hope for women like Jennifer Johnson, Kandall calls our attention to the social and personal costs of demonizing and punishing women addicts rather than trying to improve their circumstances and give them genuine help.
Weaving together a personal narrative and a sociological perspective, Surviving Alex movingly describes how even children from “good families” fall prey to addiction, and recounts the hellish toll it takes on families. Drawing from interviews with Alex’s friends, family members, therapists, teachers, and police officers—as well as files from his stays in hospitals, rehab facilities, and jails—Roos paints a compelling portrait of a young man whose life veered between happiness, anxiety, success, and despair. And as she explores how a punitive system failed her son, she calls for a community of action that would improve care for substance users and reduce addiction, realigning public health policy to address the overdose crisis.
Author Luke Longstreet Sullivan has a simple way of describing his new memoir: “It’s like The Shining . . . only funnier.” Thirty Rooms to HideIn tells the astonishing story of Sullivan’s father and his descent from one of the world’s top orthopedic surgeons at the Mayo Clinic to a man who is increasingly abusive, alcoholic, and insane, ultimately dying alone on the floor of a Georgia motel room. For his wife and six sons, the years prior to his death were characterized by turmoil, anger, and family dysfunction; but somehow they were also a time of real happiness for Sullivan and his brothers, full of dark humor and much laughter.
Through the 1950s and 1960s, the six brothers had a wildly fun and thoroughly dysfunctional childhood living in a forbidding thirty-room mansion, known as the Millstone, on the outskirts of Rochester, Minnesota. The many rooms of the immense home, as well as their mother’s loving protection, allowed the Sullivan brothers to grow up as normal, mischievous boys. Against a backdrop of the times—the Cold War, the Cuban Missile Crisis, fallout shelters, JFK’s assassination, and the Beatles—the cracks in their home life and their father’s psyche continue to widen. When their mother decides to leave the Millstone and move the family across town, the Sullivan boys are able to find solace in each other and in rock ’n’ roll.
As Thirty Rooms to HideIn follows the story of the Sullivan family—at times grim, at others poignant—a wonderful, dark humor lifts the narrative. Tragic, funny, and powerfully evocative of the 1950s and 1960s, Thirty Rooms to Hide In is a tale of public success and private dysfunction, personal and familial resilience, and the strange power of humor to give refuge when it is needed most, even if it can’t always provide the answers.
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