One of those hybrid history/memoirs that illuminates an important subject through personal experience. Fisher digs deep into the history of addiction ... Doggedly researched, layered with empathy, The Urge pulls back multiple curtains at once in examining an ailment that will likely never go away ... Fisher devotes several pages to the subject of recovery (his own included). His treatment of Alcoholics Anonymous is concise, evenhanded, and even novel in whom it brings into the picture ... The Urge contains a wealth of such research and insight, rendered with a gimlet eye and a physician’s care. Addicts who make it to the other side often feel they have survived to fulfill a higher purpose. The Urge qualifies as just such an accomplishment, an inspired dive into a condition that, in one way or another, touches us all.
Fisher takes the reader on a vivid tour over several thousand years of multiple cycles of science, medicine and literature, woven together by the thread of the author’s own alcohol and amphetamine addiction and treatment. It is made even more emphatic and moving because he is also a psychiatrist who treats such patients ... none of these insights will be a surprise to experts in this field – they are established facts. But this book is not a polemic, and one of its pleasures is the succession of historical nuggets it serves up, many of which were unknown to me ... thorough and revealing. It is largely US-centric, but, given the overwhelming influence that country has had in driving global drug policies, the narrative is still internationally relevant. Fisher’s personal saga, together with case studies of his patients, lend it an additional human depth. Pulling it all together is this final reflection, a mature view of the topic from someone with immense experience of it.
Impressive ... A nuanced, personal perspective on a health crisis that remains stigmatized and misunderstood ... Fisher weaves together history, psychology, neuroscience, sociology, philosophy and medicine to construct a holistic, humane portrait of a condition that has baffled experts for centuries ... The Urge is several excellent books in one: a complete and sweeping history of addiction, a compassionate doctor’s approach to treating people with addictions, and a blistering critique of outdated, draconian government policies around drug use and addiction.
Although Fisher wears his compassion for substance abusers prominently on his sleeve, he is also capable of throwing out some controversial observations that go against received wisdom ... Fisher provides a very detailed history of A.A., much of which information is out there already, and delves into rehab and outpatient programs ... after all the history and analysis he serves up, the original questions about addiction continue to hover in the air without definitive answers ... Although Fisher holds out hope for the 'multiple pathways of recovery,' he returns at the end of this sprawling, irresolute book to stressing the complexity of addiction and the need for a corrective context of personal responsibility and individual change. How some people get beyond their addiction remains withal mysterious and elusive; it’s not even clear how the author managed to escape his own entrapment ... From the beginning of The Urge, one of Fisher’s primary intentions seems to be to humanize the way we perceive addiction, suggesting that we evince empathy instead of casting blame. This is a laudable goal but it also blurs some of the specific, tougher issues he raises about what role choice plays in what looks to be an innate, helpless predilection; instead of focusing on the problems that come with naming and treating this condition, he offers a survey of everything under the sun that has been thought or done about addiction. The book is something of a tangle as a result and would certainly have benefited from a less amorphous sense of the message, or messages, it wishes to convey. As it is, the situation the author describes looks irremediably bleak: One comes away with the overwhelming impression that the propensity for addiction is part of the human condition, 'the blight man was born for.'
Fisher...makes a striking debut by skillfully combining a cultural history of addiction with his own story of recovery ... he shares plenty of moving stories of the scientists, preachers, and patients on the front lines of addiction and movingly recounts his own struggle with alcohol and Adderall addiction while he was a physician in Columbia's psychiatry residency program ... There's as much history here as there is heart.
Despite the subtitle, this is more than standard history ... Fisher has synthesized an enormous amount of material and is on firm ground when he writes on what he knows ... He shows tremendous empathy for addicts and their challenges, and his personal story, of an addiction that almost derailed his medical career, is powerful and dramatic. However, his critiques of government policy toward addiction are largely one-sided ... After robust and sustained criticism of most current approaches to treating addiction, readers will hope for more information about what does work, but recommendations for the 'pragmatic and pluralistic perspective' remain general. Readers familiar with the issues will engage; those seeking more insight into what causes this 'baffling' human burden—and how they can manage it in their own lives—should look beyond this book ... A useful but flawed personal and professional examination of addiction and how it has impacted humans and baffled experts.
