fisher does a really good job of presenting an informative yet philosophical text that absolutely engrossed me in a topic i didn't think i would have any interest in, and honestly i was so close to giving 5 stars but:

1. i found the book often jumped around a lot that made it confusing to follow, especially in the middle sections where i wasn't as familiar with the historical context, and which also prevented deeper analysis and depth in discussion and explanation (although to be fair that's not uncommon in nonfiction writing in this zeitgeist and he's not particularly worse than other authors)

2. the referencing system for this book is horrendous - at the back, there's a small quote followed by the citation for that specific phrase, which is fine now i'm typing it out but let me tell you it was so much more difficult than it needed to be when i was reading and i wish he'd just gone with footnotes (although again i do understand why he didn't - this book is incredibly well-researched which is fabulous and allows for a great overview but also means there's an enormous amount of material to cite - an entire third of my copy was citations)

i know the long criticism section makes it sound like i'm super critical of it, but i just think those were the things i noticed the most (as opposed to the writing style and fabulous selection of statistics and anecdotes, which were amazing and therefore didn't satisfy the nitpicky cigar-smoking monocled critic at the back of my head), and overall i'm very happy i ended up reading this, and i reckon it's a good book to kick off 2024! hopefully all my nonfiction reads will be as insightful as this one :) ( )

The Urge is a truly wonderful and unique way of enjoying the history of addiction whether you are new to the topic or rather familiar with it. Weaving personal stories from his patients with examples from literature, popular culture, and intimate pieces of his own reality as well.

Perfectly laid out this book is a welcome gem to the genre of addiction literature and the brilliance of Carl Erik Fisher shines once again.

Thank you so much to netgalley and publishers for providing an e-copy for me to read and leave my honest opinion. This is a subject that has always fascinated me and I am happy to say this book did not disappoint! Don't forget to pick up your copy as soon as possible! ( )

Probably very few people in this country have reached adulthood without being touched in some fashion by the tribulations of addiction, with or without concomitant mental disorders of other types. It's certainly true for me, and my partner of 30 years retired from a career as a substance abuse counselor. Fisher's book, exploring the history, medical, cultural, philosophical and psychological aspects, experience of, and personal and psychological reactions to addiction covers a lot of territory both new and familiar to me. Throughout, he interweaves snapshots of his own life story as a new physician struggling through a challenging residency in psychiatry in company with a whole lot of alcohol and pills, until it all falls apart and he himself undergoes hospitalization and rehab.

Briskly written, deeply researched, and extensively referenced (but smoothly and with no inhibition of the narrative flow), Fisher approaches the problem of addiction from multiple perspectives. It's fascinating to see how social attitudes towards drugs and booze and the people who are in thrall to them have ebbed and flowed, from compassion to punishment, from accusation to condemnation, to medical "disease models," and back again over the centuries. He gives sharp attention to the interplay of race and social status, and the responsibility borne (or not...) by the pharmaceutical, medical, and political establishments for the shifting dichotomy between "good drugs" and "bad drugs," and the way they are marketed to the consumers who eventually bear the brunt of social opprobrium or aid. He describes the various treatment approaches that have come and gone on the tides of fashion, marketing, and science, almost irrespective of their actual effectiveness. (N.B. those who criticize some of them have received such marks of displeasure as a four-foot rattlesnake - with its tail cut off to keep it quiet, and no doubt to really piss it off - in the mailbox.)

The greatest success of this very readable book is to underscore the problems inherent in even really understanding was addiction IS: an enormously complicated interplay of psychology, social environment, genetics, physiology and chemistry, culture, commercialism... in short, humanity's existence in the world. Why can some people simply stop, and not others? Fisher notes some surprising statistics from the post-Vietnam era, demonstrating that while 20 percent of soldiers returning from that war were considered addicted to heroin, only 1 percent of them were one year later; three years later, almost 80 percent had never slipped or relapsed. And most of them stopped using without any treatment at all. How? Why? Who knows? He is also adamant that medical practitioners should be stepping up far more to offer treatments we know can help, can mitigate the pain and harm of addictions: fewer than 10% of eligible practitioners have undergone the required extra training and licensing to be able to prescribe buprenorphine (Suboxone) to help manage patients with addiction, and according to some studies, a quarter of them don't ever actually do it. And some recovery programs refuse to accept or even eject participants who take these drugs, as though it's considered "cheating." How unhelpful!

Highly recommended for health / medical collections, and for anyone with an interest - personal or otherwise - in the problem of "the urge."

A valuable addition to the literature on addiction. ( )

The Urge is a truly wonderful and unique way of enjoying the history of addiction whether you are new to the topic or rather familiar with it. Weaving personal stories from his patients with examples from literature, popular culture, and intimate pieces of his own reality as well.

Perfectly laid out this book is a welcome gem to the genre of addiction literature and the brilliance of Carl Erik Fisher shines once again.

Thank you so much to netgalley and publishers for providing an e-copy for me to read and leave my honest opinion. This is a subject that has always fascinated me and I am happy to say this book did not disappoint! Don't forget to pick up your copy as soon as possible! ( )