The Recovery Revolution is a highly informative and intriguing historical expose of the addiction, recovery and treatment industry. Expertly and extensively researched, photographs, charts, and other documentation were provided—from a time period where medical records were poorly kept, or intentionally destroyed. Author Claire D. Clark PhD. trained as a behavioral scientist and historian of medicine; she is the assistant professor of Behavioral Science at the University Of Kentucky College Of Medicine.

Alcohol and substance abuse treatment for Victorian era “inebriates” took place in private sanitariums, those deemed “incurable” were often admitted to 19th century state funded asylums with the “lunatic” mentally ill. By 1918, health officials and politicians viewed addiction as a vice rather than a disease, and punishment and prison sentences were considered over costly treatment programs. When funding was allocated, Clark showed the debate over allocation, disbursement charges, costs, additional funding was always problematic. Although many people who use alcohol and substance are able to stop using without help or formal treatment—the need is great for federal and state funding to combat the recent plague of heroin addiction that claims too many lives, bringing devastation the scourge of criminal activity to families and communities across our nation.

In 1958, Synanon was the first pioneer innovative residential treatment/recovery program and TC (therapeutic community) to receive widespread media coverage and endorsement from heath and public officials. The founder, Charles Deterich (1919-97) found sobriety through A.A. Deterich, a dramatic popular speaker, described as a combination of “P.T. Barnum and Florence Nightingale” committed his life to helping others battle addiction. Synanon used forms of group talk therapy, visualization, meditation, mindfulness techniques, and the controversial and combative “Attack Therapy” where the addict was challenged and likely verbally abused by a therapist and/or group members. The TC’s were run by addicts helping other addicts, the treatment was highly controversial. The psychiatry movement of “new thought” ideology that defined addiction to be a social/cultural issue was supported by M. Foucault, T. Stasz, and R.D. Laing. Synanon’s greatest supporter was Abraham Maslow, and a Synanon documentary was released in 1965. In addition to recovery, Synanon branched off through the years with therapeutic, social/cultural/political, and spiritual themes.

The spectacular rise and fall of Synanon (1958-91) has been presented in films and books. Clark avoided the details associated with sensationalism and alleged criminal activity, and rather abruptly ended the Synanon story narrative. It was obvious that Deterich avoided seeking government funding for Synanon: this would have required drug testing of members, inspection of facilities, and extreme paperwork files to insure accountability and compliance with government policies. In addition, this may account for the lack of writings and documentation of Synanon for historical archives. The TC that followed and successfully modeled Synanon principles included: DayTop, Matrix House, Odyssey House, Phoenix House, Oxford House, others were listed and some were located in foreign countries.

The ending of the 1960’s brought increased awareness of illicit drug use: too many veterans were returning from Vietnam addicted to heroin. The Nixon Administration was revolutionary and innovative when it allocated $105 million USD (1971) to combat drug addiction and open Methadone Clinic’s. Research of 750 Methadone patients found that after 4 years 80% were socially responsible, and 59% were gainfully employed. The impressive results of Methadone treatment were eventually discounted by the Reagan Administration, which defunded treatment programs.
Reagan favored strict punitive measures including incarceration for minor drug offences. The Economic Recovery Act slashed corporate taxes, reduced taxes on capital gains, and lowered taxes for wealthiest citizens. Hundreds and thousands of poor Americans lost food stamp benefits, welfare was reduced or eliminated, and billions of dollars that helped states fund Medicaid disappeared. Nancy Reagan was initially viewed as out of touch with average citizens-- until she took up her “Just Say No” slogan- campaign that raised awareness of youth/teen drug use. The Reagan’s declared “A War on Drugs” promoting (free)” self-care and reliance “. This didn’t help the 1,000+ people on the waiting list for the 25 publically funded drug treatment centers.

It was interesting to note the extreme differences of political viewpoints: the debate continues between incarcerating people vs. providing treatment. With deindustrialization and the global economy, the loss of manufacturing and other blue collar jobs, American’s were more concerned about employment, economic conditions, and less about social causes that supported recovery programs. Many treatment programs moved to the prison system-- paid for by government funding or private insurance. The Drug Courts (est. 1991-) remained a less costly and effective way to keep addicts out of prison-- as more treatment under the Affordable Care Act became available. The Recovery Revolution highlights the historical significance, funding research of methods/studies, and the continuous need for health care and development in the treatment of alcohol and substance abuse. ~Special appreciation to Colombia University Press via NetGalley for the direct digital copy for the purpose of review.