A nuanced and deeply reported exposé of America’s $53 billion addiction-treatment industry and how it harms all of us.
Examining failures of the addiction-treatment industry through real-life stories.
Journalist Walter takes readers on a tour of what addiction treatment looks like in the United States. We meet Chris, a white Louisianan who works 80 hours a week and has no time or energy for counseling; April, a Black Philadelphian who struggles to get herself straight and her children back; Larry, a white doctor in Indiana who builds a practice around a newly approved medication for addiction; and Wendy, a white Californian whose son died at a recovery center. The book’s chapters rotate among the four narratives, walking the reader through the harrowing and the hopeful. Their stories are as compelling as they are hard to read, because Walter scrutinizes a largely hidden world that over-promises and under-delivers. The book is well written and strikes a good balance between the personal narratives and the broader racial and political contexts in which they play out. Readers are faced with a litany of ironies, such as 28-day programs, which can help people detox but also put them at higher risk of death should they relapse. Prescribing rules allow doctors to dole out Oxycontin, a pain medication that has contributed to the addiction crisis, to any number of their patients but drastically limit dispensing Suboxone, a treatment drug. The Affordable Care Act helped boost the recovery industry, which was sorely needed, but also allowed rapid growth of for-profit treatment centers that were more focused on making money than on making people better. Walter examines practices that are at odds with research evidence, such as the fact that most people go through multiple attempts at recovery before they reach lasting sobriety, suggesting that intakes should be easier and that efforts to boost post-treatment care, including housing and employment, should be part of the mix.
A nuanced and deeply reported exposé of America’s $53 billion addiction-treatment industry and how it harms all of us.Pub Date: Aug. 12, 2025
ISBN: 9781982149826
Page Count: 336
Publisher: Simon & Schuster
Review Posted Online: June 13, 2025
Kirkus Reviews Issue: July 15, 2025
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...
A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.
The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.Pub Date: Nov. 1, 2011
ISBN: 978-0-374-27563-1
Page Count: 512
Publisher: Farrar, Straus and Giroux
Review Posted Online: Sept. 3, 2011
Kirkus Reviews Issue: Sept. 15, 2011
BOOK REVIEW
IN THE NEWS
IN THE NEWS
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
PERSPECTIVES
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