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
A short, smart analysis of perhaps the most famous passage in American history reveals its potency and unfulfilled promise.
Words that made a nation.
Isaacson is known for expansive biographies of great thinkers (and Elon Musk), but here he pens a succinct, stimulating commentary on the Founding Fathers’ ode to “life, liberty, and the pursuit of happiness.” His close reading of the Declaration of Independence’s second sentence, published to mark the 250th anniversary of the document’s adoption, doesn’t downplay its “moral contradiction.” Thomas Jefferson enslaved hundreds of people yet called slavery “a cruel war against human nature” in his first draft of the Declaration. All but 15 of the document’s 56 signers owned enslaved people. While the sentence in question asserted “all men are created equal” and possess “unalienable rights,” the Founders “consciously and intentionally” excluded women, Native Americans, and enslaved people. And yet the sentence is powerful, Isaacson writes, because it names a young nation’s “aspirations.” He mounts a solid defense of what ought to be shared goals, among them economic fairness, “moral compassion,” and a willingness to compromise. “Democracy depends on this,” he writes. Isaacson is excellent when explaining how Enlightenment intellectuals abroad influenced the founders. Benjamin Franklin, one of the Declaration’s “five-person drafting committee,” stayed in David Hume’s home for a month in the early 1770s, “discussing ideas of natural rights” with the Scottish philosopher. Also strong is Isaacson’s discussion of the “edits and tweaks” made to Jefferson’s draft. As recommended by Franklin and others, the changes were substantial, leaving Jefferson “distraught.” Franklin, who emerges as the book’s hero, helped establish municipal services, founded a library, and encouraged religious diversity—the kind of civic-mindedness that we could use more of today, Isaacson reminds us.
A short, smart analysis of perhaps the most famous passage in American history reveals its potency and unfulfilled promise.Pub Date: Nov. 18, 2025
ISBN: 9781982181314
Page Count: 80
Publisher: Simon & Schuster
Review Posted Online: Aug. 29, 2025
Kirkus Reviews Issue: Oct. 1, 2025
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
SEEN & HEARD
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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