The Recovery Revolution: The Battle Over Addiction Treatment in the United States. By Claire D. Clark

Extract

The Recovery Revolution offers a timely history of addiction treatment in the United State, focusing particularly on therapeutic communities. Claire Clark, a historian with additional training in the behavioral sciences, presents a nuanced study of the rise, development and legacy of the 1960s therapeutic community model and the “recovery movement” it heralded. Beginning with Synanon, a controversial addiction treatment program developed in the late 1950s and popularized through the 1960s, Clark shows how a community-based approach emphasizing “recovery,” was subsumed into a greater recovery industry, and into a deeply conservative approach to drug treatment. Clark’s meticulous research is matched by her impressive mastery of health policy, past and present, and her study is a valuable contribution not only for historians, but also for policy-makers.

The book is organized into three parts: Revolution, Co-optation and Industrialization. In the first section, she describes the rise of Synanon, and how politicians and policy-makers responded to the appearance of a new player in the addiction-treatment field. In “Co-optation,” Clark describes the rise of similar therapeutic community programs, which, she explains, in fact “dulled” Synanon’s “influence on the addiction-treatment field” (78). She compellingly shows how “second-generation” therapeutic communities broke away from Synanon’s leftist, “hippy” image, to work with the Nixon administration. A salient illustration of this is Daytop’s adoption of urine drug-tests (as opposed to Synanon’s insistence on “rigorous honesty” without surveillance) (81). An additional fascinating aspect of this story is the role of “ex-addicts.” Hiring ex-addicts became an industry in itself, as a significant majority of graduates from therapeutic communities were subsequently employed by these very same institutions, with varying results.