The Recovery Revolution: The Battle over Addiction Treatment in the United States

Extract

How do you treat drug addiction? What is the goal of treatment? Is it to render the patient drug free? Is it a lifetime of abstinence? Or to improve the addict’s life and those of others by addressing physical and mental health issues, reducing criminal behaviour, and so on? A satisfactory answer to such questions is still waiting to be found. Indeed, it is something that those involved in treating addiction have grappled with for decades. In The Recovery Revolution, Claire D. Clark examines the contested nature of drug addiction treatment in the USA from the 1960s to the present. She focuses particularly on therapeutic communities (TCs), organisations that offered community-based (often residential) drug rehabilitation services. TCs were not a novel concept, they were first developed in the UK during and just after the Second World War by psychiatrists like Thomas Main and Maxwell Jones, but the form that emerged in America in the 1950s and 1960s, was different. The first of these new TCs was Synanon, founded by ex-Alcoholics Anonymous member Chuck Dederich in California in 1958. Dederich was inspired by AA’s peer-led therapeutic approach, but he saw this as too soft for heroin addicts who, he felt, were hardened by criminal careers and were using drugs in a socially unacceptable way. Such individuals needed not only to stop taking drugs, but also to address the fundamental flaws in their character that had led them to drug-taking in the first place. The Synanon treatment method involved intense group therapy sessions, called ‘games’, where residents expressed their frustrations but were also forced to confront their behaviour and underlying attitudes.