The Urge

Starred review from October 25, 2021
Fisher, an assistant professor of clinical psychiatry at Columbia University, makes a striking debut by skillfully combining a cultural history of addiction with his own story of recovery. He first looks to ancient philosophers and thinkers, noting that early definitions of addiction hinged on a "gray area between free will and compulsion." This anticipated the contemporary notion that mental disorders, including addiction, exist on a continuum. Fisher focuses mainly on the U.S., where the idea of addiction as a disease gained traction around the time of the Revolutionary War and later spawned religious temperance movements, Alcoholics Anonymous, and the war on drugs. He also shows how treatments have swayed between compassionate, rehabilitative approaches and prohibitive crackdowns, and argues that the current quality of care is "woefully" inadequate. Along the way, he shares plenty of moving stories of the scientists, preachers, and patients on the front lines of addiction and movingly recounts his own struggle with alcohol and Adderall addiction while he was a physician in Columbia's psychiatry residency program: "The fear, shame, and strategizing were exhausting." There's as much history here as there is heart. Agent: Libby McGuire, The Gernert Company.