The Urge

Our History of Addiction

By: Carl Erik Fisher

Narrated by: Mark Deakins

Named a Best Book of the Year by The New Yorker and The Boston Globe

An authoritative, illuminating, and deeply humane history of addiction—a phenomenon that remains baffling and deeply misunderstood despite having touched countless lives—by an addiction psychiatrist striving to understand his own family and himself

“Carl Erik Fisher’s The Urge is the best-written and most incisive book I’ve read on the history of addiction. In the midst of an overdose crisis that grows worse by the hour and has vexed America for centuries, Fisher has given us the best prescription of all: understanding. He seamlessly blends a gripping historical narrative with memoir that doesn’t self-aggrandize; the result is a full-throated argument against blaming people with substance use disorder. The Urge is a propulsive tour de force that is as healing as it is enjoyable to read.” —Beth Macy, author of Dopesick

As a psychiatrist in training fresh from medical school, Carl Erik Fisher found himself face-to-face with an addiction crisis that nearly cost him everything. Desperate to make sense of his condition, he turned to the history of addiction, learning that our society’s current quagmire is only part of a centuries-old struggle to treat addictive behavior.

A rich, sweeping account that probes not only medicine and science but also literature, religion, philosophy, and public policy, The Urge introduces us to those who have endeavored to address addiction through the ages and examines the treatments that have produced relief for many people, the author included. Only by reckoning with our history of addiction, Fisher argues, can we light the way forward for those whose lives remain threatened by its hold.

The Urge is at once an eye-opening history of ideas, a riveting personal story of addiction and recovery, and a clinician’s urgent call for a more nuanced and compassionate view of one of society’s most intractable challenges.

©2022 Carl Erik Fisher (P)2022 Penguin Audio

Critic reviews

One of The New Yorker’s Best Books of 2022

“An artfully combined personal narrative and genealogy of the title concept . . . [Fisher’s] authorial voice is clear and gentle. Brimming with common sense and wisdom, a salmagundi of history, science, and informed opinion, The Urge should ignite the urge for invigorated conversation and debate.”—The Los Angeles Review of Books

"[A] marvelous gift of hope . . . Fisher’s work is a challenge and an invitation to discard narrow conceptions, abandon punitive strategies, and 'free ourselves to look instead at the full variety of interventions available to help.' . . . We are fortunate that his book is here, now, within reach of policymakers, prosecutors, family members, people who are suffering from addiction, and those in recovery."—American Scholar

“A compelling history. . . . Fisher, an addiction physician and a recovering addict, illustrates the ‘terrifying breakdown of reason’ that accompanies the condition by drawing on patients’ anecdotes and on his own experience.”—The New Yorker

Fascinating deep dive into the (mostly western) history of addiction

I particularly enjoyed the discussion of the disease model of addiction and whether or not it is a distinct disease or a compilation of related symptoms. Also the history of the war on drugs and it's impact on the recovery industrial complex. It does leave out the role od people of color in thr harm reduction movement. Overall very well written and researched.

Nailed it

I’ve been podcasting on a addiction for nearly 8 years and love approach this book takes. To wage war on addiction is to wage war on our nature as humans. It’s part of us.

Great book.

Very well researched and detailed

It really is a history and wraps up to the current point in it. Insightful.

A Good read about the history of addiction

I started the book expecting to get some insights into the urge in humans that leads to addiction. But it turned out to be more about the history of how society has seen addiction over time—how the stigma developed, how the pharmaceutical system pushed people from one kind of drug addiction to another, and how the healthcare system, especially in the U.S., has dealt with these problems. It feels like the problems never really end, especially with the current fentanyl crisis. I really appreciate how the author shared his personal experience as an addict—it helped me understand the suffering that addicts go through and maybe reminds us to have more empathy and be more willing to help.

Clear and accurate description of addiction and recovery.

As a person working in the justice system helping people to find paths to recovery, I found this book to be the best that I have yet encountered at describing the complexity of Substance Use Disorder and addiction.