Millions of us suffer from addiction, including psychiatrist and recovering alcoholic Carl Erik Fisher. But where does this centuries-old behaviour come from and how should we treat it?

As a young doctor, Carl Erik Fisher came face to face with his own addiction crisis, one that nearly cost him everything. Now, in The Urge, he investigates the history of this condition; how we have struggled to define, treat, and control it; and how broader understanding and compassion could change people’s lives.

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 expansive, nuanced view of one of society’s most intractable challenges.

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‘Carl Erik Fisher takes the reader on a vivid tour over several thousand years of multiple cycles of science, medicine, and literature, woven together by the thread of the author’s own alcohol and amphetamine addiction and treatment. It is made even more emphatic and moving because he is also a psychiatrist who treats such patients … [The Urge] is thorough and revealing … [and is] a mature view of the topic from someone with immense experience of it.’

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‘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.’

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‘Fisher … 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 … 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 … There’s as much history here as there is heart.’

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‘Fisher, a psychiatrist and a patient recovering from addiction, wonders, “Is everyone somewhere on the addiction spectrum?” What factors — biological, psychological, social, cultural — play a role? A unique perspective on a frustrating, often devastating problem.’

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‘Doggedly researched, layered with empathy, The Urge pulls back multiple curtains at once in examining an ailment that will likely never go away … The Urge contains a wealth of such research and insight, rendered with a gimlet eye and a physician’s care. Addicts who make it to the other side often feel they have survived to fulfill a higher purpose. The Urge qualifies as just such an accomplishment, an inspired dive into a condition that, in one way or another, touches us all.’

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‘Eye-opening, humane, and meticulously researched.’

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‘This compassionate history urges us to leave behind moral panic and the temptation to stigmatise drug victims, and find more than one solution to a very human problem.’

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‘Thought-provoking.’

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‘I devoured [The Urge] … Drawing on his experience with addiction, as well as his training in medicine and bioethics, Fisher has produced a meticulous history of addictions — exploring why, across time and place, we pursue our compulsions and obsessions unto grave consequences.’

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‘[A] marvellous 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.’

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‘Fisher’s writing glows with compassion … The Urge is an ambitious book.’

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‘Addiction is variously described as a brain disease, a personal demon, and an epidemic. This compelling history holds that it is simply “part of humanity.” 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. He also highlights the ways in which stigmas — such as the “firewater” myth, which held that Native Americans were uniquely vulnerable to alcohol addiction — have provided “ideological cover” for policing certain groups.’