The Points Interview: Claire Clark

Claire Clark teaches at the University of Kentucky, where she is an assistant professor of Behavioral Science, secondarily appointed in the Department of History, and associated with the Program for Bioethics. The Recovery Revolution: The Battle Over Addiction Treatment in the United States (Columbia University Press, 2017) is a history of therapeutic community treatment for drug addiction.

1. Describe your book in terms your bartender could understand.

The Recovery Revolution explores the rise of addiction treatment in the United States since the 1960s. It does this by tracing the development of a peer-led treatment model called the “therapeutic community” (TC). TCs in the US had their roots in a controversial California commune, Synanon, whose residents promoted a unique, neo-Victorian brand of drug treatment. At the time, addiction treatment was mostly limited to a few hospitals and correctional facilities; both elites and people struggling with addiction were frustrated with the existing options. A small group of self-described “ex-addicts” ignited a treatment revolution in response, and their moral treatment philosophy had an outsized influence on the industry that developed in the decades that followed.

In the end, the story is ironic. Although a radical change in addiction treatment was necessary in the 1960s, ex-addict revolutionaries made a Faustian bargain in order to achieve it: their campaigns for treatment reinforced some of the most degrading “dope fiend” mythology and tarnished both people in recovery and the drug treatment industry as a whole.

Recovery advocates who use personal stories to advocate for policy change today are indebted to this earlier generation of treatment activism. But if they’re going to be effective in the long term, they also need to find a way to transcend it.

2. What do you think a bunch of alcohol and drug historians might find particularly interesting about your book?

Alcohol and drug historians have mostly focused on substance use; I hope The Recovery Revolution will be a welcome addition to the growing literature on treatment. The book features some fascinating characters and takes the voices of TC activists, who have often been dismissed as members of a lunatic fringe, seriously. The book also explains the connection between Alcoholics Anonymous and Synanon and articulates the important distinction between support groups as envisioned by old-school AA members and peer-led addiction treatment as promoted by TCs. Most importantly, The Recovery Revolution both humanizes and historicizes a “moral model” of addiction treatment, demonstrating why the model appeals to people struggling with drug use and to a wide variety of stakeholders trying to address it, and why the model has had such longevity.

3. Now that the hard part is over, what is the thing YOU find most interesting about your book?

The Recovery Revolution went to press before the results of the last presidential election. When I wrote the book, the idea of authoritarian, charismatic leadership based on dramatic rhetoric seemed like a distant historical phenomenon.

Yet the last line is a call to move beyond a “society that needs the hard sell”- that is, a society that requires a media spectacle after each drug use epidemic to inspire renewed interest in treatment. The revival of some of the most extreme language used to describe communities beset by drug use- for example, “American carnage”- is beyond what I could have imagined.

4. Every research project leaves some stones unturned. What stone are you most curious to see turned over soon?

The book touches on the racial politics of treatment, but doesn’t turn that stone over. As most general readers probably know, racism is the dominant explanation for the development of punitive US drug policies such as mandatory minimum sentences for drug possession and increased policing. Along the same line of inquiry, there is good work and work in progress (by Sam Roberts, Jill McCorkel, Allison McKim, and others) about the racial dynamics of addiction treatment and the relationship between treatment and punishment; this project is meant to complement, rather than challenge, that literature.

BONUS QUESTION: In an audio version of this book, who should provide the narration?

It’s an academic monograph and would make a horribly boring audiobook. As an alternative, I made you a soundtrack: