the "our history of addiction" episode (feat. Dr. Carl Erik Fisher, Author of "The Urge")
Jul 03, 2023
DeAnn Knighton
Today, DeAnn interviews Dr. Carl Erik Fisher, author of the "The Urge: Our History of Addiction". This has been DeAnn's favorite recovery read of the past couple of years, so it was an honor to have Carl on the Show. The episode is a high level discussion of the key themes in the book, as well as about the meaningful ways that Carl integrated his own story into this well researched and smart history of addiction. If you have not read the book, we believe this episode will make you want to! But if not, you will hear about some interesting cycles about responses to epidemics. And even more importantly, come to understand the hard truth that rings true on the macro and micro level: that medicine alone is not enough for healing.
Bio: Carl Erik Fisher is an addiction physician, bioethicist, writer, and person in recovery. He is an assistant professor of clinical psychiatry at Columbia University and also maintains a private psychiatry practice with a particular focus on the evolving science of mindfulness and meditation. He is the author of the nonfiction book The Urge: Our History of Addiction, published by Penguin Press in January 2022 and named one of the best books of the year by both The New Yorker and The Boston Globe. His writing has appeared in The New York Times, The Washington Post, The Guardian, Slate, Scientific American MIND, and elsewhere. He also is the host of the Flourishing After Addiction podcast, a deep-dive interview series exploring addiction and recovery.
Book Description: Carl Erik Fisher draws on his experience as an addiction physician, researcher, and alcoholic in recovery to trace the history of addiction: a phenomenon that’s troubled us for centuries, yet we hardly appear closer to understanding. As a psychiatrist-in-training fresh from medical school, Fisher was soon face-to-face with his own addiction crisis, one that nearly cost him everything. Desperate to make sense of the condition that had plagued his family for generations, he turned to the history of addiction, learning that the current quagmire is only the latest iteration of a centuries-old story: humans have struggled to define, treat, and control addictive behavior for most of recorded history, including well before the advent of modern science and medicine. A rich, sweeping account that probes not only medicine and science but also literature, religion, philosophy, and public policy, 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, and compassionate view of one of society’s most intractable challenges.
Today, DeAnn interviews Dr. Carl Erik Fisher, author of the "The Urge: Our History of Addiction". This has been DeAnn's favorite recovery read of the past couple of years, so it was an honor to have Carl on the Show. The episode is a high level discussion of the key themes in the book, as well as about the meaningful ways that Carl integrated his own story into this well researched and smart history of addiction. If you have not read the book, we believe this episode will make you want to! But if not, you will hear about some interesting cycles about responses to epidemics. And even more importantly, come to understand the hard truth that rings true on the macro and micro level: that medicine alone is not enough for healing.
Bio: Carl Erik Fisher is an addiction physician, bioethicist, writer, and person in recovery. He is an assistant professor of clinical psychiatry at Columbia University and also maintains a private psychiatry practice with a particular focus on the evolving science of mindfulness and meditation. He is the author of the nonfiction book The Urge: Our History of Addiction, published by Penguin Press in January 2022 and named one of the best books of the year by both The New Yorker and The Boston Globe. His writing has appeared in The New York Times, The Washington Post, The Guardian, Slate, Scientific American MIND, and elsewhere. He also is the host of the Flourishing After Addiction podcast, a deep-dive interview series exploring addiction and recovery.
Book Description: Carl Erik Fisher draws on his experience as an addiction physician, researcher, and alcoholic in recovery to trace the history of addiction: a phenomenon that’s troubled us for centuries, yet we hardly appear closer to understanding. As a psychiatrist-in-training fresh from medical school, Fisher was soon face-to-face with his own addiction crisis, one that nearly cost him everything. Desperate to make sense of the condition that had plagued his family for generations, he turned to the history of addiction, learning that the current quagmire is only the latest iteration of a centuries-old story: humans have struggled to define, treat, and control addictive behavior for most of recorded history, including well before the advent of modern science and medicine. A rich, sweeping account that probes not only medicine and science but also literature, religion, philosophy, and public policy, 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, and compassionate view of one of society’s most intractable challenges.
This is a podcast. I'm your host, and I am very excited about today's episode and the guest that is joining. It is someone whose work I deeply admire. Someone who wrote my favorite recovery read of the last couple of years without question. My guest today is Dr. Carl Eric Fisher. Caro is an addiction physician, bio ethicist, writer and human in recovery. He is an Assistant Professor of Clinical psychiatry at Columbia, and also maintains a private psychiatry practice with a particular focus on the evolving science of mindfulness and meditation. He is the author of the nonfiction book, The urge our history of addiction, which was published by Penguin Press in January of 2022. And named one of the best books of the year by both the New Yorker and the Boston Globe. His writing has appeared in The New York Times, The Washington Post, The Guardian, slate, Scientific American Mind and elsewhere. He is also the host of the flourishing after addiction podcast, a deep dive interview series exploring addiction and recovery. Because of time, we focused our conversation on his book. In the urge, Carl draws on his experience as an addiction physician, researcher and alcoholic in recovery, to trace the history of addiction, a phenomenon that's troubled us for centuries, yet we hardly appear closer to understanding. As a psychiatrist in training freshman medical school, Fisher was soon face to face with his own addiction crisis, one that nearly cost him everything. Desperate to make sense of the condition that had plagued his family for generations, he turned to the history of addiction. Learning that the current quagmire is only the latest iteration of a centuries old story. Humans have struggled to define, treat and control addictive behavior for most of recorded history, including well before the advent of modern science and medicine. He probes not only medicine and science, but also literature, religion, philosophy and public policy. He urges at once an eye opening history of ideas, a riveting personal story of addiction and recovery, and a clinicians urgent call for a more expansive, nuanced and compassionate view of one of society's most intractable challenges. I mentioned this as my favorite book on recovery in a long while. And that is not hyperbole. I was incredibly intrigued and moved by this. It is a kind of book you have to read multiple times, because there's so much in it yet. It is written in a completely accessible way. It's tricky to get a full feel of such a rich book and just a 30 minute interview. But I do think this is a great introduction. After talking with Carl, I actually jumped over and binge this podcast, and I'm thrilled that I did. As I picked up even more about the current state of academic science, advocacy and mutual help approaches to addiction. I mean, honestly, it is kind of what I wanted this podcast to be. So I'm kind of jealous, but also just really glad it exists. So please check out flourishing with addiction. So before I jump over to Dr. Fisher, I want to give you a quick passage from the book to get us started. This is free from the urge our history of addiction. As I continued my research into addiction, I noticed something interesting. The broadest thinking and most creative scholars kept making odd and intriguing connections to fields beyond my usual horizons. They drew on ancient philosophy to clarify the problem. They look to sociology to show how it is impossible to separate addiction from its cultural context, now and for generations back. They even delved into theology to trace how legacies of thinking about morality have powerfully influenced the way we think about choice and responsibility. In a short time, I became absolutely convinced stuff that medical science alone, while important, was insufficient for understanding addiction. Understanding addiction in the present required looking to the past. Carl, hello, thank you so much for being with us today.
Carl Erik Fisher:
Thanks for having me.
DeAnn Knighton:
Yeah, this is really exciting for me, your book had a really big impact on me kind of in the place that I'm at right now, in particular, really helped sum up for me what I was thinking about the depth of the issue of addiction in our country, as well as on an individual level. And all of those deeper questions I've been asking myself in my own journey, something that really stood out to me and your setup for this book around the breakdown of addiction as essentially inseparable from the cultural context or whatever is going on in our society at the time, you account quite a bit for your appreciation of the contributions of medical science, but that also, that this is a really complex issue and touching so many different modalities. It's like multidisciplinary, and all of the senses of the word. So I think it would be great to start there, maybe and just have you talk us through a little bit about the broad spectrum of the human experience that the issue of addiction touches.
Carl Erik Fisher:
Yeah, I'd be happy to talk about that. Because at bottom, the book is something I wrote for myself to understand my own addiction, and understand the addiction that was so common in my family. And it's important for me to say that because on first glance, it looks like a big history. But the point of the history is really to inform how I can understand myself better, how I can understand the phenomenon of addiction better to help real people. That's why I felt drawn to the multidisciplinarity. It's easy in academic studies, whether it be scientific or historical or otherwise, to seize on one single, simple soundbite. And we see that so commonly in policy and even advocacy. The lesson that I got over and over from the history is that this was a really profound and wide ranging phenomenon. It's something universal to human life, that there's addiction and all of us, and that we can find addiction across so many different eras and cultures, it's necessary to be humble, and to look across different fields. And you know, just as an example, I love science, and I love medicine. I'm a doctor, after all. So I get a lot from looking at the history of the science and medicine and also from the best contemporary science that we have today. But one of those specific lessons about multidisciplinarity that I kept on encountering was that medicine alone is never really enough to save us that medicine has a tremendously important job to do in terms of saving lives, and instituting treatments today, we meaning medical professionals overextend ourselves, and we have done over and over again throughout the history of addiction, claiming to have the answer to be the most important part of the solution. And so that's why it felt important for me upfront to to emphasize multidisciplinarity, and to talk about all the different connections and the points of synthesis and integration, across all the different manifestations of addiction.
DeAnn Knighton:
One of the things that I really appreciated as well as I got to know some different individuals who have contributed over the years to this issue. And once that I hadn't even really heard of before had context around. In your research, I know you spent a good 10 years digging into this narrative and figuring out the timeline of all of this, who stood out to you maybe in that process of somebody that had the most connection to you personally, in terms of their contributions to addiction.
Carl Erik Fisher:
Oh, well, you know, I love so many of the characters in the book and I love them as people and in a lot of the cases they actually printed out their photos and put it up on my wall. Or in the case of people like Benjamin Rush who existed before photos or portraits or whatnot. But you know, one name that comes to mind is Marty man, you know, Marty man is a lot like, is a lot like Benjamin Rush is a lot like Marie Niswander in that. Marty Mann is fundamentally a, I think really admirable and heroic figure in certain respects, who also had parts of her message and parts of her history that need to be critiqued that nobody got it 100% Right. And going along with what we were just talking about regarding humility, and being open to an integrative and broad based notion, you know, Marty Mann, for people who don't know her, it was a really important figure in the history of Alcoholics Anonymous, and, you know, probably not coincidentally as a woman because she's She's largely forgotten. So many people know Bill W and Dr. Bob was a very, very early member of the fellowship. She has a fascinating background as a Chicago socialite, very wealthy, hung out in London with writers like Virginia Woolf and was just like this glittering figure in the early 20th century social world, and then got a very, very bad experience with alcoholism at a time when it was very difficult to access, psychiatric care, or any medical care for alcoholism or addiction. This was a time in like the 30s 40s 50s, when people with alcohol problems would not be admitted to hospitals, even though they were in life threatening withdrawal. So she eventually through some happenstance and some luck, or grace, or whatever you want to call it wound up in, in treatment, where she was connected to the early early early fellowship of Alcoholics Anonymous, to the point where her psychiatrist at this asylum in Connecticut, had a preprint of the book, the book, Alcoholics Anonymous, hadn't even been fully published yet, it was a preprint that this guy Harry timeout, got, she wound up becoming the sponsee of Bill W, and had the idea because she herself was an advertising and brilliant and really thoughtful about this early early age of marketing. She, she was instrumental in spreading the notion of Alcoholics Anonymous, and then also making these broader advocacy movements for opening the doors of hospitals and getting treatment funded, and all the rest. And so she undoubtedly saved many, many, many lives. And in my view, she turns toward a kind of oversimplified reductionism, I tried to present her story in a relatively open ended way where, you know, I don't know that the world would have been a better place, if she did anything differently whatsoever. You know, in the early stages of her advocacy, maybe she needed a very straightforward and simplified message about disease. However, I feel like at least from today's perspective, we need to be skeptical about the way she talked about the notion of disease, I don't even care that much about whether you call addiction, a disease or not a disease, it doesn't matter that much. What matters is what the term points toward. And what she was pointing toward and saying explicitly, was that this is a problem that's rooted in biology, biology is the most important level to describe the problem. And that there's one way to get sober. And if you don't take this one way to get sober, then you'll have problems, etc, etc. She's a complicated figure in a number of different ways that, you know, for the sake of time, we will delve into, I could talk about money, man, for hours. But a lot of the people in the book are like that, you know, the people like Benjamin Rush, who, you know, were really wonderful and saved a lot of lives. But then he also did some awful things about bloodletting and yellow fever and very nice wonder did fantastic things in terms of bringing methadone treatment to the public and saving countless lives, but then also got a little overly simplistic in the way she and her collaborator Dole talked about the metabolic theories behind addiction and so forth and so on. And I bring up those stories not to say they, Oh, they should have done better or a better person would have done better, I think it's just such a profoundly identifiable and human trap to fall into to rest back on simple explanations into into lose the tolerance for the multifaceted complexity of complex problems like addiction.
DeAnn Knighton:
One of the themes that I took away from the book was almost an every piece of the story that we hear the idea of reductionism comes up over and over again, and we're in such an interesting time in terms of how information gets disseminated and how nuance gets lost so often, and what we're talking about, and particularly with activism, trying to get people to listen to a message, I think that this idea of simplification of that message can have such a value in some ways, but then also, on the other hand, like you said, has the potential to mislead. Thinking of that reductionist theme, I guess, in particular, you mentioned the disease model. And that's definitely one that stood out to me, but I would just, you know, anything else that you would say in terms of the importance of understanding the pitfalls and the value of that as it relates to scientific findings?
Carl Erik Fisher:
I talk about reductionism in the context of these big social responses to epidemics. One of the big surprises for me in doing the historical research is that despite the fact that we are in the midst of an acidly historical and devastating overdose crisis, which we could extend to a crisis of alcohol use, which is growing further and further out of control and the post COVID era. Despite all of that drug epidemics are nothing new. We've been having them for at least 500 years, I look at these bigger social responses to drug epidemics, not only because a lot of people in recovery, are curious about why are things so troubled right now? And also, you know, what part can I play? And how can I move the needle? And how can I be part of the conversation or, or help out in some way, but also because they look at ways that societies respond to drug epidemics, we can see how people understand addiction. And we've gone through different patterns, and different pendular swings of responses to addiction. And so what reductionism is the name I attached with just one of those responses, you know, people mean different things by reductionism, it's good to have certain types of reductionism, it's good to go to a laboratory and identify antibiotics when you're struggling with like a bacterial infection. I'm glad that those exists. I'm not saying science is bad. But there's a sort of overclaiming reductionism that says that science or biology or what have you, is the single best response that a certain reductionistic approach, quote, unquote, owns the response to addiction. And that's anti integrator that kind of speaks against the kind of collaboration and integration that we so desperately need. And, you know, just to contrast that identified a few other responses that societies have repeatedly kind of cycled through. And this was really interesting to me, because I thought to myself, not only why why have we had so many epidemics over so many years, hundreds upon hundreds of years of drug epidemics from a tobacco epidemic, and Christopher Columbus's day up through the rise of amphetamines in the 1920s, and all the rest everything in between? Why do we keep on cycling through these responses to and some of those other responses are things like a medical response, which is different than reductionism is sort of privileges the therapeutic and the clinical answers. One is a prohibitionist response, which says, Oh, if we just crack down on supply, then we'll solve the problem at its root that's never worked. And then there's a mutual help response, which is different than medicine, which is important to emphasize today. Because medicine sometimes blends into mutual help, especially in professional treatment settings nowadays, again, I'm not saying that's good or bad. But I think we have to be conscious about what is and what isn't mutual help. And what is and what isn't. Medicine, the upshot of all this is that, you know, all of these responses, including reductionism, and what's important to know about it is that none of these is the winner, none holds all the answers. I think that to really effectively respond to crisis, to crises of addiction, both individually. And as a group as a society as a community is we have to find points for integration, we have to find ways of bridging the divides. And to develop a thoughtful and integrative approach. That's one of the ways that Benjamin Rush went wrong. In my view, he started off a bit open minded and integrative and then narrow to a sort of reductionistic model. And that happens over and over again, throughout history. And so it just, you know, I wanted to say all that, just to say that, you know, reductionism in and of itself is just just a thing that people do. It's just a response to the important thing is to look at what it's doing and how its functioning in the moment in the context that we find ourselves in.
DeAnn Knighton:
Hey, we'll be right back. Show up and stay is a 501 C three nonprofit on a mission to build tools and content that will bridge the recovery gap. The recovery gap is the distance between healing from the substance and healing your life. There are so many ways that you can support our project, you can donate and show up and stayed up or you can follow us on Instagram and show up and stay or you can follow and subscribe to the podcast on a platform of your choice. And take a minute to write a review. Literally just listening to the podcast on a weekly basis helps We post new episodes every Tuesday. I like to say we have a bit of technology in science, but primarily storytelling and heart. Now back to the show. Before we get back to the interview, I wanted to jump in here with another quick passage from the urge. We're about to talk about dislocation theory, and I thought a little background might help. The Canadian psychologist Bruce Alexander has articulated this idea as his dislocation theory of addiction, which asserts that the most important and fundamental cause of addiction is not the biological effect of a drug or some inborn vulnerability to addiction in individuals, but rather a society's wounds. Importantly, the pain doesn't need to be the kind of concrete loss or physical separation of being torn from family and friends. There is a psychological dislocation that can be just as toxic being torn from culture and traditional spirituality, losing freedom and self determination, and lacking opportunities for joy and self expression. Even for those of us who are not suffering from such tangible deprivation today, we are just as vulnerable as our ancestors, if not more so, to the psycho spiritual one and two on the cyclical nature of this issue in our history, I definitely was drawn to what you talked about came up a couple of different times around dislocation theory as maybe a potential catalyst for some of the problems with addiction ramping up historically. That was an interesting one for me to think about in applying sort of the historical background to today's context, also, because it seems really relatable to me.
Carl Erik Fisher:
Yeah, well, a lot of people have written about dislocation, alienation, other related problems as a social problem, especially in the 20th and 21st centuries, a lot of this was applied to addiction by the Canadian psychologist Bruce Alexander, who people might know from Johann Hari, his book, and he's also buddies with Gabor Mate. And, you know, so this is this is an idea that's out there. But Bruce Alexander himself is drawing on some other thinkers who have identified this long, long tradition of pointing toward these deeper social causes of suffering and despair. The point of this as it applies to addiction is that when we have epidemics, usually people want villains, you know, they want to know, what is the bad pharma company that caused this problem? Or, you know, what is the medical problem? or what have you, epidemics generally occur at the intersection of a bunch of different causes, like sometimes it's because of a novel drug that a society is not prepared for. And sometimes it is because of some sort of force like an addiction supply industry or another sort of commercial entity pushing a dangerous substance unhealthily, there also tends to be a kind of social wounding. That's another word for this dislocation idea is that even when people have every material good that they might want, you know, whether this is like the American dream of like living in the suburbs, with the big house and the nice car or whatnot, or whether it's a society that is supposedly well resourced, like Bruce Alexander identifies Vancouver as a relatively wealthy city that still suffers from a high rate of addiction, sometimes you have to look deeper at you know, what are people's actual social connections? Do they have a shared sense of meaning and community and purpose are there you know, deep ties where people can feel less alone, or they can feel part of something larger than themselves, this can include is not necessarily requiring of spirituality that can be a powerful driver of addiction problems. Also, dislocation, I think, is a really important topic to think about what is beyond the obvious first order, quote, unquote, causes of addiction? I mean, I think we have to be careful about that word, cause did drugs matter. And the marketing matters, for sure. 100%. But the deeper wounding the social, psychological, psycho spiritual wounding is really, really crucial and kind of harder to appreciate sometimes, too.
DeAnn Knighton:
And as we look at the social context, in terms of how it trickles down to where we are on this issue, now, the issues surrounding treatment and access to treatment and all of the things that are a reality. In looking back through the history, there's a few examples that stood out to me. Well, several, but one in particular that I feel like has had a pretty big trickle down effect. I'd love to have you speak on this idea of good drugs and bad drugs, that messaging I guess, so to speak from a social context and and how that is still having some impact today.
Carl Erik Fisher:
Yeah, I mean, it really drives the issue. In a lot of cases, this polarization between supposedly good and bad drugs is really the dominant narrative we have about drug policy and people, even very smart people, or otherwise thoughtful can fall into this trap. It's got deep roots, you know, it's really, really deep in our culture in our society that as long as we can see back in history, people have sought to divide up people by good drugs and bad drugs. Certain types of drugs are associated with the wrong sort of users and other types of drugs. Sometimes they're not even called drugs are called medicines or you know, for some reason, we have a tendency to not call alcohol a drug or we don't call tobacco a drug. You know, we have the ATF, the Alcohol, Tobacco and Firearms, whatever it is organization Bureau, I don't even know if it's different. It's different than the DEA, Drug Enforcement Administration. We have a National Institute of Drug Abuse, which is different from the NI aaa The National Institute of Alcohol Abuse and Alcoholism, that runs extremely, extremely deep in our structures and our systems and our thinking, and it's misleading because it allows ideas about drugs and addiction, to be used to be pitch stir spun in a way that first off benefits. The purveyors, you know, we kind of are in a period where the pendulum is swinging against tobacco, kind of a little bit against alcohol. You know, there's a new Canadian guidelines that say alcohol is not safe in any level. I'm not a prohibitionist, I don't think we should ban alcohol. But I think overall, we generally undervalue the dangerousness and harms of alcohol and most of the reputable alcohol researchers today, agree with that. But you know, we've alcohol regulations have just not kept pace with the problems that causes. And then on the other hand, we can use drugs, and ideas about drugs as a weapon by exaggerating the harms of other types of drugs, it gives people power, and enables police expansions and false justification for the exercise of power, all of that together causes us to miss the full picture of addiction, it results in a distorted idea about what addiction is what drug uses. When is drug use harmful, how not all drug use is necessarily addictive or harmful at all. And so I think just by noticing that polarity, the pull toward good or bad is a good sort of mindfulness exercise to think deeply about drug use.
DeAnn Knighton:
I want to commend you for the way that you structured this book and brought together this information that I know it took a lot of time to research, but the way that you structured it with the intertwining of your personal story, I think, worked really well, it really helped kind of hit the points home and I felt very connected. In particular, I can relate so much to sort of this ongoing struggle you had with the acceptance, I guess, is the best word, I can think about the acceptance of this issue, and what it meant for your life. You know, moving forward, once you were kind of faced with this, I went through a very similar struggle. So, so much of what you said, just resonated. It's such an important part of this story, and just helps with the meaning and impact of the book. I'd love to hear maybe something from your own story that kind of shaped your understanding and acceptance for yourself of your own relationship with addiction.
Carl Erik Fisher:
Yeah, I don't, I don't know. It's a thank you for for the kind words. It's hard, honestly, for me to identify what was helpful, or if there was some sort of pivotal moment or, you know, what actually got me to acceptance because I do think it's not a personal task that I checked off a to do list. It's not like I put it on a little list with a box. And then I done today, the acceptance just didn't work that way. You know, I think the thing that was really helpful for me was the journey after I entered recovery. And that wasn't really like a moment or a quantum of information. It was a process it was, as you know, from the book, I went through terrific problems, my addictive crisis, really life threatening stuff, tremendous denial, going to rehab for doctors, and all the weirdness that entailed the thing that really, I think, was in any way unique. And that led to the book was the fact that, you know, once I had achieved some measure of like reasonable baseline stability, I still had this question where I was thinking to myself, what really happened to me? And, you know, without knocking some of the prevailing ideas about addiction, I felt like I just wasn't getting enough satisfaction and the answer, it just didn't make sense to me what happened to me what happened to my family? Where do I go to understand this and just starting the process of exploring and looking toward different explanations and different personal accounts, that was the thing that was really helpful was seeing firsthand how enormous the problem of addiction has been, it was really helpful. Seeing addiction throughout the ages, like Chinese scholars or ancient South Asian Indian gamblers are people during the Revolutionary War in the States, just seeing that this is an enormous problem. And that it is so consistent and prevalent in human history that helped me to see that I'm not sick or broken in some way that I have issues to deal with. And that sobriety and working toward recovery is really essential for me, to have that sense of community and fellowship across the ages, I think was really a powerful and important part of the journey for me. So I guess I would point out that it really is about the stories I wanted to write something that was accessible that was for the general public, and that was really based on stories and human personal accounts.
DeAnn Knighton:
I think of myself when I first entered treatment and how skeptical I was and I really was watching everything that was going on and being like Okay, so this is going to do it. Alright, so this is the process that I'm going through on this particular day. So it's going to get to this outcome. And the humbling part of all of it was over time obviously I let all that go. And it really kind of shaped my worldview actually, in the sense that nothing happens in a day. There's not any particular thing that happened in the course of my treatment that says, This is the reason why I happen to be on the right track right now. In my recovery, it's almost impossible to really pinpoint. Maybe to wrap us up, then, and you kind of alluded to this, and it's a probably a big question. But any suggestions or direction that you can give as it relates to where we stand right now, on this issue, where maybe the potential for some impact is there to be able to maybe move the needle in some way?
Carl Erik Fisher:
I think there's so much out there. And I don't know that there's one right answer. You know, I think about this all the time. As a sort of insecure overachiever, he was socialized medicine. All of the academic nonsense, I think it can be dangerous to think like, what's the most high value target? Or, you know, what is the world most need one of my favorite quotes about this? Actually, I've quoted other people too, but I just love it. And bears repeating is tremendous. Reverend Howard Thurman, who was as I understand it was one of Martin Luther King Junior's mentors is this beautiful quote, where he says, Don't ask what the world needs, ask what makes you come alive, and go do it. Because what the world needs are people who have come alive. So I don't think it comes from the head. I think it comes from the heart. I, you know, I think that there's any number of things that people can do to help with the problem of addiction. People can do street outreach, and they can do public service and public psychiatry, or whatever direct service provision. But there's also a tremendous, tremendous amount of work that needs to be done to change hearts and minds, to do what we can in our own small parts to occasion a change in consciousness, like it's still heavily stigmatized, and laden with shame, the notion of any sort of addiction problem or substance problem. And there's so much ideology, there's so much like divisive, partisan, polarizing ideology. There's ideology within the recovery community to you know, one of my friends who I had on my own podcast in Hampton, who, who was part of the Purdue settlement and has written a bunch and is a real recovery advocate is talked about this is that there's this sort of internalized stigma within recovery communities, too. And we I think we have to be very careful about judging other people's recoveries as well. But I think that there's a lot of policy work of medical work of social services, work of consciousness raising work, it's all good. I mean, it's really all good, just as long as you tap into what actually makes you come alive and feels authentic, and then you go do it. I love writing, you know, you could say, some sort of utilitarian calculus and the the internal critic in me, will sometimes say this, like, What the hell are you doing? Right? Like you should go off and just work in a, in a clinic. And who knows, maybe I should, but I think this is valuable, too. It's the thing that I really love, and it's a thing I think the world doesn't need. That's, that's my story, and I'm sticking to it.
DeAnn Knighton:
I just loved this episode. A massive thanks to Carl for taking the time out of his busy schedule to talk with us in this episode is going to air on Independence Day. And I had a little bit of a vision that I would read this final passage from the urge to you, and maybe play some Independence Day type music, you know, like the kindness accompany Bill Pullman when we were fighting back against all the aliens. But I thought that might be a little bit too cheesy. I'm still going to read this passage. This is a nice way I think to put a seal on the conversation that we had today. After that, Carl will take us home with information on where you can find more about his work and his book. Millions before us has struggled so fiercely and desperately with addiction. When we accept that addiction is a part of life, and that there is no single solution. We give those who are suffering a better chance for relief. We need more quality treatment. But we also need to be wary of quick fixes, and simplistic stories. And especially wary of the potential of medicine. To be co opted as a tool of control, we need to let go of oppressive prohibitionist policies that cause harm and despair. We still need some small dose of regulation, at least in the form of common sense oversight of harmful products, especially when they're pushed on us by asymmetrical forces. We need science to help us better understand the phenomenon. But we also need the humility to see that the chief lesson of science is so often the crucial importance of everything beyond the brain And no matter what technocratic aims we pursue, we will always need the grassroots wisdom of mutual help in all the forms it takes from a sponsor passing along what she has learned through the 12 steps of a to harm reduction activists banding together to save lives in their own way.
Carl Erik Fisher:
For people who are looking to find me the best place is on my website, carlerikfisher.com, where I have information about the book as well as other writing, and resources. I've got one of those newsletters where you sign up, you get a free resource, I've made my case about the many pathways to recovery. Because we're on a podcast now, it's good for me to mention, I also have a podcast. It's called flourishing after addiction of deep dive interviews with really fascinating people like experts and advocates, and people like you who are working to make sense of addiction and to look deeper lessons about how to change and grow. So it's called flourishing after addiction. And I look forward to seeing you there.