Before the 1960s, doctors were generally in control of the treatment of drug addicts. And that made a certain sense, because drug addicts had something that looked a lot like a disease or mental illness. The trouble was that doctors had no effective way to treat drug addiction. Their best idea–Federal “narcotics farms,” one in Kentucky and one in Texas–kept junkies clean, but only by keeping them away from the drugs those junkies craved. In that sense, they were no more effective than prisons, though in fairness drug farms offered various treatment regimens that enabled some addicts to get and stay clean. Other than locking them up, the medical establishment had no good answer to the question “How do you cure someone of narcotics addiction?” Essentially, then, junkies (who could not spontaneously “kick,” and a lot do) usually ended up in one of three places: on the street, behind bars, or dead.

Enter Charles Dederich. In 1958, Dederich, a veteran of AA and ex-drug addict, decided that addicts should take their treatment into their own hands, much like Bill Wilson and Bob Smith had done with AA in the late 1930s. He took what he learned in AA, adapted it, and created a long-term residential “therapeutic community” expressly for addicts and run by addicts. He called it Synanon, and with it he started what Claire D. Clark calls “the recovery revolution.”

In her terrific book, The Recovery Revolution: The Battle Over Addiction Treatment in the United States (Columbia University Press, 2017), Clark tells the story of Dederich and those who followed him (literally and chronologically) in trying to find a way to treat narcotics addiction. It’s a tale of ebbs and flows, successes and failures, enthusiasm and exhaustion lasting sixty years. Clark makes clear that the “recovery revolution” is not over by any means–we are still groping toward a good answer to the question “How do you cure someone of narcotics addiction?”