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Health Insurance

by Lonny Shavelson
New Press, 2001
Review by Fred Ashmore on Feb 19th 2002


I found Hooked fascinating and rewarding to read.  Lonny Shavelson follows five citizens of San Francisco through treatment, relapse, courts and life’s events over a period of two years.  These are biographies of real people, and Shavelson brings them to life with careful observation, narrative, explanation and many fine photographs.  The time and care that he took, both observing his subjects and sharing life events, are reflected in the quality of the work.

He watches Mike struggle with heroin, go through treatment under the rigorous and oppressive regime of Walden House, emerge into new life – and relapse.  Mike has plenty to offer, but his head takes over.  At the end of the book he has finally hit the end-stops of the system – and is released on probation to keep trying.  I really want to know whether he has finally reached stability, self-acceptance and contentment, but this isn’t a novel, it’s better than that because the people are real.

Darlene seems to be weird beyond the imagination of standard citizens.  Methamphetamine takes her into places where I can’t follow, but Shavelson can and does.  Even as reported, I found it really hard to understand what drives her.  By the end of the book, I was longing to hear a story of complete success.  I didn’t. I had to settle for the beginnings of transformation, and hope. 

Crystal transforms herself, learning to trust and tell the truth on her way to quitting crack.  I found the account of how the Drug Courts deal with her gripping and hopeful.

Glenda is tiny, she looks twice her age, and she has huge talent as a singer and a personality that engages everyone she meets.  Locked in drinking, physically wrecked and apparently hopeless, she is kidnapped into treatment.  She makes good progress, graduates – and relapses.  She doesn’t make it.  She may be a victim of her habits, but I felt the waste of her life acutely.

What about Darrell?  Darrell doesn’t really come through with the same force as the others.  Probably this is because he seems to achieve stable recovery relatively early, and continues to make steady progress.  We follow him, but his doings don’t grip me.  Success like this is great, but uneventful!

Shavelson is such a good reporter and writer that he brings these people to life, showing in particular how the systems in San Francisco succeeded and where they failed in support.  During the period when he was collecting his case data, the city moved through great changes in approach.  Shavelson shows us how they worked – or didn’t work.   He closes the book with an aftermath section in which he expounds his ideas on organising efforts to help people out of addiction.  Every element in his list of ideas is borne out by the examples he has shown in the stories.  

So who is this book for?   I think it’s for anyone who is touched by problems of addictive behavior with drink or drugs, for people involved in treatment of any kind, for people whose taxes contribute to public spending on treatment.  Does that seem to include 98% of the population?   Try it, friends, I think this book will help you get in the skin of an addict. It may help you think sensibly about what works for addicts and alcoholics, and what doesn’t seem to work.   

This isn’t a deep technical book and it’s light on statistics, though the ones Shavelson uses are worth knowing.  I don’t know whether it would teach the professionals much that they don’t already know, but the examples, arguments and discussion of approaches might help clarify thinking.

Anything negative?   Very little.  I wish the photographs had been better printed.   They survive printing with what looks like a geriatric inkjet, but I doubt they do justice to the originals.  And although I read the book cover to cover, I would really have liked an index or table to show which subject did what, when.

Thanks, Dr Shavelson.  You’ve written a fine and valuable book.


© 2002 Fred Ashmore


Fred Ashmore is a member of the public with a strong interest in drugs, drink and addiction and how people recover from them.  He is active as a meeting host for the SMART Recovery® program, which offers help for people who seek to modify harmful and addictive behavior.