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Addiction, Inc.: Medication-Assisted Treatment and America’s Forgotten War on Drugs
How the war on drugs created the gold standard treatment for addiction—until America’s opioid crisis got privatized for profit, to the detriment of patients.
Despite epidemic levels of overdoses in the United States, by 2020, only twenty percent of Americans suffering from opioid use disorder (OUD) received medication-assisted treatment (MAT), the gold standard of addiction treatment, which uses methadone, buprenorphine, or naltrexone to reduce illicit drug use and curb the symptoms of withdrawal. While MAT is the most effective treatment available for OUD, it’s also the most controversial, the most expensive, and the most difficult to access. And yet, the medications at the center of this treatment—and the private industries that distribute them—generate roughly sixteen billion dollars each year, on par with national sales of coffee and pet food.
In Addiction, Inc., historian Emily Dufton explains how this promising avenue of treatment emerged during President Richard Nixon’s war on drugs in 1971 as a radical experiment in public health, when hundreds of federally-funded treatment clinics opened nationwide. Dufton then explores how these nationalized clinics gave way to an immensely profitable private industry that offers poor care at high costs to an insufficient number of people. Drawing on original research and over a hundred interviews with policymakers, medical experts, pharmaceutical lobbyists, and patients and their families, she tells a gripping story of squandered potential and missed opportunities, as MAT transformed from a revolutionary political project launched from the White House itself into a commercial success—and a public health disaster.
Urgent, eye-opening, and deeply human, Addiction, Inc. reveals how, over the past fifty years, the United States built an addiction treatment system that made recovery harder instead of easier, and what it will take to change its course.
Despite epidemic levels of overdoses in the United States, by 2020, only twenty percent of Americans suffering from opioid use disorder (OUD) received medication-assisted treatment (MAT), the gold standard of addiction treatment, which uses methadone, buprenorphine, or naltrexone to reduce illicit drug use and curb the symptoms of withdrawal. While MAT is the most effective treatment available for OUD, it’s also the most controversial, the most expensive, and the most difficult to access. And yet, the medications at the center of this treatment—and the private industries that distribute them—generate roughly sixteen billion dollars each year, on par with national sales of coffee and pet food.
In Addiction, Inc., historian Emily Dufton explains how this promising avenue of treatment emerged during President Richard Nixon’s war on drugs in 1971 as a radical experiment in public health, when hundreds of federally-funded treatment clinics opened nationwide. Dufton then explores how these nationalized clinics gave way to an immensely profitable private industry that offers poor care at high costs to an insufficient number of people. Drawing on original research and over a hundred interviews with policymakers, medical experts, pharmaceutical lobbyists, and patients and their families, she tells a gripping story of squandered potential and missed opportunities, as MAT transformed from a revolutionary political project launched from the White House itself into a commercial success—and a public health disaster.
Urgent, eye-opening, and deeply human, Addiction, Inc. reveals how, over the past fifty years, the United States built an addiction treatment system that made recovery harder instead of easier, and what it will take to change its course.
416 pages, Hardcover
Published April 13, 2026
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Displaying 1 - 3 of 3 reviews
May 17, 2026
I first learned about this book when I watched the author, Emily Dufton, was interviewed by Brittany Page from "The Page Perspective" on YouTube. I was intrigued and added the book to my to-read list.
This book provides a detailed and thought-provoking history of medication-assisted treatment (MAT) in the United States, beginning with President Richard Nixon and the federal government’s early attempts to address heroin addiction during the 1970s. Dufton explains how MAT was initially introduced as part of a broader public-health strategy, particularly through the expansion of methadone treatment programs. Over the decades, however, the system experienced repeated cycles of political support, backlash, reform, and commercialization. Public fear, stigma surrounding addiction, changing drug policies, and the growing influence of private healthcare companies all shaped the uneven development of treatment in America.
One of the most compelling parts of the book is its examination of Switzerland’s response to addiction. Rather than relying heavily on punishment or fragmented treatment systems, the Swiss adopted a more holistic model that combined medical care, harm reduction, counseling, housing assistance, and long-term social support. Dufton uses Switzerland as an example of how addiction policy can become more effective when recovery is treated as both a medical and social issue rather than simply an individual failure or business opportunity.
A major takeaway from the book is that, despite decades of discussion about addiction treatment, the United States has made only limited progress because medication alone cannot solve the crisis. MAT can play an important role, but Dufton argues that recovery also requires stable housing, mental-health services, community support, and accessible healthcare. The book strongly suggests that a profit-driven treatment industry cannot fully address these deeper problems. Instead, meaningful progress would require a comprehensive and humane public-health approach that prioritizes people over revenue.
This book provides a detailed and thought-provoking history of medication-assisted treatment (MAT) in the United States, beginning with President Richard Nixon and the federal government’s early attempts to address heroin addiction during the 1970s. Dufton explains how MAT was initially introduced as part of a broader public-health strategy, particularly through the expansion of methadone treatment programs. Over the decades, however, the system experienced repeated cycles of political support, backlash, reform, and commercialization. Public fear, stigma surrounding addiction, changing drug policies, and the growing influence of private healthcare companies all shaped the uneven development of treatment in America.
One of the most compelling parts of the book is its examination of Switzerland’s response to addiction. Rather than relying heavily on punishment or fragmented treatment systems, the Swiss adopted a more holistic model that combined medical care, harm reduction, counseling, housing assistance, and long-term social support. Dufton uses Switzerland as an example of how addiction policy can become more effective when recovery is treated as both a medical and social issue rather than simply an individual failure or business opportunity.
A major takeaway from the book is that, despite decades of discussion about addiction treatment, the United States has made only limited progress because medication alone cannot solve the crisis. MAT can play an important role, but Dufton argues that recovery also requires stable housing, mental-health services, community support, and accessible healthcare. The book strongly suggests that a profit-driven treatment industry cannot fully address these deeper problems. Instead, meaningful progress would require a comprehensive and humane public-health approach that prioritizes people over revenue.
Review of advance copy received from Author
In Addiction, Inc, Dufton combines the academic rigor of a historian with the plot, tension, and world-building of an established author--a feat surprisingly hard to find in most nonfiction books. Before we can understand the solutions to today's opioid overdose epidemic, we first have to understand the history, and Addiction, Inc, helps us do just that via engaging storytelling and thoughtful research. Through the stories of several charismatic characters, readers are lead through the history of methadone, buprenorphine, LAAM--all forms of medications for opioid use disorder. These medications are some of the most effective medications we have for any chronic disease, yet, they are woefully underutilized, and Americans continue to die. But Dufton doesn't stop with the history, rather, she uses it to guide us to the next step--envisioning a better path ahead. If you are going to read any text in order to better understand how to end today's overdose epidemic, let it be this one.
April 6, 2026
I was not expecting this to be such an easy/enjoyable read. The author does an incredible job of bringing together the history, politics, and science of drug addiction and treatment into a page-turner book. Even those who don’t have a specific interest in the topic, I believe, will find themselves riveted and wondering what could possibly happen next in this subject turned saga.
Not only did I learn a lot, but thanks to the narrative style I retained the knowledge. This was proved to me by a friend who saw the book on my side table and asked what I had learned and I talked his ear off for a half hour at the conclusion of which he asked to borrow it when I finished. …he did not have to wait long.
Not only did I learn a lot, but thanks to the narrative style I retained the knowledge. This was proved to me by a friend who saw the book on my side table and asked what I had learned and I talked his ear off for a half hour at the conclusion of which he asked to borrow it when I finished. …he did not have to wait long.
Displaying 1 - 3 of 3 reviews