[A]s Fletcher masterfully shows, rehab culture has created a deep schism between science and its twelve-step methods. There is now a vast body of research on addiction treatment, including groundbreaking medications that can quell urges, safely fulfill an addict’s need for dopamine, and often prevent relapse. And yet, Fletcher finds that some 80 percent of rehabs in the United States dispense no medication at all. In fact, many rehabs consider the use of opiate-replacement drugs and other medications—like naltrexone, Suboxone, and buprenorphine—as equivalent to drinking or using heroin, despite the overwhelming scientific evidence of their positive effects. In other words, you’re not truly sober if you’re “on” something. To that end, many rehabs kick addicts out for secretly using—that is, for being addicts.