This is the first time in many years of reviewing for the Journal that I have had the pleasure of reading a work that I simply could not put down. The comments on the back jacket by professionals, well-known personalities, and book reviewers use phrases such as "intelligence, compassion, brilliance," "crucially important," "a terrific read," and "brings home the reality of addicts’ lives." It is all of these things and more. Dr. Shavelson, an emergency room physician, photojournalist, and author, would have produced a wonderful and compelling volume had he only described the lives of his five addicts over the 2.5-year period covered in this book. In addition, however, he has done his research on addiction, funding, and outcomes. This research is woven into the narrative with ease, and he is able to make his case relative to the dysfunction of the drug rehabilitation system in San Francisco and throughout the United States. Dr. Shavelson single-handedly does for substance abuse and dual diagnosis what the Institute of Medicine did to highlight inadequacies in the general delivery of health care in this country.