The Biology of Desire: Why Addiction Is Not a Disease

The Biology of Desire: Why Addiction Is Not a Disease is a book by Marc Lewis PhD, which I recommend that you read. It is a very important book, because it really illustrates that many of the models that are used to describe addiction are out of date or simplistic. America has held onto to the disease model of addiction while most European and other developed countries have moved on. I feel that the disease model of addiction does not describe addiction well and has resulted in treatments which do not help everyone. In my AA days, I used to cringe when anyone mentioned their disease. The book acknowledges the disease model is better than saying addiction is simply a moral issue or a result of a lack of personal willpower, but challenges its use as as an accurate model of what addiction actually is.

The Biology of Desire and Dr Marc Lewis

The book blends the stories of several people who have experienced addiction with accounts of how the brain works. Marc illustrates the way that different aspects of addiction can be linked to what is happening in the brain. Marc is a neuroscientist with a background of addiction himself which gives him a great insight to the problem. The book is written in a way that it is of value to an expert or non expert, which is very hard to achieve. He shows how many can overcome addiction, through self directed change in one’s goals and perspectives.

Marc Lewis delivers step-by-step explanations of the ways that physical actions involving drugs impact the brain to create feedback loops. Over time and through repeated behaviour, those effects change how the brain functions.

For example, dopamine uptake to the striatum—the part of the forebrain that receives input from the cerebral cortex—evolves to prioritize short-term rewards over long-term planning. At the same time, synaptic pruning results in a loss of communication between different brain systems that regulate self-control.

These changes are not the result of a disease or dominant genetic predisposition, Marc Lewis maintained, but are the predictable results of behaviour patterns and environmental impacts.

“When people talk about an addiction gene or a cluster of genes for addiction, it is just not right; it is just not scientifically valid,” he argued. “What I wanted to do is to launch an alternative based on the science, and on the neuroscience in particular, as well as the stories of addicts.”

The book does not provide a one size fits all solution to beating addiction and acknowledges that existing support groups such as Smart and AA do have a part to play and also discusses how many people become motivated to beat addiction on their own. Many who push the “Disease Theory” are often from the “12 step Treatment world”, who are against change in the way addiction is treated. I think this book would help open their eyes to an alternative way of looking at things and would explain to them why so many people do not do well after being told their problems are a disease. Of course a few people do well if they follow the 12 step rehab route and so more must be done to see if people can be sent to appropriate treatment solutions at an early stage.

You can read an excerpt from the book here http://www.memoirsofanaddictedbrain.com/excerpt-biology-of-desire/

Marc also wrote the excellent “Memoirs of an Addicted Brian” and has a great blog http://www.memoirsofanaddictedbrain.com

 

 

 

 

 

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  1. “For example, dopamine uptake to the striatum—the part of the forebrain that receives input from the cerebral cortex—evolves to prioritize short-term rewards over long-term planning. At the same time, synaptic pruning results in a loss of communication between different brain systems that regulate self-control.”

    I’m not really that invested in addiction being a DISEASE, but most people are colloquially talking about it as described above, where self control decision making circuits are affected. They are not, in my experience, trying to say addiction is a genetic disorder.

    Some people do fixate on this, but it’s not really central to a liberal “disease” model, in my opinion.

    • True, but that is just a tiny excerpt from the book, which is simply there to give anyone reading this some idea of what the book is like. I think the boo does a good job of explaining what goes on it an addict’s mind and why this happens when any rational person not affected by addiction would do something else.

      I think many ideas in treating and supporting people with addiction are out of date and a lot of research money is wasted on trying to prove genetic reasons for addiction or on propping up the disease model when, people would be helped more if funds were made available to make something such as the Sinclair method better known and more accepted or by making professionally run support groups the norm rather than simple peer support. I think this book does a good job of showing why people from a variety of backgrounds have addiction issues and that old fashioned ideas about addiction are holding things back.

  2. I totally agree, seeing your point more clearly now. Speaking of alternate methods, when I was early in recovery, I used naltrexone. Worked very well as a deterrent and blocked cravings, I was opiate and stimulant addict. Later on, I noticed it helped food cravings when I tried some left over tabs to see if it’d help “compulsive” overeating. It did.

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