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is a very important book, because it really illustrates that many of the models that are used to describe addiction are out of date or simplistic.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 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/