Brain Expert Debunks Addiction-as-a-Disease Model
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Brain Expert Debunks Addiction-as-a-Disease Model

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This post was originally published on July 29, 2015.

A neuroscientist who once had quite a penchant for opiates while an undergrad at UC Berkeley in the 70s has now turned his attention toward understanding addiction. And the latest findings from his studies of the brains of addicts may provide powerful support for the theory that addiction is not a disease.

Disproving the Disease Theory

In his new book The Biology of Desire: Why Addiction is Not a Disease, Dr. Marc Lewis, a professor at the Radboud University in the Netherlands, has a different take from many in the anti-disease camp and it’s causing quite a stir.

Most critics of the idea of addiction as a “brain disease” argue that we should look beyond the brain’s role in addiction so we can understand the importance of behavioral modification and personal choice. But instead of ditching the brain’s role in addiction to dispute the disease model, Lewis embraces it—he believes the brain itself proves the disease theory is bunk.

The brain, he explains, is actually wired for addiction. Since desire and reward are part of our ancient survival instinct, there’s nothing “diseased” or even abnormal when someone snorts a line of blow, feels unbelievably awesome and winds up wanting another one. And the same goes for a shot of whiskey.

“Brains just do what hundreds of millions of years of evolution have determined to be useful, and that includes identifying things that taste good or feel good to us,” he writes in The Biology of Desire. “The brain distinguishes those things from everything else— the background music of the humdrum world— and propels us to go after them.”

But if we’re all wired for addiction, wouldn’t that make everyone an addict or alcoholic? Well, according to Lewis, it depends. For those who have traumatic pasts, unresolved emotional or psychological wounds and mental illness, it’s especially easy to get hooked on destructive ways to feel good.

And the doc thinks once someone gets hooked, they can get unhooked—for good.

Plastic Brains

Lewis, who previously wrote Memoirs of an Addicted Brain, believes in brain plasticity, the idea that the brain is flexible, can break old habits, learn new habits and regenerate itself. Citing several case studies that are detailed in his book, he says it’s possible for addicts and alcoholics to literally rewire their addictive brains through treatments like cognitive behavioral therapy. Once this rewiring takes place, the addict is addict no more.

“Brains have to change for learning to take place,” he writes. “Without physical changes in brain matter, learning is impossible. Synapses appear and self-perpetuate or weaken and disappear in everyday learning.”

Plenty of neuroscientists have been talking about brain plasticity in recent years, and it’s amazingly good news. Mindful meditation, for example, has been proven to literally build grey matter in the brain (that’s the good stuff that leads to self-control and higher forms of learning) and ballroom dancing can ward off dementia.

Powerless No More?

If alcoholism is not a disease, the 12-step model of recovery has some explaining to do. The 12 steps insist the alcoholic or addict is “powerless” over addiction. If, through various therapeutic means, a person’s brain can be rewired away from addiction, wouldn’t it follow that s/he is not powerless after all?

Perhaps that’s something every addict or alcoholic should decide for themselves.

Whether you’re a 12-stepper or not, it’s fascinating to watch the debate on addiction as a disease unfold in medicine and science. And Lewis’s book gives us some hope. So get busy filling out a few CBT worksheets or doing a couple minutes of meditation.

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About Author

Tracy Chabala is a freelance writer for many publications including the LA Times, LA Weekly, Smashd, VICE and Salon. She writes mostly about food, technology and culture, in addition to addiction and mental health. She holds a Master's in Professional Writing from USC and is finishing up her novel.