Chances are you have been told that addiction is a brain disease from which there is some relief but no cure. That's the most popular theory going. The other main theory (fortunately, not as prevalent today) is that addiction is a choice, and people who do not give up their addiction are morally repugnant because they consciously choose their addiction over their health, their family, and their careers. That's just stupid and ignorant.
I have a sibling who is addicted to alcohol. He is not in denial, and he has already willingly submitted to a medical rehab program; however, the addiction remains. He's a great guy, and I know he feels a great deal of shame and self-loathing about how compelled he is to drink even though he hates what he is doing to himself. While the medical rehab worked to get his body accustomed to the lack of alcohol, it did nothing to help him discover the underlying psychological reasons for why he started drinking so much in the first place. That issue remains.
I picked up a book at the library a couple weeks ago that brilliantly answered the question of what addiction is and how the brain works during addiction. I was fascinated by it from page one. It's called The Biology of Desire: Why Addiction is Not a Disease by Marc Lewis, PhD.
Lewis, a neuroscientist, gives definitive reasons why classifying addiction as a disease is both biologically incorrect and damaging to addicts. It's great for the medical establishment, he acknowledges, as well as for the rehab industry. Medical professionals love to put labels on things (not to mention the pharmaceutical industry, which loves a good disease because it means they can create a profitable drug to fix it), and expensive rehab programs also benefit from the disease label.
For addicts, however, having your addiction classified as a disease is both demoralizing and incorrectly describes what is happening in the brain. To understand that addiction is a powerful (and extreme) result of desire helps addicts understand what is happening and how to change it in order to kick the addiction.
Lewis shows how the brain's neuroplasticity--the ability of the brain to change and evolve and then stabilize into particular pathways, only to evolve again when needed--is both the culprit and the savior for addiction. He lays out in layman's terms the process of how habits are formed: the neural pathways getting reinforced, the synapses building and multiplying, and the dopamine cascade that helps create that rut of habit. He describes the parts of the brain that are involved in both habit and addiction and how they work together. It soon becomes obvious that addiction is an extreme result of the stabilizing of particular habits, and the brain responds to cues surrounding the anticipation of the substance or behavior.
Lewis introduces us to five different people who have eventually kicked their addictions of choice (including one with an eating disorder). While each person and case is unique, there are underlying similarities. One similarity is that the root psychological cause of addiction is a sensation of suppression or lack, usually formed in childhood or early adolescence. The addiction, then, attempts to fill that hole. When the root cause is unearthed, examined, and understood by the addict, the need for the substance automatically begins to lessen as the former addict rewires the synaptic pathways into new habits with different cues and different results.
Lewis shows how impulsivity hardens into compulsivity as the brain is wired into a certain pathway as the addiction takes hold. Even as the addict loathes the addiction (or loves it, which is also the case), he cannot help himself from obsessing and planning the next fix. This is compulsivity. Addiction is the twin sister to OCD.
I won't go into all the biological points Lewis makes--and he makes them extremely well in a manner that any person can understand and enjoy--but his main argument is that you cannot classify the brain as diseased when it is merely doing exactly what it is designed to do. Instead, once you understand what is happening, you use the brain's natural neuroplasticity to make needed changes.
I loved this book. It was an absolute page-turner. If you know an addict or are one yourself, this book will give you tremendous hope. Boyd K. Packer, late elder in the LDS church, said, "True doctrine, understood, changes attitudes and behavior. The study of doctrines of the gospel will improve behavior quicker than a study of behavior will improve behavior." In this case, studying the principles of how the brain actually works will help addicts and their loved ones more effectively work to change behavior. I'm not an addict, but I saw excellent applications for this knowledge in my own life. I've read many books on habits and how to change them (the study of behavior), but the study of true doctrine of how the brain works has done more for my desire and ability to change bad habits into good ones than all of those books combined.
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