Our guest today is Dr Marc Lewis, a developmental neuroscientist and currently a professor at the Radboud University in Nijmegen in the Netherlands. For many years his work centred on dynamic systems approaches to understanding the development of emotions and personality but recently he has perhaps become most well known for his account of his own personal experience of drug addiction Memoirs of Addicted Brain and merging that with the neuroscience of addiction. In his latest book The Biology of Desire: Why Addiction is not a Disease he argues that seeing addiction as a disease is not only incorrect but also harmful and this will be the topic of our discussion today
MWS Podcast 78: Marc Lewis as audio only:
Download audio: MWS_Podcast_78_Marc_Lewis
What I find particularly interesting about the learning model of addiction that Marc puts forward is its recognition of the importance of personal responsibility as part of recovery. It steers a course somewhere between the deterministic oriented disease model, where the addict is arguably viewed as having no real responsibility, is pretty helpless and must therefore put their recovery largely in the hands of others. On the other extreme, there is the choice model which in its extreme form is based on an absolute view of free will. In this model, the addict is often seen as selfish and morally suspect based on a completely unrealistic view of our ability to make choices. As Marc explains, taking responsibility for one’s own recovery is essential, but it’s an understanding of responsibility that is incremental, compassionate and realistic. As one reviewer (Gene Heyman) noted on the back cover of the book ‘This is a hopeful message that has, as Lewis demonstrates the advantage of also being true’
There are some good and interesting parts to this talk, esp. in the first 20 minutes.
Whether addiction is a brain disease or not is semantics, IMO. The problem is these doctors and neuro-scientists don’t know what addiction is, worse, what causes it, and worst of all, how to fix it.
AA (and many, many, many other recovery programs that use the same 12 steps as a program of recovery) know all three, and so Dr. Lewis might want to talk to some people in AA.
Willpower and the ability to have “inter-temporal” conversations are just non-starters with real addicts. The “empowerment” piece is worthless. Addicts have no power to begin with, therefore nothing could be more disempowering than where they are right before coming into some form of recovery.
The stats on opioid and subsequent heroin addiction are killing 30,000 + people in the US every year. Rather than naysaying, I hope neuro-scientists will dig deeper into the real issues and experience of recovering addicts.
My 2c.
CORRECTION: The stats on opioid and heroin addiction show them killing 30,000+ people in the US every year.