http://www.vice.com/read/this-neuro...-a-disease-and-the-rehab-industry-is-bullshit
Your new book, The Biology of Desire: Why Addiction Is Not a Disease, eponymously puts forward that addiction is not a disease, and calling it such gets in the way of proper treatment.
Firstly, defining addicts as patients makes them passive. It makes them fatalistic and it makes them pessimistic. If you're told you have a chronic brain disease that causes you to do all this nasty shit, you don't think you'll ever get free of it. But, in fact, most addicts do recover and the statistics are very clear on that, whether they're soft drugs or harder drugs like heroin. So, it's a chronic disease? Really?
While opiate and alcohol withdrawal can wreak physical havoc on addicts, you argue that addiction is purely behavioral rather than physiological, like, say cancer is?
That's another discrepancy. You have substance addiction on one hand, and behavioral on the other: gambling, sex addiction, porn addiction, a number of eating disorders, internet gaming. The cool thing is when you do brain scans, you get the same neural activation patterns in behavioral addictions as you do in substance addictions. That should be enough to knock out the disease model. If addiction is a disease, then people who spend 12 hours a day playing video games are suffering the same way people who are addicted to heroin do.What all these patterns have in common is they involve deep learning—a set of assumptions of what you need to get through the day; that learning gets entrenched through repetition and you're addicted, but there's nothing disease-like about it. People recover from all addictions, which means it's all about neural plasticity. It's not that you go back to where you were, because development never goes in reverse, it's that you learn skills that help you overcome your impulses and you learn new cognitive habits. All learning involves changes in synapses, which means creation and strengthening of certain synapses, and the weakening or disappearance of synapses that aren't being used.
Your new book, The Biology of Desire: Why Addiction Is Not a Disease, eponymously puts forward that addiction is not a disease, and calling it such gets in the way of proper treatment.
Firstly, defining addicts as patients makes them passive. It makes them fatalistic and it makes them pessimistic. If you're told you have a chronic brain disease that causes you to do all this nasty shit, you don't think you'll ever get free of it. But, in fact, most addicts do recover and the statistics are very clear on that, whether they're soft drugs or harder drugs like heroin. So, it's a chronic disease? Really?
While opiate and alcohol withdrawal can wreak physical havoc on addicts, you argue that addiction is purely behavioral rather than physiological, like, say cancer is?
That's another discrepancy. You have substance addiction on one hand, and behavioral on the other: gambling, sex addiction, porn addiction, a number of eating disorders, internet gaming. The cool thing is when you do brain scans, you get the same neural activation patterns in behavioral addictions as you do in substance addictions. That should be enough to knock out the disease model. If addiction is a disease, then people who spend 12 hours a day playing video games are suffering the same way people who are addicted to heroin do.What all these patterns have in common is they involve deep learning—a set of assumptions of what you need to get through the day; that learning gets entrenched through repetition and you're addicted, but there's nothing disease-like about it. People recover from all addictions, which means it's all about neural plasticity. It's not that you go back to where you were, because development never goes in reverse, it's that you learn skills that help you overcome your impulses and you learn new cognitive habits. All learning involves changes in synapses, which means creation and strengthening of certain synapses, and the weakening or disappearance of synapses that aren't being used.
