Damian Thompson Damian Thompson

Ways out of recovery

Focusing on the brain’s chemistry, the neuroscientist Marc Lewis explains that addiction is not a disease — and that to claim it is actually hinders recovery

issue 20 August 2016

Perhaps because so many of them are former drunks and junkies, ‘addiction experts’ are touchy people. Often they don’t like each other — hardly surprising, since they are fighting each other for such a lucrative business. You can make bigger bucks out of selling ‘recovery’ than by peddling drugs.

That’s not to imply moral equivalence, but the two do have one thing in common: plenty of repeat customers. In any media report of a celebrity’s battle with substance abuse, the words that you’re most likely to read before ‘rehab’ are ‘in and out of’.

Ah, say the addiction gurus, but that’s because they’re suffering from a disease. This is one area in which the rivals speak with one voice. The notion of addiction as an incurable, relapsing disease is the bedrock of the recovery industry. Especially the relapsing bit.

It’s a brave man who challenges the disease theory — especially if he is himself a specialist in addiction and therefore runs the risk of being cold-shouldered at conferences and savaged in professional journals. Step forward Dr Marc Lewis, a neuroscientist who spent over 20 years as a professor of developmental psychology at the University of Toronto before taking up a teaching post in the Netherlands. His new book is subtitled ‘Why Addiction is Not a Disease’. He’s not the only academic to rubbish the disease model — but, so far as I’m aware, he is the first who has done so by setting out a comprehensive theory of addiction rooted in neuroscience.

The Biology of Desire focuses relentlessly on the chemistry of the brain. That is what makes it the most important study of addiction to be published for many years. ‘Clear, insightful and necessary,’ proclaims the plagiarist Johann Hari on the cover — a worthless plug if ever there was one, but he’s not wrong.

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