“I admit up front that I don’t like the word ‘addiction.’”
It’s not often you see an author take issue with his own book’s title, but that’s what Carlton K. Erickson, PhD does to make a point in the first sentence of The Science of Addiction: From Neurobiology to Treatment (W.W. Norton & Co., 2007).
Probably no one is more qualified than Dr. Erickson to parse the “A” word. The University of Texas distinguished Professor of Pharmacology and Director of the Addiction Science Research and Education Center in the College of Pharmacy has studied the effects of alcohol on the brain for more than 40 years.
As one would expect from a scholar with such credentials, the overriding theme of the text is, “what does the evidence say?” In the first chapter, Dr. Erickson explains why he dislikes the term “addiction” (short version — it’s unscientific, vague, and stigmatizing). He proceeds to make a convincing distinction between conscious drug misuse (he abhors the term “abuse”) and chemical dependence, which he characterizes as a brain disease involving impaired control over drug use. In this context, he cites ample evidence showing that chemical dependence is in fact a disease, and seems rather puzzled the issue is still disputed.
Later in the book, Dr. Erickson delves into the basics of brain science as it pertains to substance use and chemical dependency. He further explains how drugs that directly affect the mesolimbic dopamine system (MDS, the “reward pathway system”) have the potential to produce chemical dependence, whereas drugs with little or no effect there are incapable of producing chemical dependence.
Chapter Four covers genetic factors behind chemical dependence and Chapter Five focuses on stimulants and depressants, where he confirms there appear to be good reasons for concern about the long-term effects of methamphetamines. He also believes the hype about OxyContin overshadows the lack of evidence showing it produces chemical dependence to any greater degree than other potent painkillers.
Chapters Six and Seven cover the nuts and bolts of alcohol and other drugs, respectively. Chapter Eight, “Dependence Disease Treatment,” contains some interesting observations. First, Dr. Erickson expresses concern about the counseling research literature because it’s not always clear whether various approaches are more effective with substance abusers as compared to chemically dependent individuals.
Later in the chapter, he reports “enormous” agreement that methadone is useful for treating opiod dependence. However, unlike many researchers, he seems to acknowledge there are valid reasons behind the methadone controversy, one reason being the laissez-faire response of too many methadone clinics to their clients’ use of other drugs. In the “Treatment of Nicotine Dependence” section, he makes one of his most pointed statements in the book — “smoking is such a dangerous pastime that more tools for recovery from nicotine dependence are urgently needed.” One would think the zealous attempts to tax and regulate tobacco in recent years would have yielded the appropriate number of recovery tools but, according to Dr. Erickson’s rigorous review, that’s not the case.
The highlight of Chapter Nine, “The Power and Limitations of Addiction Research,” is Dr. Erickson’s compilation of 10 drug myths. Here, you’ll learn about two well-known drugs where overdosing is all but impossible; whether social drinking kills brain cells; and why “crack baby” is a pejorative, misleading phrase.
Who will benefit from reading The Science of Addiction? Probably anyone looking for a thorough, but compact overview of the latest evidence on chemical dependence as a brain disease. Readers wanting to review the science behind commonly abused drugs are likely to be satisfied with Dr. Erickson’s information here.
Clearly, one purpose of The Science of Addiction was to help bridge the gap between research and practice.
Dr. Erickson doesn’t think highly of many researchers’ attempts in this regard. He writes, “In my experience, most drug abuse or ‘addiction’ researchers have never knowingly talked with an ‘addict’ or problem drug abuser, attended a treatment session or 12-step meeting, or attempted to learn firsthand what the problem/disease they’re studying is all about.” Ouch…
But Dr. Erickson clearly has done his homework. The Science of Addiction is a welcome contribution to the field as a result of his diligence.
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