If addiction is a brain disease, addicts are mad, sick and defective. If it’s a failure of will, users are bad, immoral and weak.

Kicking the Habit 


by Sally Satel 



Marc Lewis makes a convincing case that addiction is not a disease, and shows why the disease model has become an obstacle to healing.





The medical and treatment establishments tell us that drug addiction is a brain disease, not an absence of willpower. Technicolor brain scans are presented as proof, and millions of dollars are invested in the search for pharmaceutical remedies.

What is unfortunate about this definition is not that it plays down the willpower dimension of addiction—the “just say no” injunction was too superficial to be of much help anyway. The danger instead lies in the black-or-whiteness of both propositions: If addiction is a brain disease, addicts are mad, sick and defective; if addiction is a failure of will, users are bad, immoral and weak.

In “The Biology of Desire,” Marc Lewis, a neuroscientist, takes a less Manichaean approach, arguing that addiction entails both biological alterations in the user’s brain and changes in his personal agency. He offers an insightful take on the interaction of mind and brain against the backdrop of the addict’s life circumstances.

Mr. Lewis is no white-coated lab shut-in. In his 20s, he consumed vast amounts of alcohol, opiates, psychedelics and stimulants, an odyssey that he chronicled in “Memoirs of an Addicted Brain” (2012). In that book and in this one, he writes about bursting neurotransmitters and sinewy neural circuitry with remarkable passion and sensuousness.


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