Marc Lewis is a former addict and a neuroscientist. He wrote two books, Memoirs of an Addicted Brain and The Biology of Desire, that I binge read when I stopped drinking. He explains why our brains are wired for addiction. “Brains just do what hundreds of millions of years of evolution have determined to be useful, and that includes identifying things that taste good or feel good to us. The brain distinguishes those things from everything else—the background music of the humdrum world—and propels us to go after them.” The reward system is what enables the addiction to slowly take place. To motivate behavior, neurons in the different parts of the brain release dopamine when a reward is expected. “Brain systems responsible for anticipating rewards, motivating us to go after them, and evaluating and reevaluating the worth of those rewards are reshaped by the repeated use of drugs, including alcohol.
“The kind of brain changes seen in addiction also show up when people become absorbed in a sport, join a political movement, or become obsessed with their sweetheart or their kids. The brain contains only a few major traffic routes for goal seeking. Like the main streets of a busy city, the same routes get dug up and paved over time and time again, no matter who’s in charge. Brain disease may be a useful metaphor for how addiction seems, but it’s not a sensible explanation for how addiction works.”
He doesn’t find it helpful to call addiction a disease because it deprives people of their will to change. They remain passive and consider themselves as victims.
« So how do we know which urges, attractions, and desires to label “disease” and which to consider aspects of normal experience and brain change? There would have to be a line in the sand somewhere. Not just the amount of dopamine released, not just the degree of specificity in what we find rewarding, not just the (lack of) availability of top-down cognitive control: these are continuous dimensions. They don’t lend themselves to two distinct categories: disease versus good health. Some authorities apply the disease label when the pursuit of a drug, drink, or activity seriously interferes with one’s life. But again, where should we draw the line? »
-Memoirs of an Addicted Brain, a Neuroscientist Examines his Former Life on Drugs, Marc Lewis
-Biology of Desire, Why Addiction is not a Disease, Marc Lewis