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Judith Grisel, Never Enough: The Neuroscience and Experience of Addiction (New York: Doubleday, 2019), 241pp.

Judith Grisel, Never Enough: The Neuroscience and Experience of Addiction (New York: Doubleday, 2019), 241pp.Judith Grisel, a behavioral neuroscientist and professor of psychology at Bucknell University, chose the subtitle of her best-selling book quite carefully. For about ten years, from ages thirteen to twenty-three, she abused drugs at a prodigious rate. By some miracle she survived the mental illness of drug addiction with the help of a 28-day residential treatment program and three months in a halfway house. Since finishing her PhD, for twenty-five years she's studied the neurobiology, chemistry, and genetics of addictive behavior. And thus her mixed genre book that's partly the autobiography of personal experience and the scholarship of hard science.

In Grisel's view, addiction is the result of numerous factors: genetic predisposition, developmental influences, environmental input, and personal choices. After she surveys most every sort of drug you ever heard of in the middle seven chapters of her book, she asks the loaded question, "why me?" The short answer will disappoint many: "we don't know." Today we rightly dismiss the older "moral model" that addicts suffer from weak character. But the pendulum swing that appeals to "abnormal biology" alone is just as reductionistic. In the end, why some people become addicts and others do not is unpredictable and inscrutable.

And what about treatment and recovery? It's "no more likely than it was fifty years ago." Despite the lure of what she dismisses as "neurohype," addiction is "highly resistant to treatment," with recovery rates as low as 10%. As with other brain diseases like Alzheimer's and bipolar disorder, we still lack not only a causal explanation but also an effective cure. Individual variation is huge. Even an objective definition of addiction among experts is controversial beyond agreement about general characteristics like tolerance, dependence, and craving. "Bottom line: despite small advances in understanding addiction, rates of addictive disorders are rising."

Speaking from her personal experience that's informed by her professional science, Grisel's best advice is to listen to those who love you most, and to live in a community of accountability. Truly, an ounce of prevention is worth a pound of cure when it comes to drug addiction.

Dan Clendenin:

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