A new perspective on addiction

Addiction should be seen as a learning disorder, according to the author of this book.

Cover of ‘Unbroken brain: a revolutionary new way of understanding addiction’, by Maia Szalavitz

Unbroken brain: a revolutionary new way of understanding addiction, by Maia Szalavitz. Pp 336 £21.16. New York: St Martin’s Press; 2016. ISBN 978 1 25005 5 828

Addiction is often seen as the consequence of an “addictive personality” or a “broken brain”. But the author of this book — herself a former heroin and cocaine addict — suggests that such a view is a myth and is based on unfounded ideas that have led to decades of inappropriate and ineffective treatment.

Instead, Maia Szalavitz offers a new perspective, arguing that addiction should be seen not as a disease — and certainly not as a crime — but as a developmental disorder akin to autism, dyslexia or attention deficit hyperactivity disorder. She defines addiction as “compulsive behaviour despite negative consequences”, which is an accepted characteristic of such learning disorders.

Pointing out that most addictions begin in late adolescence or early adulthood, the author suggests that addictive behaviour arises during a specific phase of brain development and is related to difficulties in interacting with other people. She believes that the best way to reduce the harm associated with addiction is to recognise it as a developmental disorder and manage it accordingly. Addicted people should be understood as individuals and treated with compassion, she says.

My own experience as a pharmacist supports her view. In community practice in London in the 1970s, I was involved in supplying addicts with methadone on a daily basis, and I made a point of treating them with the same respect that I showed to all my other patients. Those who managed to give up their drug habit told me that my non-judgemental attitude had been a help in getting their lives in order.

As an accomplished journalist, Szalavitz writes in a clear and compelling style. Her book is based not only on her own personal history but also on an assessment of many years of research into the biological, environmental and social causes of addiction.

Whether or not the reader accepts her hypothesis, the book provides plenty of food for thought.

Andrew Haynes


Citation: The Salvadore DOI: 10.1211/PJ.2016.20201837

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