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Disease model of addiction doesn't work: neuroscientist

The Early Edition's Rick Cluff speaks with neuroscientist Marc Lewis about how we should understand addiction and why the medical model falls short.

Marc Lewis, a Canadian-education neuroscientist and former addict, says disease model "disempowering"

Neuroscientist and former drug addict Marc Lewis feels the disease model of addiction misses the mark because it makes the addicted person feel helpless. (CBC)

For decades, the mainstream approach to dealing with addiction has been to treat it as a disease that needs a cure. 

But neuroscientist Marc Lewis, a former addict himself, says that approach actually ends up hurting the addicted person's chances of moving past their addictions.

"[Addiction] is a habit of thought and behaviour that is self-perpetuating and self-reinforcing. It's obviously a pretty serious bad habit," Lewis says. "It involves changes in the brain, and nobody disputes that, but those are the kinds of changes that happen when we learn something deeply and the brain is restructuring itself accordingly."

Treating the disease as a medical problem can disempower the addicted person and take away their sense of responsibility, Lewis argues. He says for treatment to be effective, the addicted person needs to change their perspective and how they define their self, which the medical model does not address.

'Need to feel connected'

Lewis says what the disease model does is "package" the addiction and hand it off to someone else, usually medical professionals. He says that while medical professionals can be helpful in supporting the addict person (for example, as they experience withdrawal symptoms), they shouldn't be leading the effort.

When The Early Edition's Rick Cluff asked him about the role of psychiatrists in addiction treatment, Lewis insisted they aren't necessary.

"They 'take over' problems and say, 'okay, we're the boss, we're the experts here' and as a result you get rehab centres that cost huge amounts of money because they wave the medical banner," he says. "It isn't necessary… there's psychologists, social workers, community workers [instead]."

Lewis teaches in the Netherlands, and on his trip to Vancouver for a presentation, he toured inSite, and was impressed by their approach.

"It's amazing, but what they're showing, in a very palpable way is that addicts need to feel connected to the world. That's the first thing, and psychiatry doesn't do that for you," he says.

Personal experience

In his new book, The Biology of Desire: Why Addiction Is Not A Disease, Lewis mixes theory with the stories people suffering various addictions: alcoholism, heroin addiction and eating disorders to name a few.

Lewis himself experienced hard drug addiction in his 20s. He has written a memoir and started a blog about his personal connections.

"I've gotten really close to a lot of these people. I wanted to tell their story. And I wanted to see what it was like for other people, and how similar or dissimilar that was with what it was like for me," he says. "Addicts are some of my favourite people. I'm very interested in how they live and how they progress and how they heal."


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