Marc Lewis > Quotes

“The trick to overcoming addiction is thus the realignment of desire, so that it switches from the goal of immediate relief to the goal of long-term fulfillment”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“Instead of recovering, it seems that addicts keep growing, as does anyone who overcomes their difficulties through deliberation and insight.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“While re-addiction is clearly a hazard for some, others achieve a realistic and lasting confidence that they’ve outgrown their addictions and it’s time to move on. In fact, survey research published over the last thirty years indicates that most addicts eventually recover permanently.9 For them, the disease label may be an unnecessary, even harmful, burden.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“Donna made it obvious that not only is addiction a developmental journey, but it’s a journey that continues through the period of recovery. In fact, by the time I’d finished my interviews with Donna, the term “recovery” no longer made sense to me. “Recovery” implies going backward, becoming normal again. And it’s a reasonable term if you consider addiction a disease. But many of the addicts I’ve spoken with—including Donna—see themselves as having moved forward, not backward, once they quit, or even while they were quitting. They often find they’ve become far more aware and self-directed than the person they were before their addiction. There’s no easy way to explain this direction of change with the medical terminology of disease and recovery. Instead of recovering, it seems that addicts keep growing, as does anyone who overcomes their difficulties through deliberation and insight.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“Addicts experience something breathtaking when they can stretch their vision of themselves from the immediate present back to the past that shaped them and forward to a future that’s attainable and satisfying.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“Cannabinoids relax the rules of cortical crowd control, but 300 micrograms of d-lysergic acid diethylamide break them completely. This is a clean sweep. This is the Renaissance after the Dark Ages. Dopamine—the fuel of desire—is only one of four major neuro modulators. Each of the neuromodulators fuels brain operations in its own particular way. But all four of them share two properties. First, they get released and used up all over the brain, not at specific locales. Second, each is produced by one specialized organ, a brain part designed to manufacture that one potent chemical (see Figure 3). Instead of watering the flowers one by one, neuromodulator release is like a sprinkler system. That’s why neuromodulators initiate changes that are global, not local. Dopamine fuels attraction, focus, approach, and especially wanting and doing. Norepinephrine fuels perceptual alertness, arousal, excitement, and attention to sensory detail. Acetylcholine energizes all mental operations, consciousness, and thought itself. But the final neuromodulator, serotonin, is more complicated in its action. Serotonin does a lot of different things in a lot of different places, because there are many kinds of serotonin receptors, and they inhabit a great variety of neural nooks, staking out an intricate network. One of serotonin’s most important jobs is to regulate information flow throughout the brain by inhibiting the firing of neurons in many places. And it’s the serotonin system that gets dynamited by LSD. Serotonin dampens, it paces, it soothes. It raises the threshold of neurons to the voltage changes induced by glutamate. Remember glutamate? That’s the main excitatory neurotransmitter that carries information from synapse to synapse throughout the brain. Serotonin cools this excitation, putting off the next axonal burst, making the receptive neuron less sensitive to the messages it receives from other neurons. Slow down! Take it easy! Don’t get carried away by every little molecule of glutamate. Serotonin soothes neurons that might otherwise fire too often, too quickly. If you want to know how it feels to get a serotonin boost, ask a depressive several days into antidepressant therapy. Paxil, Zoloft, Prozac, and all their cousins leave more serotonin in the synapses, hanging around, waiting to help out when the brain becomes too active. Which is most of the time if you feel the world is dark and threatening. Extra serotonin makes the thinking process more relaxed—a nice change for depressives, who get a chance to wallow in relative normality.”
― Marc Lewis, Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs

“WHY ADDICTION IS NOT A DISEASE In its present-day form, the disease model of addiction asserts that addiction is a chronic, relapsing brain disease. This disease is evidenced by changes in the brain, especially alterations in the striatum, brought about by the repeated uptake of dopamine in response to drugs and other substances. But it’s also shown by changes in the prefrontal cortex, where regions responsible for cognitive control become partially disconnected from the striatum and sometimes lose a portion of their synapses as the addiction progresses. These are big changes. They can’t be brushed aside. And the disease model is the only coherent model of addiction that actually pays attention to the brain changes reported by hundreds of labs in thousands of scientific articles. It certainly explains the neurobiology of addiction better than the “choice” model and other contenders. It may also have some real clinical utility. It makes sense of the helplessness addicts feel and encourages them to expiate their guilt and shame, by validating their belief that they are unable to get better by themselves. And it seems to account for the incredible persistence of addiction, its proneness to relapse. It even demonstrates why “choice” cannot be the whole answer, because choice is governed by motivation, which is governed by dopamine, and the dopamine system is presumably diseased. Then why should we reject the disease model? The main reason is this: Every experience that is repeated enough times because of its motivational appeal will change the wiring of the striatum (and related regions) while adjusting the flow and uptake of dopamine. Yet we wouldn’t want to call the excitement we feel when visiting Paris, meeting a lover, or cheering for our favourite team a disease. Each rewarding experience builds its own network of synapses in and around the striatum (and OFC), and those networks continue to draw dopamine from its reservoir in the midbrain. That’s true of Paris, romance, football, and heroin. As we anticipate and live through these experiences, each network of synapses is strengthened and refined, so the uptake of dopamine gets more selective as rewards are identified and habits established. Prefrontal control is not usually studied when it comes to travel arrangements and football, but we know from the laboratory and from real life that attractive goals frequently override self-restraint. We know that ego fatigue and now appeal, both natural processes, reduce coordination between prefrontal control systems and the motivational core of the brain (as I’ve called it). So even though addictive habits can be more deeply entrenched than many other habits, there is no clear dividing line between addiction and the repeated pursuit of other attractive goals, either in experience or in brain function. London just doesn’t do it for you anymore. It’s got to be Paris. Good food, sex, music . . . they no longer turn your crank. But cocaine sure does.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“The results are straightforward: the higher the ACE score, the more likely a person was to end up an alcoholic, drug user, food addict, or smoker (among other things). Two graphic examples are shown in Figure 3. These results show that early adverse experience predicts a 500 percent increase in the incidence of adult alcoholism and a 4,600 percent increase in the incidence of IV drug use.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“The cannabinoid receptor system matures most rapidly, not during childhood, not during adulthood, but during adolescence. So it wouldn’t be surprising if cannabinoid activity is meant to be functional during adolescence, more functional than at any other period of the lifespan. As far as evolution is concerned, adolescents might well benefit from following their own grandiose thoughts, goals, and plans. By doing so, and by ignoring the weight of evidence—or sheer inertia—piled up against them, they would greatly amplify their tendency to explore, to try things, to imbue their plans with more confidence than they deserve. The evolutionary goals of adolescents are to become independent, to make new connections, and to find new territory, new social systems, and most of all new mates. The distortions of adolescent thinking might be precisely poised to facilitate those goals.”
― Marc Lewis, Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs

“In a nutshell, serotonin gives your neurons a thick skin, so they can withstand the pace of the bristling, bustling, neural metropolis. And then along comes a tiny army of LSD molecules, marching out of their Trojan Horse—a small purple tablet—and they look just like serotonin molecules. If you were a receptor site, you wouldn’t be able to tell the difference. Through this insidious trickery, LSD molecules fool the receptors that normally suck up serotonin. They elbow serotonin out of the way and lodge themselves in these receptors instead. They do this in perceptual regions of the cortex, such as the occipital and temporal lobes, in charge of seeing and hearing, and in more cognitive zones, such as the prefrontal cortex, where conscious judgments take place. They do it in brain-stem nuclei that send their messages throughout the brain and body, felt as arousal and alertness. And once they’ve taken up their positions, Troy begins to fall. Not through force, as with the devastating blows of alcohol and dextromethorphan, but through passivity. Once encamped in their serotonin receptors, LSD molecules simply remain passive. They don’t inhibit, they don’t soothe, they don’t regulate, or filter, or modulate. They sit back with evil little grins and say, “It’s showtime! You just go ahead and fire as much as you like. You’re going to pick up a lot of channels you never got before. So have fun. And call me in about eight hours when my shift is over.”
― Marc Lewis, Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs

“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.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“neuron”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“Addicts are excessively now-oriented, more prone to delay discounting than the population average.1 But nobody knows quite why. Perhaps it’s a personality characteristic they’ve shown since childhood, putting them at greater risk of addiction to begin with.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“Bad habits self-organize like any other habits. Bad habits like addiction grow more deeply and often more quickly than other bad habits, because they result from feedback fuelled by intense desire, and because they crowd out the availability or appeal of alternative pursuits.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“The bad guys, according to Thomas and his friends, were the “straight people.” Or, if not bad, then certainly misguided. We, on the other hand, were the freaks, the people, brave explorers of the frontiers of the mind.”
― Marc Lewis, Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs

“Remember: synapses used are synapses strengthened; they are the ruts in the garden where rainwater flows, forming deeper and deeper troughs. The congealing and narrowing of synaptic traffic, crisscrossing among the OFC, the amygdala, the VTA, and the ventral striatum, leave less and less choice. There are fewer routes to take with each replay of the fundamental story line. Leading to more repetition, less flexibility; more habit, less choice. The psychological realities of diminished choice and narrowed interests—those well-known attributes of addiction—are precisely paralleled by the neural reality of reduced flexibility in synaptic traffic patterns. But here’s the thing: the brain doesn’t really parallel”
― Marc Lewis, Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs

“Brain change equals synaptic modification, and synaptic modification results from synaptic activity that is boosted by emotion, attention, and repetition.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“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.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“I’m convinced that calling addiction a disease is not only inaccurate, it’s often harmful. Harmful, first of all, to addicts themselves. While shame and guilt may be softened by the disease definition, many addicts simply don’t see themselves as ill, and being coerced into an admission that they have a disease can undermine other—sometimes highly valuable—elements of their self-image and self-esteem. Many recovering addicts find it better not to see themselves as helpless victims of a disease, and objective accounts of recovery and relapse suggest they might be right. Treatment experts and addiction counsellors often identify empowerment or self-efficacy as a necessary resource for lasting recovery.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease

“1990s—“the decade of the brain.”
― Marc Lewis, The Biology of Desire: Why Addiction Is Not a Disease