The Science of Addiction: From Neurobiology to Treatment

by Carlton K. Erickson

Runner-up winner of the Hamilton Book Author Award, this book is a comprehensive overview of the neurobiology behind addictions. Neuroscience is clarifying the causes of compulsive alcohol and drug use––while also shedding light on what addiction is, what it is not, and how it can best be treated––in exciting and innovative ways. Current neurobiological research complements and enhances the approaches to addiction traditionally taken in social work and psychology. However, this important research is generally not presented in a forthright, jargon-free way that clearly illustrates its relevance to addiction professionals.

The Science of Addiction presents a comprehensive overview of the roles that brain function and genetics play in addiction. It explains in an easy-to-understand way changes in the terminology and characterization of addiction that are emerging based upon new neurobiological research. The author goes on to describe the neuroanatomy and function of brain reward sites, and the genetics of alcohol and other drug dependence. Chapters on the basic pharmacology of stimulants and depressants, alcohol, and other drugs illustrate the specific and unique ways in which the brain and the central nervous system interact with, and are affected by, each of these substances

Erickson discusses current and emerging treatments for chemical dependence, and how neuroscience helps us understand the way they work. The intent is to encourage an understanding of the body-mind connection. The busy clinical practitioner will find the chapter on how to read and interpret new research findings on the neurobiological basis of addiction useful and illuminating.

This book will help the almost 21.6 million Americans, and millions more worldwide, who abuse or are dependent on drugs by teaching their caregivers (or them) about the latest addiction science research. It is also intended to help addiction professionals understand the foundations and applications of neuroscience, so that they will be able to better empathize with their patients and apply the science to principles of treatment.

Genres: Addiction, Science, Psychology, Nonfiction, Counselling, Mental Health, Health

312 pages, Hardcover

First published December 1, 2006

Reviews

[Morgan Blackledge · Rating 4 out of 5]

NOTE: get the most recent 2nd Edition***

I’m a licensed therapist specializing in treatment of dual diagnosis i.e. substance use and co-occurring mental health disorders.

Additionally, I have developed and taught undergraduate and graduate level courses on addiction and treatment.

I have worked at every socio-economic strata, from skid row homeless, to teens in foster care, to working and middle class folks, to professionals including; nurses, doctors, commercial airline pilots, professors, deans of elite universities, lots and lots of high functioning, high achieving gay men, professional athletes, CEO’s and A list celebrities (in that order).

Nearly all of these clients have had depressive and anxiety related mood disorders, most of these clients had attachment and trauma related symptoms, many of them have had serious personality disorders, some have had serious brain injuries, and many of them have had serious psychotic and thought disorders.

I currently work in what is arguably the worlds best treatment facility, with an interdisciplinary team of absolutely top ranking clinicians.

I’m telling you all of this, not just because it’s hella fun to brag. But in order to lend gravity and credibility to the following statements.

In my experience, I have found that nearly everyone seeking treatment including their families and loved ones, are woefully, desperately and dangerously undereducated about alcohol and drug use, specifically it’s effects on the brain.

It takes about 1.5 hours to educate someone to a minimal level, sufficient to remove the stigma, alleviate the shame, dispel the utter confusion and significantly ameliorate the abject suffering that all but invariably accompanies this dreadfully confusing issue.

The amount of money and time that could be saved, and suffering that could be prevented, if people became educated consumers of alcohol and drugs (particularly prescription drugs) is staggering.

Nothing gives me more satisfaction in life than watching the proverbial lightbulb pop on over someone’s head when I (every so often) manage to effectively pass along this crucial, normalizing, soul mending, life saving information.

I have had dozens (less than you’d think, because people hate to read, but still a lot) of requests for an accessible, but accurate book that explains this issue.

And I’m happy to report.

This one is pretty good.

It’s intended for a general reader, but it is technical enough to be useful as an educational text for most professionals in the field.

It’s about the best one of these out there.

And I fully recommend it.

[Patricia · Rating 5 out of 5]

Well into this book, which took me two months to read, I found a quote which describes exactly what the book meant to me: "The chances are that readers of this book have been so severely affected by drug problems in their family or in society that they will want to find ways to help those in need or those they love. An accurate understanding of what drugs do and what they don't do, as well as what Addiction is what it is not, is therefore critical to overcoming drug problems."(pg 242)

I definitely chose to read this book because my need to understand the problem was hugely personal. Erickson does a fine job of surveying the literature and bringing it all together in clear, understandable prose. I've read about the neurology before, but he's explanations definitely helped clarify what is going on in the brain with each different drug. He points out what is known and what is not known and carefully lists the direction research is going and why. I appreciate that he distinguishes between addiction (with a small a) and Addiction (with a capital A), and that he updates terminology, underlining the usefulness and correctness of the current term Substance Use Disorder (SUD). The people I know and love have SUD; they are not addicts, a term generally used in a judgmental, if not pejorative sense.

I was encouraged by his description of therapeutical approaches such a Medicine Assisted Treatment (MAT) and especially Motivational Interviewing (MI), which seems like an extremely positive and compassionate psychotherapy for those with SUD. I highlighted this comment: "counseling and medications do not correct (as in repair or fix) the brain dysregulation; instead they 'push your neurochemistry' back toward normal so that patients have a better chance of feeling better (less depressed, less anxious, less drug craving.)

There is nothing easy about recovering from SUD. I think a lot of us could benefit from a greater understanding about the complexities of why some people have this disorder and the incredible challenge of coming back from the ravages of SUD. I don't anticipate a lot of people will read this book, but I'm glad it's available to those who want to know more. It's an excellent resource.

[Brad Acker · Rating 5 out of 5]

Carlton Erickson provides a neuroscientific overview of the roles that brain functions and genetics play in causing addiction. My belief is that it is critical for the addict to understand what is going on inside his brain to cause his addiction so he can best develop a plan to mitigate and eventually kill the addictive impulse.

[Healthypedia · Rating 4 out of 5]

This book provides a comprehensive exploration of addiction, drawing on neuroscience, genetics, and pharmacology to shed light on the complex nature of substance abuse.

Every year, addiction and substance abuse take a heavy toll globally. Alcohol alone is responsible for 5.3% of annual deaths worldwide, affecting 1 in every 20 people, with around 300 million individuals grappling with alcohol use disorders. This review delves into a book The Science of Addiction by Carlton K. Erickson, which addresses these pressing issues, examining its insights and research in the fight against addiction. Join us as we explore this informative book’s quest to uncover addiction’s complexities and offer valuable knowledge to combat this global problem.


Author’s background

Carlton K. Erickson, Ph.D., holds the esteemed position of Professor of Pharmacology/Toxicology and serves as the Associate Dean overseeing Research and Graduate Studies.

He leads the Addiction Science Research and Education Center within the College of Pharmacy at the University of Texas at Austin and is also an associate editor for the scholarly publication Alcoholism: Clinical and Experimental Research.


What is the book about?

The Science of Addiction by Carlton K. Erickson is a pioneering exploration into the evolving world of addiction science. This book brings exciting news to the forefront, revealing the pivotal roles of neuroscience and genetics in shedding light on the complex causes of compulsive alcohol and drug use.

Erickson delves into the burgeoning body of evidence indicating that certain individuals, though not all, grappling with excessive alcohol or drug consumption are afflicted by a challenging brain disease that proves resistant to treatment. Notably, this classification does not encompass everyone colloquially labelled as an addict, as the majority of drug users do not exhibit the characteristics of compulsive drug use disorder.

The book covers the following topics:

• What is addiction
• Brain disease aspect of addiction
• Medical diagnosis of addiction
• Neural mechanisms underlying addiction
• Genetic underpinnings of addiction
• Pharmacology of stimulants and depressants
• Pharmacological aspects of alcohol addiction
• Strategies for addiction treatment and addressing drug overuse problems

With The Science of Addiction, readers embark on a comprehensive journey into the intricate world of addiction, benefiting from the latest scientific insights, research, and perspectives on this complex issue.


Three key takeaways from The Science of Addiction

1. Addiction can potentially be considered a brain disease

One of the key takeaways from Carlton K. Erickson’s book, The Science of Addiction, is the compelling argument that addiction is, indeed, a chronic, medical brain disease. This assertion is substantiated by extensive research in genetics, neurobiology, and pharmacology, providing a clear understanding of the condition’s biological basis. Erickson emphasises the significance of pinpointing the specific brain area, the mesolimbic dopamine system (MDS), where addiction occurs. This knowledge not only aids in diagnosis but also alleviates the shame, guilt, and denial often experienced by individuals struggling with addiction, fostering a more compassionate and effective approach to treatment.

Moreover, the book draws parallels between addiction and established medical diseases, highlighting the similarities in characteristics and the need for a unified perspective. The comparison reveals that addiction possesses the hallmarks of a chronic, relapsing, medical brain disease, warranting the same attention, care, and treatment as other well-accepted medical conditions. Erickson’s comprehensive exploration challenges misconceptions, encourages open-mindedness and ultimately empowers readers to make informed judgments about the nature of addiction.

2. Genes do play a role in addiction susceptibility, but they are not the sole determinants

Each person’s unique genotype, resulting from a combination of specific alleles, influences their predisposition to various characteristics, including addiction susceptibility. The interplay between genetics and environmental factors, such as lifestyle and exposure to substances, further complicates the genetic landscape of addiction.

Genetic studies, like the Collaborative Studies on the Genetics of Alcoholism (COGA), have made significant progress in identifying the genetic components of alcoholism and related phenotypes. These studies demonstrate that addiction is a polygenic disease influenced by multiple genes, with some individuals inheriting a greater number of addiction-related genes than others. The intricate relationship between genes, environmental factors, and addiction susceptibility underscores the multifaceted nature of this complex disorder.

3. Alcohol – the most popular drug

The book provides a comprehensive examination of the effects of alcohol on the brain and body and reveals the profound impact of heavy and prolonged drinking on nervous system function and overall health. While moderate alcohol consumption may not be highly toxic to the body, chronic and excessive use can lead to a range of severe consequences. Notably, the book underscores the long-term damage alcohol inflicts on the brain, as demonstrated through MRI studies revealing structural changes and volume reductions in critical brain regions. Additionally, it emphasises the role of metabolism, toxic breakdown products like acetaldehyde, and the variation in individual responses to alcohol in determining its effects. As a whole, the book provides a crucial resource for understanding the intricate relationship between alcohol and the human body, shedding light on the potential consequences of excessive drinking and the importance of responsible alcohol consumption.


Strengths and weaknesses, according to readers’ reviews

Strengths:
• Carleton Erickson demonstrates a remarkable balance of expertise in the field of addiction, offering well-reasoned evidence and addressing objections effectively.
• Offers a unique emphasis on the neurobiological and physiological aspects of addiction, making it stand out as an informative resource.

Weaknesses:
• Some readers may find the scientific terminology difficult to grasp initially, requiring additional research and exploration of terms to fully understand the content.
• Despite being informative, the book lacks sufficient practical guidance for those seeking insights into addiction treatment strategies.


Best quotes from The Science of Addiction

“The chances are that readers of this book have been so severely affected by drug problems in their family or in society that they will want to find ways to help those in need or those they love. An accurate understanding of what drugs do and what they don't do, as well as what Addiction is what it is not, is therefore critical to overcoming drug problems.”

“People often wonder how alcohol can be a legal, socially accepted drug when most other mood-altering drugs are illegal to possess, sell, or use. Alcohol’s use is historical, and to prohibit its sale and use would break established cultural, religious, and social traditions, as well as cause significant federal and state tax-revenue losses.”

“Research shows that alcohol can cause permanent problems with nervous system function. We know that people who drink heavily over a prolonged period may have memory loss, confusion, and often problems with feelings and sensations in their hands and feet.”


Final takeaway

The Science of Addiction by Carlton K. Erickson offers a pioneering and comprehensive exploration into the intricate world of addiction. With a focus on the roles of neuroscience and genetics in understanding addiction, Erickson presents compelling arguments that addiction can be considered a chronic brain disease, emphasising its biological basis within the mesolimbic dopamine system. The book challenges misconceptions and fosters a compassionate approach to treatment. It also highlights the interplay between genetics and environmental factors in addiction susceptibility and provides valuable insights into the effects of alcohol on the brain and body.

While some readers may find the scientific terminology challenging and seek more practical treatment guidance, this book is an essential read for those looking to gain a deep understanding of addiction’s complex nature, making it particularly valuable for healthcare professionals, researchers, and anyone affected by addiction in their lives.

[Katrice · Rating 3 out of 5]

This was a good book and provides readers with useful information abt chemical dependency. However, at times was extremely wordy and I would get lost in the neurology jargon. Nonetheless, after doing further exploration of certain terms everything was cool. This is a good tool to have in your professional library. An updated version will be great!

[Chuck · Rating 5 out of 5]

Unequivocally THE book to read on Addiction (No, I intended to use "A" with Addiction. Read the book for the rationale). Carleton Erickson does not disappoint. I respected his balance and expertise before reading this edition, but he surpassed himself. He answered several objections I had with reasoned evidence. Hands down—the best discussion of Addiction.

[James G. · Rating 4 out of 5]

As a substance abuse counselor, I learned a lot about the science of addiction in this book. Again, as a substance abuse counselor with a bachelors degree and not a PhD, i found the book hard to follow at times because of all the scientific words. Author does a great job promoting the opioid epidemic and how SUDS needs to be more researched, funded, and trained. Good book.

[Kaspar Kl · Rating 5 out of 5]

I usually don't leave reviews or use goodreads that often but just had to say that this was the best book on addiction for me yet, I loved the neurobiological/physiological side of it, learned many new things. And I work in complete different field.

[Oliver Morgan · Rating 4 out of 5]

Good informative book on addiction from a pharmacist.

[Lauren ₊⋆·˚‧₊ · Rating 5 out of 5]

Very interesting and useful to get a clinical view of things to understand the Addicts in my own life.

[Monica Willyard Moen · Rating 4 out of 5]

This is not a self-help book in the strictest sense of the word. Rather, it is a book written from a pharmacological point of you about what we know of addiction, it’s causes, and its treatment. The focus is on what we know from scientific studies, neuroscience investigations, and clinical trials of medications that affect addiction in one way or another. This book has little to say about family origin, social environments, or psychological causes of addiction. It does discuss subjects like genetics, how drugs and alcohol interact with the brain and nerves, and how treatments actually work in the brain and the rest of the body.
The focus of this book is on the major addictions, meaning drugs, alcohol, and gambling. These are areas where there are a significant number of studies and experimental work with the brain to understand how these addictions work and what we might do to relieve them. The author is also careful two separate true chemical addiction from those who casually miss use or abuse drugs and alcohol. He posits that there is a small subgroup of drug abusers who are chemically and physically dependent and whose Brain regulation or dysregulation drives their craving for their drug of choice. These are people who are resistant to 12 step recovery, talk therapy, and other softer methods. The author seems to believe that we can develop medications targeting the receptors in the brain of such individuals to help them kick their drug habit for good. It is possible that as we understand more about genetics, we will be able to target specific genes that cause poor regulation of moods in the brain. For now, we must content ourselves with targeting specific neurotransmitters to regulate mood and curb cravings.

[Sean · Rating 3 out of 5]

Make no mistake this book is first and foremost about the SCIENCE of addiction. Do not read this book if you are looking on how to treat or interact with clients who have a history of drug/alcohol misuse. The author presumes that the reader is familiar with brain chemistry and anatomy, and spends a lot of time talking about DNA and RNA sequences. However, where this book disappoints is that is brushes over the specifics of and symptoms of long term drug and alcohol misuse. For example, with alcohol the author fails to detail what copious alcohol consumption does to the corpus collosum or the CNS. It lists of symptoms, without explaining the hows and whys. There are other more comprehensive books on the subject.

[Karla · Rating 4 out of 5]

I really enjoyed the information this text provided. I could have lived without the first chapter and the chapter on brain imaging. The rest was incredibly informative. The appendices were excellent as well. I would highly recommend this book to anyone interested in the neurological effects of drugs. The text describes the different drugs available, their effects on the body as well as the differences between them.

[Amber · Rating 4 out of 5]

"...never trust a junkie..."
But seriously, so far this book is a good read. Science, whodathunkit, actually has insight about neurobiology and its interreaction with behavior.

[Morgan Blackledge · Rating 4 out of 5]

A concise, clear introduction to the neuroscience of addiction. This is a darn good book. Read it.

[Sarah · Rating 3 out of 5]

Very heavy on the science and light on practical treatment

[Abdelrahman · Rating 5 out of 5]

Great read. It strikes the right balance between being too simplistic or too complex for a layperson. Even as someone who studied psychology and is currently a medical student, I found this book very informative and interesting. It gave me a well-rounded view of chemical dependence, including its neural basis, social issues associated with it, and treatment methods. I would recommend it as a starter for anyone interested in this field.