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The Biology of Desire: Why Addiction Is Not a Disease

4.06  ·  Rating details ·  1,100 ratings  ·  125 reviews
Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the "disease model" of addiction is wrong and illuminates the path to recovery.

The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease. But in The Biology of Desire, cognitive neuroscientist and
Hardcover, 256 pages
Published July 14th 2015 by PublicAffairs (first published May 26th 2015)
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Brenda -Traveling Sister
Feb 12, 2017 rated it it was amazing
I found The Biology of Desire to be a powerful, enlightening and interesting read that gave me a good understanding of addiction, how the brain works, why it changes and why addiction should not be considered a disease. Marc Lewis helped me understand what can work to overcome addiction.

I followed this book after reading his book Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs.

I highly recommend both for readers who have a passion or interest in understanding
Morgan Blackledge
Jul 26, 2015 rated it really liked it  ·  review of another edition
When it comes to addiction. It seems like everyone has a different (deeply held, strongly defended) opinion.

Religious people call it a moral failing and they say we just need to pray to Jesus more.

Conservatives call it a failure of willpower. They tell us to "Just say no" and to "DARE" to abstain.

Liberals tell us it's a symptom of social inequities. They tell us we need to provide the urban poor with equal access to healthcare and human services.

AA people tell us it's a spiritual disease and
Aug 08, 2015 rated it really liked it  ·  review of another edition
The strength of this book lies in how well it ties various strands together - it is part introduction to neuroscience, part polemic and part compelling storytelling. Lewis fails at none of these things, does all of them very well, and if he fails to be truly great at any of them, it hardly seems worth a complaint. Except of course, that there are glimpses that he could be really great, and I haven't read a punch-the-air-great book in months... so basically, I want him to write more.
My interest
Peter (Pete) Mcloughlin
Whether addiction can be explained via the medical model or via the learning theory model is a matter of theoretical dispute. When that happens we need data. What kinds of recovery interventions work. I liked the author's stories of addiction and his defense of learning theory but at this time when the theories are in dispute (medical model or learning model), we need data on recovery and what works. I would love to see that. A little evidence-based research on what works for recovering addicts ...more
Sarah Whitney
Sep 06, 2017 rated it really liked it

The debate may hinge on the issue of control. If you don't have control over your substance use, then you have a disease, and if you do have control (but aren't using it), then addiction is a choice. The leak in the logic is the assumption that choice is a deliberate, rational function we can apply at will. But choice is nearly always irrational - which is only to say that it is executed by the same brain that gives rise to hope, need, fear, and uncertainty, a
Feb 05, 2017 rated it it was amazing
This is an absolutely fascinating book. As a mental health professional, I’ve always been a little uncomfortable with the push to identify addiction as a disease. There are clearly benefits to doing so; insurance companies are more likely to offer coverage for medical conditions as opposed to behavioral health conditions, for instance. The disease model also offers relief from stigma and feelings of moral/character failure on the part of the person struggling with addiction, which is often quite ...more
Muhammad Hazem
Oct 21, 2016 rated it really liked it
Recommended to Muhammad by: Farouk Kadous
The biology of desire is a powerfully scientific book that tackles the mainstream notion of addiction being a disease in a very interesting sense. The author presents a solid case of how addiction works, using captivating narratives of addicts, eloquently illustrating their suffering while shedding a spotlight on the underlying reasons using neuroscience.

The book is not for those who are seeking recovery, in my opinion, but for those who want to gain a solid understanding of a globally
Shaun Shelly
Jul 16, 2015 rated it it was amazing
This book is really amazing. Marc Lewis combines the narrative experience of "addiction" and the neuroscience and explains in a very accessible manner why addiction is not a disease. This is one of the few books on addiction that is both accessible and robust in terms of the science. Marc Lewis also explains what is needed to best assist those with problematic drug use. A must read for anyone interested in addiction.
michelle lise
OMG... Discovering that this is coming out in 2015 has just completely made my day. Maybe even my year. It goes without saying that I am very excited for this! I don't know how I'm gonna wait for the release date to arrive. Marc Lewis rules.
Ammara Abid
Jan 15, 2016 rated it really liked it
I read this book in dribs and drabs as I'm not into neuroscience but finally I did. yayyyy Coming to the book it is Interesting, informative, time-consuming and mind swirling ( just kidding,,, no, no, I'm serious, for me it is) first 40 pages are hard for me, the starting wasn't impact full at all. But as the book progressed it became interesting. Apart from the neurological mechanisms what makes this book worth reading is the relationship of the addicts Natalie, Brian, Donna, Jhonny & Alice ...more
Jul 25, 2015 rated it it was amazing
Other than Addiction: A Disorder of Choice, the best book on addiction I've read and one that convincingly argues that it is not a disease from a neurological and scientific basis.
Scribe Publications
A courageous and much needed voice in rethinking addiction — Lewis takes addiction out of a disease model and reframes it as a negative outcome of neuroplasticity. This model provides realistic hope, given that what has been learnt can be unlearnt by harnessing the principles of neuroplasticity. Through his intimate personal and professional knowledge of addiction, Lewis reframes our understanding of its mechanisms and nature in a way that is empowering.
Barbara Arrowsmith-Young, Author of the
Edward Taylor
May 26, 2019 rated it it was amazing
Shelves: faves, psychology
As a person recovering from an opioid-based addition, I always found it interesting to see what people think of the issues I was facing at the time of my darkest moments. I had been crippled and partially paralyzed by a spinal cord injury, I was living with an undiagnosed case of major depressive disorder and PTSD from both my military career and years of child abuse at the hands of my parents. My issues, though products of my environment were my own and I never blamed anyone else because of ...more
Scott Wozniak
Sep 08, 2018 rated it really liked it
This is an excellent book on what's happening in the brain during addiction. The author is good at explaining the complex brain science to non-scientists. What I liked most was how he deliberately intertwined the personal experiences from therapy with the chemical/biological factors. Most people are one or the other, ignoring the other field.

To be clear, it's not a book on how to help addicts break free, but there are some thought provoking examples of others who are doing good work in this
Cassie Pearson
May 13, 2018 rated it it was amazing  ·  review of another edition
Admittedly, my praise for this book comes partly from the relief at finding someone in the field who holds similar views to my own, and partly from a joy of interconnectedness and understanding for the people who have shared their anecdotes within.
The stories are well-told, the science well-explained, and the whole work is simultaneously accessible and enlightening. Highly recommend to anyone who has struggled with addiction/eating disorders personally or who knows someone who has. It will,
Jun 16, 2017 rated it liked it
Marc Lewis is not the greatest writer, but he is intelligent and has passion for the subject. You can tell like he just really, really wanted to find a way to express a few good ideas in the long form of a book, and he does so through some decent but slightly contrived case studies. Fairly typical for a Phd who is likely more used to annotating research papers. He does well to include his knowledge of neuroscience, and doesn’t belabor his own experience with addiction -which he has a whole other ...more
Jamie HB
May 24, 2016 rated it really liked it
This book stresses that if you truly want to understand addiction, it is important not to treat or think of it as a disease. I really like this book because it includes a number of full chapters about individuals' experiences with addiction that are very insightful, and give the reader an idea of the difference between use and abuse by examining the different phases/stages that people go through. The author also talks about how the same treatment methods don't work for everyone. Some addicts ...more
Aug 16, 2015 rated it really liked it
I felt that this book was very optimistic and gave a deeply scientific view of what goes on in the brain at the onset of an addiction and how close it is to falling in love or pursuing a goal. However, I would have liked to see more on physiological addiction and withdrawal and how it affects the brain. While he explores why someone may start doing heroin he does not touch upon how much of continued use is compulsion and how much of it is physical addiction, if there is even a difference. I ...more
Sean Rosensteel
Oct 11, 2019 rated it really liked it
A special thanks to Carly Benson from Miracles Are Brewing for sharing this read with me. My three big takeaways include:

1. Addiction is not a disease

2. Brain change is a consequence of learning

3. Quitting is a continuation of development

Please visit my blog for a more in-depth look at these takeaways.
Lisa Kirwan
Nov 07, 2015 rated it it was amazing
Excellent book. The author manages to take an objective look at the physiology of addiction and explain it in plain language while humanizing his work with case studies -- without getting hung up on the politics and morality of addiction. Very informative explanations of why addiction happens and perspective on the changes that need to be made to overcome an addiction.
John Howlett
Sep 30, 2015 rated it it was ok
I got the recommendation for this book from "The Week" magazine. I agree with the premise 100%, but stating the case doesn't require a book, a magazine article would have sufficed. Half the book is stories of people falling into and rising out of addiction that I found of little use.
Simon Kidd
Jan 28, 2017 rated it it was amazing  ·  review of another edition
Shelves: addiction
I wrote a lengthy 'review essay' for this book on my blog. It's too long to post on Goodreads, but can be seen here:
Kathy Fish
An amazing look at how our intricate our brains are and why we make the choices we do.
Aug 13, 2015 rated it did not like it
Five people is hardly a disease model.
Joshua Kong
Feb 25, 2019 rated it it was amazing
The most comprehensive and logical explanation of addiction I have yet encountered. After struggling with drug addiction and undergoing a behavioral modification program in county jail, this book has confirmed my suspicions about the dubious nature of the disease model of addiction. The book argues that addiction as a disease model is a oversimplification and at worse a misinterpretation of the research on neuroplasticity. One of the main reasons he believes that the disease model is incorrect ...more
Travis Lupick
May 19, 2017 rated it really liked it
Shelves: drugs-addiction
This is not a review but is based on an interview I had with the author. It was originally published in the Georgia Straight newspaper.
It has been very useful for western society to classify addiction as a disease, according to Marc Lewis, a Toronto neuroscientist. That has let drug users understand their cravings as something that can be dealt with within existing health-care systems. It has also allowed doctors to treat addiction with pharmaceutical tools like methadone and permitted
Sep 17, 2015 rated it it was amazing
Professor Marc Lewis initially captivated my attention with his TED talk where he told his story of recovered opioid addict becoming professor of neuroscience. His path to recovery and advises that he provided to addicts were substantial different from paradigms employed by “faith-based” organizations, such as AA and NA. Later, I’ve read his article in which he argued that addiction is not a disease. This view is different from position take by mainstream addiction researchers, NIDA and rehabs ...more
Franks V.
Oct 27, 2017 rated it it was amazing

Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the "disease model" of addiction is wrong and illuminates the path to recovery.

The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease, based on evidence that brains change with drug use. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that addiction is not a

Jan 14, 2020 rated it it was amazing
The disease model of addiction has felt to many of us like the most compassionate way to make sense of an impossible situation, but what are the side-effects of labeling it so? This problem is big and nuanced and the author approaches it with large research studies and specific case studies to make the lessons memorable.

"Temperance activists saw alcohol itself as the cause of alcoholism much like contemporary disease theorists see drugs rather than environments as the cause of drug addiction."

Amy C.
I loved every word, sentence, paragraph and page of this book! For anyone who struggles with addiction of any kind or for anyone working in the addiction or recovery sphere, this book is essential. It challenges and compellingly argues that the disease model of addiction is inaccurate, outdated and no longer serves its purpose (beyond pharmaceuticals used to ease withdrawal symptoms and cravings, which have an essential utility). This book is heavy in neuroscience (which I loved!) and uses this ...more
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12 Step & Recover...: New book challenges dogma in addiction/recovery 1 8 Aug 18, 2015 09:14AM  
A must read for those interested in Addiction 1 4 Jul 16, 2015 01:47PM  

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Marc Lewis is a neuroscientist and professor of developmental psychology, recently at the University of Toronto, where he taught and conducted research from 1989 to 2010, and presently at Radboud University in the Netherlands. He is the author or co-author of over 50 journal publications in psychology and neuroscience, editor of an academic book on developmental psychology, and co-author of a book ...more
“Instead of recovering, it seems that addicts keep growing, as does anyone who overcomes their difficulties through deliberation and insight.” 4 likes
“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.” 2 likes
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