The Chemical Carousel: What Science Tells Us About Beating Addiction

by Dirk Hanson

An in-depth look at addiction science and medical treatments for drug abuse.

Genres: Nonfiction

472 pages, Paperback

First published April 12, 2009

Reviews

[Morgan Blackledge · Rating 5 out of 5]

I'm an interning psychotherapist at an addiction recovery facility. I approach addiction and recovery from a "whole person", neurobiological perspective i.e. I consider addiction to be a disease, with biological (particularly neurobiological), psychological and social factors all playing important roles in etiology and intervention. This book is a terrific primer on all of the above. I will absolutely recommend this book to my clients. It is very well written and researched. It's as informative as it is entertaining. I am personally agnostic regarding 12 step - AA and its variants. I do not coerce my clients into attending meetings or getting a sponsor. 12 step works for some and fails for others. This book covers 12 step programs in a generous light without the usual "it's the only way" dogma. Even more encouraging is the books rendering of the harm reduction philosophy/model which approaches addiction as a public health issue and focuses on reducing harmful behaviors rather than demanding abstinence or refusal of services. This is an excellent book. I highly recommend it.

[Alexis · Rating 5 out of 5]

I seem to have developed an obsession with reading books about drugs. My mom and I were talking about this, and I realized that this obsession has been there since I was 16. I started reading books about psychdelia and alternate states and counterculture, and have pretty much been very interested in these things my whole life.

"The Chemical Carousel" should be read by anyone who is interested in drugs and addiction. It's an example of excellent scientific writing. Author Dirk Hanson has struggled with his own addictions to cigarettes and alcohol and his perspective is illuminating. He really goes into the biochemical nature of addiction and what the drugs do to the brain.

He also touches on the history of the drug wars, and why abstinence education in drugs might not work for some people. I am fascinated by neuroscience, and so I was quite interested in his explanation of how drugs work on the brain.

Also, I was stunned by the similarities between the drug addicted brain and the depressed brain, and the link between addiction, depression, sleep disorders and eating disorders. There are also tons of facts in this book-

1. Cocaine used to be used for dental surgery
2. Women who are more highly educated are more likely to be alcoholic
3. There has been VERY little research done on the effects of marijuana
4. Prozac and LSD are rather similar molecules

Hanson also spends a lot of time talking about SSRIS and depression medication, which will be fascinating for anyone who has ever had to take depression meds.

The book is highly scientific, so I wouldn't recommend it to anyone who doesn't like reading words like "serotonin reuptake", "dopamine" or "hippocampus." It's still a pretty accessible read, though.

This book gives a really good explanation of the biochemical nature of addiction. Pair this up with Gabor Mate's emotional and social theories of addiction in "In the Realm of Hungry Ghosts", and you'll have a pretty good understanding of why some people get addicted to drugs while other people don't.

[Mark · Rating 4 out of 5]

This was an engaging tour of what is known about addiction, drugs, and the brain. There is a great early chapter on the prolific and troubled history of drugs and civilization that really sets the stage for the subsequent circus-like tour of common drugs and their chemical and physiological pathways. The author draws distinctions and points out similarities between some drugs, for example grouping alcohol and heroine into the same chapter while caffeine and nicotine share another. The fundamental mechanism in the brain blamed for our biological propensity to seek and reseek is the Reward Pathway circuit, which gets its own chapter, and there are chapters for the other common classes of drugs as well as an interesting short take on carbohydrate craving as addiction. The tone of the book is that of a journalist learning all he can about addiction and the brain in order to write the-book-that-will-change-his-life. You can tell he has a personal stake in understanding all of these things, though it does leave one wondering if someone a little closer to the research could have explained more thoroughly or constructed a more coherent big picture view of chemical action in the brain. But I doubt it would have been as entertaining! For a more thorough take on the science, there are a couple of others on the radar: The Science of Addiction, and Foundations in Behavioral Pharmacology.

[James Brown · Rating 5 out of 5]

I've read a lot of books on alcoholism and addiction, and this ranks high on my list as well researched, informed and an intelligent analysis of addiction.

[Robin R · Rating 5 out of 5]

I read this for a Physiology and Pharmacology of Addiction course. It is the best for class text I have ever read! It is jam-packed with information. From info on individual drugs, how the brain works, what therapeutic potential drugs have, who is developing and researching medications and how we are/need to change addiction treatment approaches. A main concept Hanson continuously reinforces is the significant evidence that supports the idea that while taking drugs is a choice, addiction is a disease. There is a point when drug abuse, leads to the brain changing. The changes occur in the same brain areas that are responsible for keeping us alive, driving us to to seek food, water, to reproduce, and fight or flee. Drug molecules impersonate our body/brain's natural chemicals, so our brains adapt as its systems are repeatedly flooded with what it thinks are too many chemical molecules.

I say, read the book and present an argument that our current /past approaches to addiction are helpful. Hanson tells us repeatedly in his book that of those who have been to treatment, of any kind, the majority still struggle maintaining long term sobriety. Incarceration doesn't seem to drive sobriety either, yet the focus is still on punishing addicts (criminal behavior needs punishment even when it is associated with drug-seeking or being under the influence); however, addiction needs treatment. Treatment that targets the biological basis that made things "go haywire" from choosing to abuse to feeling helpless against this monster of addiction. Treatment that also still includes targeting behaviors and coping mechanisms to face enviornmental triggers that lead to craving and relapse (seen in the brain changes as well). A new leaf where instead of beating them down, locking them away, we try to help people heal and return to meaningful involvement in their lives, community, etc.

This book has made me more driven to educate others and ever the field of social work with inmates with a new perspective on addiction. What are we gaining from shaming people? I can say from the addicted persons I have worked with, addicts do feel the pain of what their addiction does to their life. They hate that the severe life-altering consequences can't "wake them up", make them stop craving drugs and returning to drug use. They have very low self worth, and feel worthless and like they will never be valued again. Is this healing them? NO. Is telling them it is their fault making things change? No. Is connection to a higher power and support system enough? Rarely, every now and again someone in the beginning of addiction can be pulled back this way, but established addicts need more than that.
Most people with substance abuse disorder, need long term help maintaining sobriety, retraining their brains, combating environmentally triggered craving and relapse (a process also observed as based in the brain's maladapted circuitry). I don't say these things because I "feel bad" for those who have risked and lost it all. Due to their addiction. I say them because now I see the evidence. The evidence that addiction is a disease and needs to be treated as one: targeting biological, psychological and social/spiritual elements, for people to manage it and live successfully in spite of it.

[Nick Black]

http://cenblog.org/terra-sigillata/20...