Why Our Brains Are Prone to Addiction -- A Neuroscientist Explains
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Memoirs of an Addicted Brain may be the most original and illuminating addiction memoir since Thomas De Quincey's seminal Confessions of an Opium Eater. What makes it such a standout from the genre's overflow of self-indulgent mediocrities isn’t merely its supple intelligence and subtle style but the unique perspective of the author. From the age of 15 until his recovery at 30, Marc Lewis spent most of his waking life under the influence of every drug he could get his hands on, developing an extreme addiction that cost him everything but his life. Once clean, he found his vocation as a neuroscientist, focusing on the drug-based brain changes driving cravings and relapse.
Lewis’ twin expertise as a longtime addict and a brain scientist enabled him to producea memoir mapping, in remarkably lucid and vivid detail, entirely new ground. Weaving together his objective accounts of drugs' effects on the brain with descriptions of his mind's subjective experience, he brings to light how the very shape of intoxication on one substance or another provides mirrors the shape of the specific chemical reactions taking place inside your skull.
These pioneering observations fit effortlessly into the overall narrative, which is as over-the-top suspenseful as David Carr’s classic The Night of the Gun. From alienated adolescent introduced to alcohol and marijuana in a Machiavellian prep school, Lewis makes the leap to college at Berkeley in 1968 at the peak of psychedelia; never one to moderate, he gobbles hallucinogens by the handful and then moves on to shooting heroin, barely escaping death by OD.
His early 20s find him backpacking through Southern Asia, sniffing nitrous oxide in the jungle, buying heroin hot off the factory line and paying nightly visits to opium dens (read excerpt). Back home in Toronto, he marries badly and begins stealing opiates from the science labs and medical centers where he is earning a PhD in psychology. Easily outfoxing the experts he works with, he has years in which to perfect his criminality and deepen his addiction until he is busted and sentenced to recovery. But as his marriage unravels, he relapses, injecting oxycodone and methamphetamine on a daily basis while working at a psychiatric hospital.
At age 30, facing the possibility of a long prison sentence, he finally finds the endless road of recovery and begins to rebuild his life.
For all its braininess and pain, Memoirs of an Addicted Brain is also seriously funny.
With this electrifying debut amidst rave reviews, Lewis is finding himself much in demand, a new (and somewhat unsettling) situation for someone who is after not celebrity but truth. He recently started his own thought-provoking blog, memoirsofanaddictedbrain.com, which already has a large following, and he has also signed on as a regular blogger at Psychology Today.
He spoke to The Fix from The Netherlands, where he teaches at Radboud University. —Walter Armstrong
The Fix: You titled your book Memoirs of an Addicted Brain—not an “addicted mind”?
Marc Lewis: I call it brain rather than mind because I wanted to focus on how drugs affect the mechanisms of the brain to establish an addiction. But I also wanted to describe what takes place in the mind, the shape of the subjective experience of being on a particular drug, since each one gives a different experience—and I spent time on all of them.
But in the end, the mind and the brain are interdependent, and your own personal subjectivity and the objective transformations in your brain are deeply interconnected. The brain gets “caught up” in the experience of the specific drug in a way that mirrors what happens to your mind.
I also wanted to tell a good story to the best of my ability—a narrative about my experience, my escalating drug use, and the extremes that I went to.
You describe your drug experiences, starting with alcohol, moving on to marijuana, hallucinogens, opiates, meth, etc., in remarkably precise and colorful detail. Did you keep a journal during all those years that you were then able to use when writing the book?
I kept journals from the age of 17. I have stacks and stacks of them. I got very involved in trying to describe the experience of being on these drugs. I would try to do it while I was taking them, and when that become impossible because of the actual effects I was experiencing, I would write about the experience afterward. But the journals are filled with all different aspects of my experience of addiction, as that came to define my life in my 20s, during the entire decade of the ‘70s.
I wrote even more about trying to psych myself up to stop using them or get my use under control.
In each chapter, with each drug, you move from a description of your subjective experience to an equally vivid account of what is taking place in your brain. You write, “The psychological realities are precisely paralleled by the neural realities.” Have you faced any pushback from researchers who say that the parallel is not so neat?
My theories are generally in the mainstream of addiction science. I did a lot of research before I wrote the memoir. I spoke to many experts. I wanted to be able to represent the best thinking about how each drug works in the brain. The only parts where I went off on my own were in some of the modeling, for example, when I hypothesize about the internal voices we have in our minds and how this internal dialog may be caused on a neurobiological level.
I also wanted to reach the common reader who may be dealing with addiction either firsthand or not, and communicate the science in as compelling a way as possible.
Many addict memoirs look back in condemnation and often some voyeuristic bravado. You write about the drug experience and your former selves in a sympathetic, largely nonjudgmental way, acknowledging that you did some truly crazy, criminal things in order to feed your habit.
I have always had a reflective, analytical nature. I am as driven to explain experience as I am to have the experience. So I took that into my addiction and also into my writing.
But drugs are so powerful and fascinating, so outside the bounds of normal, everyday life, that the experience just floored me. And I wanted to record that. It’s very hard to capture in the moment what a drug experience is like. So many of the effects are novel but fleeting. I wanted to hold onto the images that were vanishing before my eyes as long as I could.
Your memoir starts when you are 15 and shipped off to an all-male military-type school where you were miserable, to put it mildly. Do you think that if your parents had allowed you to leave school and come home, your life, and your addiction, would have been better?
Yes, I do. The school was a very dark place, with constant bullying and hazing. For a bookish, Jewish Canadian boy like me to be dropped into a kind of Lord of the Flies environment, with American Navy traditions and discipline, was such a radical change that I fell into a reactive depression that last for the entire two years. I had been a relatively happy teenager until then.
I very well may have gone on to have problems with drugs, but I doubt whether I would have developed an extreme addiction if I had not had that depression at such an impressionable age.
As a neuroscientist, I now recognize that a long, deep depression can have a very negative impact on the developing teenage brain. Also, that age is a pivot point in life, when a child is becoming an adult, forming his or her own identity and a strategy for dealing with the world. And what I was learning was that I did not know how to deal with the world. I was alienated and isolated.
After you graduated, you went to college at Berkeley just as the Bay Area was becoming the world capital of the countercultural revolution. Drugs were a routine part of everyday life. You moved quickly into hallucinogens and then into heroin. In fact, you OD’d on heroin when you were 20 and almost died. After that, some people would swear off drugs for good, but not you. Why?
I was so young that I actually felt more shame than fear. I couldn’t believe that I had been so stupid as to almost kill myself for the sake of getting high. But I did take one precaution after that—I stopped using needles. Shooting up was on my “forbidden” list. Of course, over time my forbidden list kept getting winnowed down, and a few years later, when I was traveling in Asia, I was shooting heroin and methamphetamine again. And in the last year or so of my addiction, I was shooting almost everything.
Some people would say that you were trying to kill yourself.
I was certainly taking serious risks that I often did not have control over, but I don’t think I was trying to kill myself at all. At the end, I was in a state of disassociation, I was impulsive, and I wanted immediate gratification. I was not able to realistically weigh the benefits against the costs for my present or my future. This is the way children think at about age four or five. It is also the way people in end-stage addiction think.
Many researchers believe that some people are “born” addicts, due to a combination of genetics, early environment, etc. Yet you make little mention of genes or heredity in your book. Why?
One reason is that genetics is not my expertise. But I also have doubts about what it can really tell us about addiction that is useful. It seems clear to me that there is no such thing as a single addiction gene. Addiction is far too complex a behavior to be reduced to the expression of one gene, or even a group of genes, that science might someday be able to turn off. Addiction is not a physical disease like cancer in which a fairly clear line can often be drawn between genetic mutations and disease development.
It’s true, however, that certain kinds of addiction run in families. But there, I think, it has more to do with the underlying causes of—or orientations to—addiction, such as impulsivity. And we do absorb through early experience the fuckups of our parents, and if alcoholism, say, is a major source of dysfunction in your family, you’re going to be deeply influenced by it one way or another.
On the subject of early development, do you look at your dependence on drugs as an effort, however inadequate, to solve certain psychological problems?
Taking drugs, particularly opiates, was for me about taking in something warm and safe that I had control over and that no one could take away from me. In that respect, I was dealing with certain early issues involving my relationship to my parents. My father was a busy doctor who was often uncommunicative and absent, and my mother was impulsive, kind of wacky. I was drawn to opiates because they can make the world seem like a secure place.
In the classic narrative of addiction and recovery, “hitting bottom” plays a pivotal role—getting to a point when life on drugs becomes unbearable. In what ways was that true for you?
I certainly did hit bottom, many times! The story I tell in my book can seem like one of going from bottom to bottom—not simply overdosing but stealing drugs, getting arrested, shooting up methamphetamine for days at a time while trying to hold down a job at a psychiatric facility. Unfortunately, I was quite adept at hiding my drug use, and I also had a high tolerance for the negative consequences.
Why do you think you were eventually able to stop using drugs? Can you explain it scientifically?
It’s very hard to analyze what takes place in the brain to enable quitting to stick. For one thing, it is a development that is probably unique to each person and their own capacities for self-regulation. The closest I can come to describing it is with metaphor, such as a switch being flipped, or a pivot point being reached.
My own recovery was partly based on how terrible I eventually came to feel when I was on drugs. Whatever rewards that being high had once had were no longer available. Being so immersed in constant drug taking became associated with so many awful feelings that it was a far worse experience than anything sobriety had to offer.
You do not mention going to AA or any other 12-step program as part of your recovery. Did you ever attend a meeting?
The more I become an “addiction personality”—with my book, my speaking, my blog—the more I come to appreciate what stormy political waters talking about AA can land me in. All I can say is that I was not attracted to the idea of working my problems out in a group setting. I had already done two relatively short stints in therapy, and these did not help me quit, and I think I was convinced that my recovery was going to come from me alone or not at all.
I stopped using in 1981, and I was living in Toronto, and AA and other 12-step programs were not the ubiquitous presence that they are now. It wasn’t like I was talking about my drug problems and the immediate response from other people was, "Go to AA or NA." In fact, I very rarely talked to anyone at all about my drug problems. After college, my drug use was mainly a solitary act. I went to graduate school and I went to work often on some combination of drugs, but I took pride in the fact that I could get away with it. Almost no one knew the trouble I was in.
You appear to have been drawn to meditation with a curiosity about your mind similar to the way you were drawn to experimenting with drugs. Did you use meditation to help recover from drug use?
Meditation, like drugs, was very much a part of the culture when I was coming of age, and it also involved entering a certain mental state that I could observe myself experiencing. But meditation didn’t work for me as a way to deal with the problems that were driving me to do drugs, though it may have proved helpful in extending the periods of time when I was trying not to use drugs.
I am much more disciplined about meditation now than I was then. I do what’s called insight meditation. I find it very helpful—it is centering, I feel at peace, I can suck in all those spurts of negative emotion better.
You write about the toxicity of addiction and its effect on the brain, which you refer to as “the unique fatalism of plasticity lost”? What do you mean?
By toxicity, I mean not the toxins and other harmful properties in the drug itself but the toxic consequences it has for brain mechanisms due to the simple fact that it has a direct, unmediated effect. Alcohol and drugs cause a kind of supercharged addiction, at least compared to addictions associated with sex or gambling.
Drugs cause your brain to lose its plasticity in that the many synaptic pathways that have been laid down for a wide range of goal-seeking behavior converge on the one goal of getting high. You reduce the multiplicity of rewards to one synaptic configuration, and this becomes a progressive feedback loop that entrenches itself. Addicts struggle like crazy to escape from this “unique fatalism of plasticity lost”—they struggle much harder than people who don’t go through this could ever imagine—and many of them succeed and do recover.
You also write, “Addiction is just a corrupted form on learning.” Could you expand on that?
There is a debate about what addiction is: Is it a disease? Is it a choice? I view it as an accelerated process of learning, and I think using learning as the metaphor to understand it can be very useful. It uses all the same brain mechanisms as learning—from the most fundamental to the most advanced—but whereas learning has a shape to it, and it leads somewhere, addiction sets in motion a learning process that leads nowhere. It is just self-reinforcing with no object but itself.
What are the permanent “scars”—if any—on your brain and your mind as a result of your years of drug use?
I don’t think I have any permanent damage because the brain has a remarkable ability to repair itself. But there was psychological damage, at least in the sense that after a few years, I got into a second marriage for the wrong reasons—because I was carrying a burden of guilt about having been addicted for so long and wanted to compensate by becoming a “responsible” person.
How do you now incorporate that period of drug use into who you are today? What are the costs and benefits?
I don’t like to think of my years of addiction as a waste. During those 10 or 12 years I wasn’t only doing drugs—I explored life, I traveled, I studied and worked, sometimes successfully, other times not so much. Anyway I built up my mental muscle because given that I was doing my best to function at a fairly high level while on lots of drugs, the mountain I had to climb every day was a lot higher than most mountains. That helped me to know my own strengths and weaknesses.
I also think I am a more wide open person—maybe “blown open” would be more accurate—than many people. I am not very judgmental, I listen to other people, and I don’t expect them to be a certain way.
You still drink alcohol. How are you able to moderate your use?
Actually I’m looking forward to having a scotch as soon as we conclude the interview since it’s 9 pm here in the Netherlands!
For the first 20 years of my recovery I did not drink, but when I met the woman I am now happily married to, I started to drink moderately with her—wine at dinner and so forth—and have really had no problem with it.
Being drunk is not an attractive state to me, compared to the extremes I enjoyed on hallucinogens or opiates. I sometimes think it’s almost tragic that alcoholics fuck their lives up for something as uninteresting and mundane as alcohol. Other drugs are far more exciting!
Do you still have cravings? How do you deal with them?
I have a very mild craving for booze and sometimes for opiates. A few years ago I had to have back surgery, and I was in sufficient pain that the doctor prescribed oxycodone. And just as before, it felt really, really good. I immediately realized I had to be very careful. I developed some hard and fast rules about only taking the prescribed dose and never for more than five days at a time. I was able to do that, and I didn’t feel the need to not take them because of fear of a relapse.
With the publication of your book, a lot of people who know you presumably now know that you are a former drug addict. What has that been like for you?
So far I have liked becoming an “addiction person.” It is a new and unexpected experience for me. One of the reasons I wrote the book is that I felt I had something valuable to say that had not really been said before, given my position as someone who had had both an extreme addiction and who went on to become a researcher into the neuroscience of addiction.
Again, I saw connections between the subjective experience and the objective mechanisms that I hoped would be compelling to people. I’m interested in bringing the science to the street. And to my surprise, many people have told me it is new information, it is illuminating, it has helped them. I’m thrilled to find out that it seems to have struck a chord with people.
To read an excerpt from Memoirs of an Addicted Brain, go here.