Unbroken Brain: A Revolutionary New Way Of Understanding Addiction Book Pdf
As an accomplished journalist, Szalavitz writes in a clear and compelling style. Her book is based not only on her own personal history but also on an assessment of many years of research into the biological, environmental and social causes of addiction.
Unbroken Brain: A Revolutionary New Way of Understanding Addiction book pdf
Her writings on radical addiction therapies have been featured in The Washington Post, Vice Magazine, The Wall Street Journal, and The New York Times, in addition to multiple other publications. She has been interviewed about her book on many radio shows including Fresh Air with Terry Gross and The Brian Lehrer show.
There are many more points Szalavitz makes in this quite comprehensive book about addiction. She reviews in detail the connection between our drug policies and racism. She gives us the the dope on dopamine. She describes the twin hooks of wanting and having. She gets autobiographical, revealing her own transit into and out of addiction. But, for me, it is the counterpoint she provides to the last great book about addiction that is most valuable. Read Unbroken Brain if you need to understand something about addiction. Unbroken Brain by Maia Szalavitz PDF
Maia Szalavitz is an award-winning author and journalist who covers addiction and neuroscience. Her next book, Unbroken Brain (St. Martins, April, 2016), uses her own story of recovery from heroin and cocaine addiction to explore how reframing addiction as a developmental disorder could revolutionize prevention, treatment and policy.
Although self-help books do offer some important benefits in recovery, they should not be used as a replacement for traditional forms of addiction treatment. Detox, counseling, and holistic treatments provide the best foundation for sobriety.
Reading books about addiction recovery and memoirs of prominent personalities who share their struggles (which you may identify with) can be significantly beneficial for maintaining emotional sobriety and relapse prevention.
This highly structured setting is optimal for those looking to escape triggers at home, such as methadone-using social circles, easy access to the drug, or problematic/abusive relationships. Having removed themselves from their personal lives and daily activities, patients can spend valuable time understanding their methadone addiction.
The Behavioral Corner Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner; you're invited to hang with us, as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and wellbeing. So you're on the corner, the Behavioral Corner, please hang around a whileSteve Martorano Hello, everybody, and welcome again to the Behavioral Corner. My name is Steve Martorano -- right where you left me hanging here on the Corner. Real quick for those of you who might not understand the conceit here -- we think if you stay in one place long enough, all the interesting people in the world will wind up crossing your path. And so that's what we're dedicated to doing on the Corner, we, we try to run into interesting people, we know they have lots of great information for us and that's certainly the case today. So that's the Behavioral Corner. It's a podcast about everything. As a matter of fact, that affects our physical, psychological, emotional, spiritual well being, we're going to take a look at a topic that is, has been foremost in our mind here for a very long time, because we first heard about harm reduction a very long time ago. And I'll tell you the context of that in a second. But to shed a lot of light on this topic, we welcome to the corner, our guest, Maia Szalavitz. Maia is a journalist, and she is a New York Times bestselling author. Her book, which brings her to us today is entitled -- her latest book -- is entitled Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction. Maia, thanks so much for joining us.Maia Szalavitz Thanks for having me.Steve Martorano And thanks for writing the book. It's absolutely timely and absolutely necessary that people understand this. Okay, let's begin with the definition of terms here. We'll start...we'll start at the very beginning. Harm reduction is a term that is so clearly beneficial, that one wonders how it has become the source of controversy when it is associated with the issue of substance abuse. I mean, as you point out in your book, as a society, we go to great lengths to reduce harm across all kinds of activities, from seat belts in cars to helmets in football, although one wonders whether that's enough harm reduction in any way, you know, do no harm goes to the essence of the Hippocratic Oath, which first does no harm. Nevertheless, when people started to talk about harm reduction, and we'll find out about when that started, it automatically pushed a lot of strange buttons. So let's begin at the beginning. How did harm...where did harm reduction begin? And how did he get to be so controversial?Maia Szalavitz Sure. So in drug policy, harm reduction is the idea that we should try to stop people from getting hurt, rather than try to stop them from getting high. And that is enormously controversial because the War on Drugs has as its goal to induce harm in drug users so that they will supposedly realize that they have a problem and quit. And so if you reduce the harm, the fear is that they would never quit and they'll just be having so much fun being addicted, that it will make the drug problem much worse. The reality, of course, is that addiction is defined as compulsive drug use that continues in the face of negative consequences. So if negative consequences, we're going to fix it, by definition, it wouldn't exist. And yet we have this whole apparatus of enforcing the idea that if we can just make the consequences bad enough, and make people hit bottom, and be tough to them, we will solve this problem. And so anything that gets in the way of being tough and being cruel, and making everything as bad as possible for people who use drugs, as an example for kids, so this is why you shouldn't do them. That is why harm reduction is controversial because it's saying that the drug war idea is fundamentally flawed.Steve Martorano Yes, it's the antithesis of Just Say No.Maia Szalavitz Exactly. And it's really saying that you know, just as with any other medical condition, the way to help is to treat people with dignity and respect and empathy and not try to grind them into the ground because you think you know what's better for them.Steve Martorano There are some fascinating reasons why that's the case. We probably won't have time to go into but as you know, substance abuse and treat...treatment of substance abuse grew up outside of the medical establishment. It was never really a medicine. It was never really a therapeutic field. It was in fact a spiritual goal -- put your faith in God and God will deliver you from this plight. But that has some bearing on the way it has been approached. And when you talk about the war on drugs, being set up to make it more difficult for people to get help, I wonder whether that means you don't accept the idea that they are suffering from a disease? And maybe I'm wrong about this. Do you believe that? Addiction is a brain disease? Maia Szalavitz Okay, so it depends on what you mean by brain disease. If you mean by brain disease, Alzheimer's, or progressive neurological damage, then no, it is not. The research is pretty clear that drug addiction is a learning disorder. And what that means is, in order to get addicted, you have to learn that the drug fixes something for you, and then that has to become ingrained in your behavior in a similar way to how people fall in love or get preoccupied, quite rightly, with their new baby.Steve Martorano Well, again, we can go off on all kinds of tangents here. That's a fascinating take on this now...Maia Szalavitz ...and that was my last. Steve Martorano I mean, that's, you know, it's interesting. I mean, if it's a learned behavior, then...then it can be unlearned.Maia Szalavitz Well, exactly. And also, what I think is that, you know, there's a very specific type of emotional learning, that happens when you fall in love or have a child, and it just resets your whole priorities, towards making sure that you sustain those relationships, and, you know, keep the kid alive and healthy, and all that. And so, you know, when that object gets replaced by a drug, then what you're doing --- it's...it's just like if you think about people who have affairs. They're like, hiding it, they're lying about it. It's not very different from that, like, people will rob things because they're love. It's...it's the same kind of thing. We've just made it super alien.Steve Martorano It rearranges the priorities and directs them in an unhealthy way. All the priorities are staying high. And damn the consequences, which is...Maia Szalavitz Well, I mean, the thing is...the thing about that is that people who are addicted, have a reason to be addicted generally. So it's not like you're happily going along your life, and you just get exposed to this thing. And you just give up everything to become selfish and evil. What generally happens is, you've either been traumatized as a child, you have a mental illness, or you have just severe despair. And, or you may have all three, then you come across something that actually makes life feel bearable. And yeah, you're gonna fall in love with that, and then it's going to be trouble because it will start to interfere with the rest of your life.Steve Martorano Yeah, and I know, you tell that story beautifully in another of your books, The...The Unbroken Brain or The Unbroken Brain. And I'll tell you, I should have mentioned in the beginning, you got my attention with the essay in the New York Times from a few weeks back, which had the brilliant headline in terms of tension getting about opioids or like love.Maia Szalavitz Yeah, I mean, I think like, I'm kind of amazed that more the public doesn't understand that because it's like, fundamental physiology. And when you look at it, like if you block brain opioids, bonding does not happen in other species. And we presume that it's similar in humans, but we, fortunately, don't usually do that.Steve Martorano Yeah, well, I mean, yes, it is another great mystery of this situation. And that is, and I just, I was going with this, but I mean, in terms of why people get high/ Okay? Simply put, I've interviewed so many people now who have gone through horrors and come out the other side. And almost to a person when asked, "Why did you begin getting high?" Beyond what you said about trauma -- there's, there's always a lot of that -- they said they liked it.Maia Szalavitz You're not gonna get addicted if you don't like it. And I mean, one of the things that most people don't know and that I wasn't able to mention in the New York Times essay is only about a third of people who get exposed to opioids feel that sense of love and comfort and warmth. The other two-thirds either it's kind of like a meh experience or they actively aversive, so they like they're made nauseous, they're numb, they just don't like it at all. Now, even among the third that like it, at least half of them, often more than half don't become addicted. And that tends to have to do with the fact of they have a life that they don't want to give up in service to this drug.Steve Martorano You also think some people just are not predisposed genetically,Maia Szalavitz How would a genetic predisposition work? It has to work by you're making you like the drug, or by making you unhappy. So it's like, I think we think these genes are this kind of magical thing that just do things. But the reality is that they have to act or a specific mechanism. And a mechanism by which they act is do you like this stuff or not? And the other mechanism is, are you traumatized, and does has that affected your physiology such that you feel this experience. Steve Martorano I didn't mean to imply that genes are destiny, but they are a factor. That could be. Maia Szalavitz Oh, yeah, yeah. Well, I mean, they like, you know, so it's, you know, it's probably about half and half, like how addiction just like any other complex behavioral trait, whether it's intelligence or whatever, it's usually around 50%. So yeah, so it's like, okay, we've got that 50%. And, and this is why addiction is so complicated because it's like the thing that predisposes me to addiction, which for me, was like depression that was kind of brought on by like, being sort of incredibly lonely and outcast due to, as I find out on being on the autism spectrum, somebody else may get addicted, because they're seriously impulsive. And they're not anxious, which I am. They are, bold, and they want to do everything. Steve Martorano They're risk-takers. Maia Szalavitz Right. And like, you know, I'm scared to drive but I shot heroin. So...Steve Martorano You know, there's...I'm sure you're aware of a terrific book that has been written recently, where they make it seems odd to think about this a correlation between the attitudes and behavior of big wave surfers, and drug addicts. Maia Szalavitz Well, yeah, of course. But it's like, would I ever be a big wave surfer? It's funny, I just spent hours watching them when I was on a plane, and I love the ocean, I love the waves, I do not like getting wiped out even by a small wave. So no, that is just not going to be my thing. But I understand. And I think that when we look at people who are prone to addiction, we have to see that there are very different traits that can get them there. So it might be one person who's super bold and seeking stimulation, the other person may be retreating from stimulation, and some people have like extremes on both ends. So you know, they kind of swing back and forth. But I think it's really important to recognize that there is no one addictive personality. Steve Martorano Yeah.Maia Szalavitz There is a whole slew of them. Steve Martorano Well, Maia Szalavitz is our guest, she is the author of a brand new book called Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction -- which is troubling to think about. Addiction has a past, and apparently, it's going to have a future too. But anyway, very complicated event, people who abused drugs and are caught in that device, we're learning more and more about how to treat that going forward. So let's pivot now to exactly what you're talking about. So this is a complicated thing that we're really not very good at understanding, much less treating, and instead of continuing to hammer away at the silver bullet, that will make you go away. We've got to stop the harm. And the harm, incidentally, cannot be exaggerated. One hundred thousand people now did in the past couple of years -- more than auto accidents and heart disease -- it's a slaughter out there. So tell us about harm reduction, its origins briefly, I know, it's a long story, but it began in the home of The Beatles, right?Maia Szalavitz Exactly. So the idea of harm reduction has been floating around for a long time going back to like hypocrisy...(laugh) Hippocrates, as you say, I do not want to call them a hypocrite. Steve Martorano No.Maia Szalavitz Anyway, that old doctor dude -- and in Amsterdam, their drug policy had been sort of based on that. What Liverpool did, however, as they took the idea of harm reduction, and they made it into a political movement and a movement within public health, that our goal really has to be to reduce harm, and that if we're trying to harm people in order to help them, that's not really a good idea. Whenever we try to do that we've had terrible bad side effects and oftentimes, you end up making people worse. So what this does, what harm reduction does, and why it has been so scary to prohibitionists and supporters of the drug war is that it says policies should be making things better, not worse for anybody. The idea of a policy that is focused on making someone's life miserable in order to convince their children not to do it. This is using people's instruments, this is not okay. The prohibitionist have taken the moral high ground for so long saying, "Oh, what about the children?" You know, you know, we have to be cruel to people who use drugs so that like children won't take after them? Well, first of all, if I'm dying in a corner somewhere, no kid is gonna see it hopefully. And second of all, shouldn't we be teaching our children that we should be compassionate for people who are ill? And shouldn't we be teaching our children that we want to make life better for people not worse and that disabling people should not be our goal, enabling people to have a productive and happy life as much as possible -- that's what harm reduction is about. And we don't want to disabled people with tough love, or jails or any of that. We want to minimize the harm that is done to them and to people around them. And by doing so, help them actually move towards recovery. And this is the thing that a lot of people really don't get. A lot of people recover, because they have hope, not because they have more despair.Steve Martorano And they recover because they're still alive. Maia Szalavitz Well, exactly. If you're dead, you can't recover. And that's one of the fundamentals of harm reduction. You know, what's interesting is, if you do the most enabling thing in the world, prescribe heroin, okay, they got the heroin, like, they don't have to chase it anymore. They don't need money, they got the drug, it's all good, right? Well, if you actually do that, people think, Oh, it'll extend the addiction they'll never get well, they'll just like, you know, go along in a haze. In reality, what happens is, when you take away the cops and robbers and all the chasing of the drugs and the money, people have a lot of time. Suddenly they're like, "Okay, maybe I should get a job, maybe I should, you know, see my family more." Also, there's this phenomenon that happens. If you get what you really, really want, and you think is going to fix your life -- it usually doesn't. And there's a sense of like...like, you get this big success, and it's like, everything's gonna be solved now. Everybody loves me, it's all gonna be good. And then it's like, no, you're still you, and you still have all your problems. So that's a similar thing that happens when people who use drugs get all the drugs they want. Once you can sort of open up that space where they see okay like more did not solve this. Then you can start to see, okay, well, you know, what is behind this? Why are you doing this? And the other thing that's essential to harm reduction is treating people kindly. And you know, people who are actively using people will, you know, cross the street to avoid them, people will just, you know, say terrible things about them and to the -- people even commit violence against them -- it's a very acceptable prejudice. And so when somebody says, "Hey, I think you deserve to live, whether you continue using or not. I'm not going to demand abstinence from you, in order to think you deserve to live, I'm going to say your human being, all of us have gifts, please be able to use yours."Steve Martorano To put a fine point on this. There's nothing mutually exclusive, about harm reduction, and gett