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Never EnoughReview - Never Enough
The Neuroscience and Experience of Addiction
by Judith Grisel
Doubleday, 2019
Review by Christian Perring
Jun 18th 2019 (Volume 23, Issue 25)

Judy Grisel is a researcher in neuroscience at Fuhrman University, South Carolina. Her specialty is in addiction. She also tells her own story of her relationship with drugs, which she used heavily in her youth and then completely stopped using. She tells us a little about her family but not a lot. She gives some comments on her experiences with different drugs but does not say much about how she came to take them or what happened to her when she did. So this is a long way from being a memoir, and Grisel tends to be terse about most of her topics. Never Enough is a fairly short book and most of it is devoted to explaining how different drugs work and that they do to people. Her main message is, unsurprisingly, that most drugs are bad for you. She also emphasizes, refreshingly for a neuroscientist, that a complete neuroscientific understanding of addiction is a long way off. She says that there are probably as many explanations of drug use as there are drug users, and the chances of any one-size-fits-all treatment emerging is very unlikely. So she is pessimistic about the hopes for the problems of addiction going away any time soon. One of her motivations for studying addiction in the first place was to find a cure for addiction, but now she is skeptical that we will find anything that could count as a cure in the foreseeable future. So while Never Enough is less encouraging about the achievements of neuroscience than many other comparable books about the brain and drugs, it is refreshingly modest and realistic about our current lack of understanding how how to stop people from engaging in risky behavior. It also avoids taking a strong stance on some of the most controversial issues in addiction, such as whether addiction is best understood as a "brain disease." Grisel tends to take a practical stance, rather than an ideological one, and she points out that most existing approaches to addiction have only very limited success and it certainly does not seem to help social problems to punish addicts for their behavior.

While our neuroscientific understanding of drugs is limited, we do have some understanding of the different categories of drugs, and the bulk of Never Enough explores just about every drug there ever was. After a couple of chapters on basic brain science, Grisel goes through THC, opiates, alcohol, tranquilizers, stimulants, and psychedelics, finishing with a smattering of other drugs that can also be abused. Sometimes Grisel's explanations are quite technical, and although one may nod along with her with a feeling that one is understanding, and her language is always approachable, readers who haven't taken several courses on brain science will probably find that they could not really explain the differences between different drugs in any depth even after reading the book. Still, it is good to see that there is some kind of basic categorization of the mechanism of drug effects that makes sense. For most drugs, they have come into public consciousness when they gained a reputation for either their great benefits, their terrible health consequences, or for the famous people who died taking them. So Grisel is able to fill pepper the science with some history or celebrity factoids as she goes along, and that makes the book appealing. She tends to be very skeptical about the supposed benefits of most drugs, and she emphasizes that any drug that can lead to addiction will probably have bad long term effects. So even for THC, which she says she really loved to take, she argues that long term use will probably lead to a long term lowered mood and a lack of ability to concentrate. Yet when she gets to the psychedelics, she is far more optimistic and positive, arguing that while they can lead to bad experiences, when taken in the right circumstances, there is no risk of addiction and they can have very definite life benefits. She writes enthusiastically about the use of psychedelics to help people with terminal illness come to terms with their condition.

There are footnotes to the book, but they are not extensive, so this would probably not be a great resource to use to find more scholarly references. It is very much an introduction to the lay reader about how drugs work. The unabridged audiobook is performed by the author herself, which was probably a mistake, since her reading is low energy and mostly monotone.

 

© 2019 Christian Perring

 

Christian Perring teaches in NYC.


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