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The Thirteenth Step: Addiction in the Age of Brain Science (2015)

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The past thirty years have witnessed a revolution in the science of addiction, yet we still rely on outdated methods of treatment. Expensive new programs for managing addiction are also flourishing, but since they are not based in science, they offer little benefit to people who cannot afford to lose money or faith in their recovery.

Clarifying the cutting-edge science of addiction for both practitioners and general readers, The Thirteenth Step pairs stories of real patients with explanations of key concepts relating to their illness. A police chief who disappears on the job illustrates the process through which a drug can trigger the brain circuits mediating relapse. One person's effort to find a burrito shack in a foreign city illuminates the reward prediction error signaled by the brain chemical dopamine. With these examples and more, this volume paints a vivid, readable portrait of drug seeking, escalation, and other aspects of addiction and suggests science-based treatments that promise to improve troubling relapse rates. Merging science and human experience, The Thirteenth Step offers compassionate, valuable answers to anyone who hopes for a better handle on a confounding disease.


Don't misunderstand my position on addiction; like the author, I believe 12 step programs are ineffective. I'll go further though - they are a disgrace; they need to be replaced immediately instead of pushed as the main tool.

The author also pushes the illogical and repeatedly discredited canard that addictions are diseases. Common sense tells us otherwise, as does fundamental science, yet there are plenty of people out there (like the author) still claiming that science has demonstrated that addictions are diseases. This lie is hurting countless people by delaying and thwarting efforts by well meaning souls to help addicts.

Speaking of souls, what could be more soul crushing to be told repeatedly that alcoholism is a disease for which there is no cure; that alcoholics will spend the rest of their lives fighting cravings for booze? It takes will power (and only will power) to end addiction, so why undermine it so thoroughly when it is so essential to recovery?