A bracing--and compassionate--challenge to the idea of addiction as a disease. From a leading psychiatrist at the Yale School of Medicine and the medical director of a methadone clinic in Washington, DC.
Ask someone why they got a brain tumor. They won't know. But ask someone why they developed an addiction and they'll have a personal, meaningful explanation. Why? Because, Sally Satel argues, unlike a brain tumor, addiction is not a disease, and, in particular, not a brain disease. Dismantling the conventional framing of addiction,
Not a Disease makes a compelling case for more refined--and useful--conceptual and clinical perspectives. Addiction, Satel suggests, is better understood as a symptom rather than a disease--a symptom of psychic pain that needs to be anesthetized. Only by recognizing this will we find a more effective approach to recovery.
A practicing physician who has worked with addicts for many years, Satel explores why people consume substances to excess, and why conflicting ideas--held by physicians, scientists, policymakers, and the public--complicate treatment and policy. Without dismissing biological factors, she looks at the drug epidemic in Ironton, Ohio, a small American town in decline, breaking down the conventional wisdom that ascribes too much power to the capacity of drugs to enslave users' brains, and too little to the vulnerabilities of people and places that draw them to drugs in the first place. Her analysis of the misguided responses to the crisis of addiction to prescription opioids illuminates the plight of millions of patients plunged into needless and solitary agony.
Boldly recasting the nature of addiction, from painkillers to fentanyl,
Not a Disease holds out hope for a more humane way to meet this deep and widespread societal challenge.
對「成癮是一種疾病」這項觀念提出振聾發聵且充滿同理心的挑戰。
作者是 Yale School of Medicine 的知名精神科醫師，也是華盛頓特區一家 methadone 診所的醫療主任。
如果問一個人為什麼會得腦瘤，他不知道答案。但如果問一個人為什麼會形成成癮，他通常能給出一個個人化且深具意義的解釋。為什麼？因為 Sally Satel 主張，成癮不同於腦瘤，並不是一種疾病，尤其不是腦部疾病。《不是疾病》拆解了對成癮的傳統理解框架，令人信服地提出更精細、也更實用的概念與臨床觀點。Satel 認為，與其把成癮視為一種疾病，不如將它理解為一種症狀——一種需要透過麻醉來緩解的心理痛苦症狀。唯有認清這一點，我們才能找到更有效的復原方法。
Satel 是一名實際執業的醫師，多年來一直與成癮者共事。在本書中，她探討人們為何會過度使用物質，以及醫師、科學家、政策制定者與大眾所抱持的相互衝突觀點，如何使治療與政策更加複雜。她並未否定生物因素，而是以美國俄亥俄州伊倫頓（Ironton）這座日漸衰落的小城所爆發的藥物流行疫情為例，剖析過度強調藥物奴役使用者大腦的能力、卻低估那些最初吸引人們接觸藥物的人與地方所具有的脆弱性的傳統觀點。她對處方 opioid 成癮危機中錯誤應對方式的分析，揭示了數百萬名患者陷入不必要且孤立無援的痛苦處境。
《不是疾病》大膽重新詮釋從止痛藥到 fentanyl 的成癮本質，為我們如何以更人道的方式面對這項深刻且廣泛的社會挑戰，帶來一線希望。
Sally Satel, MD, is a senior fellow at the American Enterprise Institute and the medical director of a methadone clinic in Washington, DC. She is a lecturer at the Yale School of Medicine and the author of numerous books, including her most recent, Brainwashed: The Seductive Appeal of Mindless Neuroscience, with Scott Lilienfeld, which was a finalist for the Los Angeles Times Book Prize in Science.
