Review: 'Unbroken Brain' takes a look at addiction

"Unbroken Brain: A Revolutionary New Way of Understanding Addiction" (St. Martin's Press), by Maia Szalavitz

Nancy Reagan's death last month caused some to take stock of her mantra "Just Say No" and why it failed to prevent addiction or dissuade many young people in the 1980s from experimenting with dangerous drugs.

In "Unbroken Brain," science writer Maia Szalavitz, a high school student in the Reagan years, describes her own drug odyssey - LSD, cocaine, heroin - and her first steps toward successful recovery at age 23 in 1988. Since then, understanding addiction and treatment has been her life's work. She's now regarded as a leading authority, with articles in Time, The New York Times, Psychology Today and other major publications.

Her previous book, "Help at Any Cost," examined programs for troubled teens. This time, she argues for a radical rethinking of addiction with a new emphasis on learning.

She writes that although addiction is a disease, a more nuanced analysis reveals it to be a learning disorder, more like dyslexia than diabetes, opening new possibilities for treatment, recovery and drug policy. This learning disorder framework takes into account genetic vulnerabilities, brain development and experience, she says, and helps explain why locking up addicted offenders largely fails to rehabilitate them.

Addiction is a pattern of learned behavior defined by persistence despite negative consequences, she writes, and that is why punishment - because prison, after all, is just one more negative consequence - doesn't work and can be counterproductive.

Szalavitz finds some value in the Alcoholics Anonymous self-help movement, but objects to its elevated status in medical and criminal justice systems. In what other disease, she asks, would medical professionals recommend submission to a Higher Power as an essential part of treatment? A chapter on programs employing the learning disorder insight offers another way.

Szalavitz's personal story complements her research without overshadowing it, including an unforgettable scene in which she does cocaine with Jerry Garcia of the Grateful Dead. She writes movingly about the mental and emotional consequences of drug withdrawal, far worse than the physical symptoms, in her experience: " ... what tormented me most as I shook through August of 1988 wasn't the nausea and chills but the recurring fear that I'd never have lasting comfort or joy again."

Anyone who has battled addiction or seen it harm a loved one will gain insights from "Unbroken Brain," and if it influences policymakers, too, everyone will benefit.