Today, at 60, Dr. Lewis is married again, this time to a former graduate student in her early 40s, and is the father of twin five-year-old sons. He is a long way from the guy who liked to inject speedballs of heroin and cocaine into his veins for the sensation they produced that he was being tumbled in the waves of the ocean.
An opiate beckons
But the spectre of his former addiction is never far away. Emigrating a year ago to the Netherlands, where his wife is a tenured professor of developmental pediatrics, Dr. Lewis hurt his back, and was prescribed oxycodone. He finally stopped using it this June, months after his pain had subsided. “It took months to get off it. For me, it had all this imagery from long ago as well – I want to have that safe warm thing inside my body where no one can take it away for the next six hours. To me, that's the core of what you're after.”
Memoirs of an Addicted Brain
Dr. Lewis is convinced that feelings of inadequacy and shame – the devils that taunt most addicts – are actually universal, even if most of us won't admit them. Those negative emotions co-opt our brain lanes more easily than we realize.
“When you're a kid and you're four or five years old, you feel shame when your parents shame you. It's pretty straightforward. When they say something like ‘I told you nine times not to do that' or ‘you're being selfish,' we feel shame, we hang our heads, we try not to do that thing.”
But shame is so painful and powerful, Dr. Lewis says, it may carve synaptic ruts as quickly as drugs can. “Where does it come from, the shame, after you've grown up? No one is actually saying things to you any more, but I think you internalize the parent.” If this is true, you will not be wanting to trowel on the emotional blackmail, Mommy, in case little Esmé becomes a junkie.
Advances in neuroscience have already suggested new approaches to treating addiction. Dr. Lewis cites dopamine inhibitors, and deep-brain stimulation (for depression) that breaks up habitual synaptic routes, as two promising possibilities.
But a cure for addiction may be impossible. If Marc Lewis is right, and addictive tendencies are as universal as he suggests, there is no such thing as an addict: There are only more and less extreme cases of neurological longing. Desire – the foundation of human choice, as rationalism would have it, and therefore of human dignity – is actually most of what we are, as human beings.
Because of the way cortical dopamine works, the prospect of feeling better (the thought of that dose, that hamburger) is even more motivating than the reward. Anticipation is all. As Dr. Lewis points out, if you block the dopamine receptors of a hungry rat sitting in front of a pile of food, it won't eat. “It says, ‘Yeah, I'm hungry, but so what?' So we need these systems to drive us to pursue any goal.”
He suspects this is why couples (and especially men) who spend all their time together get bored: They flood their dopamine systems, and then the engine of desire won't even kick over.
These are not new findings, but, as the scientific foundation for the detailed memoirs of a former drug addict, they sharpen our understanding of why we do what we shouldn't. It may even be an evolutionary flaw. “The brain's condensation of value – its tendency to reduce human longing to the most easily satisfied patterns – is a mistake,” Dr. Lewis says. “It's a mistake to be so reward-dependent. It's always bad to put all your eggs in one basket. It's better to diversify.”
The addicts certainly need to know that. But so do we all.
Ian Brown is a Globe and Mail feature writer.