Judith Grisel's Never Enough explains addiction through personal history and approachable science

Once addicted to drugs, the behavioral neuroscientist uses her own history with illicit substances to present a unique understanding of their effects on the brain

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      Judith Grisel enjoyed using drugs. Cannabis, especially.

      “In many ways my relationship with the drug was among the purest and most wonderful relationships of my life,” she writes in Never Enough: The Neuroscience and Experience of Addiction (Doubleday, February 2019). “From the first time I got high until long after I’d smoked my last bowl, I loved the drug like a best friend.”

      The behavioral neuroscientist and professor of psychology at Pennsylvania’s Bucknell University also once had an intense love-hate relationship with cocaine, and pretty much any mind-altering substance within reach.

      It’s been three decades since she stopped using drugs, save for her daily use of the coffee bean. But Grisel concedes she sometimes misses them, and still sees potential benefits in the occasional use of certain substances; psychedelics, primarily, which she notes new research suggests may help some people with mental-health issues such as PTSD.

      And so, Grisel told the Straight, in that regard, it’s a sad story she tells in Never Enough. It turns out that mind-altering drugs simply aren’t good for you, cannabis included.

      “Using drugs to change the way we think, feel, and behave, is ancient and universal,” Grisel says in a telephone interview. “I do think that, not only is it natural, but that there are some benefits. I might have not survived my childhood without all that weed, now that I think about it. So I’m not against it. But I do think that addiction takes all the fun out of it, and that there are consequences for people, their families, and society.”

      Grisel sought an education and then a career in neuroscience because of her addiction to drugs. The book recounts how she entered the field with the goal of finding a “cure”.

      “I thought that if I could find the cellular switch that flipped somewhere between my third and my fourth drinks, or each time a promising bag was within my sight, and then find a way to keep this switch in the ‘off’ position, I might be able to refrain from…spending all my tips on very temporary thrills, or making blacked-out road trips to Dallas,” she writes.

      Nearly three decades into her search, Grisel writes that she’s learned the problem is not so much the drugs, per se, but rather the human brain’s powerful ability to respond to the altered chemistry that drugs produce.

      “There will never be enough drug, because the brain’s capacity to learn and adapt is basically infinite,” reads Never Enough. “What was once a normal state punctuated by periods of high inexorably transforms to a state of desperation that is only temporarily subdued.”

      While a cure for addiction remains elusive, there’s never been a more urgent need to pursue the question.

      Opioids alone killed nearly 4,000 people across Canada in 2017, up from roughly 3,000 the previous year, according to Health Canada. In the United States, 47,600 people died after taking opioids in 2017, up from 42,400 in 2016, according to the U.S. National Institute on Drug Use. It’s one of the worst health crises the continent has ever experienced, and there’s no end in sight.

      With a tidy writing structure that weaves personal anecdotes alongside accessible science, Never Enough describes how the brain of someone addicted to drugs changes as the time they struggle with their drug use drags on.

      The book focuses on neurochemistry, but Grisel emphasizes that addiction is generally the result of a combination of genetic predisposition, developmental influences, and environmental input.

      “Since the beginning of when we’ve kept records, people have been using drugs to change the way they feel. So what’s different? Why do we have so much addiction now?” Grisel asks. “Isolation. Generally, in our distant history, it [drug use] was a communal activity, with spiritual or at least cultural overtones. It was something people did together. So using alone [is what’s different].”

      Grisel’s measured take on drugs means it’s not all bad news for everyone who enjoys a little help to keep the party going.

      “To the banker who uses cocaine once every four-to-six weeks, I would say, ‘Good for you’. I don’t think that’s so terrible,” Grisel says. “If you are one of these rare individuals that really does well with moderation—and that does sound pretty moderate if you’re just doing a little coke—ya, I think that is all right.”

      The problem is that for so many people, the brain’s adaptive nature makes moderation so difficult.

      “Luxuries become habits, habits become compulsions, and compulsions become addictions,” Grisel says.

      In addition to the imperative of moderation, the other major piece of advice that Grisel offers in Never Enough is for kids to stay away from drugs. It’s not a “Just say no” message she’s borrowed from the DARE program. There are very real reasons to wait, she explains.

      “Until you are 25, the brain is still being organized,” Grisel says. “So if you perturb it while it is still being organized—during development—then it alters the organizational structure. Whereas if the basic scaffolding is all laid down, once the pathways are all basically set—which they are sometime between 23 and 25—then you are more-likely to be able to undo it [changes to the brain made by using drugs].”

      Doubleday

      Never Enough also includes lessons that apply to the war on drugs and which can inform North America’s response to the opioid epidemic. For example, Grisel says, it’s time for an honest assessment of criminalization.

      “If punishment worked, surely we would see diminishing numbers of addicts, and we don’t. We see more and more,” Grisel says. “I think it is alienating, to say to people, ‘You are bad and you’ve got to not be bad and we’re going to help you not be bad by doing bad things to you’.”

      The same sort of logical evaluation led her to support harm reduction at a time when the Ontario government and states such as Washington, Pennsylvania, and Massachusetts are debating the merits of supervised-injection facilities like Vancouver’s Insite.

      “I think supervised injection is a great idea, because I don’t think punishment works,” Grisel says. “I don’t think it condones using. It is just trying to say, ‘Here’s a safe place’.

      “We should use every strategy we can to support people to be healthy,” Grisel continues. “It’s not like we’re going to teach people not to use by letting them die. That won’t work.”

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