Dirk Hanson’s The Chemical Carousel is an in-depth survey and discussion of the pharmacology of addiction. It focuses around one central point: a certain percentage of the population is susceptible to addictions, while others can use addictive drugs occasionally and never get addicted. Because of the physiological, psychological, and sociological problems addiction leads to, we need to understand the brain changes that occur during addiction, withdrawal, and relapse. The study of the pharmacological action of many psychoactive substances is ongoing, as is research into the pharmacology of addiction itself. This detailed generalist account is probably the most comprehensive single work on the topic for the lay reader.
Initially, as I read through this fairly substantive tome I had doubts about the author’s general view of addiction. Hanson clearly views addiction as a brain disorder, one to which a particular percentage of the population, say 10% or so, is susceptible largely, Hanson argues, by virtue of genetics. While the other 90% of the public can occasionally go on a methamphetamine binge or experiment with heroin without becoming addicted, this minority will become addicted. This is because of tremendous individual variability in brain chemistry. While I still have my doubts about whether a pharmacological model explains every facet of addiction and recovery, Hanson does an outstanding job of explaining the various effects of psychoactive substances on neurotransmitters and the reward pathways of the brain. In the end, he also admits that addiction is a complicated phenomenon with sociological and psychological causes as well as physiological ones. Nonetheless, the physiological mechanisms need to be elucidated, and Hanson focuses largely on this.
The heart of the book is a dissection of the effects of various commonly used psychoactive substances on the brain, and a discussion of possible treatment options, including newer pharmaceuticals compounds, that attempt to stem cravings and thus prevent the ubiquitous condition known as relapse. Hanson focuses on substances that are commonly abused and known to be addictive: nicotine, alcohol, stimulants, opiates. He also includes cannabis though considerably less is known about the mechanism of cannabis addiction, and controversy remains over whether cannabis can be really said to be addictive at all. Hanson devotes three long chapters to discussing pharmacological agents used to treat substance abuse, addiction, and craving. Many new drugs either just coming on the market or not yet on the market are discussed.
It is hard to summarize the results, since Hanson paints a complex picture that includes findings from hundreds if not thousands of research studies. Research on these topics is ongoing and increasing. Though not a light read, The Chemical Carousel is an important and comprehensive look at the contemporary science of the addicted brain.
Science reporter Hanson presents a savvy, big-hearted exploration of the latest investigations into addiction science.
Like it or not, the popular imagination still views addiction not so much as a disease, but as the product of a weak-willed lifestyle. But, as biological psychology indicates, the concept is much more complicated. Hanson begins with an overview of drugs—use and abuse, legal and illegal—and how they work on our brains, with a particularly astute look at the roles of dopamine and serotonin and how nerve receptors function. He then shifts into methods of treating the disease of addiction, sociological as well as medical. In a soothing bedside manner, Hanson serves forth the whole addiction picture without false promises or dire forecasts. We each have biochemical individuality while sharing neurochemical pathways of reward and relief and unconscientiously fashioning them to our desires: ways to feel good, molecular levels of bliss. Though Hanson’s tone may be conversational, like an informal chat with an informed friend, he nonetheless takes readers through the science of brain function and explicates what is known about its chemistry, physiology and psychology. He looks at the pros and cons of today’s pharmacopoeia, and gives a thorough, entertaining tour of the government’s part in its creation. The author is equally engaging when it comes to the role of diet and exercise. Hanson also has much to say in the contest between criminalization and harm reduction, strategies that “aim for the creation of non-coercive, community-based recovery programs and resources for drug users.” In all instances, he smartly summarizes the medical studies and gives sources to pursue investigation.
Insights into addiction that are wise, generous and humble.
Midwest Book Review
The Chemical Carousel is presented in four parts - a history, addictive substances, cures, and a conclusion. It is well researched, written and edited, providing the most current/contemporary information available. I didn't know we now have a 'science' of addiction...great!...and if so, this book should be required reading.
I found Hanson's research to be helpful in clarifying the problems, such as: the difference between the disease of alcoholism (a brain chemistry disorder characterized by continued compulsive use of alcohol despite severely adverse consequences) and alcohol abuse (the deliberate overuse of alcohol - binge drinking). A deeper, educated understanding about addictions may help to dissolve the common view of the addict as an immature and irresponsible person, short on will power, low on self-esteem, and forever at the mercy of his/her addictive personality.
If you, a friend or family member have an addiction problem, read this book. I don't think you'll be disappointed, and you may, if you are looking, find the help you need.
James Brown, author of The Los Angeles Diaries
I've read a lot of books on alcoholism and addiction, and this ranks high on my list as well researched, informed and an intelligent analysis of addiction.