The Fix [Hardcover]

Well, somebody had to use this as a title for a review of a book about addiction, so I thought I would get there first.

I wouldn't describe myself as addicted to anything. But I have noticed addictive tendencies in myself as I go through life and so this book caught my eye. Damian accurately unveils the wrong-thinking behind the so-often heard phrase, 'I couldn't help myself'. It is something we have always known deep down inside - and is both a frightening challenge and a wonderful release to see the truth laid bare.

We really can choose. Calling addiction a disease is an oversimplification.

One of the key evidences of his argument is the addiction and subsequent spontaneous curing of US heroin-addict soldiers in Vietnam. If they were really suffering from a disease then the majority wouldn't have kicked the habit so easily when they returned to the States where opportunity and need were relatively lacking.

Although to a far lesser degree, this related easily to my own experience - where opportunity and emotional need drive behaviours that are less than ideal. He highlights the variety of ways that modern life - from junk food to the internet and to booze - provide those easy opportunities for little 'pick-me-ups' but then lead us to be disappointed in ourselves, harm ourselves and our relationships, or just destroy ourselves. He talks a lot about dopamine which I kind of followed, but there's an awful lot of uncertainty about the science, and it is very difficult to draw distinct and objective lines of causation in all this. There are several chapters on alcoholism, internet porn and drugs that show the continuum of addiction has some horrific extremes. He is more honest than I would be.

The opportunity and psychological need that we have for these little 'fixes' is what the free-marketeers play-on so readily, and what gives us the excuses we need to hide behind when self-discipline deserts us. Or should that be when we desert self-discipline? He also refers to the pyramid of addictive behaviour - where the top third represent sold-out addicts, the middle third those who struggle with addictive tendency, and the bottom third represents the majority who don't run into problems except when opportunity and need are unavailable. He points out that modern life is squeezing down on this pyramid - making it harder for all of us no matter where we sit in the pyramid. I agree absolutely.

A cracking good read to boot. My only criticism is that he reiterates the same kind of points many times from different angles. I recognize the strength of this in justifying his arguments, but for me was a bit repetitive at times.

There's no doubt that people consuming much more of various things than is good for them is a major health issue: huge and rapidly-growing numbers are suffering liver damage from excessive alcohol consumption, the most perfunctory glance around shows the number of severely obese people is rising rapidly to give two obvious examples.
What Telegraph journalist and former alcoholic Damien Thompson argues persuasively is that in addition to the more traditional image of the addict injecting heroin or drinking alcohol first thing in the morning many other people are being drawn into addictive patterns of behaviour by skilful manipulation of brain chemistry, leading to games, gambling, pornography, electronic consumer goods, foodstuffs all developing - indeed being consciously designed to have - addictive qualities.

Alert readers will have noticed Mr Thompson being referred to as a former alcoholic rather than the more common usage "recovering". That is quite deliberate. The book has an ambivalent attitude towards the orthodox perspective on addiction offered by the 12 Step philosophies (Alcoholics Anonymous, Narcotics Anonymous and variants thereon.) While the author has used them and gained benefits from them he is also critical of the "disease model" which they use and which has become the most common method of understanding addiction.

It is rather surprising to find no reference to Herbert Fingarette'sHeavy Drinking: The Myth of Alcoholism as a Disease which examined the subject scientifically and found that not only is 12 Step treatment pretty ineffectual - usually about the same as spontaneous remission (or in everyday language a boozer is just as likely to stop drinking without AA as with)but that the ideology of alcoholics having no self-control means that if someone who has been attending AA resumes drinking they drink more and do more harm to themselves than than someone who has not received that form of treatment.

While there is a great deal of important information in this book, and I would recommend reading it I do have some reservations. Mr Thompson's understandable personal sympathy for AA and 12 Steps - he has clearly gained something personally from them - prevents him, in my opinion from carrying the logic of the rest of his argument to its conclusion, that the disease model of addiction and much of the "rehab" industry is in many cases actively perpetuating a cycle of substance abuse, rehab, relapse and preventing the adoption of more behaviourally-based models of treatment which could be more effective.

And while much of the book is extremely persuasive the section on internet usage relies much too heavily on anecdotal evidence and to my mind gives far too much credence to Baroness Greefield's unfounded assertions.

But overall an important book on an important issue.

I'm fascinated by addiction and this book is written well, but very much in the style of a newspaper article. When Mr Thompson wants some thoughts on low-fat alternatives, he goes to see his mate Henry Dimbleby. Indeed most of the expert opinion comes from his acquaintances. Much of the stuff is lurid, but I liked the author's confessional style.

I've researched AA a bit, and whereas I can see the validity of his criticisms, the point is that AA is a path to take for those who have reached an impasse, and whether alcoholism is a disease or not is not so important as does it work as a way to beat the booze? It offers a fellowship of men and women who share a goal.

The point that we can be tempted to choose things over people is a good one. I read this book in about three days, so while it might not be a masterpiece, you'll probably get to the end of it.