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Book Review: The Affliction of Addiction

Addiction is arguably one of the largest problems we face today, and one that does not discriminate based on class, gender, or socio-economic status. In his new book, The Affliction Of Addiction: It’s Not That Complicated (Science Answers All Questions), clinical therapist Adam McArnold argues that we already have the answers we need to fight the battle against addiction – if we just look in the right places.

McArnold writes that what matters most is not what caused the addiction, but what treatment professionals believe about the causes of addiction.

“Logically speaking, addiction will probably always appear to be a self-induced mental disorder stemming from the willfully excessive use of a psychotropic medication,” writes McArnold.

But this belief also sends addicts into a negative downward spiral where – in the midst of languishing self-esteem and confidence – they reach again for another drug. It also ignores what McArnold says is now undeniable evidence that drugs don’t just affect each person differently, but have very different effects on different brains. Some brains are predisposed to addiction.

Genetic predisposition doesn’t mean that one is impaired, but that they have a biological reaction to drugs that is stronger than the normal population. And simply believing that some are more vulnerable to the effects and adaptations of drug use than others, McArnold argues, makes all the difference.

“It is becoming more and more obvious that some people, if not most, are more resistant to [these types of] neurological changes. Therefore, only those who are more susceptible to neurological changes develop chemical addictions, and the degree to which one is vulnerable to these changes lies in one’s uniquely individual biological reaction to a specific chemical substance,” McArnold writes.

Referencing a powerful statement made by Dr. Nora Volkow, Director of the National Institute of Drug Abuse (NIDA) that biological predisposition may account for forty to sixty percent of the reason why some people develop an addiction and others do not, McArnold argues that it’s time to re-think how we treat addiction.

The prevailing thought among those who treat addiction is that in order to be helped, addicts have to “hit their bottom,” and that when they do they will be ready to admit that they have a problem and take meaningful steps to overcome it. Most practitioners feel that the underlying cause of addiction is of little consequence.

However, what is consistently overlooked is that all addicts suffer from a core-driven unease even when they are sober. The suggestion that psychosocial issues such as stress or difficulty in relationships drive addiction undermines the fact that the addiction itself comes with several neurological adaptations that cause changes in the brain. These changes are not only linked to urges and cravings, but cause addicts to feel uneasy, experience low emotional tolerance and high arousal levels – all of which make them want to use.

Further, addiction treatment often centers around drawing the addicts’ attention to the biological adaptations that occur as a consequence of drug use, all the while ignoring the very real and prevailing evidence that some people are more vulnerable to neurological adaptation than others.

“Biological evidence does not equate to bio-vulnerability unless it is used for causal purpose and presented as such – evidence to the fact that some people are more vulnerable to neurological adaptation than others,” McArnold writes.

McArnold argues that what is missing from addiction treatment is a foundation on which to build a long, stable, and lasting sobriety, including knowledge as to why addictions happen and why an addict can never go back to using.

Recovery is often based on maintaining a stable level of psychosocial functioning so as to eliminate any psychological stressors that can lead a person to use. But McArnold writes that this type of recovery is conditional; it hinges upon sidestepping life’s challenges.

“How defeating and hopeless is this?” McArnold asks.

Treatment for addiction should start by realizing that the drug, and not the person, caused the addiction. While they can never use safely again, their addiction was not the result of their lack of mental fortitude, life challenges or a bad hand they were dealt.

What this perspective offers addicts is a way to believe that they can recover.

“Today we know that the brain actually does repair itself. To what extent we do not yet know, but it does explain why some addicts experience physical urges and cravings for years after cessation, which eventually do subside,” McArnold writes.

When addicts understand that safe substance use was never an option for them and never will be in the future, they can build a recovery that is not hinged upon overcoming mental inadequacies. One important differentiation is viewing addiction as a biological condition, as opposed to a behavior. While the influence to use can be biological, psychosocial, or social in nature, McArnold argues that what causes the spiral progression of addictions is the biological vulnerability. The focus of treatment then begins with first recognizing that addictions are biologically-conceived, emotionally-centered, adaptation-driven, and recoverable.

With convincing evidence and powerful insights, McArnold offers a paradigm shift in the world of addictions. He doesn’t simply ask us to rethink how we conceptualize and treat addiction, but to do better to provide treatment that doesn’t ignore the very real biological condition of addiction. It is a book that anyone treating or struggling with an addiction should read.

The Affliction of Addiction: It’s Not That Complicated (Science Answers All Questions)

Adam McArnold

Pen Pal Press (2016)


311 Pages

Book Review: The Affliction of Addiction

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Claire Nana

Claire Nana is a regular contributor and book reviewer for Psych Central.

APA Reference
Nana, C. (2017). Book Review: The Affliction of Addiction. Psych Central. Retrieved on November 25, 2020, from
Scientifically Reviewed
Last updated: 3 Jul 2017
Last reviewed: By a member of our scientific advisory board on 3 Jul 2017
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