Never Enough: The Neuroscience and Experience of Addiction

by Judith Grisel

From a renowned behavioral neuroscientist and recovered drug addict, an authoritative and accessible guide to understanding drug addiction: clearly explained brain science and vivid personal stories reveal how addiction happens, show why specific drugs--from opioids to alcohol to coke and more--are so hard to kick, and illuminate the path to recovery for addicts, loved ones, caregivers, and crafters of public policy.

Addiction is epidemic and catastrophic. With more than one in every five people over the age of fourteen addicted, drug abuse has been called the most formidable health problem worldwide. If we are not victims ourselves, we all know someone struggling with the merciless compulsion to alter their experience by changing how their brain functions.

Drawing on years of research--as well as personal experience as a recovered addict--researcher and professor Judy Grisel has reached a fundamental conclusion: for the addict, there will never be enough drugs. The brain's capacity to learn and adapt is seemingly infinite, allowing it to counteract any regular disruption, including that caused by drugs. What begins as a normal state punctuated by periods of being high transforms over time into a state of desperate craving that is only temporarily subdued by a fix, explaining why addicts are unable to live either with or without their drug. One by one, Grisel shows how different drugs act on the brain, the kind of experiential effects they generate, and the specific reasons why each is so hard to kick.

Grisel's insights lead to a better understanding of the brain's critical contributions to addictive behavior, and will help inform a more rational, coherent, and compassionate response to the epidemic in our homes and communities.

Genres: Nonfiction, Science, Psychology, Addiction, Neuroscience, Health, Mental Health

243 pages, Hardcover

First published February 19, 2019

About the author

JUDITH GRISEL, Ph.D., is a behavioral neuroscientist and a professor of psychology at Bucknell University. She has been awarded more than a million dollars in federal funding to pursue research on the causes of drug abuse. Her work focuses on what in the brain predisposes people to addiction, and her most recent paper revealed a genetic risk for alcoholism in women.

Reviews

[Petra X · Rating 5 out of 5]

This is the brilliant and almost exhaustively informative story of a neuroscientist and how she conquered the existential crisis of emptiness by filling it with drugs of all kind starting with alcohol when she was 12, and funded it by jobs, shoplifting, theft from employers, and worse theft from friends. And was undone by a single phrase from her father, who previously had more or less cut her out of his life, "I just want you to be happy" which reached her where nothing had before.

Eventually she decided to see what life was like without drugs and embarked on a cure, rehab and education. She became a PhD, a neuroscientist specialising in the brain and addiction.

Despite all the author does and says briefly about her subsequent life as a mother and scientist, she has never conquered her existential emptiness and, it seems, always feels the pull of death to the end. She thinks of suicide, she thinks of drugs, she thinks of alcohol and through sheer will power, resists them all, but instead writes about these dark temptations.

It is an interesting book because of the author's dual viewpoints and her ability to see the physical, psychological and intellectual aspects of addiction.
__________

Reading notes Good book, well written. I can't read books about addiction without thinking of my bf/FwB status indeterminate whose youngest son battered down his eldest brother's door to find him dead on the floor of a heroin overdose. This was 9 years ago. It shattered the family. See in the comments to Killing Season: A Paramedic's Dispatches from the Front Lines of the Opioid Epidemic how it has affected friends and family of GR friends.

[Morgan Blackledge · Rating 5 out of 5]

Author Judith Grisel is a recovered drug addict who got clean in the 80s and became a neuroscientist in search of a cure for addiction.

Now, 40 some years later, she’s all but thrown in the towel on that project.

There is no cure.

There may never be a “cure”.

Addiction is simply not that kind of issue.

Addiction has historically been viewed as a weakness of will, or flawed character, or due to an addictive personality.

That’s all a bunch of primitive, punitive, ignorant, dysfunctional, ineffective, grossly inaccurate nonsense.

More recently, the disease model of addiction has been promoted to counter all of that.

And it is a huge firmware upgrade.

But the disease model is still confusing, slightly disingenuous, and somewhat intellectually dishonest.

Particularly when you understand the issue with greater resolution.

Addiction can be considered a disease, but a very different kind of disease than cancer or the flu.

Addiction involves a complexity of interacting biological, psychological, social, environmental, cultural and even ‘spiritual (with an asterisk)’ factors.

Yes, it’s a brain disease of sorts, involving artificially super stimulating compounds that hack, exploit and re-wire a vulnerable brains evolutionarily conditioned motivation, reward and learning systems.

But that’s not what most people think of when they hear ‘addiction is a disease’ and that’s not the kind of thing a pill or surgery will ever be able to ‘cure’.

Addiction is (like diabetes) a chronic condition, typically necessitating a long term, comprehensive and systematic program of bio-psycho-social rehabilitation. But that takes a lot of work. And no pill can do all that.

Addiction is manageable.

Millions of people recover every day, and go on to lead highly productive, meaningful lives, that are frequently highly enriched as a result.

People in recovery often develop super human psycho-social skills resulting from the programs of rigorous honesty, personal exploration and growth, self care, radical acceptance and compassion, and commitment to service and community typically necessary to overcome this tremendous adversity.

Again, that all takes work. Really really hard as fuck, hard, hard, extremely difficult, extremely rewarding and meaningful, really hard fucking work.

It’s like Britney says.

And she should know.

Ya gotta work biotch.

So Judith Grisel’s work didn’t produce a miracle cure.

But her decades of work did provide humanity with something that is arguably as important.

Clarity.

Or good, organized data (GOD).

That’s an old atheist joke (not a very funny one, but then again, it’s not a very funny subculture).

Never Enough toggles between addiction memoir (written in the first person) and neuroscience popularization (written in the third person), providing the reader with a gritty hell ride through personal ruin to recovery, intermittently augmented with extremely fucking interesting neuroscience that normalizes the issue and introduces badly needed clarity to the Tower of Babel that is the current public conversation.

In a nutshell: if you tip your your brain out of balance with the happy chemicals in drugs of abuse, your brain compensates in a multitude of problematic ways, including by over producing the opposite neurochemistry, which makes you feel worse than awful when you’re not high.

Recovery necessarily entails healing this imbalance and the underlying issues that initially lead you-me-us-them to the blunt, bottle, pooky or point.

And did I mention that takes really hard work?

Addiction is a brain disease, a deadly illusion, an evolutionary miss-match, a product of learning gone wild, a public health issue, a spiritual crisis and so much more.

Never Enough provides a clear, realistic window into a large section of the issue, from the inside out, written by a former coke slamming neuroscientist.

How much more could a reader honestly ask for?

FIVE STARS (🌟X5)

NOTE: Never Enough is not a self help book. And the author is not an expert in recovery. Additionally, she seems to lack important insight into how good therapy and sober social support can help. Lots of other good books for that. This book is only good for those interested in a clear explanation of the neuroscience, from a trustworthy source. So if that’s what you’re after, consider yourself informed.

[Kristy · Rating 4 out of 5]

3.5 Stars

An eye-opening and informative book about addiction and neuroscience. Written by an addict turned PhD recipient, there were great insights along with well-researched data. A lot of pieces of information I didn’t know and having Grisel’s personal experience interjected really helped flesh out the material. Addiction is a crippling and oft misunderstood mental illness that so many battle and it was good to see text that exposed the reality of addiction while not shaming those who suffer. Grisel covers alcoholism as well as a gamut of drugs, both legal and illegal. Not only does she detail effects of them she also explores the neurological response garnered from taking them.

This is the perfect blend of science and memoir (leaning more toward the former) and I’d recommend to anyone interested in learning more about addiction or drugs in general.

I received an advanced copy through Netgalley in return for an honest review.

[Lindsay Nixon · Rating 2 out of 5]

STOP, read Chasing the Scream: The First and Last Days of the War on Drugs if you want to learn about addiction/neurology re: addiction.

and The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma helps explain trauma (the root to most addiction)

I have never been so disappointed by a book. It's a weird book in that it starts off as, and sometimes returns to being, a memoir of a junkie. The rest feels like a stale book report prepared by a High School student about various drugs or effects, almost as though it was lifted from wikipedia, except wikipedia goes into more depth.

Have I mentioned I was sorely disappointed? What a bore. The audible is especially flat and terrible.

I was so sure this would be my non-fiction of the year. When clients ask me if they are addicts or addicted to something I tell them #1, addiction is by self-diagnosis, but a test I use with myself often is "will there ever be enough?" I like to tell the story of a man who liked a sandwich so much he ordered another (this is from the AA book), or if one Tylenol works, why not take 2 so it works even better? With this very test being the NAME of the book I had the highest of hopes. Again, GOOD FOR HER but this book is a NOPE.

I'm SO DISAPPOINTED.

[Mehrsa · Rating 5 out of 5]

This is a great combination of research and memoir by someone who was both an addict and a scientist. I learned a lot from this. And I appreciate that she did not overplay her hand when it came to drugs like certain natural psychedelics where there is not a scientific consensus that they are harmful. She does make a very very compelling case about all the other drugs being addictive (to those who have addictive personalities) or otherwise have side effects.

[Juliet Rose · Rating 5 out of 5]

This is a solid book on the science of addiction. The author, a recovering addict and neuroscientist, digs into the data on substance abuse on the body, particularly the brain. She manages to stay neutral, only sharing scientific data and not too much opinion. She is also quick to acknowledge data isn't a solution, rather a jumping off point to understanding the why's and develop treatment.

[Denise · Rating 3 out of 5]

Reads more like a textbook which became a bit monotonous. I much prefer the book Dopesick by Beth Macy for a look at addiction, but it was interesting to hear the authors reflections on her own experience with drugs and addiction. This book would probably be more interesting for those who have only a small knowledge of addiction/drugs and the neuroscience behind it. Its a good introduction that includes the science and factual information on the subject that i find important, but still manageable for those who are not up to date on scientific jargon (though it does become a bit too flooded with jargon at times).

[Rebecca · Rating 3 out of 5]

(2.5) Judith Grisel first got drunk at age 13. From then until her early twenties, she was always seeking oblivion via one drug or another. There came a point when she was homeless and, while they were bingeing in a South Florida hotel room, her drug buddy remarked to her that there would never be enough cocaine for them. This served as a turning point: Grisel got clean, embarked on a PhD program in behavioral neuroscience, and for the past 20 years has been investigating the biological basis of addiction and the gender differences involved.

Her book raises questions of nature, nurture and culture. Drugs function, Grisel explains, by altering our baseline. Drugs change the rates of biological functions and have inevitable side effects. Over time the nervous system adapts to counteract these effects and return to homeostasis. Drug use is only initially, and briefly, about seeking a high; from fairly early on, it instead becomes a matter of needing to take that drug to simply feel normal. Addiction is a mental illness, the author stresses, and substance abuse disorder affects 16% of the U.S. population, with a whopping 25% of deaths attributable to drug abuse.

Grisel proceeds class by class through the various types of drugs, including alcohol, to explore how they affect the body. It’s difficult to decide who would be an ideal audience for her book. There is too much detail on biology and chemistry (including graphs and diagrams) for it to be suited to the average lay reader. And though I found Grisel’s experiences interesting, much of the general information about addiction was familiar to me from other books, such as The Recovering by Leslie Jamison, The Trip to Echo Spring by Olivia Laing, and Mayhem by Sigrid Rausing, as well as plenty of memoirs by former addicts. Perhaps if you haven’t read much about addiction, though, this will prove to be a valuable introduction.

[Mel · Rating 3 out of 5]

I had to really take my time with this one... Grisel proves her wisdom over and over, detailing the hows and whys of addiction specific to different drugs, but it missed the mark I was hoping it would land on in the end. I guess it's that I was hoping for more of a tell-all about this neuroscientist's own trial with addiction while she was much younger as she still lives to warn us nearly 30 years after getting sober, but instead it read mostly like a textbook. I was glad to have this information in one place, sporadically broken up (mostly in the very beginning and ending) by her insights and allusions to her experiences, but I was hoping for more of a literary bent. The note she ends on is really a good one though, pointing to the fact that we so often perceive addicts as "them" and instead of being the people those addicts need when they're at they're worst, we're quick to judge and lament how these people got themselves there on their own and should pull themselves up in the same way- but that is wholly the worst thing we, either the non-addicts or recovering addicts, could possibly do, and after all aren't we ALL just the same kind of human trying to make it through this life in one piece?

[Makiah · Rating 5 out of 5]

A very humanizing look at addiction.

[Mark Bailey · Rating 5 out of 5]

Judith Grisel is a recovering addict turned behavioural neuroscientist, and quite a remarkable person.

Her journey is fascinating, and although quite complex in parts due to me not having much clue about the intricacies of neuroscience and the brain, she gives outstanding insight into different types of drugs (including legal drugs such as tobacco and alcohol) and the whys and hows that some of us seek oblivion.

Unfortunately there is no cure, and may never be. Addiction is extremely complex, including many different psychological, environmental, biological, social, cultural, spiritual tropes.

The power of this book is to dispel the often morally bankrupt and backward view that parts of society impose on addicts, and provide a level of clarity for us to begin understanding more.

Standouts:

The sheer power of the human brain: Any stimulus that alters brain functioning to affect the way we feel will elicit a response by the brain that is exactly opposite to the effect of the stimulus. In other words, before you take cocaine and go to the moon, be prepared for your excruciating fall back down to earth.

Highly recommend this book!

[LittleSophie · Rating 5 out of 5]

That was a really informative and engaging book about the neurological implications and pecularities of addiction and specific drugs. The author mixes easy to follow scientific explanations with more colloquial musings about her own experience with addiction, which worked really well, I think, and prevented the book from ever feeling didactive.
I really recommend this for an informed, sympathetic and emphatic view on the rising tide of addiction.

[Susan · Rating 5 out of 5]

This is not just another drunkalogue, but instead is a review of the way drugs affect our brains, down to specific neurotransmitters and receptor sites that I found fascinating reading. The author does relate some of her own drinking and drug use experience to establish her bona fides, but the most interesting part for me was the science and the way epigenetics may influence who becomes addicted and who doesn't.

[GONZA · Rating 4 out of 5]

Interesting overview on addiction, mostly because told from the point of view of an ex-consumer. Some things I already knew, some other not really. To read.

Interessante visione d'insieme sulle dipendenze, soprattutto perché raccontate da chi ci é passato e ancora lotta per non ricaderci. Alcune cose le conoscevo, altre non tanto bene. Da leggere.

THANKS EDELWEISS FOR THE PREVIEW!

[Mehtap exotiquetv · Rating 3 out of 5]

Sucht. Wie beeinflusst es das Gehirn und warum sind bestimmte Menschengruppen anfälliger für Substanzen als andere? Dieser Frage geht die Neurowissenschaftlerin Judith Grisel nach. Sie selbst hat einen Großteil ihres Lebens mit Drogenmissbrauch verbracht, bevor sie endgültig damit abgeschlossen hat und ein neues Leben mit der Anwort auf Sucht im Gehirn begonnen hat.

Ein interessantes Buch über die Mechanismen des Gehirns und wie unser Erwartungsbereich des Gehirns Drogenkonsum fördert.
Ich fand es schade, dass es in diesem Buch nur um Drogen ging und nicht auch Allgemein um Sucht.

[Carrie Poppy · Rating 5 out of 5]

Great

[Scottsdale Public Library]

“Never Enough: The Neuroscience and Experience of Addiction” challenges trendy pop-psychology notions of how the brain works to uncover the underlying truths behind addiction. The book is eminently readable for the lay person, even riveting at times, despite technical descriptions and jargon that require a little more focus. Autobiographical details are included, but this book is not an addiction memoir. Examples from Grisel’s own experiences serve to add depth to what is a precise and clear-eyed look at both the way addictive substances interact with the brain as well as how cultural and individual experiences create, affect, and complicate a person’s lifetime potential for addiction. - Anja P.

[Rick Wilson · Rating 3 out of 5]

Delivers less on the neuroscience of addiction, and more on a pharmacological tour of how different drugs affect the brain.

It’s very interesting for that, I read through the whole thing in nearly one sitting, but it does not do much to deliver on the core of addiction beyond very basic “sometimes it’s this, sometimes it’s that, brains and genetics are weird”

Writing is clear and good, but again, this is more a collection of essays on different drugs than a neuroscience based book on addiction.

[Caroline Miller · Rating 1 out of 5]

This was a bit too much science talk for me and kinda all for nothing. Basically an addict can never get enough of their preferred drug and there's no cure. The end.

[Wendelle]

This book is a fascinating piece on the research about the formidable experience of addiction and the different classifications and schedules of drugs. The thesis is in the title: the neuroscience of drugs causes addicts to think that what they're consuming is 'never enough'. This is because of the brain wiring for tolerance: increasing amounts of drugs are needed to produce the same effect or high. Furthermore, to cut consumption leads to withdrawal, the production of the opposite effect, for instance, pausing a drug that causes euphoria leads to debilitating depression; pausing a drug that causes peace induces paranoia, and so on.

What starts as recreation becomes an overwhelming compulsion that denies the person of freedom to choose. We stand helpless against the demands of addiction. Proof of this are multiple cases where, to obtain the prescribed pills, the people claimed toothache, one tooth at a time, until they have sacrificed all the teeth in their mouth to get the pill dose they continually crave for.

There have been some interventions against addiction but they may be extreme, as this book discusses. For example, some drugs are addictive because they hit the pleasure center of our brains, the nucleus accumbens, like a gravy train, producing dopamine like no other stimulation (sensual pleasure, travel, gossip) can. Thus, some countries like China and Russia practice surgery that severs the addicts' neuron connections to this part of the mesolimbic pathway. While this in effect cures the addict of the chase for drugs, it robs the addict of the usual pleasures of existence too, reducing the sensation to bleak survival. There's also putting a person under anesthesia and dosing their brain's receptors with Narcan, but the treatment's self-defeating if the addict exits with an impulse to immediately get high. The author also mentions a phenomenon during the Vietnam War, wherein 20% of American soldiers were addicted, but only 5% came back with chronic addiction, as they were detoxed in a foreign environment before embedding back to America, and the geographical difference in the external environment of detoxification and normalization made a critical difference in their rates of relapse.

The author's recommended solution is to respect a person's free will. What does this mean in practical terms? When a person starts trying out drugs, they enter this arrangement of their own free will. When they are already addicted and turning to drugs not out of chosen desire but from the throes of withdrawal, unable to opt out even though they very much would like to, they are not taking drugs of their own free will. This is when interventions could be done without moral impasse. The author also stresses that supply-side interventions, such as prohibitions and the 'War on Drugs', are ineffectual, as illicit drug dens and casual drug-cooking operations always crop up to meet the demand.

This is a very interesting book to read and learn about addiction.

[Łucja · Rating 4 out of 5]

Ciekawa książka poruszająca problem uzależnień w ciekawy bardziej naukowy sposób niż chociażby dzieci z dworca zoo które były bardziej biografią przez co tamta książka jest bardziej uniwersalna i wstrząsająca ze względu na autentyczność wydarzeń. Jeżeli chodzi o nigdy dość to jest to książka napisana w sposób który nie podejdzie każdemu z racji tego że jest po prostu bardziej naukowy i wydaje mi się że moze wymagać chociaż podstaw z wiedzy biologicznej aby po prostu łatwiej było zrozumieć niektóre tematy. Mimo wszystko trochę się jednak zawiodłam z dwóch względów. Po pierwsze oczekiwałam jeszcze trochę bardziej naukowego podejścia z racji tego że autorka jest neurobiolożką a miałam trochę wrażenie jakby wszystko było opisane trochę po łebkach co prowadzi do punktu drugiego czyli wszystkie używki były tylko trochę "liźnięte" jeżeli chodzi o opis i wydaje mi się że na tym zawiodłam się najbardziej. Spodziewałam się np że problem alkoholu zostanie szerzej opisany z racji tego że jest to chyba najpowszechniejsza uzywka a poświęcone mu zostało jakieś 15 stron w tej książce. Także jeżeli ktoś chce się dowiedzieć wszystkiego po trochu to jak najbardziej polecam, ale jeżeli ktoś szuka tak jak ja czegoś bardziej naukowego dotyczącego konkretnego tematu to raczej nie znajdzie tego w tej książce

[Robin Lovelace · Rating 4 out of 5]

This is the third book I've read on substance addiction. I liked this one a lot because it explained the mechanism of addiction from a neuroscience point of view, in as easy and accesible terms as one can. Even though the science is bleak, the conclusion isn't. Maybe the answer is not in the brain, but in human connection.

My two main conclusions after diving into this subject are:

1. I am one of those people for who there will never be enough drugs in the world. This book confirmed for me what the shrooms told me a decade ago. The more you take, the bigger that inside black hole gets.
2. There is no cure, but there is a possibility of full recovery. While the solution is multifaceted, one necessary and indispesable ingredient is human connection. Heck, the most important for a succesful recovery.

Maybe Insterstellar was right (albeit cheesy and cringe): love is the most powerful force in this universe.

[Ashley · Rating 4 out of 5]

I really appreciate the interesting and detailed information on how the brain responds to different drugs. I also appreciate Grisel's acknowledgment that addiction is a complex and that there are social and cultural factors that are at play here beyond biological, and that the cure may not be in a medication alone.

However, I took a star off for what I see as the ignorant and irresponsible way Grisel characterizes methadone in the chapter on opiates. Starting with how methadone is seen as a great benefit "less likely to the addicts than to members of their communities." What? As someone who works as a counselor in a methadone clinic, I can say that we get a hell of a lot more resistance and judgment from the community than from those who seek out services.

Grisel goes on to say that because methadone is long-lasting to stave off withdrawal it "produced an immense addiction." Again I say - what? Grisel seems to know the difference between dependence and addiction, except when it comes to a treatment she has a bias against. Yes, methadone is worse to come off cold turkey than heroin, but the point is to NOT do that. The point is to taper down slowly after stabilizing in treatment, giving people time to rebuild their lives and address the circumstances that led them to using in the first place. Having helped many people taper off, and in the process of helping others, it is not the hellscape that Grisel implies unless you choose to rush it or come off abruptly. Many of my clients have felt no withdrawal at all and they were in control of the process the whole time.

Next Grisel characterizes letting young people enter methadone maintenance treatment as "in some ways a life sentence akin to housing the mentally ill in the back wards of state institutions: they'll be less trouble for the rest of us, but unlikely to have much of a life." Wow. WOW. Holy offensive ignorance, Batman. A lot of my clients, including ones in their early 20s, would be pretty surprised to learn that they don't have much of a life. Since they've entered treatment and stopped using they've been able to go back to school or work, repair their relationships with their loved ones, get married and have kids, travel, etc. I have some extremely successful clients who are highly respected in their fields. I'm willing to bet most people know or have met someone on methadone maintenance and had no idea, because you could not tell someone in recovery on methadone apart from anyone else. For many methadone becomes an extremely small part of their life - people who go to Starbucks every day for their morning coffee go there more often than some folks go to the clinic for their dose. And once again, it's not a "life sentence"! Many people can and do taper off.

I'm not saying that methadone and methadone maintenance treatment are perfect - far from it. There are plenty of valid criticisms and room for improvement. But the attitude that Grisel shares not only contributes to the shame my clients feel, it deters people from entering treatment, which is why I feel her public airing of her bias and ignorance so irresponsible. Many of my clients tell me they avoided methadone for years, treating it as a last resort after all the negative things they heard about it - only to find it was the only thing that worked for them. And yes, that includes young people who started using opiates in their early teens. Many tell me that they tried Suboxone several times - treatment that Grisel touts uncritically - but found it was too easy to sell their prescriptions to fuel their habit (yes, Grisel, Suboxone does have street value). I'm not saying that methadone is inherently superior to Suboxone, just that different approaches work for different people and denigrating one while promoting another doesn't necessarily help people.

There's no telling how things would have gone had my clients tried methadone earlier, but I can't help wondering if some of them would have lost significantly fewer years of their life to addiction if they hadn't waited until they'd been in out of detox and on Suboxone countless times before they tried it. I can't help wondering about the people who relapsed and overdosed right out of detox who never got a chance to try methadone because they died assuming it was the exact terrible (and frankly ablelist) fate that Grisel describes - that of a severely ill person, hopelessly addicted, with no life.

Grisel's experience and expertise lend a weight to her words, and no doubt that someone with an opioid use disorder or their loved ones reading this book will walk away thinking methadone should be avoided at all costs. That could do a lot of damage. If Grisel was unwilling or unable to provide a more nuanced exploration of medication assisted treatment options she would have done better by her readers to refer them to sources that do - or avoided discussing it at all - than to share her biases uncritically.

[Patrick Horgan · Rating 5 out of 5]

Fascinating and engaging, this book did a wonderful job of helping me understand neuroscience as a whole, in particular how it relates to addiction. I appreciate that the author didn't dumb down any of the science, and explained it at an advanced level.

I especially like how the author interwove her own experience in this book at just the right moments, keeping it engaging whenever it would start to become almost a tedious list of facts and studies. However, her own memories do not overpower the book, instead focusing mainly on the actual science.

I first discovered this book when I heard the author interview on Fresh Air, and highly recommend giving that episode a listen to see if you'd be interested in the material of this book. The author has a low-key, soothing, and hypnotic voice, and she reads the audiobook which I highly recommend listening to.

[Anna · Rating 3 out of 5]

The core of this book makes for a genuinely revelatory and clear way of thinking about addiction (and how to avoid it). I am not sure about some of the research the author quotes though - a lot of it sounds quite dated (at one point she literally quotes a paper from the Soviet Union) and the fact that the vast majority of drug users don't end up addicted is not directly addressed - probably because it complicates the book's thesis about the inevitability of addiction given conditions a b and c, which are then explained to be rare and unpredictable and complicated, and yet somehow inevitable. It's a mess. The author's total abstinence following years of addiction biases this book quite strongly and the author is very, very open about that bias, which makes this book less scientific than it purports to be.

[Kari · Rating 5 out of 5]

Incredibly informative and insightful investigation of addiction from the perspective of a recovering addict and neuroscientist. I enjoyed Grisel's ability to put the isolation of addiction into context with social movements and the rise of capitalism. Addiction is a personal, social, neuroscientific, and public health issue. She wove in all of the intertwining factors beautifully and in an entertaining way. Highly recommend this book to anyone as the drug crisis is more urgent than ever.

[Sabin · Rating 4 out of 5]

A neuroscientist and former substance abuser lists all the ways we can get high, down and wasted, and how most of them work to get us there. She also touches on many aspects linked to substance abuse, like environment, laws, genetics, family and support structures. Quite an exhaustive primer packed into this small seven hour volume, read by the author.

Did I mention that she's talking from experience? (in most, not all cases) She did them all, not just as a bit of an experiment, but regular substance abuse. Alcohol, nicotine, marijuana, cocaine, heroin, LSD, benzo, ketamine, amphetamines, angel dust and all the lot. And she's sober. She admits that it's not easy, not even close. She also admits that it took more than one try to achieve this. There were relapses, triggered by availability, by old acquaintances or by situations and things that her brain connects with using.

The book is sobering and informative, without being either apologetic or damning. She says outright that the drive to experiment is part of the genetic makeup of humankind and so policies should be a lot more nuanced than the hard line that the USA and other countries draw against those drugs which are arbitrarily put in high risk categories.

[Alicia · Rating 5 out of 5]

Both harrowing and beautiful. Of all the scientific endeavors, studying a human brain is the most daunting. In an effort to determine if certain genes are responsible for predisposing an individual (or a statistical likelihood in a given population) is akin to trying to find a specific house, but you don't know what street it's on, what city or even what continent. The usefulness of a fully sequenced DNA (though a monumental feat in its own right) proved to be more complicated, especially when searching for a cure for addiction. Though epigenetics is seen as a more likely culprit, the "generational trauma" may be a little too simplistic. When it comes to addictive substances, one thing seems clear across the board: everything that goes up, must come down, and it often does with violence and destruction.

Science is a humbling process because the more we learn, the more we understand how overwhelmingly little we actually know. Nevertheless, both our understanding and the advancement of our scientific instruments and tools continue to grow and there is reason to remain hopeful.

[Denisa Cîrstea · Rating 5 out of 5]

„Cine este de vină pentru această situație? Adevărul este că noi toți contribuim la răspândirea acestor droguri în comunitățile noastre, înghițind cu totul iluzia că suferința poate fi evitată prin intermediul unui remediu din exterior. Împreună cu doctorii noștri am fost într-o negare colectivă în legătură cu faptul că aceste droguri sunt incapabile să ofere o soluție durabilă pentru durerile vieții și, deci, singurii beneficiari reali sunt vânzătorii, respectiv companiile farmaceutice. (...) Marea majoritatea a noilor consumatori de heroină (aproximativ patru din cinci) încep prin proasta utilizare a analgezicelor eliberate pe bază de rețetă și apoi recurg la narcoticele de stradă, pentru că sunt mai ieftine și mai ușor de obținut.”

[Nathan Marone]

Part memoir, part drug reference textbook, and part long form essay on the relationship between the brain and addiction. When these three components are in balance, Grisel's book is insightful and compassionate. She speaks as someone who knows from experience and from hitting the books. The book does lose track a bit in the second half, because Grisel begins to focus on drug types that she has little-to-no experience with, and so it reads like a reference textbook for a stretch.

I'll be thinking about this one for a while. I'm not a drug addict myself, but Never Enough gave me some perspectives that might help me think about "lesser" addictions, like food, cellphone addiction, or whatever. Which is to say that though this book is specifically about drug addiction, the lessons it provides cast a wider net for us all.