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This is an excellent book on addiction and should be read by professionals working in the field, as well as those who are seeking recovery.

Richard S is a psychiatrist who has worked (in the US) for more than 25 years with those who suffer from addictions, both to alcohol and to various drugs, both legal and illicit.  In this book, he tackles some of the big questions:  Is addiction a disease? Why me?  Does treatment work? Is a spiritual awakening necessary for recovery?

He provides one of the best discussions I have come across on the “voluntary” nature of addiction.  Addicts of various types are often regarded with scant sympathy, even by medical professionals, when compared, for example, with cancer sufferers or accident victims.  “A self-inflicted condition” is a commonly heard expression.  Yet whilst the taking of a drug is a choice (in initial stages anyway,) the condition of addiction is not.  No-one chooses to be addicted – this is a neurological condition (or perhaps neuro-psychological.)  Doing something about the condition of addiction is, however a choice and this book provides good insights into how to make this choice and to maintain sobriety. 

There are excellent discussions of topics such as risk factors for developing addiction, problems of diagnosis, measuring treatment outcomes, goals of treatment, medications and why medical science can’t “cure” addiction.

Richard S also tackles the topic of spirituality in recovery from addiction, which few other authors do – not well anyway.  He covers the meaning of spirituality and endeavours to separate out this concept from denominational religion.  Topics include addiction as a metaphor for human suffering, thinking about a higher power, are science and spirituality compatible.  Unfortunately the medical and psychological professions do their best to pretend that spirituality does not exist – or is at best irrelevant and the whole concept does get badly confused with religion, particularly “traditional” Christianity and this, understandably puts many people off.

My only criticisms are that the author tends to regard 12 step programmes as the only effective treatment option.  There are other approaches which have good success rates for those who remain with them in treatment.  In the final chapter, discussing spirituality, he also puts forward some notions that are based on some rather questionable concepts and I think he would lay himself open to being shot down by those of a skeptical orientation.

These relatively small points aside, this is an excellent book and is well worth owning.

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