A good education on addiction, fascinating case histories, and a sensible formula for treatment.

DOPAMINE NATION

FINDING BALANCE IN THE AGE OF INDULGENCE

An addiction specialist discusses her patients’ problems and how she deals with them, and it’s an unsettling picture.

Lembke, medical director of the Stanford Addiction Medicine clinic, begins with a lesson in neuroscience. Nerves along brain pathways that process rewards (i.e., pleasure) use dopamine as a “neurotransmitter”—to deliver signals. The more dopamine an experience releases, the more we enjoy it. However, dopamine processes pain as well as pleasure, and a healthy brain maintains a balance. Most of us stop eating when we feel full. Coffee often provides all the stimulation we need. Gambling, drinking, shopping, or watching pornography are intermittent activities. Addiction, the mark of an unhealthy brain, is a compulsive behavior that continues despite the harm it causes, and it’s a worldwide epidemic. The biggest risk factor is easy access. History books proclaim Prohibition a failure, but it produced a big drop in alcoholism, public drunkenness, and alcohol-caused liver disease, which rose again after repeal. Today, it seems, all indulgences are accessible. Since around 2000, the rampant overprescription of narcotics has produced skyrocketing addiction and death. The internet allows us to engage in social as well as unseemly activities in private. Popular medical books rely on vivid case histories, and Lembke offers plenty. Her first is a lifelong masturbation addict who was ultimately able to achieve control. There follow accounts of other types of addicts, and she describes her treatment strategy based on the acronym DOPAMINE: data, objectives, problems, abstinence, mindfulness, insight, next steps, and experiment. Most readers will find it reasonable, and the author does not trumpet its success rate. Some of the most insightful passages involve lying, a malignant process in a cooperative society but essential to maintaining addictive behavior. Many people believe that honesty—unmasking our flaws—will drive people away, but it does the opposite.

A good education on addiction, fascinating case histories, and a sensible formula for treatment.

Pub Date: Aug. 24, 2021

ISBN: 978-1-5247-4672-8

Page Count: 304

Publisher: Dutton

Review Posted Online: June 16, 2021

Kirkus Reviews Issue: July 1, 2021

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A lucid (in the sky with diamonds) look at the hows, whys, and occasional demerits of altering one’s mind.

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THIS IS YOUR MIND ON PLANTS

Building on his lysergically drenched book How to Change Your Mind (2018), Pollan looks at three plant-based drugs and the mental effects they can produce.

The disastrous war on drugs began under Nixon to control two classes of perceived enemies: anti-war protestors and Black citizens. That cynical effort, writes the author, drives home the point that “societies condone the mind-changing drugs that help uphold society’s rule and ban the ones that are seen to undermine it.” One such drug is opium, for which Pollan daringly offers a recipe for home gardeners to make a tea laced with the stuff, producing “a radical and by no means unpleasant sense of passivity.” You can’t overthrow a government when so chilled out, and the real crisis is the manufacture of synthetic opioids, which the author roundly condemns. Pollan delivers a compelling backstory: This section dates to 1997, but he had to leave portions out of the original publication to keep the Drug Enforcement Administration from his door. Caffeine is legal, but it has stronger effects than opium, as the author learned when he tried to quit: “I came to see how integral caffeine is to the daily work of knitting ourselves back together after the fraying of consciousness during sleep.” Still, back in the day, the introduction of caffeine to the marketplace tempered the massive amounts of alcohol people were drinking even though a cup of coffee at noon will keep banging on your brain at midnight. As for the cactus species that “is busy transforming sunlight into mescaline right in my front yard”? Anyone can grow it, it seems, but not everyone will enjoy effects that, in one Pollan experiment, “felt like a kind of madness.” To his credit, the author also wrestles with issues of cultural appropriation, since in some places it’s now easier for a suburbanite to grow San Pedro cacti than for a Native American to use it ceremonially.

A lucid (in the sky with diamonds) look at the hows, whys, and occasional demerits of altering one’s mind.

Pub Date: July 6, 2021

ISBN: 978-0-593-29690-5

Page Count: 288

Publisher: Penguin Press

Review Posted Online: April 14, 2021

Kirkus Reviews Issue: May 1, 2021

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This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

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BETWEEN THE WORLD AND ME

NOTES ON THE FIRST 150 YEARS IN AMERICA

The powerful story of a father’s past and a son’s future.

Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”

This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

Pub Date: July 8, 2015

ISBN: 978-0-8129-9354-7

Page Count: 176

Publisher: Spiegel & Grau

Review Posted Online: May 6, 2015

Kirkus Reviews Issue: July 1, 2015

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