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THE THIRTEENTH STEP

ADDICTION IN THE AGE OF BRAIN SCIENCE

An informative and compassionate chronicle of Heilig’s own growth as a physician and researcher.

Heilig sums up what he has learned during his 20 years as a physician and researcher in the treatment of alcohol and other addictive disorders.

The author is a specialist in the field of neuropsychopharmacology, and he has treated patients and directed research for two decades in the United States and Sweden. Heilig subscribes to the view that “addiction is inherently a chronic, relapsing disease, not much different from…hypertension, diabetes, or asthma,” which, while not curable, can be successfully managed so that sufferers can lead productive lives. Continued abuse of an addictive substance creates transformations in the brain that create a physiologically based need for the drug in order to avoid the pain of withdrawal as well as the necessity of taking a higher dose to experience pleasure. Environmental factors such as stress can trigger recurring drinking bouts, even in cases where patients have not ingested alcohol for a sustained period and no longer suffer from symptoms of withdrawal. The author also examines the genetic component of addiction. In the case of drinking, it is connected to the ability of alcoholics to get pleasurably drunk without experiencing immediate negative consequences such as nausea, dizziness, or blackout. While there is consensus within the medical community that alcoholism is a disease, its chronic nature is not yet sufficiently recognized and requires continued medical intervention. Heilig reports on his own research, which involves studying how the brain's neural circuitry is hijacked by addictive substances that trigger the release of high doses of the neurotransmitter dopamine, which creates the perception of pleasure. His aim is to develop counteractive drugs that have minimal side effects. Heilig writes compassionately of the problems of patients caught in the grip of addiction whose lives often spiral out of control despite their struggle to remain sober. There are “two perspectives" he writes,"of science and humanism," which "are inseparable in any area of medicine, but perhaps most so in psychiatry and addiction medicine."

An informative and compassionate chronicle of Heilig’s own growth as a physician and researcher.

Pub Date: May 12, 2015

ISBN: 978-0-231-17236-3

Page Count: 320

Publisher: Columbia Univ.

Review Posted Online: March 4, 2015

Kirkus Reviews Issue: March 15, 2015

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A PEOPLE'S HISTORY OF THE UNITED STATES

For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.

Pub Date: Jan. 1, 1979

ISBN: 0061965588

Page Count: 772

Publisher: Harper & Row

Review Posted Online: May 26, 2012

Kirkus Reviews Issue: Jan. 1, 1979

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HOW DEMOCRACIES DIE

The value of this book is the context it provides, in a style aimed at a concerned citizenry rather than fellow academics,...

A provocative analysis of the parallels between Donald Trump’s ascent and the fall of other democracies.

Following the last presidential election, Levitsky (Transforming Labor-Based Parties in Latin America, 2003, etc.) and Ziblatt (Conservative Parties and the Birth of Democracy, 2017, etc.), both professors of government at Harvard, wrote an op-ed column titled, “Is Donald Trump a Threat to Democracy?” The answer here is a resounding yes, though, as in that column, the authors underscore their belief that the crisis extends well beyond the power won by an outsider whom they consider a demagogue and a liar. “Donald Trump may have accelerated the process, but he didn’t cause it,” they write of the politics-as-warfare mentality. “The weakening of our democratic norms is rooted in extreme partisan polarization—one that extends beyond policy differences into an existential conflict over race and culture.” The authors fault the Republican establishment for failing to stand up to Trump, even if that meant electing his opponent, and they seem almost wistfully nostalgic for the days when power brokers in smoke-filled rooms kept candidacies restricted to a club whose members knew how to play by the rules. Those supporting the candidacy of Bernie Sanders might take as much issue with their prescriptions as Trump followers will. However, the comparisons they draw to how democratic populism paved the way toward tyranny in Peru, Venezuela, Chile, and elsewhere are chilling. Among the warning signs they highlight are the Republican Senate’s refusal to consider Barack Obama’s Supreme Court nominee as well as Trump’s demonization of political opponents, minorities, and the media. As disturbing as they find the dismantling of Democratic safeguards, Levitsky and Ziblatt suggest that “a broad opposition coalition would have important benefits,” though such a coalition would strike some as a move to the center, a return to politics as usual, and even a pragmatic betrayal of principles.

The value of this book is the context it provides, in a style aimed at a concerned citizenry rather than fellow academics, rather than in the consensus it is not likely to build.

Pub Date: Jan. 16, 2018

ISBN: 978-1-5247-6293-3

Page Count: 320

Publisher: Crown

Review Posted Online: Nov. 12, 2017

Kirkus Reviews Issue: Dec. 1, 2017

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