Introduction

Hi, my name's Lisa. I'm not an alcoholic.

What I am is a student at a university in Boston, going into the last year of a biopsychology major and preparing to apply to medical schools. This blog is going to be a place for me to talk about my summer at home; the internships I'm going to go through, the people I'm going to meet, and the treatment strategies -- medical and otherwise -- that I'm going to witness. This summer, I'm going to learn about addiction.

My father is a physician, a general practitioner by training, and the chances that I was going to follow in his footsteps have always been pretty good. I grew up in and around his family practice, watching him administer flu shots and chickenpox vaccines, give physicals, and treat all sorts of everyday problems. Then, ten years ago, he came home from a conference, announced that everything had changed, and bought the space next door to his office to open a new practice while the old one was slowly dismantled. The examination tables, the EKG machines, the scales, the otoscopes and opthalmoscopes all vanished. The patient population changed. The new practice was a specialty practice, providing care to a segment of the population that has been, and is, desperately sick and criminally underserved: the addicted.

At that life-changing conference, my dad discovered buprenorphine, the partial opiate agonist that acts to eliminate cravings and prevent withdrawal symptoms in people who have been addicted to opioids, even if the addiction had been ongoing for most of their lives. Almost as soon as the new practice opened, I got to see patients coming in and thanking him tearfully for giving them their lives back, for helping them to feel normal, for freeing them from this compulsion that had been dogging them for years and that they had given up hope on ever being able to shake.

Around this time I was in high school, first discovering evolutionary psychology and the biological mechanisms of behavior. By the time I got to college I knew that the brain -- that absurd, impossible, fantastic mechanism whose complexity we're only just beginning to comprehend -- was my true passion, the thing that I would devote my life to studying. And addiction, a disease of the brain, fascinated me -- just as the way people seem to blame its symptoms on conscious behavioral causes baffled and enraged me.

So I decided to go to medical school, to follow in my father's footsteps and get the degree that would enable me to treat the chemical imbalances that facilitate addiction and all the suffering it causes. And at the same time, to fight the deep-rooted misconceptions that have led to the demonization and marginalization of those suffering from this disease.

This summer, I'm studying addiction from as many angles as I can. I'm going to work in my father's practice, which is based purely on medication maintenance; I'm interning and observing at a 30-day inpatient facility run on the 12-step model; and at the end of the summer, I'm going to intern for a month at an upscale spa-like holistic treatment facility. I'm going to write about it all here, and try to get as thorough an understanding of this field and these people as I possibly can before I start on my own path to help.

The title of this blog comes from the definition of addiction given by the American Medical Association:

"Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. The addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction can involve cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death."

It's my hope that this summer, and this blog, will give me a greater and more meaningful understanding of the state of treatment and the ineffective mythologies of addiction than I could ever get in classes.

So, that's my story. I'm not an alcoholic, and I'm looking forward to a world where nobody else is, either. And this summer is where I'm going to start.