Maia Szalavitz is an award-winning journalist with over three decades of experience reporting on addiction, neuroscience, and public policy. She recently spoke at an event sponsored by the U of M Medical School’s Medical Discovery Team on Addiction (CCAPS LearningLife was also a cosponsor). Below is a recap of that event.

What Is Addiction?

The American Psychiatric Association’s definition of addiction is “a brain disease that is manifested by compulsive substance use despite harmful consequences.”

Slide of Maia Szalavitz book Unbroken Brain

Szalavitz noted near the beginning of her talk that we punish people with addiction when they are suffering from something that, by definition, does not respond to punishment. She argued addiction is fundamentally a learning disorder. How so? Like learning disorders, addiction:

  • typically starts during a specific time of life.
  • affects only one type of learning, not general intelligence.
  • can be linked with skills not just deficits.

Historically, there have essentially been two approaches to treating addiction. The disease model suggests that the brain is hijacked, and sick people should receive treatment as they would if they had a chronic illness. This theory implies that people with addiction are not responsible for their behavior. Szalavitz stressed that “addiction skews choices, it doesn’t remove them.”

The second approach is the moral model, where addiction is a choice and involves deliberate bad behavior. Some believe it can therefore be addressed through prayer, confession, and meditation.

What if addiction were neither disease nor sin? Szalavitz proposed that both models are flawed. “Addiction is what happens when your brain falls in love with a substance rather than a person. It’s when your brain has learned to love the wrong thing.”

So, What Next?

Szalavitz recommended developing different treatment approaches that meet unique client needs. More treatments should consider harm reduction. Counselors should see clients as “learners who need an education, not sinners.”

Maia Szalavitz on stage with Stephanie Curtis

Just as there are many different ways someone becomes addicted, “there are just as many ways to end it.” There are addicted people who are risk takers, and others who have anxiety or depression who would need to be regarded differently.

Preventive measures can start in childhood by helping kids with trauma find positive coping mechanisms, she continued. Psychological research on learning can be used to inform treatment methods. Policies that don’t criminalize addiction can be considered.

Szalavitz encouraged society to work toward destigmatizing medications that are effective against opioid addiction, and to stop arguing whether or not addiction is a sin or a disease. Also, she added, counselors should be paid appropriately. She closed with a plea for compassion, then answered a few questions from the audience, moderated by Minnesota Public Radio’s Stephanie Curtis.
Recovery on Campus (ROC), University of Minnesota
LearningLife, College of Continuing and Professional Studies, University of Minnesota
The Steve Rumler HOPE Network
The Chris Wivholm Foundation