Is Addiction a Brain Disease? A Neurologist Explains the Science and Stigma With Dr. Carolyn Larkin Taylor

In this episode of The Hanley Effect, neurologist Dr. Carolyn Larkin Taylor shares how three decades in practice shaped her view of addiction as a brain disease, not a moral failing. She traces her path from early training in Philadelphia to many years of practice in Washington State, explains why the developing brain is especially vulnerable (“wet cement”), and offers concrete examples of how addiction shows up in neurology clinics (e.g., withdrawal‑related seizures, B12 deficiency from nitrous oxide). Together, hosts Dr. John Dyben and Dr. Rachel Docekal with Dr. Taylor unpack the “rock bottom” myth, the fine line between compassion and enabling, and why family education changes outcomes.What We CoverDr. Taylor’s path in neurology: From training and early practice in Philadelphia to decades of patient care in Washington State, including building group practice and an MS‑focused center.Addiction is a brain disease: Why language matters, how stigma blocks care, and the role of dopamine pathways, stress reactivity, and metabolism in vulnerability.Genetics & risk: Twin/adoption research suggests 40–60% heritability; we can’t predict which young person will be most at risk, so prevention and education are essential.The adolescent brain (“wet cement”): Early exposure can re‑wire maturing circuitry and raise adult addiction risk (4–6×); abstinence and healthy routines can still support re‑wiring, but it’s harder later.What neurologists see:Alcohol/benzodiazepine withdrawal seizures in teens and adults.B12 deficiency (e.g., from nitrous oxide) presenting as numbness/tingling.Seizures are misattributed to other conditions when withdrawal is the driver.Rock bottom is not a treatment plan: Why earlier intervention saves lives; how families can “raise the bottom” with boundaries and support.Compassion vs. enabling: Understanding survival‑driven brain changes (craving feels like “air/water”) while guiding loved ones toward care.Systems & solutions: Family education (including intensive family programs), the limits of punishment/incarceration, and the urgent need for more mental‑health resources.Continuing education for clinicians: How required CME around substance use (spurred by the opioid crisis) is improving clinical literacy.How to ConnectLearn more about Hanley Foundation treatment programs and family education: hanleycenter.orgAdmissions & info: 844‑502‑4673