# Another view of addiction



## David Baxter PhD (Apr 17, 2017)

*The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think*
By Johann Hari, _The Huffington Post_
Jan 20, 2015; Updated Jan 25, 2016 

It is now one hundred years since drugs were first banned ? and all  through this long century of waging war on drugs, we have been told a  story about addiction by our teachers and by our governments. This story  is so deeply ingrained in our minds that we take it for granted. It  seems obvious. It seems manifestly true. Until I set off three and a  half years ago on a 30,000-mile journey for my new book, _Chasing The Scream: The First And Last Days of the War on Drugs_,  to figure out what is really driving the drug war, I believed it too.  But what I learned on the road is that almost everything we have been  told about addiction is wrong ? and there is a very different story  waiting for us, if only we are ready to hear it. 

 If we truly absorb this new story, we will have to change a lot more than the drug war. We will have to change ourselves.

 I learned it from an extraordinary mixture of people I met on my  travels. From the surviving friends of Billie Holiday, who helped me to  learn how the founder of the war on drugs stalked and helped to kill  her. From a Jewish doctor who was smuggled out of the Budapest ghetto as  a baby, only to unlock the secrets of addiction as a grown man. From a  transsexual crack dealer in Brooklyn who was conceived when his mother, a  crack-addict, was raped by his father, an NYPD officer. From a man who  was kept at the bottom of a well for two years by a torturing  dictatorship, only to emerge to be elected President of Uruguay and to  begin the last days of the war on drugs.

 I had a quite personal reason to set out for these answers. One of my  earliest memories as a kid is trying to wake up one of my relatives,  and not being able to. Ever since then, I have been turning over the  essential mystery of addiction in my mind ? what causes some people to  become fixated on a drug or a behavior until they can?t stop? How do we  help those people to come back to us? As I got older, another of my  close relatives developed a cocaine addiction, and I fell into a  relationship with a heroin addict. I guess addiction felt like home to  me.

 If you had asked me what causes drug addiction at the start, I would  have looked at you as if you were an idiot, and said: ?Drugs. Duh.? It?s  not difficult to grasp. I thought I had seen it in my own life. We can  all explain it. Imagine if you and I and the next twenty people to pass  us on the street take a really potent drug for twenty days. There are  strong chemical hooks in these drugs, so if we stopped on day  twenty-one, our bodies would need the chemical. We would have a  ferocious craving. We would be addicted. That?s what addiction means.

 One of the ways this theory was first established is through rat  experiments ? ones that were injected into the American psyche in the  1980s, in a famous advert by the Partnership for a Drug-Free America.  You may remember it. The experiment is simple. Put a rat in a cage,  alone, with two water bottles. One is just water. The other is water  laced with heroin or cocaine. Almost every time you run this experiment,  the rat will become obsessed with the drugged water, and keep coming  back for more and more, until it kills itself. 

 The advert explains: ?Only one drug is so addictive, nine out of ten  laboratory rats will use it. And use it. And use it. Until dead. It?s  called cocaine. And it can do the same thing to you.? 

 But in the 1970s, a professor of Psychology in Vancouver called Bruce Alexander  noticed something odd about this experiment. The rat is put in the cage  all alone. It has nothing to do but take the drugs. What would happen,  he wondered, if we tried this differently? So Professor Alexander built  Rat Park. It is a lush cage where the rats would have colored balls and  the best rat-food and tunnels to scamper down and plenty of friends:  everything a rat about town could want. What, Alexander wanted to know,  will happen then? 

 In Rat Park, all the rats obviously tried both water bottles, because  they didn?t know what was in them. But what happened next was  startling. 

 The rats with good lives didn?t like the drugged water. They mostly  shunned it, consuming less than a quarter of the drugs the isolated rats  used. None of them died. While all the rats who were alone and unhappy  became heavy users, none of the rats who had a happy environment did. 

 At first, I thought this was merely a quirk of rats, until I  discovered that there was ? at the same time as the Rat Park experiment ?  a helpful human equivalent taking place. It was called the Vietnam War.  _Time_ magazine reported using heroin was ?as common as chewing  gum? among U.S. soldiers, and there is solid evidence to back this up:  some 20 percent of U.S. soldiers had become addicted to heroin there,  according to a study published in the _Archives of General Psychiatry_. Many people were understandably terrified; they believed a huge number of addicts were about to head home when the war ended. 

 But in fact some 95 percent of the addicted soldiers ? according to  the same study ? simply stopped. Very few had rehab. They shifted from a  terrifying cage back to a pleasant one, so didn?t want the drug any  more.

 Professor Alexander argues this discovery is a profound challenge  both to the right-wing view that addiction is a moral failing caused by  too much hedonistic partying, and the liberal view that addiction is a  disease taking place in a chemically hijacked brain. In fact, he argues,  addiction is an adaptation. It?s not you. It?s your cage.

 After the first phase of Rat Park, Professor Alexander then took this  test further. He reran the early experiments, where the rats were left  alone, and became compulsive users of the drug. He let them use for  fifty-seven days ? if anything can hook you, it?s that. Then he took  them out of isolation, and placed them in Rat Park. He wanted to know,  if you fall into that state of addiction, is your brain hijacked, so you  can?t recover? Do the drugs take you over? What happened is ? again ?  striking. The rats seemed to have a few twitches of withdrawal, but they  soon stopped their heavy use, and went back to having a normal life.  The good cage saved them. (The full references to all the studies I am  discussing are in the book.)

 When I first learned about this, I was puzzled. How can this be? This  new theory is such a radical assault on what we have been told that it  felt like it could not be true. But the more scientists I interviewed,  and the more I looked at their studies, the more I discovered things  that don?t seem to make sense ? unless you take account of this new  approach.

 Here?s one example of an experiment that is happening all around you,  and may well happen to you one day. If you get run over today and you  break your hip, you will probably be given diamorphine, the medical name  for heroin. In the hospital around you, there will be plenty of people  also given heroin for long periods, for pain relief. The heroin you will  get from the doctor will have a much higher purity and potency than the  heroin being used by street-addicts, who have to buy from criminals who  adulterate it. So if the old theory of addiction is right ? it?s the  drugs that cause it; they make your body need them ? then it?s obvious  what should happen. Loads of people should leave the hospital and try to  score smack on the streets to meet their habit.

 But here?s the strange thing: It virtually never happens. As the Canadian doctor Gabor Mate  was the first to explain to me, medical users just stop, despite months  of use. The same drug, used for the same length of time, turns  street-users into desperate addicts and leaves medical patients  unaffected.  

 If you still believe ? as I used to ? that addiction is caused by  chemical hooks, this makes no sense. But if you believe Bruce  Alexander?s theory, the picture falls into place. The street-addict is  like the rats in the first cage, isolated, alone, with only one source  of solace to turn to. The medical patient is like the rats in the second  cage. She is going home to a life where she is surrounded by the people  she loves. The drug is the same, but the environment is different. 

 This gives us an insight that goes much deeper than the need to  understand addicts. Professor Peter Cohen argues that human beings have a  deep need to bond and form connections. It?s how we get our  satisfaction. If we can?t connect with each other, we will connect with  anything we can find ? the whirr of a roulette wheel or the prick of a  syringe. He says we should stop talking about ?addiction? altogether,  and instead call it ?bonding.? A heroin addict has bonded with heroin  because she couldn?t bond as fully with anything else. 

 So the opposite of addiction is not sobriety. It is human connection. 

 When I learned all this, I found it slowly persuading me, but I still  couldn?t shake off a nagging doubt. Are these scientists saying  chemical hooks make no difference? It was explained to me ? you can  become addicted to gambling, and nobody thinks you inject a pack of  cards into your veins. You can have all the addiction, and none of the  chemical hooks. I went to a Gamblers? Anonymous meeting in Las Vegas  (with the permission of everyone present, who knew I was there to  observe) and they were as plainly addicted as the cocaine and heroin  addicts I have known in my life. Yet there are no chemical hooks on a  craps table.

 But still, surely, I asked, there is some role for the chemicals? It  turns out there is an experiment which gives us the answer to this in  quite precise terms, which I learned about in Richard DeGrandpre?s book _The Cult of Pharmacology_. 

 Everyone agrees cigarette smoking is one of the most addictive  processes around. The chemical hooks in tobacco come from a drug inside  it called nicotine. So when nicotine patches were developed in the early  1990s, there was a huge surge of optimism ? cigarette smokers could get  all of their chemical hooks, without the other filthy (and deadly)  effects of cigarette smoking. They would be freed. 

 But the Office of the Surgeon General has found that just 17.7  percent of cigarette smokers are able to stop using nicotine patches.  That?s not nothing. If the chemicals drive 17.7 percent of addiction, as  this shows, that?s still millions of lives ruined globally. But what it  reveals again is that the story we have been taught about The Cause of  Addiction lying with chemical hooks is, in fact, real, but only a minor  part of a much bigger picture.

 This has huge implications for the one-hundred-year-old war on drugs.  This massive war ? which, as I saw, kills people from the malls of  Mexico to the streets of Liverpool ? is based on the claim that we need  to physically eradicate a whole array of chemicals because they hijack  people?s brains and cause addiction. But if drugs aren?t the driver of  addiction ? if, in fact, it is disconnection that drives addiction ?  then this makes no sense. 

 Ironically, the war on drugs actually increases all those larger  drivers of addiction. For example, I went to a prison in Arizona ? ?Tent City?  ? where inmates are detained in tiny stone isolation cages (?The Hole?)  for weeks and weeks on end to punish them for drug use. It is as close  to a human recreation of the cages that guaranteed deadly addiction in  rats as I can imagine. And when those prisoners get out, they will be  unemployable because of their criminal record ? guaranteeing they with  be cut off even more. I watched this playing out in the human stories I  met across the world.

 There is an alternative. You can build a system that is designed to  help drug addicts to reconnect with the world ? and so leave behind  their addictions. 

 This isn?t theoretical. It is happening. I have seen it. Nearly  fifteen years ago, Portugal had one of the worst drug problems in  Europe, with 1 percent of the population addicted to heroin. They had  tried a drug war, and the problem just kept getting worse. So they  decided to do something radically different. They resolved to  decriminalize all drugs, and transfer all the money they used to spend  on arresting and jailing drug addicts, and spend it instead on  reconnecting them ? to their own feelings, and to the wider society. The  most crucial step is to get them secure housing, and subsidized jobs so  they have a purpose in life, and something to get out of bed for. I  watched as they are helped, in warm and welcoming clinics, to learn how  to reconnect with their feelings, after years of trauma and stunning  them into silence with drugs.  

 One example I learned about was a group of addicts who were given a  loan to set up a removals firm. Suddenly, they were a group, all bonded  to each other, and to the society, and responsible for each other?s  care. 

 The results of all this are now in. An independent study by the _British Journal of Criminology_  found that since total decriminalization, addiction has fallen, and  injecting drug use is down by 50 percent. I?ll repeat that: injecting  drug use is down by 50 percent.  Decriminalization has been such a  manifest success that very few people in Portugal want to go back to the  old system. The main campaigner against the decriminalization back in  2000 was Joao Figueira, the country?s top drug cop. He offered all the  dire warnings that we would expect from the _Daily Mail_ or Fox  News. But when we sat together in Lisbon, he told me that everything he  predicted had not come to pass ? and he now hopes the whole world will  follow Portugal?s example.

 This isn?t only relevant to the addicts I love. It is relevant to all  of us, because it forces us to think differently about ourselves. Human  beings are bonding animals. We need to connect and love. The wisest  sentence of the twentieth century was E.M. Forster?s ? ?only connect.?  But we have created an environment and a culture that cut us off from  connection, or offer only the parody of it offered by the Internet. The  rise of addiction is a symptom of a deeper sickness in the way we live ?  constantly directing our gaze towards the next shiny object we should  buy, rather than the human beings all around us.

 The writer George Monbiot has called this ?the age of loneliness.?  We have created human societies where it is easier for people to become  cut off from all human connections than ever before. Bruce Alexander ?  the creator of Rat Park ? told me that for too long, we have talked  exclusively about individual recovery from addiction. We need now to  talk about social recovery ? how we all recover, together, from the  sickness of isolation that is sinking on us like a thick fog.

 But this new evidence isn?t just a challenge to us politically. It  doesn?t just force us to change our minds. It forces us to change our  hearts. 

 Loving an addict is really hard. When I looked at the addicts I love,  it was always tempting to follow the tough love advice doled out by  reality shows like _Intervention_ ? tell the addict to shape up,  or cut them off. Their message is that an addict who won?t stop should  be shunned. It?s the logic of the drug war, imported into our private  lives. But in fact, I learned, that will only deepen their addiction ?  and you may lose them altogether. I came home determined to tie the  addicts in my life closer to me than ever ? to let them know I love them  unconditionally, whether they stop, or whether they can?t. 

 When I returned from my long journey, I looked at my ex-boyfriend, in  withdrawal, trembling on my spare bed, and I thought about him  differently. For a century now, we have been singing war songs about  addicts. It occurred to me as I wiped his brow, we should have been  singing love songs to them all along. 

_The full story of Johann Hari?s journey ? told through the stories of the people he met ? can be read in Chasing The Scream: The First and Last Days of the War on Drugs, published by Bloomsbury. _


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## David Baxter PhD (Apr 17, 2017)

*Comment on The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think*:

Articles titled like this one are often called "click bait", because they offer something expressed in superlatives and fail to deliv er on the promise.

I'm not necessarily saying that this is the case for this article, or that the author, Johann Hari, intentionally titled the article as click bait.

But I am always wary about titles like this and you should be too.

The author seems to be trying to make the claim that all our previous ideas about addiction are simply wrong and that his (her?) slant on addictions is the correct one.

The reality is that addiction may have many causes, different causes in different individuals, and that both genetics and the specific drug of choice are probably also involved for most addictions.

At the same time, I think this article has value is asking us to look at other factors besides those two. The one this article highlights may indeed accurately describe one of the causes in certain addicts, and certainly is a factor that should be considered in treatment and in planning for relapse prevention.

I think the article's reference to gambling "addiction" is also noteworthy, but not for the reasons the author suggests. It's become popular in recent years to refer to various obsessional or compulsive behaviors as addictions - gambling addiction, internet addiction, sex addiction, gaming addiction - and this is probably a mistake for several reasons. Applying the addictions model to such behaviors really doesn't help us in understanding the behaviors or in  treating them, so iut does a disservice both to the misnamed compulsive behaviors and to real addictions.

It's an interesting article. Just be cautious not to interpret the author's conclusions as a "one size fits all" model of addiction and treatment of addictions.


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## GDPR (Apr 18, 2017)

I stumbled upon that article somewhere last year I think and had mixed emotions about it.I wish it was as simple as the author makes it sound.

One thing both my sons have said though is what always makes them go back to using is missing/craving the lifestyle that goes along with it,so there might be a little bit of truth to the article,at least for them.It's a combination of many different things I think,maybe individual for each addict that each individual needs to figure out in order to recover.I don't think there should be a one size fits all approach to it.


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## Puzzler (Apr 26, 2017)

Oversimplification always comes with its drawbacks. I remember reading a more nuanced take on Bruce Alexander's findings a few years ago. I think this BBC article quote by Tom Stafford brings out one important take-away:



> ... when stories about the effects of drugs on the brain are promoted to the neglect of the discussion of the personal and social contexts of addiction, science is servicing our collective anxieties rather than informing us.



I think it is helpful to learn about ways we are all similar, as well as our differences. Just not one to the exclusion of contrary evidence.


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