The Likely Cause of
Addiction Has Been Discovered, and It Is Not
What You Think
By Johann Hari
January 24, 2015 "ICH"
- "HP"
- 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. The book has been
praised by everyone from Elton John to Glenn
Greenwald to Naomi Klein. You can buy it at
all good bookstores and read more at
www.chasingthescream.com.
See Also -
The Bomb in the Brain
- The Effects of Child Abuse
- The True Roots of Human Violence