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July 31, 2021

Can we just Admit we Don’t Know Sh*t about Addiction?

 

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“Imagine if all of you, for 20 days now, went off and used heroin three times a day…”

Journalist Johan Hari posed this hypothetical in his viral and much-cited TED Talk, “Everything you think you know about addiction is wrong.” For all practical purposes, he was trying to explain that most of these people in the audience would likely come away unscathed by this experience. Why?

Well, here’s where we get into the “Rat Park” experiment conducted by Canadian Bruce Alexander in 1979. I’ll break it down quick and easy for you: by putting some rats in a lonely cage and others in a cage with other rats and cheese and toys—both cages equipped with morphine laced water bottles—the behavior of both sets of rats proved, beyond a shadow of a doubt, that addiction had little to do with chemistry. Addiction was entirely environmental. This was because the rats with friends, toys, and access to sex couldn’t really be bothered with the morphine, whereas the rats that were alone almost always used the morphine until they overdosed and died.

“The opposite of addiction is not sobriety. The opposite of addiction is connection,” states Johan Hari at the end of the TED Talk, as the room erupts in applause. This line became the battle cry of millions of counselors in the addiction and recovery field and, most especially, on social media. Many addicts could easily agree. “I’ve always had very little connection in my life,” went the mindset. “This makes perfect sense.”

Unfortunately, the “Rat Park” study had some severe flaws that have been largely overlooked by the hundreds and hundreds of scholars and authors who have cited it in books and articles over the last 20 years. One need not go any further than Wikipedia to find out that another scholar tried replicating the experiment and could not achieve a result even similar to Alexander’s. Even worse, the problems with Alexander’s study included “equipment failures, lost data, and rat deaths.” It wasn’t as if this was initially overlooked, either. Alexander did not have an easy time finding a journal that would publish “Rat Park” for these very reasons.

But, as many people already know, in the world of social media, truth is always going to take a backseat to flashy and easy—and there is nothing flashier and easier than to stick the complicated human problem of addiction in a neat little box. This is no different from what the government did years ago when it began the very costly and ineffective “War on Drugs.” In his TED Talk, all Hari is doing is picking it up from one box and putting it into another.

I get the temptation to do this. It would be nothing short of miraculous to be able to possess an easy answer to addiction. Once you had that, you’d really only be moments away from repairing a hole in the fabric of humanity that was killing millions of people. Last year alone, drug overdoses in the United States shot up to 93,000—an unheard of number in our country’s history.

If I sound like a spoilsport, I apologize. However, my issue with bad science goes right back to those 93,000 people and the millions of lives affected by their premature deaths. The dramatic increase in the prescribing and administration of opiates that sits at the roots of this crisis was justified by one doctor’s letter to a medical journal that was misread, misused, and misunderstood. Armed with this letter and financial incentives, companies like Purdue Pharma and McKesson were able to convince doctors all over the country to become a lot more liberal about prescribing OxyContin and other dangerous opiates.

There is nothing benign about bending facts to sell pills, books, seminar seats, or influence. People die in the process.

The ugly and too-often-ignored truth about addiction is that it is not the opposite of connection; it is not a moral failing; it is not directly linked to childhood trauma, and it is not strictly an urban problem. It is all of those things and some others, as well. It’s part social, part economic, part physiological, and part psychological.

Of course, this would not garner too much applause at a TED Talk, nor would it be shared on Facebook millions of times, and that is what makes it “ugly.” I don’t know exactly how long the medical field has been trying to sum up the mysteries of human addiction, but I’d venture to guess that it goes back many hundreds of years.

As the Narcotics Anonymous text so succinctly puts it, the disease of addiction is “cunning, baffling, and insidious.”

While it may seem vexing to conclude with a chaotic and unruly idea, it may soften the blow to remember that the universe itself is chaotic. This was the main reason that man created religion. And while there is nothing inherently dangerous about religion, it has been used to start countless wars and oppress millions of people. The casualties from bad science are just as horrific.

So perhaps we should do everything we can to just get comfortable with chaos.

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