Addiction: It may not be us; it may be our cages
Our country’s “War on Drugs” began in 1971 with President Nixon’s declaration that drug use was “public enemy number one in the United States.” In addition to drugs as a symbol of youthful rebellion and radicalization, America’s new home-turf war was fueled by a growing literature base supporting the biological theory of addiction. However, one of the most interesting experiments to emerge from that era challenged this biological view. It became known as “Rat Park.”
He had proven that a fulfilling life could deter a healthy rat from choosing drugs in the first place, but would a new environment be enough to cure an addicted rat?
Before the advent of “Rat Park,” widely publicized experiments demonstrated that the presence of drugs in a rat’s cage caused the rat to become addicted. If given the choice between two water bottles – one filled with pure water and the other with cocaine- or heroin-laced water – the rats chose the drugged water almost every time. Many rats even drank the drugged water until they died. The presence of drugs, paired with their strong chemical components, changed the user’s biology, making drugs impossible to resist. This research gave us the answer to our nation’s drug problem. It was simple: we need to ban drugs.
Addiction is an adaptation
At around this same time, a researcher named Bruce Alexander challenged this theory. Familiar with the rat experiments, he considered the lives those rats led – stuck in metal cages with nothing to do. Isolated. Bored. No friends. Maybe if they had more fulfilling lives, he thought, they might choose abstinence. To test his theory, Alexander built a rat utopia – “Rat Park.” It had everything a rat could want. Room to run around. Wheels to run in, balls to play with. And most importantly, rat friends. The rats were then given the same water choices as the caged rats. You guessed it. The happy rats didn’t drink the drugged water. You could say they were “high on life.”
Our approach to treating addiction has not shifted to incorporate a focus on societal and environmental factors that contribute to drug use. The U.S. continues a strategy that has proven unsuccessful and costly.
Compelled by these findings, Alexander continued his research. He had proven that a fulfilling life could deter a healthy rat from choosing drugs in the first place, but would a new environment be enough to cure an addicted rat? The question had serious real-life implications. With the Vietnam War raging, it was reported that 20 percent of U.S. soldiers were addicted to heroin. The country was bracing for an onslaught of veterans with addiction problems to return home.
To push his theory, Alexander isolated some rats in the depressing metal cages for 57 days where they drank the drugged water until they were heavily addicted. On day 58, Alexander moved them into Rat Park. You guessed it again. They stopped drinking the drugs in favor of a drug-free existence, even at the expense of withdrawal symptoms. Not long thereafter, our country’s soldiers returned. Approximately, 95 percent of them stopped using drugs, most without accessing detoxification services.
Put our money where the evidence is
Despite Bruce Alexander’s research, our approach to treating addiction has not shifted to incorporate a focus on societal and environmental factors that contribute to drug use. The U.S. continues a strategy that has proven unsuccessful and costly. We simply ban drugs at an annual cost of $40 billion. What if that money was instead used to prevent the social causes of addiction? Fifteen years ago, Portugal asked this question. Plagued with one of the worst drug problems in Europe, the country stopped spending money arresting and incarcerating users, and instead used the money “reconnecting” individuals with addiction to their communities. Money was spent on housing, supported employment, socialization, and psychological treatment. For a third time, you guessed it. Today, drug use in Portugal is down 50 percent.
My intent here is not to dispel the biological model of addiction. The literature supporting biological antecedents to addiction is widespread and compelling as described in last week’s blog post by Rachael Mazzella.
I argue, however, that it will never explain the whole story. When our health plan members, our friends, or our family members are struggling with a substance use disorder, for some maybe the problem isn’t them. Maybe it’s not the drugs. Maybe it’s their cage.