Looking for ‘Likely’ Cause of Addiction Won’t Get You Far

On Tuesday Huffington Post published an article with the headline, “The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think” written by Johann Hari. As is always the case with articles and arguments (including my own right here), there is something right about them. And something wrong. It is always important to identify each.

I’ll start with the right first. It is appropriate to ask, “What causes some people to become fixated on a drug or behavior until they can’t stop?” Those of us who are addicts ask ourselves this, as do those who know/ love/ live with us. Another great question that is dependent on the answer to the first is, “How do we help them?” I offer an addendum—How do we help ourselves?

Hari is also right to identify addiction as a symptom of a deeper sickness in the way we live. I certainly agree. Suffering is part of the human condition and addiction is a particular form of suffering. Addiction is an existential condition. It fundamentally affects the type of meaning and sense a person can make of herself and her place in the world. Addiction may accelerate as suffering does, which in turn increases suffering. The different forms of suffering become entangled, making it more likely that a person might seek to use chemicals or drugs. If we do want to lessen the chances of someone developing an addiction, we might look to various ways to alleviate suffering and, as Hari advocates, create more opportunities for human connection.

…I have some serious concerns with Hari’s arguments about an environment causing addiction…-Peg O’Connor

However, I have some serious concerns with Hari’s arguments about an environment causing addiction or causing a person to leave an addiction behind. As a philosopher, I tend to pay special attention whenever a causal claim is made. A causal claim is one of the strongest claims a person can make. She is claiming that two events are related to each other in such a way that one has the power to bring about another event that follows. Hari makes some unjustified causal claims that weaken his argument.

Hari references the Rat Park experiments. Put a rat into a cage with two bottles—one with plain water and one with cocaine laced water—and the rat will go for the cocaine water. In the 1970s, Bruce Alexander did some revised Rat Park studies. Instead of a bleak cage with an isolated rat, he put groups of rats in cages with various forms of play, stimulation, and good food. Rats in those conditions didn’t prefer the cocaine water to the plain water. Happy well-fed social rats had a good life and didn’t become heavy users.

Hari then cites Alexander’s further study of Rat Parks in which he introduced the isolated rats that got hooked on coke to Happy Rat Park. After a few twitches of withdrawal, they went back to a normal rat life.

Hari’s conclusion is, ‘the good cage saved them.’ There is also the implied related claim that ‘the bad cage destroyed them.’-Peg O’Connor

Hari’s conclusion is, “the good cage saved them.” There is also the implied related claim that “the bad cage destroyed them.” This is the locus of my concern. The cage has all the agency. The environment has all the power to destroy or to heal the rats. Let’s put aside the question of whether rats have agency, and turn to the case involving humans that Hari references to support the claim that the environment has all the causal power to good or bad effect.

What is the Environmental Impact on Addiction for Humans?

The number of veterans who became addicted to heroin while serving in Vietnam was relatively estimated to be 20 percent. Hari then claims, “some 95% 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 anymore.” A more pleasant cage saved them.

So, yes environments matter enormously. But this is not the same as saying that the environment causes [addiction].-Peg O’Connor

What Hari doesn’t mention is that a number of these addicted soldiers were “dried out” or were put into rehab before they were sent back home to the states. It is true that those soldiers who did this and then returned home had much lower rates of addiction or relapse than authorities would have imagined. The belief is that the environment in which they used was radically different from the one to which they returned. So, yes environments matter enormously. But this is not the same as saying that the environment causes. Here’s a feature about those veterans on NPR.

For Hari, the rats who became normal and the vets who didn’t keep using heroin show the view that the brain is hijacked by the chemical hooks or certain drugs or behaviors is wrong. If truly hijacked, a change in the environment wouldn’t make a difference. But there is a change, so Hari makes a leap to the conclusion that the new environment caused the change in use.

Here’s another way to tack into the problems I see with Hari’s claim that environments cause addiction or cause a person to be cured.

Hari’s conclusion that good or bad environments cause addiction rests upon an assumption that addiction is all in the brain or addiction is all in the environment. This is a false dichotomy that carries the load of his argument. Consider the fact that the brain is itself an environment of neurotransmitters, synapses, proteins, etc. The brain is located within the environment of the human body, which in turn is simultaneously within multiple physical and social environments. Environments overlap with each other. In the case of addiction, which environment is good or bad? This question cannot be answered in part because it is not well formed.

Addiction is a highly complex set of phenomena that cannot be reduced to one cause, which means there is not one solution or treatment.-Peg O’Connor

Instead of trying to answer a question that is a false dichotomy, let’s instead ask and answer questions about intersections and multiple causes. Addiction is a highly complex set of phenomena that cannot be reduced to one cause, which means there is not one solution or treatment. It may not be possible to untangle these factors because they become stuck together. Many of them are already relational or composite, so they can’t be reduced to their simple or single parts.

Hari’s argument does poignantly address ways that addiction is not just a problem of an individual with a brain that has gone haywire. I couldn’t agree more and I’ve argued elsewhere that we need to retire the analogy of the hijacked brain. We do need to attend to the fact there are social/ economic/ political realities that mean individuals and groups of people are more likely to suffer greatly and unjustly. We do need to examine the conditions in which some people live where getting high or being wasted is preferable to confronting a reality that offers no hope or no joy.

Aurora Photos: Todd Korol, Jakub Sliwa, Cary Wolinsky

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Rehabs.com. We do believe in healthy dialogue on all topics and we welcome the opinions of our professional contributors.

What Are Your Thoughts on this Topic?

  • annemfletcher

    As always, a brilliant analysis. And what’s lost in all of this is the added complexity that co-occurring mental health disorders add to the mix of this important conclusion, “Addiction is a highly complex set of phenomena that cannot be reduced to one cause, which means there is not one solution or treatment.”Many human “rats” come out of the best of cages (or ones that were pretty good) and their mental health disorders lead them to self-medicate with alcohol and drugs and often go undiagnosed before a vicious cycle is established.

    • BmoreDisqus

      Your point about co-occurring disorders is especially relevant since according to the author of the Vietnam heroin study, one of the limitations was that “the men in Vietnam had been selected for psychiatric health, in so far as the draft boards and the Army could do so.”

  • chastity gowen

    I am an addict and I definitely feel that addiction is a disease of the brain. I do know for sure that my environment as a child, a teenager and a young adult caused me to have depression and anxiety and I never learned how to cope with my problems because help was never available. I stastarredarted using drugs so that I could cover up my pain, so I could function in day to day life without the severe anxiety and depression. Im not sure if I would have grown up in a better environment if things would have been different. I don’t know if i would have still been an addict but I feel like I would have been an addict either way. I know why I started . I had no coping skills.

  • http://AddictionMyth.com/ AddictionMyth

    OK but the bigger point is that his research is helping end the drug war, which is predicated on the brain-hijack fallacy. Which means that fewer people will be sent to your beloved cult to be abused and exploited and brainwashed into suicide. Or as you call it, “Discover a new way of living.”

  • Sarah Pearce

    I think this is the most poignant response I’ve seen. Johann Hari is a disgraced journalist. He has used these tactics before. A quick Google search would cure anyone of taking him seriously.

  • Simon Lewis

    So we have a journalist and a philosopher debating the cause of addiction? Why don’t you try and get an Addiction Specialist to give the right answers? This is total nonsense….

  • Angela Shortt

    I posted the reference article to Facebook because I agree that community can help with recovery from addictions. And if the cause of addictions is substances, how do you explain hoarding, sex and love addiction, gaming, shopping/debting, and of course, gambling? I agree with Dr. O’Connor, the causes of addiction are extremely complex. I am not a drug addict or alcoholic, and never have been, despite being a teenager in the mid 70s, a time when I saw many people use and get addicted to drugs and alcohol. My drug of choice has been and still is food, and it has been since I was a little girl. Recovery from that addiction has been…well, not fun. How do you explain being addicted to something that people need to survive, and for me, isn’t related to fast food like so many young people? The questions are perplexing, and the answers aren’t easily forthcoming. For now, I’m grateful to have a loving and helpful community that, despite my isolationist tendencies, helps me through recovery.

  • BrittaH2O

    To a degree everyone’s addiction is different but when I read this article the emotion I felt is beyond description because reaffirmed a phenomenon which I personally experienced to a tee. The problem is everyone’s perfect “cage” is different and if you’re like me you don’t even know exactly what it entails. I’d say I’m close enough to an expert, having abused the same substance for half my life and having been on all sides from dealer to strung out and “in the closet” to shrugging my shoulders as if to say “idgaf”. Mind you, much like the author of this article I’d have thought, “No way, it’s harder then that.” because I’m an addict with a greater curse of a militant unforgiving expectation of myself which fueled my refusal of my socially unacceptable condition and a desire to shake my addiction. With no success, I could try every approach or every reason, even becoming successful in a promising career and by all appearances normal, productive, and totally self sufficient but still hated myself because even if only I knew, I still knew that without my drug I was left wanting, hungry. Half my life into my addiction and even before that, I’d be sober and drive through a certain neighborhood or even have a certain thought and immediate anxiety would set in until I could get high or sometimes my attempts at sobriety would be met with severe depression to which I would succumb, even spent six sober months in Mexico which was in no way an accomplishment because if I could have, I would’ve, in a heartbeat. Even with impending health complications that accompany long term use it didn’t matter. When I’d given up and accepted that I’d be the “poster child” for the functioning addict I accidentally stumbled upon my perfect “cage”. I was two months in before I noticed a weight was lifted thanks to an anxiety attack upon having a domestic dispute and at first I didn’t even recognize the feeling. I’ll add, yes, my perfect “cage” was still just a short drive(15 mins) from a dope spot but it was four states away from my home state and I was in the company of semi-inspiring company, flawed as they may have been. All I know is that I didn’t even want it or reminisce, more free of my addiction than I had been in 15 years of addiction and literally by accident. Not saying its realistic for everyone, not saying its easy, wanting isn’t always enough no matter how bad but you’re brain and body can do without if you find that place or that thing that fills that void (notice I didn’t say person). Place or thing. Not saying its the perfect answer but if you’re like I was than this FYI is for you, there is one out there.

  • Me24u

    Addiction wether it is drug or alcohol is a disease. To give the disease a platform in your reason to any degree is give it access permission. For once you have the disease it will out reason you every single time once in . If you dont think its a disease ,meaning its chronic,progressive and in the end if untreated fatal,then thats fine but its wrong. Yet you will repeatedly suffer at its hands as it deploys behind the scenes of your own thinking to defeat you every time. Wether you through habitual use or genetics got this disease is of little value really because once you have it you have hard wired your body to always use once you start. An alcoholic is helpless to be a moderate social drinker just as a heroin addict will someday be able to shoot up recreationally. The real flaw in any kind of non disease model is that it never deals with the “I” in the equation but leaves the “I” to function to some degree or another within the fallacious idea being reasonable. The ” I” has been hard wired to use and it doesnt care what language you use the machine until disconnected is programmed to use. You can spin out as many scenarios,words,ideas,theories,good and bad houses with mice but whatever you do, the machine will work around it and it can because it has entry through the “I” gate. In other words once you have this disease you have it for life. There really is only one way out and every scientific serious credible recovery resource uses it,the 12 steps. With the 12 steps and a spiritual awakening you can create a daily interruption within the machine ( you ) and interrupt the disease from interacting within the “I ” gate and operating behind the scenes to create the myriad of mental programs it stores to implement when it wants you act them out to use..or feed the disease. Yes the best you can hope for is a one day reprieve and its worked for me for ten years.

  • BmoreDisqus

    Great analysis. I regret the amount of time I just spent looking up all of the studies Hari referenced and writing my on critique to leave on the page of his Ted Talk about this. I wish I had found your article first because you hit all of the main ideas that I had in mind, especially in regard to the Vietnam study and the fact that half of the men addicted in Vietnam were required to be medically detoxed and participate in “a few weeks” of a rehabilitation program prior to returning to the US.

    One thing I just noticed after reading the NPR article that you linked to, Hari must have gotten his statistics from that article, but it’s not consistent with the actual study. According to the 3-year follow up report, of the men who were addicted to heroin in Vietnam, 50% used heroin at least one time on their return, 8% relapsed to addiction within 1 year and 12% met criteria for addiction again within 3 years of returning home.

    In the NPR article, it says, “I believe the number of people who actually relapsed to heroin use in the first year was about 5 percent,” Jaffe said recently from his suburban Maryland home. On Ted, Hari claimed 95% of the vets “just stopped” using heroin after returning to the US.

    It’s pretty understandable that Jaffe misremembered the exact number when he was giving an interview from his couch 40 years after the study. But the context makes it pretty clear that he wasn’t positive and was coming up with a number off the top of his head. But Hari, HARI! Supposedly you spent 3 years researching this to salvage your reputation after being caught plagiarizing quotes from other sources.

  • https://www.ibogainealliance.org Jonathan Dickinson

    Hari is a reporter, who is reporting on Bruce Alexander’s work. From what I’ve read here you’ve looked at the Rat Park experiment, but not the greater foundation of Alexander’s social dislocation theory which Hari is trying to explain. It seems like it would be more substantial to discuss Alexander’s work in the Globalization of Addiction. It is in fact, not the “environment” that he talks about, but “social dislocation” which can happen in any kind of environment.

  • Jeremy Schoenhaar

    This, at the bear minimum, means we still have the wrong approach at treating addiction and the drug problem in general. For one the fact that the vast majority of users are not addicts. They smoke a joint friday night after work, snort a line of coke at a party, whatever and then for weeks or months at a time don’t touch anything more then coffee. Yet if caught these non-problematic users could be imprisoned and stigmatized essentially starting their way into the very thing we’re trying to combat – drug addiction. Also I’ve been through two rehab centers. One concentrated solely on the abused drug. Nothing else, weather the drug be alcohol, cannabis, coke or bleach there was no other therapy. We were then released back into the world. In the second one we visited Phsychologists that tried to find the root of this self-medication frequently sending us out with pills after 15 Minutes of “analysis”. After 15 Minutes “you have adhd, here take this ritalin once a day” or “oh you bi-polar, here take Lithium and Zoloft twice a day” then the majorty of us were released back into the same environment. If you analysis is correct, and I agree with it in part, then we need a dual track treatment. We need to of course do drug withdrawls for addicts, releasing them back to abusive families, mobbing and bullying in school, poverty and unemployment is a waste. we’re setting the majorty up to relapse. we’ve done nothing more then give them a break from hell. I was lucky, I had someone on the other side of the rabbithole. Most of them don’t. Prohibiting drugs isn’t the answer and neither is our simplistic “treat the drug problem”. We need to PREVENT addiction. That means preventing abuse (weather physical, psycological or sexual), bullying, mobbing, poverty, and unemployment. Our Prohibitionist stance is counter productive to that, in fact it encourages just that! so the question is do we want to treat addicts, or do we want to punish use. these are mutually exclusive of one anouther. So make up your minds!