Full text of Johann Hari, British writer and journalist, on “Everything you think you know about addiction is wrong” at TED June 2015 conference.
Listen to the Audio MP3 here: Everything you think you know about addiction is wrong by Johann Hari – Audio MP3
One of my earliest memories is of trying to wake up one of my relatives and not being able to. And I was just a little kid, so I didn’t really understand why, but as I got older, I realized we had drug addiction in my family, including later cocaine addiction.
I’d been thinking about it a lot lately, partly because it’s now exactly 100 years since drugs were first banned in the United States and Britain, and we then imposed that on the rest of the world. It’s a century since we made this really fateful decision to take addicts and punish them and make them suffer, because we believed that would deter them; it would give them an incentive to stop.
And a few years ago, I was looking at some of the addicts in my life who I love, and trying to figure out if there was some way to help them. And I realized there were loads of incredibly basic questions I just didn’t know the answer to, like, what really causes addiction? Why do we carry on with this approach that doesn’t seem to be working, and is there a better way out there that we could try instead?
So I read loads of stuff about it, and I couldn’t really find the answers I was looking for, so I thought, okay, I’ll go and sit with different people around the world who lived this and studied this and talk to them and see if I could learn from them. And I didn’t realize I would end up going over 30,000 miles at the start, but I ended up going and meeting loads of different people, from a transgender crack dealer in Brownsville, Brooklyn, to a scientist who spends a lot of time feeding hallucinogens to mongooses to see if they like them — it turns out they do, but only in very specific circumstances — to the only country that’s ever decriminalized all drugs, from cannabis to crack, Portugal.
And the thing I realized that really blew my mind is, almost everything we think we know about addiction is wrong, and if we start to absorb the new evidence about addiction, I think we’re going to have to change a lot more than our drug policies.
But let’s start with what we think we know, what I thought I knew. Let’s think about this middle row here, right? Imagine all of you, for 20 days now, went off and used heroin three times a day. Some of you look a little more enthusiastic than others at this prospect. Don’t worry, it’s just a thought experiment. Imagine you did that, right? What would happen?
Now, we have a story about what would happen that we’ve been told for a century. We think, because there are chemical hooks in heroin, as you took it for a while, your body would become dependent on those hooks, you’d start to physically need them, and at the end of those 20 days, you’d all be heroin addicts. Right? That’s what I thought.
First thing that alerted me to the fact that something’s not right with this story is when it was explained to me. If I step out of this TED Talk today and I get hit by a car and I break my hip, I’ll be taken to hospital and I’ll be given loads of diamorphine. Diamorphine is heroin. It’s actually much better heroin than you’re going to buy on the streets, because the stuff you buy from a drug dealer is contaminated. Actually, very little of it is heroin, whereas the stuff you get from the doctor is medically pure. And you’ll be given it for quite a long period of time. There are loads of people in this room, you may not realize it, you’ve taken quite a lot of heroin. And anyone who is watching this anywhere in the world, this is happening. And if what we believe about addiction is right — those people are exposed to all those chemical hooks — What should happen? They should become addicts. This has been studied really carefully. It doesn’t happen; you will have noticed if your grandmother had a hip replacement, she didn’t come out as a junkie.
And when I learned this, it seemed so weird to me, so contrary to everything I’d been told, everything I thought I knew, I just thought it couldn’t be right, until I met a man called Bruce Alexander. He’s a professor of psychology in Vancouver who carried out an incredible experiment I think really helps us to understand this issue.
Professor Alexander explained to me, the idea of addiction we’ve all got in our heads, that story, comes partly from a series of experiments that were done earlier in the 20th century. They’re really simple experiments. You can do them tonight when you go home if you feel a little bit sadistic. You get a rat and you put it in a cage, and you give it two water bottles: One is just water, and the other is water laced with either heroin or cocaine. If you do that, the rat will almost always prefer the drug water and almost always kill itself quite quickly. So there you go, right? That’s how we think it works.
In the ’70s, Professor Alexander comes along and he looks at this experiment and he noticed something. He said ah, we’re putting the rat in an empty cage. It’s got nothing to do except use these drugs. Let’s try something a bit different. So Professor Alexander built a cage that he called “Rat Park,” which is basically heaven for rats. They’ve got loads of cheese, they’ve got loads of colored balls, they’ve got loads of tunnels. Crucially, they’ve got loads of friends. They can have loads of sex. And they’ve got both the water bottles, the normal water and the drugged water.
But here’s the fascinating thing: In Rat Park, they don’t like the drug water. They almost never use it. None of them ever use it compulsively. None of them ever overdose. You go from almost 100% overdose when they’re isolated to zero percent overdose when they have happy and connected lives.
Now, when he first saw this, Professor Alexander thought, maybe this is just a thing about rats, they’re quite different to us. Maybe not as different as we’d like, but, you know — But fortunately, there was a human experiment into the exact same principle happening at the exact same time. It was called the Vietnam War. In Vietnam, 20% of all American troops were using loads of heroin, and if you look at the news reports from the time, they were really worried, because they thought, my God, we’re going to have hundreds of thousands of junkies on the streets of the United States when the war ends; it made total sense.