The pharmaceutical industry hopes to do for addiction what it did for depression. But does addiction demand a scientific solution?
When some of the top scientists in Britain were asked a few years ago to forecast how new technologies and scientific advances could be used to influence society in 20 years, they made some remarkable projections: that the brains of addicts could be “reprogrammed” to counter the effects of long-term addiction; that neural imaging could allow us to “identify former, current, and potential addicts”; and that anti-addiction vaccines could be used to immunize children deemed at risk of becoming addicted. (Vaccines for nicotine, cocaine, and meth are already in development. They work by producing antibodies to a specific drug, binding to it when it enters the bloodstream, and keeping it from entering the brain.)
Any addiction vaccine would likely come booby-trapped with contentious ethical questions. Should we force addicts, especially those who commit crimes (or those who repeatedly fail at taxpayer-funded treatment programs), to be vaccinated? And should children deemed “genetically predisposed” to addiction be vaccinated, even though they might never grow up to abuse drugs?
In their 52-page report, titled “Ethical Aspects of Developments in Neuroscience and Drug Addiction,” the British scientists hinted that we might even consider a mandatory national vaccination. “If it is not justifiable to vaccinate the entire nation,” the scientists wrote, “it could be feasible, and more affordable, to target certain groups within it. While there may be legitimate reasons to screen a certain population … groups could be selected on more dubious arguments.”
It wouldn’t be the first time we proposed radical solutions to deal with incorrigible addicts. In the early 1900s, some doctors called for the sterilization of drug abusers, and the state of Indiana passed a law banning marriages between “habitual drunkards.”
These extreme measures came only after countless miracle medications and cures—including an anti-alcohol vaccine extracted from horses’ blood and a bottled 69-cent cure for morphine and opium addiction advertised in the Sears, Roebuck & Company catalog—turned out to be useless. (Others were laced with the very drugs they were supposed to be “curing.” One study found that 19 of the 20 opium cures at the time contained … opium.)
In his book Slaying the Dragon: The History of Addiction Treatment and Recovery in America, William White recounts other failed treatments for addicts in the 19th century and first half of the 20th: shock therapy, prefrontal lobotomy surgery, spinal puncture, colonic irrigation therapy, and “the exposure of alcoholics to hot-air boxes and light boxes that mimicked the climatic conditions of the equator, where alcoholism was rare.”
Today, hopes are again high for a medical cure for addiction, and pharmaceutical companies are in a mad dash to develop drugs that target a handful of brain areas believed to play a part in addictive thinking and behavior.
“With the scientific advances we’re making in understanding how the human brain works, there’s no reason we can’t eradicate addiction in the next 20 or 30 years,” says Matthew Torrington, an addiction doctor in Los Angeles. “People are always going to drink and always going to try drugs, but do they need to become crack addicts? Do they have to take meth to the point where they lose their teeth and ditch their kids? Is that really necessary? I think addiction is the most beatable of all the major problems we face. And I think we will.”
Science, it seems, has always been just about to save us from addiction. “But it has never lived up to its promise,” argues Bruce Alexander, professor emeritus of psychology at Simon Fraser University in Vancouver. “Addiction doesn’t demand a scientific solution.” Alexander is among a vocal minority of addiction researchers who believe that focusing on a pill to treat addicts fails to address the primary cause of becoming and staying hooked: our unhappy, disconnected lives.
In 1981, Alexander and his team of researchers set out to study the role of our environment in addictive behavior. Like most addiction researchers at the time, they planned to use rats. But they went about it differently. Until then, most addiction scientists had simply put rats in small, individual cages and watched as they eagerly guzzled drug-laced solutions and ignored water and food, sometimes dying in the process.
This phenomenon was regarded—first by researchers, then drug czars, then parents trying to keep their kids off drugs—as proof of the inherently addictive quality of drugs and of the inevitable addiction of any human who used them repeatedly. (This was false, of course. Most people who try drugs don’t become addicted to them.)
So, what made all those lab rats lose their minds? Bruce Alexander and his research team had a simple hypothesis: The rats had awful lives. They were stressed, lonely, bored, and looking to self-medicate. To prove it, Alexander created a lab rat dream house he called “Rat Park Heaven.”
The 200-square-foot residence featured bright balls and tin cans to play with, painted creeks and trees to look at, and plenty of room for mating and socializing. Alexander took 16 lucky rats and plopped them in Rat Park Heaven, where they were offered water or a sweet, morphine-based cocktail (rats love sweets).
Alexander offered the same two drinks to the sixteen rats he isolated in cages. The results? The Rat-Parkers were apparently having too much fun to bother with artificial highs because they hardly touched the morphine solution, no matter how sweet Alexander and his colleagues made it. The isolated and stressed rats, on the other hand, eagerly got high, drinking 16 times the amount of the morphine solution as the rats in rodent paradise.
When I spoke with Alexander, he predicted that unless we undergo nothing short of a “cultural renaissance” and all start living in a human version of his Rat Park (which he conceded isn’t likely), we won’t be eradicating addiction anytime soon.
The truth is, neither the doctors and scientists who are predicting that we can do for addiction what we did for depression—nor the skeptics, like Alexander, who believe that addiction demands a cultural solution—know what the future holds for addiction treatment. Addiction is complicated, and anyone who tells you otherwise is on crack. So while addiction neuroscientists eagerly peer inside the addicted brain in search of a medical solution they believe is in there somewhere, most addicts in recovery aren’t holding their breath.
William C. Moyers, a recovery advocate and the author of the addiction memoir Broken, was invited to speak a few years ago at an addiction conference at M.I.T. In a room full of scientists and addiction researchers obsessed with the intricacies of the human brain, Moyers reminded them that treating addiction might be even more complicated than they thought.
“I have an illness with origins in the brain, but I also suffered with the other component of this illness,” he told the gathered researchers and scientists, some of whom dutifully took notes. “I was born with what I like to call a hole in my soul … A pain that came from the reality that I just wasn’t good enough. That I wasn’t deserving enough. That you weren’t paying attention to me all the time. That maybe you didn’t like me enough.”
The conference room was as quiet as it had been all day. “For us addicts,” he continued, “recovery is more than just taking a pill or maybe getting a shot. Recovery is also about the spirit, about dealing with that hole in the soul.”
—This essay was excerpted from Benoit’s book, America Anonymous: Eight Addicts in Search of a Life.