Can Connection Really be the Cure for Addiction?

Johann Hari’s NY Times bestseller about the causes of addiction and depression brings a lot to the table. So did his TED talk in 2015 at the TED Global conference in London titled “Everything you know about Addiction is wrong”. But does Hari’s notion that the lack of connection in people’s lives is the root cause of addiction hold ground? Can connection really prevent or be the cure for addiction? Let’s take a look at Hari’s proposition and what it entails.

Johann Hari’s Premise

According to Hari, it’s not brain chemistry that decides addictions or drug use. It’s more about the environment the individuals were part of and their social influences. How did he come to this conclusion? He travelled over 40,000 miles to nine countries to meet social scientists who were discovering that depression isn’t caused by chemical imbalances in the brain or by faulty genes, but as a result of faulty social environments that individuals were subjected to.

An example that Hari uses as part of his TED talk case is that of a grandmother going in for hip replacement surgery. While in the hospital for a few weeks the grandmother is treated with diamorphine to ease her pain. Hari explains that while the heroin bought on the streets is never 100% pure, diamorphine is the purest form of heroine. Technically, addictions to drugs are said to develop after 21 days of continued use. Yet when the grandmother comes out of the hospital after three weeks, she hasn’t turned into a drug addict. Although the risk factors for addiction in the hospital were higher, most people who are treated in hospitals with diamorphine do not turn out to be addicts at all. Hari thus contradicts the universal belief in drug induced addiction.    

Hari uses the decriminalisation efforts of the Portuguese government as an example of how connection can help drug addicts break free of their addictions. Around 2000, Portugal had nearly 1 percent of its population addicted to heroin. Their war on drugs only made matters worse. So they did something different. Drugs were decriminalised and the money that was once spent on arrests and jailing addicts was redirected to reconnect them. The government helped them get housing and subsidised jobs, and entered them into treatment programmes. As a result, 15 years later drug use in Portugal was down 50 percent. 

Hari also cites the Rat Park experiment to explain why individuals who are connected do not become drug addicts and individuals who reconnect find it easier to stop substance abuse. For example, the rats in the Rat Park which was more like a rat heaven did not opt to take morphine although they had an ample supply of it. It was only the rats that were in isolation that drank morphine. Hari examines the social factors that are causes of addiction – trauma, loneliness, hardship, disconnection and more – and submits that reconnection and finding methods of reconnecting may really be the cure for addiction and other psychological conditions such as depression and anxiety. And that reintroducing an individual to society, giving them a reason to wake up in the morning and making them feel like a part of something is the key to fighting drug addiction.

What is ‘The Rat Park’?

The Rat Park was a study conducted by Bruce Alexander, and looked at drug addiction among rats in the 1970s. He conducted the study with colleagues at the Simon Fraser University in British Columbia and published his paper in 1981 in the Psychopharmacology journal.

Alexander’s study was based on the hypothesis that addiction isn’t caused by drugs or their addictive properties, but by living conditions of the subjects. He built a large housing colony for rats that was 200 times the size of standard cages. The cage was filled with food, playing wheels, colourful balls, plenty of mating space and about 16 to 20 rats. This cage was a sort of rat heaven and was called The Rat Park.

Groups of rats spent varying amounts of time in The Rat Park or in isolation. The rats had the option of drinking fluid from two drop dispensers; one dispensed water while one dispensed morphine.

Alexander found that the rats in isolation instantly took to the morphine; and later still opted for the morphine although they were also given a choice of water. The rats in The Rat Park did not. The Rat Park rats tried the morphine occasionally but rejected it in preference for water. Alexander found that the rats in isolation drank 19 times more morphine than those in The Rat Park. However, the rats in the Rat Park preferred communal activities like eating, playing, mating and fighting.

Alexander found the most interesting group to be the ones that started out in isolation and later moved to The Rat Park.  Although these rats had been drinking only morphine while in isolation, they rejected the morphine when they entered The Rat Park and opted for plain water. He wrote that this group showed minor signs of withdrawal such as twitching, but no seizures or sweats. Alexander’s experiment proved that although rats in isolation chose drugs, the rats in The Rat Park did not choose drugs though they were easily available. He found that affinity of isolated rats or people to drugs differed from the response of normal rats or people to drugs. Alexander said that ‘normal’ people can ignore drugs even when it was amply available in their environment.

Does The Rat Park Situation Apply to Humans?

Although Hari applies The Rat Park situation to humans and claims that connection is the cure for addiction, it’s not as clear cut as that. As Dr. Adi Jaffe points out, life is not stress free. Individuals suffer from imperfect marriages, psychological and physical abuse, depression, dietary limitations, wars and trauma. Earth is not a utopia, and individuals affected by traumatic experiences, bad circumstances, or biological problems may struggle with drugs. Jaffe also expands that “genetic differences, neonatal circumstances and early nutrition can alter brain mechanisms making people more or less susceptible to trauma”. Yes, many people can use drugs without getting addicted; but some individuals have a greater need for alternate coping mechanisms and the temporal relief that drugs provide them. Also, while connection may be a vital step on the road to recovery, Hari was not the first to discover this. 12-step programmes such as Alcoholics Anonymous and Narcotics Anonymous were putting alcoholics and drug addicts into groups where they could form support systems that provide them with real and reliable connections decades before The Rat Park experiment. 

The Rat Park exhibits that environment is one of the important risk factors for addiction development. But the premise that you take a rat out of the cage and he will automatically be fine is false when applied to humans. Hari touts lack of connection to be the singular cause of addiction, and that people who feel caged form addictions to drugs and other bad habits. But simply taking drugs away from an addict or putting him into a work programme is not enough. The addict has to be taught how to deal with his environment. He has to learn how to handle the triggers that cause him to shoot up or to smoke or drink. Depending on the substance being abused, he may have to detox slowly under guidance of a doctor to prevent the adverse withdrawal symptoms like seizures or black outs.

The Rat Park scenario ignores or minimises the physical component of addiction. Although some addictions may start off as a result of social influences or mental problems; that in no way negates the effect that the drug has on the person’s chemical and physical processes. The brain’s dopamine receptors play an important part in continuing the addiction cycle. Once hooked, the individual may become dependent on drugs or alcohol no matter how connected they are.