A lengthy story in this past Sunday's New York Times Magazine asked: "An Anti-Addiction Pill??" The story winds its way through many different approaches to addiction and in so doing examines the range of discovery that has been underway in recent years. Brain imaging is leading doctors to a better and better understanding of the mechanisms of addiction. But while the story presents a great deal of optimism up front, supplied in large part by pharmaceutical companies, reality is a much murkier picture.
"An Anti-Addiction Pill?" does a fine job of covering much of the ground that researchers have traversed over the last decade. What has worked in the past, where new research has led us. However, most doctors and researchers quoted are quick to note that treating an addict with drugs is only part of the solution. One particular project described in the story illustrates perfectly the difficulties of treating an addict.
Beginning in the late 1970's, [Bruce Alexander, emeritus professor of psychology at Simon Fraser University in British Columbia], and his team of researchers at Simon Fraser set out to study the role of our environment on addictive behavior. Until that point, most scientists studying addiction 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 noted — first by researchers, then drug czars, then parents trying to keep their children off drugs — as proof of the inherently addictive quality of drugs and of the inevitable addiction of any human who used them. This was false, of course. Most people who use drugs don't become addicted.
So what made all those lab rats lose their minds? Bruce Alexander and his research team had a rather 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 heaven he called Rat Park. 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 into Rat Park, where they were offered water or a sweet, morphine-based cocktail (rats love sweets). Alexander offered the same two drinks to the control group of rats he left 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 arguably depressed rats, on the other hand, eagerly got high, drinking more than a dozen times the amount of the morphine solution as the rats in paradise.
When I spoke with Alexander recently, he predicted that unless we undergo 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.
As we have said many times here before, treating addiction is a multi-faceted problem, especially at the community level. The NYT article is worth the time, if only to catch up on much of the new thinking and research that is out there. As a problem, though, addiction isn't going anywhere. Sure we may be able to treat each addict with a pill, but to truly cure addiction, we'll need to look at the bigger picture, and its unclear whether anyone is willing to do that.
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