Addiction: It's a Mindset

On Monday, I was talking about how providing free housing to homeless people reduces healthcare expenditures on those people and mentioned an experiment with providing free housing for homeless people, an experiment which has been duplicated with positive results in several different cities, by the way. Well, this experiment yielded a separate, unlooked for result. It showed that providing housing to homeless people also "cured" the majority of them of their addictions and/or addiction behaviors.

Whaaat?

Yeah, you heard me.

This shouldn't have been as surprising as it was because we've known for a long time that one of the drivers of addiction is hopelessness and despair. It should be obvious that people with nowhere to live instead dwell with hopelessness and live in despair. Take those things away -- yes, I know; it's not always that easy -- and suddenly the impetus to "drown your sorrows" is gone.

But it's about more than that. It's about purpose.

So let's take a step back a moment.

When this experiment, the one about providing free housing to homeless people, was first proposed, many of the critics said it would never work because all of the drug addicts (including those addicted to alcohol) -- and face it, a majority of those who are homeless suffer from some kind of substance abuse issue -- would just sell off all of  the furnishings (which are also provided) to buy drugs and end up living in what amounted to no more than a flop house or a drug den. While it was acknowledged that that was a distinct possibility, enough people wanted to see what would happen to go through with it. After all, it was an experiment.

I don't think what happened was what anyone really expected to happen but it is, nevertheless, what happened, and that's that people cleaned up. Not gradually, either, but almost immediately. Sure, there were some people who did sell off all of the furniture for drugs or whatnot, but those cases were relatively few and, when they did, the furniture was replaced -- yes, even over and over again -- and many of those people also cleaned up, as soon as they realized that what was happening was real.

The consensus was that it was about more than hope; it was about purpose. These people, these people who had been living on the streets, some for years and years, had had no purpose. They had simply been existing but, given a place they could call home, they suddenly found purpose in their lives and the need for the drugs (including alcohol) dissipated. They had something to live for, even if it was just caring for their new living space, which the vast majority took great pride in.

So now let's get a little philosophical.

For a long, long time we've know that our current method of trying to break people from drug addiction doesn't work. That method amounts to taking the drugs away from them and telling them "no!" Most people who go through rehabilitation programs relapse because the programs, though they get they drugs out of the addict's system, don't do anything to address the causes of the abuse. What we really expect is for people to just "power through it" and through an effort of willpower to say "no" to the drug everyday. Even when that's not what they want to do.

I use that term "want" in the same way someone who is overweight might say, "I want to lose weight," while never taking any actual action to accomplish that. Or someone might say, "I want to have a clean house," while never actually cleaning up. Or, "I want to write a book," while never putting pen to paper. What these statements really mean is, "I want to have done it," but the people saying them don't really want to expend the necessary energy to accomplish their "goals."

Most addicts who go through programs "want" to be clean in that same kind of way. Generally, they are not there by choice but because someone they care about has somehow coerced them into it. So, sure, they "want" to have never gotten hooked to begin with but they don't really want to quit.

And they don't really want to quit because they have no reason to quit.

Look, when you talk to any addict who has cleaned up his/her life, you'll find it's because the person found something else to live for, even if that something else is actually being sober. That can be the purpose; it's just usually not.

Oh, by the way, another big contributor to everything that happened in these free housing experiments was community. Suddenly, the homeless didn't feel alone. They lived in communities with each other, and that helped with... everything. Loneliness and alone-ness are big factors in addiction. And, even when you love someone, even when you believe that person is not alone, that may not be how the addict feels.

So what is it I'm saying? I'm saying two things:
1. As with healthcare costs, we can cut addiction among the homeless population (which also affects healthcare costs) by doing the simple thing of providing them living spaces. For free. No strings.

2. We can cut addiction in the rest of the population by striving to help these people find purpose. It's not so simple as just taking away the drugs and saying "no." And, yes, I realize this is not an easy thing I'm saying here. It's not an easy fix with a one-step solution like taking away the drugs and saying "no." It's a solution that would take some work, but it's a better solution.

And it's why I said, "Let's get philosophical," because the solution will be different for every person. What is "purpose" for one person is not necessarily so for another. Maybe I should have said, "Let's get psychological."

Look, I'm not saying that addiction is all in the mind and that you can just think your way out of it. If that were true, addiction wouldn't be a problem at all. However, we can do much more to approach addiction in a mentally appropriate way, and that starts with getting to reasons why addiction happens in the first place.

The New Face of Addiction and Why We Need To Stop the War on Drugs

First, let me just say, that I am not "for" drugs. I barely drink (and was well over 30 before I ever had any alcohol at all), have never smoked (anything), and am fairly resistant to taking even painkillers (which my wife thinks is insane). Basically, unless the doctor has told me to take it, I'm not much for putting drugs into my body. I'm part of the "war on drugs" culture that came out of the 80s. You know, that whole egg-frying-in-a-pan-that's-really-your-brain thing.

BUT!

We have the wrong idea about addiction and what it means, and the way we've been warring against drugs for the past few decades obviously hasn't worked. Of course, most people, especially old, rich, white dudes in politics strongly believe in doing the same thing over and over and over and over with the hope that, at some point, it will suddenly work. Einstein's definition of insanity.

For a long time, we've know that some personalities are more prone to addiction than others, you know, weak people. At least that's how we've always termed it culturally. Weak people are poor people, usually minorities, who are unable to enrich themselves, living destitute lives hooked on drugs and alcohol. If only they were better, stronger people, they wouldn't have problems with the drugs.

But that's all wrong, and that's not what it means when we say that some personalities are more prone to addiction than others. [For a discussion of personality, you can take a look at my "Exploring Personality" series.] Now, I'm not going to get all clinical, and I'm not going to cite a bunch of studies and include a lot of links that no one is going to look at anyway. This is going to be a very general overview of some recent studies and what I think they mean. So, sure, the conclusions are my own, but I think they are valid.

One thing we know is that some people are more prone to addiction than others, but let me re-frame that statement:
Under the right conditions, all people are prone to addiction. Some people are more prone, but all people are susceptible. And it doesn't even have to do with the actual drugs.

See, if you put a rat, alone, in a small cage with nothing in it but the rat, well, it doesn't make the rat happy. If you hang a bottle of water on one side of the cage and a bottle of drug-spiked water on the other side of the cage, guess which water the rat will drink. It doesn't take long before you have one addicted little rat. And I hear you thinking, "But that's just a rat..."
Wait! There's more!

If you have another cage, a large, comfortable cage full of fun, little rat toys and a whole community of rats and you have the same two bottles of water, guess what happens. The rats almost never become addicted. Some of them, sometimes, will sample the drug water, evidently just for the experience of it, but it doesn't become a cage full of drug-addicted rats. It's kind of the definition of recreational drug use. All of them try it but, mostly, they just ignore it.

What you can take from this is how rats react to their environments. Rats in a negative environment -- alone in a cramped little cage with no stimulation -- will becomes addicts if given accessibility to drugs. Rats in a positive environment -- plenty of social opportunity and things to keep them busy -- will almost never become addicts even with easy access to drugs. The reality of the situation is that it's not the drugs that are the problem; it's the environment.

Now, if you take an addicted rat, and not just an addicted rat, a heavily addicted rat, and take him out of his cramped, little cage and put him in the other cage, the one with all the rat friends and toys, a very unexpected thing happens: The rat kicks its addiction. It almost immediate, in fact. Some of them have to deal with withdrawal symptoms, but, pretty much, they just stop the drugs. Even though the drugs are right there in front of them, they give them up. Not some of the rats. All of the rats.

Because the addiction stems from the poor environment and the brain's search for (for lack of a better all-encompassing term) stimulation, not the drugs. The drugs are just the tool the brain uses to deal with what is, basically, a trap. But you take away the trap and you give the rat freedom and options and a social environment and you take away the "need" for the drug and the brain just says, "That's enough."

Do you know what this tells me? It tells me that people with addiction problems are suffering from the same condition as the rat in the tiny cage. They feel trapped and the drugs are the way they cope. We've been trying to solve the problem by taking away the drugged water supply, but the problem is that there are too many bottles of drugged water for us to ever get rid of them all. You take one down, and someone else comes by and hangs another in the same spot. Or we take the person out of the tiny cage and put him in a slightly better cage with only plain water to drink (rehab) until he breaks the addiction but, after that, we drop him right back into the cage he was in before. It's nearly impossible to break the addiction cycle with these methods.

You know what would break the cycle and cause people to just drop their addictions? If we took the billions and billions of dollars we spend on the "war  on drugs" and used it to help build better environments for the people struggling with addiction. Which includes helping them to find some purpose and work they find meaningful. They'll give up the drugs on their own that way.

We will never win the war on drugs by trying to bring down drug dealers and take down drug lords in other countries. There's too much money to be made. The only way to break the cycle is to remove the need the for the addiction.