Addiction has psychological component

In a study first published in 1979, Dr. Bruce Alexander, a Canadian psychologist, took a new look at addiction.

Alexander was critical of previous addiction-related studies using rats. In those studies, rats were isolated in cages and offered two water bottles. One of those bottles contained plain water. The other contained water laced with addictive drugs like opiates or cocaine.

In these studies, the rats would almost always choose the bottle laced with drugs, and would use it until they ended up dying of overuse.

Alexander wondered how rats would react to the introduction of drugged water in a social setting, where they had other rats and an engaging environment to interact with. His hypothesis was that the rats that were isolated in cages used drugs obsessively because there was nothing else to do. So, he and his colleagues built an environment called Rat Park.

Rat Park housed multiple rats of both sexes, wheels for them to run on, tubes to climb through, and other stimulating objects. Into this environment, Alexander introduced two water bottles, one with drugs and one without. What he and his colleagues found was that while some rats occasionally still chose the water bottle with drugs, most did not. Those who did choose the drugged water didn’t use it obsessively or even with regularity.

This experiment seemed to show that rats were less likely to become addicted when they had a stimulating environment to distract them, but what about rats that were already addicted? Alexander tested for this as well.

Once the rats in Rat Park began breeding, he took the experiment to another level. He took rats that were raised in Rat Park and moved them to isolation cages. He also took rats that had been raised in isolation and then moved them into the rodent utopia of Rat Park. What he found was that, as in previous studies, the rats from Rat Park that were moved into isolation began using the drug-laced water. Rats that had been raised in isolation, however, ceased using the drugged water obsessively. They were still somewhat more likely to use the drugged water than their peers raised in Rat Park, but the obsessive and self-destructive use seen in isolation was no longer observed.

Alexander’s hypothesis was that addiction was not caused by the chemical dependence that addiction is often attributed to, but was a social disease arising from feelings of isolation and hopelessness. After all, he noted, people who were hospitalized for long periods following surgery, and received daily dosages of pain medication, didn’t all come out of the hospital addicted. Likewise, he noted, veterans of the Vietnam War who used heroin regularly while in the jungles didn’t all continue to use once they returned to their homes and families.

However, there were some problems with Alexander’s study. It couldn’t be replicated, for example. While he claimed that the problems with replication might have been due to genetic differences between his rats and the rats used in the follow-up studies, there are other issues.

For one thing, people aren’t rats. They’re more complex, and they often carry their metaphorical cages with them.

In addition, multiple other studies, that have been replicated, show that the chemical dependence that opiate addicts feel is real and physical, not just a psychological dependence. But there is an undeniable psychological component to addiction as well. This psychological dependence or craving is why addicts who have gone through physical withdrawal from opiates already, for instance while in jail or treatment programs, often return to use, despite knowing that it means a return of the feeling of sickness when the drugs wear off.

But understanding this, and coming up with treatment strategies that address both the physical craving and the psychological stressors that lead to addicts seeking escape, can be more successful than treatments that only focus on one aspect, such as physical withdrawal or psycho-social stressors alone.

One of the most important things, according to Dr. Nicholas Landry, with S.T.E.P.S. of Recovery treatment center, is establishing an understanding of the social stressors that lead to use and relapse.

These will vary from patient to patient, depending on their backgrounds and circumstances. But once patients, and their doctors and counselors, understand what stressors lead to their use, they can begin to construct alternate strategies to dealing with these stressors. This might be identifying and removing themselves from a stressful situation before it gets too overwhelming. Or, it might be coming up with a viable strategy to resolving an issue before it spirals out of control.

No matter what it is, it requires a commitment from the addict to learning about themselves, their stressors, and how to overcome them. It also requires understanding from friends, family and other allies, and help from them in identifying when stressors may be emerging and in engaging strategies to overcome them.

Another aspect of addiction not addressed by Alexander’s study are underlying mental health issues that may lead to drug use. Landry explained that, in many cases, addicts have undiagnosed or untreated mental health issues that lead them to self-medicate in an effort to find balance in their lives. If they can identify and successfully treat those issues, it can help them avoid relapse as well.

Regardless of whether they are overcoming social and individual stressors, or attempting to self-medicate to treat their mental issues, Landry said that the keys to overcoming addiction are establishing healthy habits and coping mechanisms. This means choosing to take positive steps, rather than retreating into drug use. But this isn’t always something addicts can do on their own.

This is one place where the lessons of Alexander’s study can prove beneficial. A supportive environment, where addicts feel engaged, fulfilled, and connected to their community, can reinforce their decisions to make positive choices rather than retreating to the temporary solace that their drug use brings.

Next week, we will take a look at how the community, including law enforcement and other social institutions, can support addicts on their journey to recovery, as our series continues.