The horizon is not so far as we can see, but as far as we can imagine

The Cause of the Opiate Epidemic

Let us introduce you to Rat Park. You’ve heard the story about how addictive drugs are. Put a rat in a cage with a lever for water and a lever for water with drugs (heroin/cocaine) and without drugs, and the rat will soon be hitting the lever for drugs as fast as it can.

Drugs are sooooo addictive.

Right.

Well, here’s Rat Park.

Professor Alexander built Rat Park. It is a lush cage where the rats would have colored balls and the best rat food and tunnels to scamper down and plenty of friends: Everything a rat about town could want. What, Alexander wanted to know, will happen then?

In Rat Park, all the rats obviously tried both water bottles, because they didn’t know what was in them. But what happened next was startling.

The rats with good lives didn’t like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did.

Sigh.

Somehow the story of Rat Park doesn’t get told often. I’ve read a lot on pain policy and addiction, and I hadn’t heard of it until recently.

Why is that, I wonder?

What has changed in the US to cause the “sudden” opiate epidemic, do you think?

Well, we all know the answer. The US isn’t “Human Park” any more, it’s a dystopian nightmare, full of poverty, despair, and people isolated from friends and family. The social welfare stats for large parts of the country are in free fall.

When life is shit, people turn to chemical joy–or chemical anaesthesia, at least.

What the US is doing is cracking down on opiate use, as if it’s a criminal problem. OR they are pretending it’s a medical problem.

It’s neither. It’s a social and economic problem, and its to do with a society which offers shitty lives for people.

In the 1800s, Emile Durkheim, the pioneering sociologist, did a study on suicide. He did it specifically because suicide seemed like the most individual of decisions.

And he found that it wasn’t; the likelihood and number of suicides tracked social engagement almost exactly. Roman Catholics committed suicide the least and had the strongest social ties. After the Catholics were the Protestants, then then non-religious, and those categories tracked how much social contact people had.

Most of who we are is other people and our relations to them. Most of the rest is our environment. Decisions that seem like they are made by individuals are really only partially so; they are informed by the environment in which we live. They are influenced by people, economic opportunities, and beauty, or the availability of love, friendship, security, and hope.

The opiate epidemic won’t be “fixed” through criminilization or medicalization: Even if opiate overdoses go down, people will turn to other forms of self-destructive behavior. This is because the problem isn’t opiate availability, it is that their lives are objectively shit.

Want to fix the opiate epidemic? Start with a 90 percent marginal tax rate on the richest people in America and spend the money on making everyone else’s lives better. Oh, and do simple stuff like universal health care, which, well, costs less and produces better results and doesn’t lead to despair, because people know that if they get sick they’ll get the care they need and it won’t cost them everything.


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80 Comments

  1. Peter**

    The 1970’s? Medical patients just naturally wean themselves from opiates? I guess this explains why addiction is almost unheard of among wealthy suburbanites, rich actors, rock stars and sports heros.

  2. V. Arnold

    Very relevant post Ian; many of us have long known the truth.
    But it’s in the PTB’s interest to blame pharmaceutical companies and doctors for the epidemic.
    I have had first hand experience with opioids and it a seductive dance indeed; especially if one’s life is shit, or not.
    This is only going to get worse; and strangely enough; the opioid pipeline will remain open; it solves so many problems for the PTB…

  3. V. Arnold

    Also, your closing solutions will be ignored; not in the interest of the deep state government…

  4. ‘Meircans, bare-footed barely literate rubes sprawled drooling Pavlovianly across a “couch” the backseat out of a nineteen sixty-eight Chevy Suburban drunk as a skunk on the Ambien, Prozac, Viagra and Megyn Kelly crotch-shots Now on NBC! Kool-Aid blindly following a charismatic “leader” to suicide and dragging the rest of us with them have been so conditioned to their “superiority” they’ve forgotten they too are animals. Pavlov’s dogs and Alexander’s rats can’t possibly apply to them, it applies to dogs and rats.

  5. Thanks for writing about this, Ian. Truth.

  6. mc

    Thanks, Peter, for making all the smart stuff here sound even smarter.

  7. The Stephen Miller Band

    I guess this explains why addiction is almost unheard of among wealthy suburbanites, rich actors, rock stars and sports heros.

    Because Prosperity As We Know It is not all it’s cracked up to be. It’s just plain old cracked up.

    We need to create our own definition of Prosperity and that definition should inherently be anti-exploitative.

    All of these people you have mentioned, the Rock Stars & Famous Actors & Wealthy Suburbanites & Sports Heroes, have gained Prosperity via exploitation and they reap the whirlwind of their lie, or many do.

    As well, those who worship these people thus enabling the Prosperity they’ve achieved also in turn exploit these Grotesque Distortions, these Arrogant Twisted Tortured Souls, by effectively tethering them to a persona and image that can never change and must never waiver.

    Each, The Idol & The Worshiper, are locked in a dysfunctional, incarcerating arrangement that, when considered collectively at scale, prevents us from evolving socially & societally.

    Imagine Melania’s existence — her State of Mind. Imagine Ivanka’s. Imagine Obama’s. Imagine Hillary’s. These people are not enviable. They are pathetic and they are a hinderance to our Social Evolution. They are living a lie. We are all living a lie — a lie we strive to hide with a piss-poor style of lipstick we’ve managed to smear all over the place because we can’t even get the lying right.

    Everyone Needs A John Givings. Everyone Needs To Be John Givings And Call This THING Out For What It Really Is — An INSANE ASYLUM.

  8. Creigh Gordon

    “Start with a 90% marginal rate on the richest people in America and spend the money on making everyone else’s lives better.”

    Start with a 90% marginal tax rate on the richest people to prevent them from having the money to ruin everything for the rest of us. I could make arguments that we don’t need their money to make a decent society, but the bottom line is, they are using their money to ruin our society, and we need to stop them.

  9. The Stephen Miller Band

    I commentator here, at their blog, suggested reading John Steinbeck’s Cannery Row, so I took their advice and purchased a copy and I’m now reading it. I love it. I knew I would, not only because of this commentator’s appreciated description of it, but also because John Steinbeck has never disappointed me. He’s a talented, evocative, provocative writer who says it like it is, and he does so with clever wit.

    Prosperity is a permanent, common theme Steinbeck employs and tackles throughout many of his works. His Literary Footprint underscores the Struggle we call Life, and he brings that Struggle we call Life to life in his vivid descriptions of the people, places and various times who/that comprise that Struggle. It’s not a Pretty Picture, but Steinbeck manages to transform that hideous image into something beautiful.

    In the following passage from Chapter 2, Steinbeck eloquently describes the disposition of the despised, but ever-so-barely tolerated, Cannery Row Bums, and in the process he chastises and admonishes society’s notion of Prosperity and the pain, suffering and destruction it needlessly engenders & enables. To be Productive in this System, you are necessarily a Rapist. Productivity equals raping the Earth & destroying it in our current System.

    And all manner of incentives & disincentives are employed to keep people in place and true to this form and the goal — which appears to be the unadulterated annihilation of our habitat. Therefore, those who refuse to participate in the Raping, who refuse to be Productive, and instead choose to Drop Out and be Scavengers, are frowned upon and considered to be Bums and no one wants to be a Bum.

    In Steinbeck’s Time, the Time he wrote of in this book Cannery Row, the only thing lower than a Bum according to societal standards at the Time, was a Pimp, but that’s changed. Pimps in our current societal arrangement have considerably elevated their Social Status. A Pimp can now be POTUS. But not a Bum. A Bum will always be that — a Lowly Bum.

    Blessed Are The Bums, For They Shall Inherit The Earth.

    Mack and the boys too, spinning in their orbits. They are the Virtues, the Graces, the Beauties of the hurried mangled craziness of Monterey and the cosmic Monterey where men in fear and hunger destroy their stomachs in the fight to secure food, where men hungering for love destroy everything lovable about them. Mack and the boys are the beauties, the Virtues, the Graces. In the world ruled by tigers with ulcers, rutted by strictured bulls, scavenged by blind jackals, Mack and the boys dine delicately with the tigers, fondle the frantic heifers, and wrap up the crumbs to feed the sea gulls of Cannery Row.

    What can it profit a man to gain the whole world and to come to his property with a gastric ulcer, a blown prostate, and bifocals? Mack and the boys avoid the trap, walk around the poison, step over the noose while a generation of trapped, poisoned, and trussed-up men scream at them and call them no-goods, come-to-bad-ends, blots-on-the-town, thieves, rascals, bums. Our Father who art in nature, who has given the gift of survival to the coyote, the common brown rat, the English sparrow, the house fly and the moth, must have a great and overwhelming love for no-goods and blots-on-the-town and bums, and Mack and the boys. Virtues and graces and laziness and zest. Our Father who art in nature.

    ~John Steinbeck

  10. DMC

    Boredom and isolation could explain a fair number of maladaptive responses that occur in socially significant numbers. Read an article awhile back that looked at the origins of the “Deplorables” or at least a faction thereof, in the demographic of young, un- or under-employed males that make up most of the users of 4chan(do I need to explain what that is to anybody?). These are the same guys that mutate into MRAs and Alt-Righters and Gamer-gaters and other such reactionary categories, though it should be noted that Anonymous and WikiLeaks originated with 4chan as well.

  11. Willy

    I’d think that boredom and isolation would need the additional ingredient of hopelessness to create the need for something to take all that away. With hope people are more motivated to spend their time working towards something.

    Peter believes that quality of life has no correlation with drug addiction. But if that was true shouldn’t we’d be hearing about drug addiction within the plutocratic and politician class matching that of the poor and the entertainers? Wouldn’t they be far more attractive targets to the “pushers”.

  12. FINALLY!!!!!
    SOMEONE recognizes what a red herring the “obsession with drug addiction” is, and that the REAL issues are those concerning the quality-of-life phenomenons.
    The same can be said about the “gun violence prevention” obsessions as well.

  13. tryggth

    Looking foreword to your follow-up “The Cultural Impoverishment of Late Stage Capitalism/Neoliberalism”

  14. highrpm

    @peter**
    I guess this explains why addiction is almost unheard of among wealthy suburbanites, rich actors, rock stars and sports heros. then don’t go down that path thinking it leads to Rat Park.

  15. StewartM

    One of the rare times I’ll differ with you, Ian. Because there is the counter-example of the experiments with sweetened alcoholic beverages set out for *wild* green monkeys on St. Kitts. Some completely abstain and are not interested at all, some drink in moderation, some steadily, and some essentially drink themselves to death (and note, in about the same proportion observed in humans). This seems to indicate that there is definitely some individual genetic susceptibility that’s hardwired.

    Amongst humans, we also have the examples in historical times of the devastating effects that alcohol had upon populations that until historical times had little or no exposure to alcohol (so they had little “resistance” to it built up, so to speak). These include Native Americans, Australasian aborigines, and other aboriginal peoples. Note these effects were recorded long before their lives with to shit by being sequestered on reservations.

    So….I conclude that while bad environmental factors might lead one to turn to psychoactive substances, their appeal to you, the likelihood of you getting addicted, and the severity of said addiction is all hardwired. It’s why some people who drink or drug heavily just sober up one day by deciding they are just going to quit, while no amount of pain or intervention gets others to stop. I see an analogy to military service; appeals to patriotism and duty might get you to join the service, but your ability to fight effectively depends on other factors.

  16. The Stephen Miller Band

    Our Culture is a Culture of Addiction & Obsession. Some of that Addiction & Obsession is to drugs, but it’s not the only thing. Far from it.

    Some people, many even, are addicted to Money and they spend the better amount of each and every day obsessing over how to get more and more of it.

    Others are addicted to and obsessed with sex or gambling or eating or cigarettes or bird watching or sports or commenting to blogs or blogging or some are addicted to Twitter & Tweeting and some are addicted to and obsessed with Power and the accumulation of it.

    The Puritans were obsessed with & addicted to Spartanism, so an addiction and obsession isn’t always about more, it can also be about less.

    In a Nutshell, we, as a species, are rather F*cked Up. We are never content.

  17. People who want to kill themselves have uses, as long as they do suicide rates will continue.

  18. Oh, BTW flipping houses are in – this means that real estate crash is 2-3 years out.

  19. Hugh

    “Most of who we are is other people and our relations to them”

    Or as I like to say, society is Mother, Father, Sister, Brother. Without society, we would be just animals with no language or religion. And of course, most of us would simply not exist since society gives us the resources to live longer and sustain larger populations.

    “the problem isn’t opiate availability, it is that their lives are objectively shit”

    Exactly. Give people the chance for a meaningful life, and they will choose life. Treat us like shit and surround us with shit, and we fall apart. We lose ourselves.

    I could not agree more with this essay.

  20. Hugh

    “I guess this explains why addiction is almost unheard of among wealthy suburbanites, rich actors, rock stars and sports heros.”

    Contrary to published reports, wealth does not equate to happiness, that is if having a lot is OK, then having too much is even better.

    At the other end of the economic spectrum, if you do not have the building blocks that most of us need for a happy and meaningful life, then you probably aren’t going to have one. If you live in an environment of violence and want, most of the connections we need to others to keep our own balance intact will not be there or will be totally twisted up. The difference between this and a rich person’s world is that for the rich person they have a choice between entitlement and connection while, with few exceptions, the poor person living among drugs and violence has neither.

  21. Steeleweed

    Posted on this issue at the old Agonist, preserved at http://www.steeleweed.com/2015/10/30/managing-the-pain/

  22. Steeleweed

    @StewartM

    I agree that there is a genetic component to one’s physical response to various drugs, from opiates to alcohol. However, susceptibility to addiction is ultimately a matter of one’s mental state, which can be heavily influenced by the environment – social, economic, political, spiritual, intellectual. Millions of doses of Prozac and Zoloft are given without anyone bothering to ask if the patients’ life circumstances are depressing; Valium and Klonopin without inquiring into the source of stress/anxiety.

    Bottom line, I suppose is that the world defines ‘normalcy’ and ‘sanity’ as it chooses. And when the world has, in fact, gone mad, any escape can be looked at as a survival mechanism. You might indeed end up running off a cliff while fleeing a monster, but that just means none of your available options were good.

    As Waylon said, “”I’ve always been crazy but it kept me from going insane”.

  23. Webstir

    I think you’re on the money, Ian. Kind of. You see, coming from an alcoholic whose been sober for over a decade now, it really all maturity. And maturity, for those that don’t know, is essentially a set of coping mechanism. Addiction, is not more than never learning how to internally cope with the external world. Thus, the addict reaches for external sources to cope, i.e.. drug of choice. Now, this often creates a downward spiral because we often get in trouble when we’re “all fucked up.” Those that have the ability to take advantage of services, have better outcomes than those that do not.

    Pretty simple.

  24. Ian Welsh

    There are, of course, both genetic and personal issues related to any type of addiction. Both my parents were alcoholics, I’m familiar.

    However, when a social group sees an explosion, the problem is not a whole bunch of people suddenly expressing, it is a social issue. Those people may have some vulnerability to that issue, but that vulnerability would never have expressed without the environmental changes/pressure.

    This is similiar to some people being predisposed to heart disease, but that predisposition being much less likely to express if they eat a healthy diet and get enough of the right type of exercise. Take those people, have them be sedentary and feed them badly, and BOOM, lots of heart disease.

  25. Some Guy

    100% spot on Ian, I have nothing to add – other than that StewartM’s comment and your response to him added the only bit of context I felt was missing from the original piece.

    Would that more people had read, ‘The Spirit Level’ which provides reams of quantitative support for what you are saying here.

  26. Tomonthebeach

    Ian’s causal assertion linking drug abuse to social conditions is very consistent with the science of addiction. Addiction to opioid and opiate drugs is a brain disease. That is well-established in the research literature. The mechanisms of addiction biologically-speaking are well-known. The brain is also where we experience pain both physical and emotional. When exposed to these drugs, our brain’s dopamine system quells pain of both types.

    Opioid and opiate drugs also have another, more lethal effect beyond analgesia. Take a large enough dose over time, and most addicts lose their will to keep on living – an odd side effect of a drug that dissipates the pain of living.

    To make matters worse, in larger dosages, opioids will kill you. Society continues to assume that fatal drug overdoses are accidental despite decades of anthropological research reporting that addicts are very aware of the dosages and effects of the drugs that they consume. Accidental overdose postmortems do achieve one thing. They assuage the guilt of survivors. But, in doing so, such postmortems shift the focus of intervention to interdicting supply rather than eliminating the socioeconomic triggers that led to the abuse of drugs in the first place – Ian’s recommendation.

  27. jackiebass

    This isn’t new or sudden. The problem existed in the past but was mostly confined to minorities. Now it effect white middle class and white people that used to be middle class. It has spread from the cities out into the country. I think it’s all about the slow decline of the middle class. At one time it was easy to go out and get a well paying job without an education or much training. That slowly ended with the imposition of neoliberal economics It was done slowly to help hide what was happening. These type of jobs disappeared for several reasons. For a while people maintained their living standard with cheap credit. This isn’t sustainable hence we now see the effects and results on these destructive policies. Government policy helped facilitate this. We have the best government money can buy. This is hard to change because of all of the propaganda people are constantly exposed to. People are so distracted they don’t realize what is happening to them and society.

  28. V. Arnold

    Tomonthebeach
    June 5, 2017

    Addiction to opioid and opiate drugs is a brain disease. That is well-established in the research literature.

    I categorically reject that assertion; research literature be damned.
    That’s just mainstream statist crap.
    AA has made alcoholism a disease; thereby absolving their members of all responsibility for their addictions. I again reject the disease categorization.
    Opiate, opioid, and alcohol addictions are physiological in fact; the inability to quit is a combination of both physical and subsequent psychological dependencies.
    While this creates a difficult road ahead; it’s not insurmountable.
    Unfortunately there are many “programs” available; almost all very bad because they simply transfer dependencies from drugs to support groups or worse; programs like methadone.
    Usians are band aide addicted for quick, cheap, and easy “solutions”, which are simply traps to keep one “in line”.
    I’ve been on the front line working a street clinic in Portland, Oregon under a genius at treating addiction; Charles Spray, MD.
    He was vilified and driven from practice by the statist bastards of the medical profession.
    I assure you, addiction can be beaten, but; not in the U.S., as it is today.
    If one truly wants to quit addiction; you’ll have to help yourself; and it can be done; I know that for a fact!
    I would add; if one can’t think outside the box; that one is sunk.

  29. Ché Pasa

    Oh now. Drug use and addiction is rampant among the High and the Mighty. Rampant. Is that because their lives are shitty? No.

    Drugs are available, for one thing, and the culture supports their use for performance enhancement, endurance, envisioning alternatives, disruption, and so on.

    Drug use and addiction among the Lower Orders is not that much different, except that it is also useful to the High and the Mighty — in part by helping to control/eliminate portions of the undesirable populations. It’s been going on for a very long time, involving many millions of disposable “surplus” people, including but not limited to the white underclass.

    The High and the Mighty can get high without consequence, the Lower Orders are faced with drug use and addiction dilemmas — death “from despair” and/or imprisonment among them –they can’t solve. Win-win, what’s not to like?

    When a culture encourages drug use, as ours does, it should be no surprise that people use drugs both licit and illicit for whatever ails them or gets them high. When drugs are made available in abundance, as seems to be the case with opioid pain medications in certain ruralish white enclaves in what appears to be a highly targeted and deliberate effort by pharmaceutical companies, pharmacies and prescribing physicians, it’s no surprise that working class white folks become addicts and some OD. Just so with heroin, crack, crank and so on.

    It’s no accident, and it’s ultimately not because “those people’s lives” are shitty.

  30. Faith Carr

    SIDE NOTE: a few years ago big pharma came up with a NEW pain medication. It didn’t sell well. Mainly because they cost somewhere around $ 600 a month. As opposed to the $50-$100 of opioids.

    What to do, what to do? Why…. CREATE an epidemic of abuse! Cut as many people off as possible – no matter their actual chronic pain. Spread it all over the media, the doctors, the patients. Get the insurance companies to cover 80% of the cost leaving a hefty co-pay.

    And just hoover the cash up.

    Street drugs? Accidental overdose? Or suicide? I know what my choice would be.

  31. realitychecker

    At what point does paternalism trump freedom?

    Just asking.

    Bartender!

  32. The Stephen Miller Band

    Falling into addiction goes hand and hand with the ability to abstract. Many animals live shitty lives, but we don’t see them turning to the bottle for cold comfort, do we?

    Is it true, that the greater our ability to abstract, the further we travel from the primal & visceral, the greater the allure of addiction? I think it is.

    Addiction can be an escape from shittyness, but it can also be a crude attempt to fill the growing void created by an exponentially abstracted & abstracting world. It’s a piss-poor way to try and connect in the real sense of that meaning & term. It’s woefully inadequate and never delivers on the promise it never made. It leaves The Searcher decimated rather than fulfilled.

  33. highrpm

    @cp
    oh now. you speak whereof you know. ruralish white enclaves. miserable o’l whitie. and the urbanish inner city and public housing high rises. centers of the sordid underclass culture.

  34. The Stephen Miller Band

    If you think about it, and most people don’t & won’t for the following reasons, Civilization is the worst addiction of all. Just ask Nature. All these other addictions are simulacra of the Mother Of All Addictions — Civilization. Perhaps if we cure our Addiction to Civilization, the Simulacra of Addictions within Civilization will also be cured.

    Born Expecting the Pleistocene: Psychology and the Problem of Civilization

    Civilization isn’t perfect, but it’s what we’ve got and that fact alone makes it preferable to potential alternatives. The psychological deck is stacked in favor of preserving the status quo.

    The existence bias is an example of a heuristic. Heuristics are mental shortcuts that generate appropriate conclusions under normal conditions, but can on occasion lead us wildly astray (Tversky & Kahneman, I974). The cognitive load imposed by the demands of civilized life through multi-tasking, anxiety and stress, and persistent distraction increases our reliance on heuristics and makes it less likely we will take time to think rationally about our situation and less likely that we will notice-let alone take umbrage to-the involuntary nature of our daily activities.

    Along with the existence bias and a variety of additional built-in cognitive blinders that lead us toward a passive acceptance of the status quo, multiple layers of accommodation
    to technology have generated a deep dependency on the machine of civilization, a dependency that shares a surprising number of features in common with the physical and
    psychological dependence that attend drug addiction.

    Viewing our situation as a kind of addiction provides potentially useful insight not only for understanding the psychological nature of our chains, but for mapping out potential courses of treatment as well. Rationalization, denial, avoidance, and other defense mechanisms commonly employed by addicts to justify their continued drug use also play a role in our psychological bondage to civilization. Drug addiction is a treatable condition, however, and there is an extensive arsenal of effective treatment methods and an extensive literature on the recovery process. I will explore how our understanding of drug dependence might be applied to the treatment of “civilization addiction” in some detail below. From a psychological perspective, civilization dependence is theoretically at least, treatable.

  35. Ian Welsh

    Animals with access to drugs often do drugs, actually, and they do more drugs if their lives are shitty.

    Rats are… animals.

  36. The Stephen Miller Band

    Yes, but animals don’t go out of their way to become addicted to addictive substances. With animals, I imagine it’s by matter of accident and purely physiological if they become addicted.

    Sure, if you feed rats drugs in a laboratory or otherwise, they’ll become addicted, but you fed them the drugs or they stumbled upon some source that was drug-tainted, but animals, since they have rather underdeveloped cerebral cortexes in comparison to humans, can’t reason & abstract like humans, therefore, they are more in the moment and at pone with nature and being in the moment and at one with nature has its own intoxicating rewards without resorting to addictive substances.

    Civilization is not about being in the moment and at one with nature. Civilization is obsessed about tomorrow until there is no tomorrow.

    Don’t Stop Thinking About Tomorrow

    Although, come to think about it, our dog is addicted to our love & affection and she gets her fix many times throughout each and every day. If you’re going to be addicted to something, that’s the finest addiction I know. If only we were as loving and affectionate with one another as we are with our pets, the world would be a better place.

  37. The Stephen Miller Band

    This is pertinent to the discussion of non-human animals and drug addiction.

    Animals in Science/Research — Cognitive-Behavioral Research

    COMMONS AREAS OF BEHAVIORAL RESEARCH

    DRUG ABUSE AND ADDICTION RESEARCH

    Animals are forced to become addicted to drugs (heroin, cocaine, marijuana, morphine, amphetamines, barbiturates, and tranquilizers), alcohol, and tobacco. Although most nonhuman animals have a natural aversion to alcohol or tobacco, they are made to ingest it and become dependent on it through forced inhalation or infusion, food or water deprivation, or are genetically altered to prefer it. Artificially creating addiction in animals has done little to ameliorate or reduce this country’s drug and alcohol addiction problems. Animals do not always respond to addictive substances like humans do, nor do they experience the same psychosocial pressures that play a major part in causing addiction in people. Pharmacologist Vincent Dole stated in 1986, “Some 60 years of offering alcohol to animals has produced no fundamental insights into the causes of this self-destructive behavior or even a convincing analogue of pathological drinking.”5

    Despite the inappropriateness, animal use in this area of research has been going on for decades. Meanwhile, alcohol, tobacco, and drug prevention and rehabilitation programs that help humans remain under-funded, the cost for people seeking treatment continues to increase, and the number of people using alcohol and/or drugs remains unchanged or in some instances, is increasing. According to a 2009 national survey6, “Between 2002 and 2009, the number of persons with substance [and alcohol] dependence or abuse was stable (22 million in 2002 and 22.5 million in 2009)”. However, “the rate of current illicit drug use among persons aged 12 or older in 2009 (8.7 percent) was higher than the rate in 2008 (8 percent)” and of the over 20 million people needing treatment in 2009, only “2.6 million…received treatment at a specialty facility.”

    In 2006, Americans paid in total $57.5 billion for mental health care services, which “places mental health care expenditures as the third most costly medical condition, behind heart conditions and trauma and tied with cancer.”7 The National Institute of Mental Health (NIMH) states, “Much of what we understand [in the area of mental health problems and treatment] comes from research in the field of epidemiology; the scientific study of [naturally occurring] patterns of health and illness within a population. Research on psychiatric epidemiology shows that mental disorders common throughout the United States affect tens of millions of people each year. Only a fraction of those affected receive treatment.”

  38. Ian Welsh

    Animals have issues, but obviously we cannot stick humans in mazes with two supplies of water, one drugged, one not, though I guarantee you’d get the same results.

    Again, if a population sees a sudden increase in something like addiction, the primary cause is not located in the individuals. If people cannot understand this, they cannot understand the world. It is that simple.

  39. Cagliostrowned

    “I categorically reject that assertion; research literature be damned.”

    lol

  40. The Stephen Miller Band

    Animals have issues, but obviously we cannot stick humans in mazes with two supplies of water, one drugged, one not, though I guarantee you’d get the same results.

    Don’t give the Social Engineers any ideas. They’re more than halfway there already.

    Drug Addiction is predicated by psychosocial triggers. So you’re right, Ian, Drug Addiction is a Social Phenomenon, and particularly a Human Social Phenomenon because it manifests outside of the laboratory — for now. Eventually, there will be no outside the laboratory. Who knows, maybe there already isn’t an outside the laboratory for humans, but it’s nice to pretend there is until you can pretend no longer.

  41. The Stephen Miller Band

    Speaking of Addiction, The Lamestream Media is certainly addicted to Trump. Every morning for the past year or more, when I sit down with my big cup of coffee and turn on The News, Morning Joe & CNN are concomitantly smoking a yuuuuuge bowl of Trump. They’re high as kites on Trump. They can’t get enough. They light bowl after bowl for hours on end. It’s sickening.

    And people, people like me because I’m not immune and human afterall, tune in and watch their addiction as if we can glean some kind of insight from the disgusting ritual. I mean, I have no inclination or compulsion to head to downtown Baltimore and watch Heroin Addicts shoot up and veg out, but I, we, tune in and watch The Lamestream Media destroy themselves and us by overdosing on Trump.

    Take this guy out to The Woodshed now so we can all begin the process of healing. In his place, put an Eggplant. An Eggplant is many things, but one thing it’s not is a Quisling.

    Woman Arrested for Selling ‘Donald Trump’-Branded Heroin

    Buy One Get One Free

  42. Ché Pasa

    Addicted members of the Overclass can get treatment services any time they want. Services that often enough keep them addicted and functioning. Not so for the underclasses — not by accident but by design. Limiting them, eliminating them one by one and in batches is part of the Program — as it has been at least since the Opium Wars. At least.

    So let’s not fool ourselves that any form of addiction, whether to opiates/opioids or any of the myriad other addictive substances is entirely a matter of biology, genetics or socio-economic conditions, let alone due to lack of willpower.

    In too many cases, it’s a lot more deliberate — and frequently sinister –than that.

  43. cripes

    There’s a old tension between the school of deviance, which views people’s problems largely to be the individual failing to conform to their environment as criminal, mentally ill or somesuch.

    Think of psychiatry and penology.

    Another which, largely, views those same failures to assimilate as a function of social environment of which they are only a single cog playing out their, often lousy, hand.

    Think social work, deficient as that too is in its present incarnation.

    So of course we see the same class division at work in the realm of addiction treatment as we do in our economy, health, housing and justice systems: one brutal system for the poor and another for the rich.

    When poor wittle rich girl shoots heroin, she has a pwoblem and needs help.
    When poor wittle poor boy shoots heroin, he needs to be scared straight with a few years in prison and maybe some forced sodomy. Ha ha.

    And they call addicts the sick ones?

  44. V. Arnold

    Well Ian, this thread devolved into chaos and irevelance, as usual.
    All the usual suspects spouted their off topic crap add infinitum.
    What’s the point?
    Free speech?
    Ha!
    Free for all, and boring, boring, boring…

  45. V. Arnold

    And I’ll add, this disrespects you and your blog.
    This thread on addiction is a serious subject; and yet it’s treated as a forum for all manner of opinion spouting, having nothing to do with the subject of addiction.
    You’re a weak sister in your own territory, and it does you no honor in your vainglorious attempt at relevance in today’s world…

  46. realitychecker

    A military junta and cheap child prostitutes. That’s the ticket.

  47. Peter

    I don’t think these animal studies are very useful in drawing comparisons or conclusions about the similarities between caged rat behavior and our free-range junkies. It is interesting that the rats never stopped taking the drug just moderated their intake to fit their better conditions.

    Responsibility for the so called opiate epidemic rests mostly with the junkies who’s demand for the drug drives the rest of the business. Many people who want to excuse junkies for their bad choices and weakness seem to view them and others as subject rats who need the State to intervene on their behalf. This is ironic because the State is also held responsible for the problems that cause the addiction.

    Ian is consistent in demanding one antidote be used to cure this and other social ills. Punishing hard working successful people with confiscation of a large portion of their income to be used to make junkies and other losers feel better. The State is going to give them other peoples money with politicians in control of the dole so what could go wrong?

    Junkies drive by my home every day throwing their used government supplied needles on the roadside where school-kids walk and play. I doubt that any income redistribution scheme will change that behavior.

  48. Willy

    V.Arnold,

    I generally agree with the willpower thing. But if an addict’s own life is shit, willpower is definitely more challenging (for lack of a better word) when it comes to both cause and solution. What, based on your experience, we’re you suggesting?

  49. Willy

    Damn spellchecker. “were” not “we’re”.

  50. Willy

    Punishing hard working successful people

    Do you ever even read the posts? When I worked in the corporate world, that culture rarely ever rewarded “hard working” or “successful” in any project. More often than not those people became unwitting, undeserving scapegoats for players. In a world where the owners (shareholders and board) cannot know who the top employees are, politics becomes everything.

    As for hard working successful small businesses, in my state these are routinely ignored in favor of the large corporation which has a large lobbying budget. It’s so bad the little guy often pays their taxes, and has to live by the mandates which their dark money has bought.

    Small business owners are paying for the incompetency of these corrupt corporations.

    Do you have any Usain war on drug success stories which would counter the results seen in Portugal?

  51. highrpm

    @v. Arnold
    grow up into a mature adult. stop taking things personally.

  52. V. Arnold

    Willy
    June 6, 2017

    I generally agree with the willpower thing. But if an addict’s own life is shit, willpower is definitely more challenging (for lack of a better word) when it comes to both cause and solution. What, based on your experience, we’re you suggesting?

    Addiction is a matter of choices, bad choices, IMO. I know of no accidental addicts; just people making choices at every step on the path to addiction.
    In the U.S., at this time the programs are of no value and cure nothing.
    What I’m suggesting is to educate with the facts of addiction, minus the myths, dogma, propaganda, judgements, and false beliefs; just the unbridled facts.
    IMO, that is the foundation of curing addiction and once the facts are thoroughly understood; the addict must make the final choice to quit the addiction. And then just do it, cold turkey.
    A 5 day (not one day more) tapering off can be helpful for extremely high dose users.
    To be clear; I’m speaking to opiate addiction, not, say, Vallium or Prozac type drugs.

  53. Willy

    Thanks, V. Arnold. But I still have a few questions.

    If a person has made the decision to become addicted to some substance to quiet overwhelming negative emotions, then successfully recovers, do they not now have to face those overwhelming negative emotions again? What’s next for them?

    Other people have very low insight ability and can rationalize anything even if it doesn’t make sense to their loved ones. I’d assume that getting the facts of addiction through to them would be difficult, and ‘special techniques’ might be required?

  54. V. Arnold

    Willy
    June 7, 2017

    W – If a person has made the decision to become addicted to some substance…

    Most do not/are not, recognize/aware they made conscious decisions; so, that becomes an educational point of reference.

    W – I’d assume that getting the facts of addiction through to them would be difficult, and ‘special techniques’ might be required?

    Of utmost importance, IME, is the will to quit, at all costs. Without that, I’d opine, they’ll fail and will become, in effect, a vasal of the state (some program) or die. All freedom/independence will be lost.
    It all has to be laid bare, in stark terms, the importance and real ramifications of those decisions; both going in, and, getting out, quitting.
    Not sure what “special techniques” would entail; care to explain?

  55. Willy

    I have no ‘talent’ for substance addiction, since my initial reaction to drugs has always been to feel intensely out of control (paranoid, sleepy, weak, confused…). Since nobody’s perfect, my own weakness is to try to divert unresolved “fight or flight” impulses into physical activities which I can control, but sometimes to the point of risking injury. The point is, I understand emotional outlets and diversions, but don’t understand why anybody would want to lose all self-control. That’s my background.

    I ask these questions because I have close associations who cannot seem to be told that they’re ruining their lives with dependency. They rationalize, IMO, because they’re good at it. I can’t hide things from myself very well, though I do try. But these people, not being very good problem solvers, willing to live with cognitive dissonance, will just self-medicate to get away from any difficult reality.

    I wish I had better “special techniques” to be able to get through to them.

  56. V. Arnold

    It’s late here now; so I’ll get back to you tomorrow.
    But in the meantime look up Gabor Mate on the I-net; I mostly agree with his view of the drug problem and its solutions; not 100%, but close enough.
    Cheers

  57. Ché Pasa

    It helps to understand that both the Rat Park and Case-Deaton studies are deeply flawed and basically present arguments for political positions with regard to drug use/abuse and social conditions.

    That’s not necessarily a bad thing, but it is not definitive regarding what to do about drug use and addiction problems.

    Among the Overclass where drug use and addiction are rampant, the general though not universal tendency is not to treat at all unless use/addiction interferes with important activities like looting the underclasses, and then the preferred treatment is maintenance not necessarily ending drug use or addiction.

    Not so among the underclasses.

    Making the lives of the underclasses better is desirable for itself, regardless of any effect on drug use and addiction. How to do that is the question.

    Given that Our Betters have no interest in improving the lives of their inferiors, in fact have made it a primary objective to make life worse for those beneath them, it seems to me that We, the Rabble have to take matters into our own hands. In that regard, there is no one answer to how best to do that.

  58. cripes

    Che Pasa:

    Makes sense to me.

    V Arnold:

    Your unspecified “facts of addiction” and “special circumstances” reek of false certitude and a refusal to recognize that the experience of addiction varies dramatically in different circumstances–in the USA that means class. Will power indeed.

    If you have read Gabor Mate, nothing penetrated, you spout every shopworn drug-war cliche he refutes.
    We are all lucky no one is considering V Arnold for Director of National Drug Control Policy.

    Peter:

    “Responsibility for the so called opiate epidemic rests mostly with the junkies who’s demand for the drug drives the rest of the business.”

    That’s so 80’s. Never missing an opportunity to bash the least among us!

    FYI–Officials in several cities, counties and Cherokee Nation in Oklahoma have sued drug companies for making and widely distributing the addictive (opiate) drugs. Ohio sues five drug companies for their role in opiate epidemic. Pill Mills shut down…

    You really gotta keep up.

  59. V. Arnold

    cripes
    June 7, 2017

    You agree with Che Pasa but not with my saying the very same thing in other words; you get a reading comprehension fail.
    You want to quit addiction; do it yourself; do not rely on anybody or anything else.
    But it requires a deep understanding of ones predicament.
    And I do not agree with everything Mate says.

  60. Peter

    @Cripes

    I would hope you could understand the difference between IV heroin addiction and abuse of vicodin and other pills taken orally. The drug companies don’t make heroin but they may be responsible for not reporting the large increases in drugs ordered by legal distributors in these states. They don’t push their pills on distributors but fill their orders which seems to be legal and they are only pennies per pill made on these drugs at this stage.

    The real money and mass distribution is on the black market where a pill that costs pennies is sold for $3 to $5 and it seems that diversion is taking place after the distributors take delivery. I haven’t seen any news of any investigations or arrests on this level of this crime and that is telling. Go after the big corp with deep pockets and leave the local connected criminals alone.

  61. V. Arnold

    Peter

    I would hope you could understand the difference between IV heroin addiction and abuse of vicodin and other pills taken orally.

    You make a very cogent point.

  62. cripes

    Peter:

    They do make synthetic heroin, and people shoot it up. And die.
    But I think mainly by combining opiates with other substances.
    Always this is reported as a “heroin/opiate overdose death.

    “Pink, better known by chemists as U-47700, is eight times stronger than heroin, and is part of a family of deadly synthetic opioids, all of them more powerful than heroin, that includes ifentanyl, carfentanil and furanyl fentanyl.”

    I think pink is made by Upjohn.

    Something very definitely going on at distribution end.
    I’ve never seen a factory that didn’t count every single piece part they manufactured.
    And knew precisely where they are going.

  63. V. Arnold

    Willy
    I wish I had better “special techniques” to be able to get through to them.

    Until “they” make the decision to quit; nothing you say will have any results.
    I have been in very similar situations long past; very frustrating.

  64. The Stephen Miller Band

    You make a very cogent point.

    No, he doesn’t make a good point. The physicians are Pushers for Big Pharma, some wittingly and many unwittigly. They hand Opioids out like they’re Candy. My son had surgery on his knee at age 14 and they prescribed him opioids. My wife & I said NO F*CKING WAY. Same with my daughter when she was run down by a car — they prescribed her opioids. We let her have them but we monitored it and took them away when we saw that she was recovering and her pain levels were no longer elevated. We have family members who didn’t advocate for their children like we have and left it to the judgment of their physician and the son of one of them became a full-blown addict eventually moving from these expensive Blackmarket Pills to IV and now he’s dead. They found him in an abandoned hotel stripped naked in an empty bathtub. Whoever he was with took his new clothes and shoes he was in. He had just come back from a six month rehab.

    Peter makes no sense. These pills are expensive on the Black Market. Only entitled Suburbanites can afford that kind of habit. It takes them a while to transition from Pills to IV and the reason they do is because they have remained addicted for so long and their addiction has become so bad they have alienated all of their Sugar Daddy enablers and have to turn to the cheap stuff in comparison — IV Heroin. Their initial addiction doesn’t have to do with them being poor — it has to do with their Suburban Lives being so false & empty & meaningless they’re compelled to seek something more that’s readily available and their friends are doing it and it’s the COOL thing to do. Their lives are shitty, but not in the way Ian says shitty, but in the way I’ve explained shitty. Suburbia is an illusion. It’s lipstick on the Existential Pig that is This American Life.

    The 20,000 lb elephant in the room is the ultimate source of non-synthetic heroin — Afghanistan. Donald Trump wants a greater presence in Afghanistan because productivity has been waning this past year. Afterall, if you look at the statistics, America’s presence in Afghanistan has resulted in flourishing Poppy Production after the Taliban before America’s invasion nearly eradicated it.

    If I had to guess, I would say Western Intelligence Agencies, like they did with the Black Communities with Crack Cocaine, have a goal of destroying The Middle Class and The Middle Class just so happens to be majority White.

    It’s about Class War and this is the latest phase. The Rich are hellbent on destroying the Golden Goose that lays their Golden Eggs. They think there are other Golden Gooses, but alas, there are not. Their machines will not lay Golden Eggs.

  65. V. Arnold

    STMB
    No, he doesn’t make a good point.

    Yes, you fucking moron, he does; when you don’t quote my comment out of context!!!
    Peter was talking about IV heroin vs oral ingestion!
    If, fool, you knew anything about opiate addiction; you’d have bloody known that and the important difference!
    Go fuck yourself asshole!

  66. cripes

    V Arnold:

    The only thing you can imagine is addicts using more “will power” to stop taking drugs, which is the neoliberal interpretation of all phenomena; isolated, alienated individuals doing things alone, and exercising personal responsibility. The addict is embedded in a web of social relationships that have everything to do with starting–and stopping drug abuse.

    So you have a communal water pump in London’s East End spreading cholera, does a public health campaign:

    1. tell everyone to use self control and not drink it?
    2. show everyone how to boil the water before consuming it?
    3. shut the well down and provide a safe source of drinking water?

    For one individual, its good advice to say: you have to really want to quit and do it.

    For a society o millions of individuals, it’s a poor approach to addressing the problem, as we learned with Nancy Reagan’s “Just Say No” campaign.

    You seem incapable of seeing addiction as a social phenomenon it is.

  67. cripes

    Stephen Miller Band:

    “If I had to guess, I would say Western Intelligence Agencies, like they did with the Black Communities with Crack Cocaine, have a goal of destroying The Middle Class and The Middle Class just so happens to be majority White.”

    I hate to talk about “conspiracy theories,” but if past practice is any guide…

  68. V. Arnold

    cripes
    June 8, 2017

    You’re obviously insane.
    Kindly go away.
    Thank you so much…

  69. Peter

    @Cripes

    Fentynil is another drug being diverted into the illegal market in huge quantities and is used to cut heroin, I suppose because it is cheap. I thought it was rarely prescribed and mostly used for surgery but it is nasty stuff and didn’t agree with me at all. It could be added before the smack enters the US and it does seem to cause more OD’s.

  70. cripes

    V Arnold:

    Well, that was certainly persuasive and well reasoned.
    Insults always convince me to change my understanding of a topic.
    In this case, I am convinced by your lack of integrity, bad faith and ill will.

    Thanks for educating us with your “facts of addiction.”

    Peter:

    Yes, I think the idea of people starting with opiate pills and moving to IV use is still partly true, but the responsibility of pharma companies in the opiate crisis is considerable and extends more now than in the past to injectable synthetic opiates, which are responsible for the surge in overdose deaths. Old-fashioned street heroin did not cause so many deaths.

    We can thank pharma for that.
    Or maybe the poor decision making of addicts that V Arnold is always harping on?

    If “legitimate” pharma companies developed all these heroin analogues, I have to wonder how they came to be manufactured abroad and enter the illicit market in such quantities. Is someone doing this in a basement lab, or does it originate from corporate production facilities?
    Whether Near or Far.

  71. Willy

    @V. Arnold,
    Until “they” make the decision to quit; nothing you say will have any results.
    I have been in very similar situations long past; very frustrating.

    Somewhat interesting, I looked up what some major medical service providers have to say about this. They all say something along the lines of “No need to hit bottom, because we can help!” Hmm. Is the War on Drugs not a business opportunity as well?

  72. cripes

    In drug rehab, one of the exercises for clients is to make a pie chart listing all of the people who make money from the suffering of addicts. It’s supposed to motivate them in their efforts to quit.

    With a roomful of people contributing suggestions, the list is very long indeed.
    Try it sometime.

  73. The Stephen Miller Band

    With a roomful of people contributing suggestions, the list is very long indeed.
    Try it sometime.

    And that list includes all walks of life, if you can call the vermin parasites who feed and feed on people’s addictions a walk of life, up and down the hierarchical food chain, and as always, the higher up that food chain, the less the risk and the greater the monetary reward.

    Legalize all drugs tomorrow, and Wall Street would experience a massive correction it’s so inundated with Dirty Money from the illegal trade, as if most money invested in Wall Street isn’t dirty & bloodied to one degree or another.

  74. Willy

    My neighbor had a sudden severe pain and wound up in the ER of our big city super high tech top-of-the-line hospital. He left after 5 hours with a $10,000 bill all morphened up, but with no clear diagnosis. Months later and while out of town he experienced the same pain and had to go to the local town hospital. They gave him an accurate diagnosis for $1000, and a prescription for a non-opioid which has worked ever since.

    In related news, that $10,000 clinic wound up in a scandal resulting in firings and a CEO resigning, thanks to a local newspapers investigation into their business practices.

    Possibly related, in 2016 healthcare is as an industry lobby, is far and away #1
    (Insurance is #2):
    https://www.statista.com/statistics/257364/top-lobbying-industries-in-the-us/

    Why the hell does the healthcare industry even need to be lobbying?

  75. Cripes

    For the money. I’m assuming that’s a rhetorical question.
    Or we could save a boatload of money by eliminating the insurance middlemen and Hospital administrators. Unfortunately their idea of saving money is to reduce patient services.

  76. Willy

    Yup. Too much freedom = too much corruption. Checks and balances is the only way. But slowly, as each person gets their own version of being screwed, they’ll come to understand.

  77. Sue

    Thank you for this excellent post, Ian. In the discussion here in the comments, I am wondering how many people read the linked article “Rat Park” in its entirety (“The Likely Cause of Addiction Has Been Discovered And It Is Not What You Think”)? The main point is this:

    “If you still believe — as I used to — that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander’s theory, the picture falls into place. The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different.

    This gives us an insight that goes much deeper than the need to understand addicts. Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It’s how we get our satisfaction. If we can’t connect with each other, we will connect with anything we can find — the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about ‘addiction’ altogether, and instead call it ‘bonding.’ A heroin addict has bonded with heroin because she couldn’t bond as fully with anything else.

    So the opposite of addiction is not sobriety. It is human connection.”

    The “better cage” needed is an entirely new human socioeconomic system that respects our innate psychobiology. Wendell Berry and others have written eloquently about this. The following short piece offers a way forward and suggests that limits are the key to healing humanity and our planet:

    https://thefrailestthing.com/2011/11/03/conviviality-and-friendship-ivan-illich-and-wendell-berry-on-the-virtues-of-limits/

  78. Dale

    I full heartedly agree with your conclusions, all of them. You could not be more correct. However, I would like to add another theory to the mix. I believe there is another factor at work that starts earlier than an age at which one recognizes that life can be very shitty indeed. That something is called attachment disorder, and it has its roots in infancy, when solid bonds should be developing between the parents and the child; the mother especially. When a child has a mother who is cold, inattentive, overly critical, demanding perfection, having unreasonable expectations of the child’s performance, etc. the normal bonding is disrupted. This can even happen in the “nicest” of families, and without regard to economic circumstances. It is also a legendary problem with children in foster care. Either way, the child grows up without an experience or model of a loving relationship, and is left feeling empty, unloveable, and filled with pain. A person suffering from attachment finds it difficult or impossible to have and maintain intimate, trusting relationships. When something (alcohol, cocaine, gambling, shopping) comes along that offers an instant high, it offers relief from their pain, and becomes a compulsive behavior. Add in our superficial, disconnected, and cruel culture, and such a person has little chance of a fulfilling life. We must add toxic parenting to our very long list of societal issues.

  79. Dale

    Error: In the sixth line from the bottom, it should be “attachment disorder”, not just “attachment”.

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