The Addict in All of Us

One human brain is much like the other.

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Since WWI, and in many cases even earlier, soldiers have had to deal with the long, tedious hours of war when nothing is happening—the lulls between fighting. As one British NCO who served on the Western Front from 1913-1918 said:

I often wonder how we got over boredom of it all. You just imagine – nobody can imagine – being stuck in a trench, 6 feet high, in the middle of winter, day after day with nothing to do at all, really, there was nothing you could do. Well I’m talking about a quiet period, when there was nothing much doing. Because there were periods when perhaps for days on end there’d be no shellfire at all you know.

Vietnam in particular was a war filled with protracted periods of boredom broken up by intermittent bouts of action. G.I.s would sometimes spend weeks, even months, just waiting for something to happen. Hugh Penn, a Vietnam vet, recalled that G.I.s passed the time by playing touch football and drinking beer at $1.85 per case. But an idle mind is the devil’s playground, and football and beer didn’t cut it for everyone.

Vietnam lies just outside the “Golden Triangle” of Southeast Asia, the region responsible for most of the world’s heroin supply during the war. In 1971, Golden Triangle labs began producing “no. 4 heroin,” which was up to 99% pure. Naturally, it eventually found its way into the hands of bored, very stressed soldiers wrestling with the anxiety that comes with being exposed to intermittent bouts of terror. In interviews, 85% of those returning home said they had been offered heroin. By the war’s end, 35% of enlisted men admitted they had tried the drug. As Adam Alter recounts in Irresistible, the heroin was so pure that 54% of all users became addicted, “many more than the 5-10 percent of amphetamine and barbiturate users who developed addictions in Vietnam.”

In early 1971, President Richard Nixon sent two U.S. congressmen, Republican Robert Steele and Democrat Morgan Murphy, to Vietnam to gauge the epidemic’s severity. While in Saigon, they learned that 90 soldiers had died from overdoses in the year prior, and the two congressmen themselves were even approached by heroin vendors. “The Vietnam War is truly coming home to haunt us,” Steele and Murphy said in a report. “The first wave of heroin is already on its way to our children in high school.”

Not long after, Nixon held a press conference to announce the new “war on drugs,” declaring that “Public enemy number one in the United States is drug abuse.”

The Nixon administration had reason to worry. For one thing, the U.S. wasn’t prepared to deal with upwards of 100,000 heroin addicts coming home. For another, this was heroin. In 2007, British researchers conducted a study to assess the harm of various drugs and found that heroin was in a category all its own. On three scales measuring the likelihood that a drug would inflict physical harm, cause social harm, and induce addiction, heroin scored the highest rating—a perfect three out of three. The detoxing experience is hellish, and 95% of heroin addicts relapse. Telling someone to quit heroin is like telling someone to drown calmly.

The Lee Robins Study

To combat the imminent scourge, the government opted to increase support in both Vietnam and the United States. The Special Action Office of Drug Abuse Prevention was created to promote prevention and rehabilitation and to track addicted service members when they returned home.

U.S. soldiers at Long Binh base, northeast of Saigon, line up to give urine samples at a heroin detection center in June 1971, before departing for the U.S. | AP

Lee Robins, a professor of psychiatry and sociology at Washington University who specialized in the root causes of psychiatric epidemics, was appointed lead researcher of a study intended to monitor the progress of returning soldiers. Said Robins in 2010:

[Studying] heroin use in a highly exposed normal population was unique because there is nowhere else in the world where heroin is commonly used. In the United States itself, heroin use is so rare that [a national survey] of 2,400 adults obtained only about 12 people who had used heroin in the last year. Because heroin users are scarce both worldwide and in the United States, most of our information about heroin comes from treated criminal samples.

But what Robins discovered stretched credulity. As mentioned above, 95% of all heroin addicts relapse. However, among recovering Vietnam vets addicted to heroin, 95% managed to stay clean within a year and just 12% relapsed within three years. Robins’ findings completely upended the prevailing view at the time, which considered heroin addiction to be a permanent and irreversible condition. Unsurprisingly, nobody believed her. They thought she was a Nixon shill and politically motivated. But her research was sound and the results real.

Robins’ findings revolutionized our understanding of addiction and how the brain works, revealing that addictions can quite literally spontaneously dissolve if there’s a radical change in environment. The reason so many Vietnam vets escaped their heroin addictions was because they had escaped the circumstances that ensnared them.

For starters, access to the drug in Vietnam was beyond easy. Few soldiers had ever been within a mile of heroin back in the states, but in Vietnam, teenage girls hawked $4 vials from roadside stands along the highway between Saigon and the Long Binh U.S. Army base. These were basically lemonade stands dishing out the most addictive drug known to mankind with little signs attached to the front that probably read, “G.I. #1! No. 4 heroin $4! No VC!” In Saigon, street vendors distributed free vials knowing soldiers would return for more (which is exactly what dealers do in Atlanta’s BLUFF). Even the maids who cleaned the barracks peddled vials as they worked.

More importantly, in Vietnam, soldiers spent all day surrounded by cues triggering heroin use. Friends, fear, and firefights are a potent mix. At home, however, there was no trace of the jungle and its many unique elements — the suffocating heat, the pterodactyl-size mosquitoes, the mud and dust, the pitch-black nights, the draws from hell — nor was there any gunfire, artillery, helicopters, c-rations, malaria, rainy seasons, sleep deprivation, or Viet Cong. They arrived home to not only a completely different life, but an entirely different world.

As James Clear highlighted in Atomic Habits, a behavior that has been encoded in the mind is ready to be used whenever the relevant circumstances resurface.

When Patty Olwell, a therapist from Austin, Texas, started smoking, she would often light up while riding horses with a friend. Eventually, she quit smoking and avoided it for years. She had also stopped riding. Decades later, she hopped on a horse again and found herself craving a cigarette for the first time in forever. The cues were still internalized; she just hadn’t been exposed to them in a long time. Once a habit has been encoded, the urge to act follows whenever the environmental cues reappear.

For the typical heroin user who goes to rehab, which is completely devoid of problematic environmental stimuli, they return to the real world and its constant reminders of “the scene of the crime,” so to speak—all the same sights and smells and sounds that remind them of using and how good it feels to be high, plus, more often than not, the same life circumstances that led them to become an addict in the first place.

You Are Not So Different

In the decades since the Vietnam war ended, neuroscience has made incredible leaps and bounds, and we now know what a lot of people are reluctant to accept, in large part because it strongly conflicts with the oppressive imperative to health that’s become the center of a new Western morality: Every human brain has the capacity for addiction. Like all pitfalls in life, addiction is remarkably democratic; the presumption that certain people are inoculated against substance abuse or maladaptive behaviors for any reason — socioeconomic standing, race, occupation, genetics — is false.

When I was a junior in high school, I had a catastrophic injury during our first football game of the season. A 350 pound nose guard, an absolute mammoth of a man, fell on my left leg after I was tripped up in a scrum, completely shattering the leg, dislocating and breaking the ankle, and tearing all of the ligaments. It hurt a little. Kind of tickled. As you’d imagine, I was given a ton of painkillers with unlimited refills. High strength Oxycodone. The pills worked, but only for an hour or two, at which point the pain would again rear its ugly head. So, I started taking the pills preemptively to ward off the pain altogether, popping them like Skittles.

Fast forward to 4-5 months later and the refills went bye-bye, commencing a tortuous two-week detoxing experience: I couldn’t sleep or eat, my body ached terribly, cold sweats non-stop, a never-ending migraine, etc. I was 16 and naïve, so only vaguely cognizant of what was happening and why, but years later it would dawn on me how hopelessly addicted I’d become. This addiction by accident is what happens to thousands and thousands of people every year. At least 80% of heroin addicts start with prescription pain meds.

Even though science — not The Science™, but real science — has revealed that addiction, be it behavioral or substance-based, is not a moral weakness or an issue of self-control, there are still people who’d rather continue thinking otherwise. The idea that a very thin line indeed separates those who develop addictions from those who don’t, and but for the grace of God it could just as easily be you who’s so burdened, is something many would prefer not to contemplate. Much easier to go on believing that heroin is a problem for toothless pillbillies and whores and convicts, those deviants with their Dionysian proclivities, all of whom deserve to be held in open contempt throughout the mainstream of elite opinion.

Another truth that folks would do well to remember is that some people have more reasons to hurt than others. Somatically, yes, but also psychologically. Never mock a pain that you haven’t endured. It is a weakness, a fault, that, while not unique to Americans, is certainly endemic: The inability to understand what life is like in the shoes of another person, to step outside oneself and appreciate the raw edges of human existence. We are always so quick to judge others who have lived, or are living, under circumstances we ourselves have not.

Addicts shouldn’t be dismissed as weaker specimens or morally corrupt, as if of delicate constitution. Such dismissals are the epitome of intellectual laziness, the mark of a small mind. Many addicts are simply unlucky. Endless variables determine the trajectory of one’s life, millions of little experiences that steer you toward certain outcomes and pull you toward others. Environment isn’t the sole determining factor in whether or not someone becomes an addict, but it plays a much bigger role than was once believed. Even your standard pipe-hitting VC-slaying All-American G.I. is prone to weakness when he finds himself in the wrong setting and circumstances, and even the hardiest recovering addict will relapse if presented with the right contextual cues. But to contemplate such a thing is to complicate the pseudo-reality in which many people would rather reside, where concepts are well-defined and nuance is rare, and simplistic moral binaries — good or bad, right or wrong — ensure ambiguity and what-ifs remain anathema.

It doesn’t take a great deal of imagination to think of a reason or two why someone might be drawn to poisonous ameliorators. I knew a girl — we’ll call her Kristina — who started getting high and drinking when she was in the 6th grade. Kristina’s mother’s second husband would ply her with weed and alcohol because it made her more submissive and easier to control when he molested her. He’d threaten to hurt her mom if she resisted. So, Kristina drank and smoked what she was given, and she learned to cry without making any noise, and at some point down the road she found that certain substances did more than just make you feel good, they softened memories and even helped you forget.

Some people, they accrue too much bitter wisdom in too few years, and thereafter seek out ways to anesthetize a reality that’s often too painful to endure. The substance or behavior itself isn’t addictive until we learn to use it as a therapeutic salve for our psychological troubles. If you’re anxious or depressed, for example, you might find that drugs or certain behaviors that involve a rise in dopamine — gambling, video games, shopping, eating, etc. — lessen what hurts. The mind learns to associate self-medicating with taking up substances or behaviors that dull the continuous pain of persistent hardships. And some people have more than others.