The PJ Tatler

What Really Causes Addiction? Maybe It's Your Cage

Nature or nurture? A predisposition to addiction, or the drugs themselves? A new book suggests neither of the above:

It is now one hundred years since drugs were first banned – and all through this long century of waging war on drugs, we have been told a story about addiction, by our teachers, and by our governments. This story is so deeply ingrained in our minds that we take it for granted. It seems obvious. It seems manifestly true. Until I set off three and a half years ago on a 30,000-mile journey for my book ‘Chasing The Scream – The First And Last Days of the War on Drugs’ to figure out what is really driving the drug war, I believed it too. But what I learned on the road is that almost everything we have been told about addiction is wrong – and there is a very different story waiting for us, if only we are ready to hear it. If we truly absorb this new story, we will have to change a lot more than the drug war. We will have to change ourselves.

I’m always wary of stories that begin so portentously, but please read on:

Here’s one example of an experiment that is happening all around you, and may well happen to you one day. If you get run over today and you break your hip, you will probably be given diamorphine – the medical name for heroin. In the hospital around you, there will be plenty of people also given heroin for long periods, for pain relief. The heroin you will get from the doctor will have a much high purity and potency than the heroin being used by street-addicts, who have to buy from criminals who adulterate it. So if the old theory of addiction is right – it’s the drugs that cause it; they make your body need them – then it’s obvious what should happen. Loads of people should leave hospital and try to score smack on the streets, to meet their habit.

But here’s the strange thing. It virtually never happens. As the Canadian doctor Gabor Mate was the first to explain to me, medical users just stop, despite months of use. The same drug, used for the same length of time, turns street-users into desperate addicts – and leaves medical patients unaffected.

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.

And now read the whole thing.