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A Public Health Rescue Mission

Substance abuse and addiction impact many of us in the context of our human experience.  The 2016 Surgeon General’s Report: Facing Addiction in America defines addiction as a substance use disorder categorized as severe and associated with compulsive or uncontrolled use of one or more substances.  Furthermore, this report suggests that addictive substances are powerful culprits that compel humans to action.  Irresistible, chemical hooks.  This view of addiction has informed our cultural approach to drug treatment and drug policy for generations.  From the War on Drugs to the current epidemic of Opioid-related mortality, the consistent, public health message has been that powerful, addictive substances cannot be allowed to circulate in human society, especially if, as we have been told, “This is your brain on drugs.” 

The theory of the chemical hook has roots in laboratory studies conducted using rats during the 1950s and 1960s, devised to learn about the addictive qualities of heroin, amphetamines, morphine, cocaine, and other drugs.  Scientists put rats in “Skinner Boxes” – tiny, isolated cages – and starved them for hours on end.  The rats lived in these boxes 24/7, were allowed no room for movement, and no interaction with other rats.  They were hooked up to various drugs using intravenous needles implanted in their jugular veins.  The rats could inject themselves with the drug by pushing a lever in the cage.  Typically, the rats would press the lever enough to consume large doses of a drug, often choosing it over food and water, in many cases until death.  The studies hereby concluded that the drugs were irresistibly addictive substances due to their unique chemical properties, a notion which fed very neatly into the fearsome images being propagated about illicit drugs and drug use in the culture at that time.

However rats, like humans, are social, industrious creatures that thrive on contact and communication with others.  With this in mind, psychologist Dr. Bruce Alexander devised an experiment that would come to a much different conclusion about addictive behavior.  Alexander and colleagues built a large colony to house rats, with more than 200 times the floor space of standard Skinner Boxes, as well as alternative reinforcers including exercise wheels, platforms for climbing, and wood chips for strewing around, as well as the opportunity for social, and sexual, interaction with other rats.  He then ran several experiments comparing the drug intake of rats housed in what became known as “Rat Park”, with those kept in Skinner Boxes.  In virtually every experiment, rats in Skinner Boxes consumed more drugs, by every measure that could be devised.  And not just a little more.  A lot more.  The Rat Park experiment deduced that psychology – a subject’s mental, emotional, and psychosocial state – was perhaps the greatest indicator of addictive behavior, not the drug itself. 

At a time when public health discourse surrounding addiction echoes the same policy and response that have failed generations of Americans, and disproportionately effected others by treating addiction as criminal justice issue, what can be learned from the example of Rat Park?  Like rats, human beings are heavily reliant on an environment including alternative reinforcers and connection with others to achieve meaning, happiness, and fulfillment in life.  Lab rats with opposable thumbs, evolving through the potholed experiment of civilization.  The cages we inhabit are constructed by social and environmental context, populated by our families, friends, enemies, colleagues, strangers, neighbors, intruders, and other pawns in the game, set against the backdrop of our homes, communities, schools, workplaces, extra curricular activities, and so on.  The health and social outcomes of this experiment vary, and are linked to myriad factors.  Perhaps instead of focusing on chemicals as the primary factor in this equation, we should focus on our cage. 

From the Producer/Director of the groundbreaking social action documentary “HEALING VOICES” comes Part II in a public health trilogy about the American Condition. “RECOVERING ADDICTION: A Public Health Rescue Mission” challenges inherent cultural ideology relating to drug use, addiction, and drug policy in America, and offers a hopeful, social solution to one of the nation’s most pressing and deadly public health issues.  From the streets of New York City to the Rust Belt and the Ozarks, this character-driven documentary is a rescue mission to restore humanity and a harm reduction approach to America’s modern public health landscape.