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Everything you think you know about addiction is wrong

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    One of my earliest memories
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    is of trying to wake up
    one of my relatives and not being able to.
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    And I was just a little kid,
    so I didn't really understand why,
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    but as I got older,
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    I realized we had
    drug addiction in my family,
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    including later cocaine addiction.
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    I'd been thinking about it a lot lately,
    partly because it's now exactly 100 years
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    since drugs were first banned
    in the United States and Britain,
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    and we then imposed that
    on the rest of the world.
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    It's a century since we made
    this really fateful decision
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    to take addicts and punish them
    and make them suffer,
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    because we believed that would deter them;
    it would give them an incentive to stop.
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    And a few years ago, I was looking at
    some of the addicts in my life who I love,
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    and trying to figure out
    if there was some way to help them.
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    And I realized there were loads
    of incredibly basic questions
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    I just didn't know the answer to,
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    like, what really causes addiction?
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    Why do we carry on with this approach
    that doesn't seem to be working,
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    and is there a better way out there
    that we could try instead?
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    So I read loads of stuff about it,
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    and I couldn't really find
    the answers I was looking for,
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    so I thought, okay, I'll go and sit
    with different people around the world
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    who lived this and studied this
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    and talk to them and see
    if I could learn from them.
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    And I didn't realize I would end up
    going over 30,000 miles at the start,
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    but I ended up going and meeting
    loads of different people,
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    from a transgender crack dealer
    in Brownsville, Brooklyn,
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    to a scientist who spends a lot of time
    feeding hallucinogens to mongooses
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    to see if they like them --
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    it turns out they do, but only
    in very specific circumstances --
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    to the only country that's ever
    decriminalized all drugs,
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    from cannabis to crack, Portugal.
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    And the thing I realized
    that really blew my mind is,
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    almost everything we think
    we know about addiction is wrong,
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    and if we start to absorb
    the new evidence about addiction,
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    I think we're going to have to change
    a lot more than our drug policies.
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    But let's start with what we think
    we know, what I thought I knew.
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    Let's think about this middle row here.
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    Imagine all of you, for 20 days now, went
    off and used heroin three times a day.
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    Some of you look a little more
    enthusiastic than others at this prospect.
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    (Laughter)
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    Don't worry,
    it's just a thought experiment.
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    Imagine you did that, right?
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    What would happen?
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    Now, we have a story about what would
    happen that we've been told for a century.
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    We think, because there are
    chemical hooks in heroin,
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    as you took it for a while,
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    your body would become
    dependent on those hooks,
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    you'd start to physically need them,
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    and at the end of those 20 days,
    you'd all be heroin addicts. Right?
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    That's what I thought.
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    First thing that alerted me to the fact
    that something's not right with this story
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    is when it was explained to me.
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    If I step out of this TED Talk today
    and I get hit by a car and I break my hip,
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    I'll be taken to hospital
    and I'll be given loads of diamorphine.
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    Diamorphine is heroin.
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    It's actually much better heroin
    than you're going to buy on the streets,
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    because the stuff you buy
    from a drug dealer is contaminated.
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    Actually, very little of it is heroin,
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    whereas the stuff you get
    from the doctor is medically pure.
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    And you'll be given it for quite
    a long period of time.
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    There are loads of people in this room,
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    you may not realize it,
    you've taken quite a lot of heroin.
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    And anyone who is watching this
    anywhere in the world, this is happening.
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    And if what we believe
    about addiction is right --
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    those people are exposed
    to all those chemical hooks --
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    What should happen?
    They should become addicts.
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    This has been studied really carefully.
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    It doesn't happen; you will have noticed
    if your grandmother had a hip replacement,
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    she didn't come out as a junkie.
    (Laughter)
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    And when I learned this,
    it seemed so weird to me,
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    so contrary to everything I'd been told,
    everything I thought I knew,
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    I just thought it couldn't be right,
    until I met a man called Bruce Alexander.
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    He's a professor
    of psychology in Vancouver
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    who carried out an incredible experiment
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    I think really helps us
    to understand this issue.
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    Professor Alexander explained to me,
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    the idea of addiction we've all
    got in our heads, that story,
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    comes partly from a series of experiments
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    that were done earlier
    in the 20th century.
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    They're really simple.
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    You can do them tonight at home
    if you feel a little sadistic.
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    You get a rat and you put it in a cage,
    and you give it two water bottles:
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    One is just water, and the other is water
    laced with either heroin or cocaine.
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    If you do that, the rat will almost always
    prefer the drug water
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    and almost always
    kill itself quite quickly.
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    So there you go, right?
    That's how we think it works.
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    In the '70s, Professor Alexander comes
    along and he looks at this experiment
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    and he noticed something.
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    He said ah, we're putting
    the rat in an empty cage.
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    It's got nothing to do
    except use these drugs.
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    Let's try something different.
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    So Professor Alexander built a cage
    that he called "Rat Park,"
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    which is basically heaven for rats.
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    They've got loads of cheese,
    they've got loads of colored balls,
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    they've got loads of tunnels.
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    Crucially, they've got loads of friends.
    They can have loads of sex.
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    And they've got both the water bottles,
    the normal water and the drugged water.
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    But here's the fascinating thing:
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    In Rat Park, they don't
    like the drug water.
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    They almost never use it.
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    None of them ever use it compulsively.
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    None of them ever overdose.
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    You go from almost 100 percent overdose
    when they're isolated
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    to zero percent overdose when they
    have happy and connected lives.
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    Now, when he first saw this,
    Professor Alexander thought,
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    maybe this is just a thing about rats,
    they're quite different to us.
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    Maybe not as different as we'd like,
    but, you know --
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    But fortunately, there was
    a human experiment
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    into the exact same principle happening
    at the exact same time.
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    It was called the Vietnam War.
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    In Vietnam, 20 percent of all American
    troops were using loads of heroin,
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    and if you look at the news
    reports from the time,
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    they were really worried, because
    they thought, my God, we're going to have
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    hundreds of thousands of junkies
    on the streets of the United States
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    when the war ends; it made total sense.
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    Now, those soldiers who were using
    loads of heroin were followed home.
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    The Archives of General Psychiatry
    did a really detailed study,
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    and what happened to them?
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    It turns out they didn't go to rehab.
    They didn't go into withdrawal.
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    Ninety-five percent of them just stopped.
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    Now, if you believe the story
    about chemical hooks,
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    that makes absolutely no sense,
    but Professor Alexander began to think
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    there might be a different
    story about addiction.
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    He said, what if addiction isn't
    about your chemical hooks?
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    What if addiction is about your cage?
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    What if addiction is an adaptation
    to your environment?
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    Looking at this,
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    there was another professor
    called Peter Cohen in the Netherlands
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    who said, maybe we shouldn't
    even call it addiction.
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    Maybe we should call it bonding.
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    Human beings have a natural
    and innate need to bond,
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    and when we're happy and healthy,
    we'll bond and connect with each other,
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    but if you can't do that,
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    because you're traumatized or isolated
    or beaten down by life,
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    you will bond with something
    that will give you some sense of relief.
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    Now, that might be gambling,
    that might be pornography,
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    that might be cocaine,
    that might be cannabis,
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    but you will bond and connect
    with something because that's our nature.
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    That's what we want as human beings.
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    And at first, I found this quite
    a difficult thing to get my head around,
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    but one way that helped me
    to think about it is,
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    I can see, I've got over by my seat
    a bottle of water, right?
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    I'm looking at lots of you, and lots
    of you have bottles of water with you.
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    Forget the drugs. Forget the drug war.
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    Totally legally, all of those bottles
    of water could be bottles of vodka, right?
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    We could all be getting drunk --
    I might after this -- (Laughter) --
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    but we're not.
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    Now, because you've been able to afford
    the approximately gazillion pounds
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    that it costs to get into a TED Talk,
    I'm guessing you guys could afford
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    to be drinking vodka
    for the next six months.
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    You wouldn't end up homeless.
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    You're not going to do that,
    and the reason you're not going to do that
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    is not because anyone's stopping you.
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    It's because you've got
    bonds and connections
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    that you want to be present for.
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    You've got work you love.
    You've got people you love.
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    You've got healthy relationships.
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    And a core part of addiction,
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    I came to think, and I believe
    the evidence suggests,
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    is about not being able to bear
    to be present in your life.
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    Now, this has really
    significant implications.
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    The most obvious implications
    are for the War on Drugs.
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    In Arizona, I went out
    with a group of women
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    who were made to wear t-shirts
    saying, "I was a drug addict,"
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    and go out on chain gangs and dig graves
    while members of the public jeer at them,
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    and when those women get out of prison,
    they're going to have criminal records
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    that mean they'll never work
    in the legal economy again.
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    Now, that's a very extreme example,
    obviously, in the case of the chain gang,
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    but actually almost
    everywhere in the world
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    we treat addicts to some degree like that.
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    We punish them. We shame them.
    We give them criminal records.
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    We put barriers between them reconnecting.
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    There was a doctor in Canada,
    Dr. Gabor Maté, an amazing man,
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    who said to me, if you wanted to design
    a system that would make addiction worse,
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    you would design that system.
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    Now, there's a place that decided
    to do the exact opposite,
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    and I went there to see how it worked.
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    In the year 2000, Portugal had
    one of the worst drug problems in Europe.
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    One percent of the population was addicted
    to heroin, which is kind of mind-blowing,
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    and every year, they tried
    the American way more and more.
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    They punished people and stigmatized them
    and shamed them more,
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    and every year, the problem got worse.
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    And one day, the Prime Minister and
    the leader of the opposition got together,
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    and basically said, look, we can't go on
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    with a country where we're having
    ever more people becoming heroin addicts.
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    Let's set up a panel
    of scientists and doctors
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    to figure out what would
    genuinely solve the problem.
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    And they set up a panel led by
    an amazing man called Dr. João Goulão,
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    to look at all this new evidence,
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    and they came back and they said,
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    "Decriminalize all drugs
    from cannabis to crack, but" --
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    and this is the crucial next step --
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    "take all the money we used to spend
    on cutting addicts off,
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    on disconnecting them,
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    and spend it instead
    on reconnecting them with society."
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    And that's not really what we think of
    as drug treatment
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    in the United States and Britain.
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    So they do do residential rehab,
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    they do psychological therapy,
    that does have some value.
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    But the biggest thing they did
    was the complete opposite of what we do:
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    a massive program
    of job creation for addicts,
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    and microloans for addicts
    to set up small businesses.
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    So say you used to be a mechanic.
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    When you're ready, they'll go
    to a garage, and they'll say,
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    if you employ this guy for a year,
    we'll pay half his wages.
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    The goal was to make sure
    that every addict in Portugal
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    had something to get out
    of bed for in the morning.
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    And when I went and met the addicts
    in Portugal,
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    what they said is,
    as they rediscovered purpose,
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    they rediscovered bonds
    and relationships with the wider society.
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    It'll be 15 years this year
    since that experiment began,
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    and the results are in:
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    injecting drug use is down in Portugal,
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    according to the British
    Journal of Criminology,
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    by 50 percent, five-zero percent.
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    Overdose is massively down,
    HIV is massively down among addicts.
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    Addiction in every study
    is significantly down.
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    One of the ways you know it's worked
    so well is that almost nobody in Portugal
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    wants to go back to the old system.
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    Now, that's the political implications.
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    I actually think there's a layer
    of implications
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    to all this research below that.
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    We live in a culture where people
    feel really increasingly vulnerable
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    to all sorts of addictions,
    whether it's to their smartphones
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    or to shopping or to eating.
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    Before these talks began --
    you guys know this --
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    we were told we weren't allowed
    to have our smartphones on,
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    and I have to say, a lot of you
    looked an awful lot like
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    addicts who were told their dealer
    was going to be unavailable
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    for the next couple of hours. (Laughter)
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    A lot of us feel like that,
    and it might sound weird to say,
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    I've been talking about how disconnection
    is a major driver of addiction
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    and weird to say it's growing,
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    because you think we're the most connected
    society that's ever been, surely.
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    But I increasingly began to think
    that the connections we have
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    or think we have, are like a kind
    of parody of human connection.
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    If you have a crisis in your life,
    you'll notice something.
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    It won't be your Twitter followers
    who come to sit with you.
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    It won't be your Facebook friends
    who help you turn it round.
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    It'll be your flesh and blood friends
    who you have deep and nuanced
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    and textured, face-to-face
    relationships with,
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    and there's a study I learned about from
    Bill McKibben, the environmental writer,
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    that I think tells us a lot about this.
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    It looked at the number of close friends
    the average American believes
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    they can call on in a crisis.
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    That number has been declining
    steadily since the 1950s.
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    The amount of floor space
    an individual has in their home
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    has been steadily increasing,
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    and I think that's like a metaphor
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    for the choice we've made as a culture.
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    We've traded floorspace for friends,
    we've traded stuff for connections,
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    and the result is we are one of the
    loneliest societies there has ever been.
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    And Bruce Alexander, the guy who did
    the Rat Park experiment, says,
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    we talk all the time in addiction
    about individual recovery,
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    and it's right to talk about that,
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    but we need to talk much more
    about social recovery.
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    Something's gone wrong with us,
    not just with individuals but as a group,
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    and we've created a society where,
    for a lot of us,
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    life looks a whole lot more
    like that isolated cage
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    and a whole lot less like Rat Park.
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    If I'm honest, this isn't
    why I went into it.
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    I didn't go in to the discover
    the political stuff, the social stuff.
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    I wanted to know how to help
    the people I love.
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    And when I came back from this
    long journey and I'd learned all this,
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    I looked at the addicts in my life,
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    and if you're really candid,
    it's hard loving an addict,
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    and there's going to be lots of people
    who know in this room.
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    You are angry a lot of the time,
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    and I think one of the reasons
    why this debate is so charged
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    is because it runs through the heart
    of each of us, right?
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    Everyone has a bit of them
    that looks at an addict and thinks,
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    I wish someone would just stop you.
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    And the kind of scripts we're told for how
    to deal with the addicts in our lives
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    is typified by, I think,
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    the reality show "Intervention,"
    if you guys have ever seen it.
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    I think everything in our lives
    is defined by reality TV,
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    but that's another TED Talk.
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    If you've ever seen
    the show "Intervention,"
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    it's a pretty simple premise.
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    Get an addict, all the people
    in their life, gather them together,
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    confront them with what they're doing,
    and they say, if you don't shape up,
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    we're going to cut you off.
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    So what they do is they take
    the connection to the addict,
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    and they threaten it,
    they make it contingent
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    on the addict behaving the way they want.
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    And I began to think, I began to see
    why that approach doesn't work,
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    and I began to think that's almost like
    the importing of the logic of the Drug War
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    into our private lives.
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    So I was thinking,
    how could I be Portuguese?
  • 13:26 - 13:29
    And what I've tried to do now,
    and I can't tell you I do it consistently
  • 13:29 - 13:31
    and I can't tell you it's easy,
  • 13:31 - 13:34
    is to say to the addicts in my life
  • 13:34 - 13:36
    that I want to deepen
    the connection with them,
  • 13:36 - 13:40
    to say to them, I love you
    whether you're using or you're not.
  • 13:40 - 13:43
    I love you, whatever state you're in,
  • 13:43 - 13:45
    and if you need me,
    I'll come and sit with you
  • 13:45 - 13:48
    because I love you and I don't
    want you to be alone
  • 13:48 - 13:50
    or to feel alone.
  • 13:50 - 13:52
    And I think the core of that message --
  • 13:52 - 13:55
    you're not alone, we love you --
  • 13:55 - 13:58
    has to be at every level
    of how we respond to addicts,
  • 13:58 - 14:00
    socially, politically and individually.
  • 14:00 - 14:05
    For 100 years now, we've been singing
    war songs about addicts.
  • 14:05 - 14:09
    I think all along we should have been
    singing love songs to them,
  • 14:09 - 14:13
    because the opposite of addiction
    is not sobriety.
  • 14:13 - 14:17
    The opposite of addiction is connection.
  • 14:17 - 14:19
    Thank you.
  • 14:19 - 14:26
    (Applause)
Title:
Everything you think you know about addiction is wrong
Speaker:
Johann Hari
Description:

What really causes addiction — to everything from cocaine to smart-phones? And how can we overcome it? Johann Hari has seen our current methods fail firsthand, as he has watched loved ones struggle to manage their addictions. He started to wonder why we treat addicts the way we do — and if there might be a better way. As he shares in this deeply personal talk, his questions took him around the world, and unearthed some surprising and hopeful ways of thinking about an age-old problem.

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Video Language:
English
Team:
closed TED
Project:
TEDTalks
Duration:
14:42
  • The English transcript was updated on 3/7/2016. At 11:17, "He looked at the number of close friends the average American believes they can call on in a crisis." was changed to "It looked at the number of close friends the average American believes they can call on in a crisis."

English subtitles

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