Everything you think you know about addiction is wrong
-
0:01 - 0:02One of my earliest memories
-
0:02 - 0:05is of trying to wake up
one of my relatives and not being able to. -
0:05 - 0:08And I was just a little kid,
so I didn't really understand why, -
0:08 - 0:10but as I got older,
-
0:10 - 0:12I realized we had
drug addiction in my family, -
0:12 - 0:14including later cocaine addiction.
-
0:14 - 0:19I'd been thinking about it a lot lately,
partly because it's now exactly 100 years -
0:19 - 0:22since drugs were first banned
in the United States and Britain, -
0:22 - 0:24and we then imposed that
on the rest of the world. -
0:24 - 0:28It's a century since we made
this really fateful decision -
0:28 - 0:32to take addicts and punish them
and make them suffer, -
0:32 - 0:36because we believed that would deter them;
it would give them an incentive to stop. -
0:36 - 0:41And a few years ago, I was looking at
some of the addicts in my life who I love, -
0:41 - 0:45and trying to figure out
if there was some way to help them. -
0:45 - 0:48And I realized there were loads
of incredibly basic questions -
0:48 - 0:50I just didn't know the answer to,
-
0:50 - 0:52like, what really causes addiction?
-
0:52 - 0:56Why do we carry on with this approach
that doesn't seem to be working, -
0:56 - 0:59and is there a better way out there
that we could try instead? -
0:59 - 1:00So I read loads of stuff about it,
-
1:00 - 1:03and I couldn't really find
the answers I was looking for, -
1:03 - 1:07so I thought, okay, I'll go and sit
with different people around the world -
1:07 - 1:08who lived this and studied this
-
1:08 - 1:11and talk to them and see
if I could learn from them. -
1:11 - 1:14And I didn't realize I would end up
going over 30,000 miles at the start, -
1:14 - 1:17but I ended up going and meeting
loads of different people, -
1:17 - 1:20from a transgender crack dealer
in Brownsville, Brooklyn, -
1:20 - 1:24to a scientist who spends a lot of time
feeding hallucinogens to mongooses -
1:24 - 1:25to see if they like them --
-
1:25 - 1:28it turns out they do, but only
in very specific circumstances -- -
1:28 - 1:31to the only country that's ever
decriminalized all drugs, -
1:31 - 1:33from cannabis to crack, Portugal.
-
1:33 - 1:36And the thing I realized
that really blew my mind is, -
1:36 - 1:40almost everything we think
we know about addiction is wrong, -
1:40 - 1:43and if we start to absorb
the new evidence about addiction, -
1:43 - 1:46I think we're going to have to change
a lot more than our drug policies. -
1:46 - 1:50But let's start with what we think
we know, what I thought I knew. -
1:50 - 1:52Let's think about this middle row here.
-
1:52 - 1:55Imagine all of you, for 20 days now, went
off and used heroin three times a day. -
1:55 - 1:59Some of you look a little more
enthusiastic than others at this prospect. -
1:59 - 2:00(Laughter)
-
2:00 - 2:02Don't worry,
it's just a thought experiment. -
2:02 - 2:04Imagine you did that, right?
-
2:04 - 2:05What would happen?
-
2:05 - 2:09Now, we have a story about what would
happen that we've been told for a century. -
2:09 - 2:12We think, because there are
chemical hooks in heroin, -
2:12 - 2:14as you took it for a while,
-
2:14 - 2:16your body would become
dependent on those hooks, -
2:16 - 2:18you'd start to physically need them,
-
2:18 - 2:21and at the end of those 20 days,
you'd all be heroin addicts. Right? -
2:21 - 2:22That's what I thought.
-
2:23 - 2:26First thing that alerted me to the fact
that something's not right with this story -
2:26 - 2:28is when it was explained to me.
-
2:28 - 2:32If I step out of this TED Talk today
and I get hit by a car and I break my hip, -
2:32 - 2:35I'll be taken to hospital
and I'll be given loads of diamorphine. -
2:35 - 2:37Diamorphine is heroin.
-
2:37 - 2:40It's actually much better heroin
than you're going to buy on the streets, -
2:40 - 2:43because the stuff you buy
from a drug dealer is contaminated. -
2:43 - 2:45Actually, very little of it is heroin,
-
2:45 - 2:48whereas the stuff you get
from the doctor is medically pure. -
2:48 - 2:50And you'll be given it for quite
a long period of time. -
2:50 - 2:52There are loads of people in this room,
-
2:52 - 2:55you may not realize it,
you've taken quite a lot of heroin. -
2:55 - 2:59And anyone who is watching this
anywhere in the world, this is happening. -
2:59 - 3:01And if what we believe
about addiction is right -- -
3:01 - 3:04those people are exposed
to all those chemical hooks -- -
3:04 - 3:06What should happen?
They should become addicts. -
3:06 - 3:08This has been studied really carefully.
-
3:08 - 3:12It doesn't happen; you will have noticed
if your grandmother had a hip replacement, -
3:12 - 3:14she didn't come out as a junkie.
(Laughter) -
3:14 - 3:18And when I learned this,
it seemed so weird to me, -
3:18 - 3:21so contrary to everything I'd been told,
everything I thought I knew, -
3:21 - 3:25I just thought it couldn't be right,
until I met a man called Bruce Alexander. -
3:25 - 3:28He's a professor
of psychology in Vancouver -
3:28 - 3:30who carried out an incredible experiment
-
3:30 - 3:32I think really helps us
to understand this issue. -
3:32 - 3:34Professor Alexander explained to me,
-
3:34 - 3:37the idea of addiction we've all
got in our heads, that story, -
3:37 - 3:39comes partly from a series of experiments
-
3:39 - 3:41that were done earlier
in the 20th century. -
3:41 - 3:42They're really simple.
-
3:42 - 3:45You can do them tonight at home
if you feel a little sadistic. -
3:45 - 3:49You get a rat and you put it in a cage,
and you give it two water bottles: -
3:49 - 3:52One is just water, and the other is water
laced with either heroin or cocaine. -
3:53 - 3:56If you do that, the rat will almost always
prefer the drug water -
3:56 - 3:58and almost always
kill itself quite quickly. -
3:58 - 4:00So there you go, right?
That's how we think it works. -
4:00 - 4:04In the '70s, Professor Alexander comes
along and he looks at this experiment -
4:04 - 4:05and he noticed something.
-
4:05 - 4:08He said ah, we're putting
the rat in an empty cage. -
4:08 - 4:10It's got nothing to do
except use these drugs. -
4:10 - 4:11Let's try something different.
-
4:11 - 4:14So Professor Alexander built a cage
that he called "Rat Park," -
4:14 - 4:17which is basically heaven for rats.
-
4:17 - 4:20They've got loads of cheese,
they've got loads of colored balls, -
4:20 - 4:21they've got loads of tunnels.
-
4:21 - 4:25Crucially, they've got loads of friends.
They can have loads of sex. -
4:25 - 4:29And they've got both the water bottles,
the normal water and the drugged water. -
4:29 - 4:32But here's the fascinating thing:
-
4:32 - 4:36In Rat Park, they don't
like the drug water. -
4:36 - 4:37They almost never use it.
-
4:37 - 4:40None of them ever use it compulsively.
-
4:40 - 4:41None of them ever overdose.
-
4:41 - 4:45You go from almost 100 percent overdose
when they're isolated -
4:45 - 4:48to zero percent overdose when they
have happy and connected lives. -
4:48 - 4:51Now, when he first saw this,
Professor Alexander thought, -
4:51 - 4:54maybe this is just a thing about rats,
they're quite different to us. -
4:55 - 4:57Maybe not as different as we'd like,
but, you know -- -
4:57 - 4:59But fortunately, there was
a human experiment -
4:59 - 5:02into the exact same principle happening
at the exact same time. -
5:02 - 5:04It was called the Vietnam War.
-
5:04 - 5:09In Vietnam, 20 percent of all American
troops were using loads of heroin, -
5:09 - 5:11and if you look at the news
reports from the time, -
5:12 - 5:15they were really worried, because
they thought, my God, we're going to have -
5:15 - 5:18hundreds of thousands of junkies
on the streets of the United States -
5:18 - 5:20when the war ends; it made total sense.
-
5:20 - 5:24Now, those soldiers who were using
loads of heroin were followed home. -
5:24 - 5:27The Archives of General Psychiatry
did a really detailed study, -
5:27 - 5:29and what happened to them?
-
5:29 - 5:32It turns out they didn't go to rehab.
They didn't go into withdrawal. -
5:32 - 5:35Ninety-five percent of them just stopped.
-
5:35 - 5:38Now, if you believe the story
about chemical hooks, -
5:38 - 5:41that makes absolutely no sense,
but Professor Alexander began to think -
5:41 - 5:44there might be a different
story about addiction. -
5:44 - 5:47He said, what if addiction isn't
about your chemical hooks? -
5:47 - 5:49What if addiction is about your cage?
-
5:49 - 5:52What if addiction is an adaptation
to your environment? -
5:52 - 5:54Looking at this,
-
5:54 - 5:57there was another professor
called Peter Cohen in the Netherlands -
5:57 - 5:59who said, maybe we shouldn't
even call it addiction. -
5:59 - 6:01Maybe we should call it bonding.
-
6:01 - 6:04Human beings have a natural
and innate need to bond, -
6:04 - 6:07and when we're happy and healthy,
we'll bond and connect with each other, -
6:07 - 6:10but if you can't do that,
-
6:10 - 6:14because you're traumatized or isolated
or beaten down by life, -
6:14 - 6:17you will bond with something
that will give you some sense of relief. -
6:17 - 6:20Now, that might be gambling,
that might be pornography, -
6:20 - 6:22that might be cocaine,
that might be cannabis, -
6:22 - 6:26but you will bond and connect
with something because that's our nature. -
6:26 - 6:28That's what we want as human beings.
-
6:28 - 6:32And at first, I found this quite
a difficult thing to get my head around, -
6:32 - 6:34but one way that helped me
to think about it is, -
6:34 - 6:38I can see, I've got over by my seat
a bottle of water, right? -
6:38 - 6:41I'm looking at lots of you, and lots
of you have bottles of water with you. -
6:41 - 6:43Forget the drugs. Forget the drug war.
-
6:43 - 6:48Totally legally, all of those bottles
of water could be bottles of vodka, right? -
6:48 - 6:51We could all be getting drunk --
I might after this -- (Laughter) -- -
6:52 - 6:53but we're not.
-
6:53 - 6:56Now, because you've been able to afford
the approximately gazillion pounds -
6:56 - 7:00that it costs to get into a TED Talk,
I'm guessing you guys could afford -
7:00 - 7:02to be drinking vodka
for the next six months. -
7:02 - 7:04You wouldn't end up homeless.
-
7:04 - 7:08You're not going to do that,
and the reason you're not going to do that -
7:08 - 7:09is not because anyone's stopping you.
-
7:09 - 7:12It's because you've got
bonds and connections -
7:12 - 7:13that you want to be present for.
-
7:13 - 7:16You've got work you love.
You've got people you love. -
7:16 - 7:18You've got healthy relationships.
-
7:18 - 7:20And a core part of addiction,
-
7:20 - 7:23I came to think, and I believe
the evidence suggests, -
7:23 - 7:27is about not being able to bear
to be present in your life. -
7:27 - 7:29Now, this has really
significant implications. -
7:29 - 7:32The most obvious implications
are for the War on Drugs. -
7:32 - 7:36In Arizona, I went out
with a group of women -
7:36 - 7:40who were made to wear t-shirts
saying, "I was a drug addict," -
7:40 - 7:44and go out on chain gangs and dig graves
while members of the public jeer at them, -
7:44 - 7:48and when those women get out of prison,
they're going to have criminal records -
7:48 - 7:51that mean they'll never work
in the legal economy again. -
7:51 - 7:55Now, that's a very extreme example,
obviously, in the case of the chain gang, -
7:55 - 7:57but actually almost
everywhere in the world -
7:57 - 7:59we treat addicts to some degree like that.
-
7:59 - 8:02We punish them. We shame them.
We give them criminal records. -
8:02 - 8:04We put barriers between them reconnecting.
-
8:04 - 8:07There was a doctor in Canada,
Dr. Gabor Maté, an amazing man, -
8:07 - 8:11who said to me, if you wanted to design
a system that would make addiction worse, -
8:11 - 8:13you would design that system.
-
8:13 - 8:16Now, there's a place that decided
to do the exact opposite, -
8:16 - 8:18and I went there to see how it worked.
-
8:18 - 8:21In the year 2000, Portugal had
one of the worst drug problems in Europe. -
8:21 - 8:25One percent of the population was addicted
to heroin, which is kind of mind-blowing, -
8:25 - 8:28and every year, they tried
the American way more and more. -
8:28 - 8:31They punished people and stigmatized them
and shamed them more, -
8:31 - 8:33and every year, the problem got worse.
-
8:33 - 8:36And one day, the Prime Minister and
the leader of the opposition got together, -
8:36 - 8:38and basically said, look, we can't go on
-
8:38 - 8:42with a country where we're having
ever more people becoming heroin addicts. -
8:42 - 8:44Let's set up a panel
of scientists and doctors -
8:44 - 8:47to figure out what would
genuinely solve the problem. -
8:47 - 8:50And they set up a panel led by
an amazing man called Dr. João Goulão, -
8:50 - 8:51to look at all this new evidence,
-
8:52 - 8:53and they came back and they said,
-
8:53 - 8:57"Decriminalize all drugs
from cannabis to crack, but" -- -
8:57 - 9:00and this is the crucial next step --
-
9:00 - 9:03"take all the money we used to spend
on cutting addicts off, -
9:03 - 9:05on disconnecting them,
-
9:05 - 9:08and spend it instead
on reconnecting them with society." -
9:08 - 9:13And that's not really what we think of
as drug treatment -
9:13 - 9:15in the United States and Britain.
-
9:15 - 9:17So they do do residential rehab,
-
9:17 - 9:19they do psychological therapy,
that does have some value. -
9:19 - 9:23But the biggest thing they did
was the complete opposite of what we do: -
9:23 - 9:25a massive program
of job creation for addicts, -
9:25 - 9:28and microloans for addicts
to set up small businesses. -
9:28 - 9:30So say you used to be a mechanic.
-
9:30 - 9:32When you're ready, they'll go
to a garage, and they'll say, -
9:32 - 9:35if you employ this guy for a year,
we'll pay half his wages. -
9:35 - 9:38The goal was to make sure
that every addict in Portugal -
9:38 - 9:40had something to get out
of bed for in the morning. -
9:40 - 9:44And when I went and met the addicts
in Portugal, -
9:44 - 9:46what they said is,
as they rediscovered purpose, -
9:46 - 9:49they rediscovered bonds
and relationships with the wider society. -
9:49 - 9:52It'll be 15 years this year
since that experiment began, -
9:52 - 9:53and the results are in:
-
9:53 - 9:55injecting drug use is down in Portugal,
-
9:55 - 9:58according to the British
Journal of Criminology, -
9:58 - 10:00by 50 percent, five-zero percent.
-
10:00 - 10:04Overdose is massively down,
HIV is massively down among addicts. -
10:04 - 10:07Addiction in every study
is significantly down. -
10:07 - 10:10One of the ways you know it's worked
so well is that almost nobody in Portugal -
10:10 - 10:12wants to go back to the old system.
-
10:12 - 10:14Now, that's the political implications.
-
10:14 - 10:17I actually think there's a layer
of implications -
10:17 - 10:19to all this research below that.
-
10:19 - 10:22We live in a culture where people
feel really increasingly vulnerable -
10:22 - 10:25to all sorts of addictions,
whether it's to their smartphones -
10:25 - 10:26or to shopping or to eating.
-
10:26 - 10:29Before these talks began --
you guys know this -- -
10:29 - 10:31we were told we weren't allowed
to have our smartphones on, -
10:32 - 10:34and I have to say, a lot of you
looked an awful lot like -
10:34 - 10:37addicts who were told their dealer
was going to be unavailable -
10:37 - 10:39for the next couple of hours. (Laughter)
-
10:39 - 10:42A lot of us feel like that,
and it might sound weird to say, -
10:42 - 10:45I've been talking about how disconnection
is a major driver of addiction -
10:45 - 10:47and weird to say it's growing,
-
10:47 - 10:50because you think we're the most connected
society that's ever been, surely. -
10:50 - 10:53But I increasingly began to think
that the connections we have -
10:53 - 10:56or think we have, are like a kind
of parody of human connection. -
10:57 - 10:59If you have a crisis in your life,
you'll notice something. -
10:59 - 11:02It won't be your Twitter followers
who come to sit with you. -
11:02 - 11:05It won't be your Facebook friends
who help you turn it round. -
11:05 - 11:08It'll be your flesh and blood friends
who you have deep and nuanced -
11:08 - 11:11and textured, face-to-face
relationships with, -
11:11 - 11:15and there's a study I learned about from
Bill McKibben, the environmental writer, -
11:15 - 11:17that I think tells us a lot about this.
-
11:17 - 11:21It looked at the number of close friends
the average American believes -
11:21 - 11:23they can call on in a crisis.
-
11:23 - 11:26That number has been declining
steadily since the 1950s. -
11:26 - 11:29The amount of floor space
an individual has in their home -
11:29 - 11:31has been steadily increasing,
-
11:31 - 11:33and I think that's like a metaphor
-
11:33 - 11:34for the choice we've made as a culture.
-
11:34 - 11:39We've traded floorspace for friends,
we've traded stuff for connections, -
11:39 - 11:43and the result is we are one of the
loneliest societies there has ever been. -
11:43 - 11:46And Bruce Alexander, the guy who did
the Rat Park experiment, says, -
11:46 - 11:50we talk all the time in addiction
about individual recovery, -
11:50 - 11:52and it's right to talk about that,
-
11:52 - 11:54but we need to talk much more
about social recovery. -
11:54 - 11:58Something's gone wrong with us,
not just with individuals but as a group, -
11:58 - 12:00and we've created a society where,
for a lot of us, -
12:00 - 12:03life looks a whole lot more
like that isolated cage -
12:03 - 12:05and a whole lot less like Rat Park.
-
12:05 - 12:08If I'm honest, this isn't
why I went into it. -
12:08 - 12:11I didn't go in to the discover
the political stuff, the social stuff. -
12:11 - 12:14I wanted to know how to help
the people I love. -
12:14 - 12:17And when I came back from this
long journey and I'd learned all this, -
12:17 - 12:20I looked at the addicts in my life,
-
12:20 - 12:24and if you're really candid,
it's hard loving an addict, -
12:24 - 12:27and there's going to be lots of people
who know in this room. -
12:27 - 12:29You are angry a lot of the time,
-
12:29 - 12:33and I think one of the reasons
why this debate is so charged -
12:33 - 12:36is because it runs through the heart
of each of us, right? -
12:36 - 12:39Everyone has a bit of them
that looks at an addict and thinks, -
12:39 - 12:41I wish someone would just stop you.
-
12:41 - 12:45And the kind of scripts we're told for how
to deal with the addicts in our lives -
12:45 - 12:46is typified by, I think,
-
12:46 - 12:49the reality show "Intervention,"
if you guys have ever seen it. -
12:49 - 12:51I think everything in our lives
is defined by reality TV, -
12:52 - 12:53but that's another TED Talk.
-
12:53 - 12:55If you've ever seen
the show "Intervention," -
12:55 - 12:57it's a pretty simple premise.
-
12:57 - 13:00Get an addict, all the people
in their life, gather them together, -
13:00 - 13:03confront them with what they're doing,
and they say, if you don't shape up, -
13:03 - 13:05we're going to cut you off.
-
13:05 - 13:08So what they do is they take
the connection to the addict, -
13:08 - 13:10and they threaten it,
they make it contingent -
13:10 - 13:12on the addict behaving the way they want.
-
13:12 - 13:16And I began to think, I began to see
why that approach doesn't work, -
13:16 - 13:20and I began to think that's almost like
the importing of the logic of the Drug War -
13:20 - 13:22into our private lives.
-
13:22 - 13:26So I was thinking,
how could I be Portuguese? -
13:26 - 13:29And what I've tried to do now,
and I can't tell you I do it consistently -
13:29 - 13:31and I can't tell you it's easy,
-
13:31 - 13:34is to say to the addicts in my life
-
13:34 - 13:36that I want to deepen
the connection with them, -
13:36 - 13:40to say to them, I love you
whether you're using or you're not. -
13:40 - 13:43I love you, whatever state you're in,
-
13:43 - 13:45and if you need me,
I'll come and sit with you -
13:45 - 13:48because I love you and I don't
want you to be alone -
13:48 - 13:50or to feel alone.
-
13:50 - 13:52And I think the core of that message --
-
13:52 - 13:55you're not alone, we love you --
-
13:55 - 13:58has to be at every level
of how we respond to addicts, -
13:58 - 14:00socially, politically and individually.
-
14:00 - 14:05For 100 years now, we've been singing
war songs about addicts. -
14:05 - 14:09I think all along we should have been
singing love songs to them, -
14:09 - 14:13because the opposite of addiction
is not sobriety. -
14:13 - 14:17The opposite of addiction is connection.
-
14:17 - 14:19Thank 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.
- Video Language:
- English
- Team:
closed TED
- Project:
- TEDTalks
- Duration:
- 14:42
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Krystian Aparta
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."