A Prescription for Change

Amidst the ongoing opioid epidemic in the United States, the assertion that “addiction is a disease” continues to dominate the public discourse surrounding substance use and drug policy. While the brain disease model of addiction is often credited with clearing the way for a more empathetic approach to treating and policing drug use, the work of many psychological scientists suggests that addiction may arise from the same basic psychological mechanisms that allow us to discover a passion for jogging, adapt to our environment, and feel loved.

When studies conducted in the 1960s indicated that lab rats would self-administer drugs even until death, many researchers took it as evidence of the inexorable appeal of substances like morphine and heroin. A decade later, Bruce Alexander’s series of “rat park” experiments at Simon Fraser University in British Columbia, Canada would turn this claim on its head.

Alexander’s rats, which were kept isolated in small metal cages with little else to do beyond sleep, eat, and wait, also filled their time by consuming large quantities of drugs. Not so for rats raised in a less traditional lab environment, however. Free to roam within the walls of a large plywood box painted with a forest scene and filled with others of their kind, more often than not the rats chose running in an exercise wheel, climbing wooden towers and tin cans, mating, and bonding with offspring over the temptation of a morphine drip. And when they did choose to partake, the social rats consumed far less than their isolated counterparts.

“They forgot to tell us the importance of the environment,” behavioral neuroscientist Carl Hart, chair of the Department of Psychology at Columbia University, said of earlier addiction studies. “They forgot to tell us that the rats or primates only had that lever leading to the drug administration, and if that’s the only thing they have in that cage, why are we surprised that’s the activity in which they engaged?”

Since learning about the findings of these early addiction studies as an undergraduate student at the University of Maryland in the 80s, Hart — an advocate for science-based drug policy who’s appeared everywhere from “Real Time with Bill Maher” to “The O’Reilly Factor” — has extended Alexander’s rat park findings to human participants. When offered a choice between $5 at the end of a study and a hit of crack cocaine worth more than $5 right then and there, only half of people known to be addicted to cocaine chose the drug, Hart said. In a similar study of 13 recreational methamphetamine users, participants abstained at even higher rates, choosing $5 over self-administering drugs 59% of the time over the course of five 2-day trials. When the incentive was raised to $20, they chose the substance over cash in just 17% of trials.

These findings, while observed in a small pool of participants, suggest that providing people with attractive alternatives removes much of the incentive to use, Hart said. Extrapolated to the real world, alternatives might not only increase access to meaningful employment and mental healthcare for individuals with substance use issues, but could also change the way society conceives of drug use.

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