Photo credit: Anna Jaffe
I live in a city in the grip of opiates. Shady-looking men in ragged clothes selling on street corners in the dark, always in the dark. Teenagers with a glaze over their eyes. First responders carrying around cans of Narcan and billboards advertising the opioid antagonist to common citizens as well. Politicians within my city and well beyond it promise to “clean up” the streets by attempting to sweep pain pills under some proverbial rug, out of reach of those who need and use them.
Here’s the issue: We can roust up all the opioids from all four corners of the earth. We can dump them in some clean canister and toss it out to sea, where it will bob and sink and eventually wash up on some white sandy beach, only to be opened and passed around, and around, and around, the drugs once more making their way into every crack and crevice of society. Getting rid of opiates is not going to get rid of the opiate problem.
A long time ago, at the turn of the last century, opiates were fully legal. You could buy them at your corner store, or in your preferred pharmacy. They were sold in small bottles with names like “Mrs. Winslow’s Soothing Syrup,” an opiate concoction meant to calm your colicky baby and maybe the mother of that baby too. People in all sorts of pain, in pains big and small, sought out opiates and used them and then stopped using them once their aches were gone. It was that simple. One would think, with opiates so freely available, that the addiction rate would have been sky high, but in fact it wasn’t. Roughly 1 percent of Americans had an opiate problem back then, whereas far more than 1 percent have an opiate problem now. Availability, you see, does not cause or even contribute to the opioid epidemic, despite what our politicians think.
In the 1970s, Dr. Bruce K. Alexander did an ingenious experiment to demonstrate how opioid addiction works. He took a clutch of white wistar lab rats and fed them morphine-laced water for something like 30 days. The rats were isolated in cages with no toys or distractions, with no social stimulation, with nothing but the morphine-laced water. After Alexander had successfully addicted all of his rats, he placed a subset of them in a whole new setting that he called “Rat Park.” Rat Park had greenery and exercise wheels and all sorts of rodent goodies. There were no walls, so the rats were no longer isolated. They could frolic and mate, which they did. Now remember, these rats were completely addicted to morphine, so Alexander continued to make the morphine-laced water available to them, but he also offered them regular water as well. The rats in Rat Park, despite being physically addicted to opiates, eschewed the morphine-laced water and preferred the regular water, while those rats left lonely, in isolated individual cages, continued to need the water with morphine in it.
It is far easier to blame fentanyl or oxycodone than it is to take a good hard look at our social structure.
Rat Park is a powerful piece of drama as well as a psychological experiment. It shows us up close that, even when fully addicted, a mammal will choose to not imbibe if he or she is socially connected in meaningful ways. It shows us that availability does not cause addiction, but that isolation does. It shows us that when you provide for mammals the tools that give their lives meaning, they will choose, time and again, to use those tools, to put down the pipe and to pick up the pencil, the protractor, what have you.
Alexander’s experiment was more or less swept under the rug. This is because its implications make policy-makers uncomfortable. It is far easier to blame fentanyl or oxycodone than it is to take a good hard look at our social structure and to make a way for people to connect with one another, a way to find work that dignifies, a way to earn money, to eat, sleep, talk, to meet all the basic human needs and then some. Currently, in Portugal, the addiction rates have plummeted in large part because the government there has heeded the lessons of Rat Park and is, in response, giving addicts a chance to make their lives meaningful. Portugal is giving to addicts loans with which to start businesses, job rehabilitation and training, and the means to forge connections with others. Far more powerful than Narcan, Portugal’s efforts have paid off with many in prosperous recovery from opioid abuse. If we can’t heed the work of one Canadian scientist, can we at least look to our neighbors and see their success? I suspect not. I suspect that blaming the drug is simply cheaper and easier than giving ruined human beings a shot at remaking their lives, at decking themselves with dignity and sanguinity. Beyond that, we are a country comfortable with war and the language of war, which is why the opiate epidemic is couched in metaphors of violence and antagonism. We would have to let go of the war metaphor and meaning and embrace a human-centered, social-centered paradigm that has as its base the belief that every individual has the right to live a connected life, and access to the tools that make that possible. We would need to funnel money and time and other resources towards the poor, towards those living like Alexander’s isolated rats. It would require examining our class structure, admitting that we live in a vastly divided and disjointed country with most of the goods going to the few who live at the tip-top and very little going to our ghettos. It would require admitting that we have ghettos or ghetto-like microcosms, and then making an effort to help those enmeshed in them.
I am not optimistic about the opioid epidemic, but this is not because I think people are hopelessly addicted. They are not. My dark view has much more, has in fact everything to do with our rigid social structure and our resistance to change, especially when change requires funneling real resources towards those in less fortunate circumstances.
The power of connection, of meaningful vocation and a sense of self is such that even when fully addicted, the rats lucky enough to get into Rat Park did not even need to detox from the opiates they were addicted to. They simply stopped using once their basic needs were met. We have to ask ourselves whether we are willing to meet the needs of drug addicts, provide them with funds for small businesses, job training, or mortgages. We have to ask ourselves whether we are willing to give up the argot of war, violence, and bifurcation, and adopt in its place a language that has everything to do with dignity.
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is the author of Welcome to My Country
, Prozac Diary
, Lying: A Metaphorical Memoir
, and Opening Skinner’s Box
, among other books. She has received numerous awards, including a National Endowment for the Arts fellowship, and a Knight Science Journalism Fellowship at MIT. Opening Skinner’s Box
was nominated for Best Science Writing by the Los Angeles Times,
and her work has been reprinted numerous times in The Best American Essays
. She lives on a farm in Fitchburg, Massachusetts. Blue Dreams: the Science and the Story of the Drugs that Changed Our Minds
is her most recent book.