Vietnam Vets Proved That Addiction Is a Product of Life Circumstances

    For most people addiction is situational and of limited duration. In some cases, such as people in war zones, the situational nature of addiction is so obvious that everyone has noted it.

    Richard Wilbur, a physician who was the US assistant secretary of defense for health and environment from 1971-1973, said of this phenomenon: “Everything I learned in medical school about addiction—that someone addicted to narcotics remained hooked forever—was proved wrong.”

    In fact, over 90 percent of the returned vets who had been addicted to heroin in Asia ceased being addicted in the States virtually at once.

    The Vietnam addiction experience was catalogued by Lee Robins, a professor of social science in psychiatry at Washington University in St. Louis, and her colleagues in the 1977 classic, “Vietnam Veterans Three Years After Vietnam: How our study changed our view of herointhe most careful and detailed study of a group of hundreds of heroin-addicted people ever conducted.

    Lee Robins (Photo via Wikipedia)

    Everything Robins and her colleagues took on faith about heroin was disproved. Most soldiers (85 percent) said they found opioids readily available to them at home—so we can discount the idea of lack of supply accounting for their mass recovery.

    Half did try the drugs again in the States. But even among the most vulnerable group—the previously addicted soldiers who used heroin again stateside—fewer than a third ever became re-addicted. In other words, non-addicted use of opioids was not only possible for formerly addicted soldiers, but more likely than not under their radically transformed circumstances.

    The significance of this finding is overwhelming. Natural recovery is, by far, the norm.

    What should most impress us about this research is not so much its amazing results, but how the medical experts were completely unprepared for the reality of human addictive behavior—how sensitive it is to individual outlooks, experiences and settings.

    Obviously, for most soldiers, addiction was a temporary response to an acutely threatening and disconnected environment. Opioids no longer held that addictive power over them once they returned to a more comfortable setting. Yet unlike the medical “experts,” most human beings who learn that people leaving a war zone and returning home lose their susceptibility to addiction find this to be simple common sense!

    Even this result doesn’t tell the full story of recovery by Vietnam vets. Robins and her colleagues also discovered that heroin was no more likely to be used regularly or compulsively than other street drugs available to returned vets, such as amphetamines, barbiturates and marijuana. In other words, as defined by regular, compulsive use, heroin was not distinctly more addictive than other drugs and experiences. This reality is one that addiction experts are still struggling to grasp.

    Furthermore, Robins et al. found that those who entered treatment actually fared worse than those who avoided it.

    In fact, they found that the small number of men who continued with their addictions had shown these tendencies and life problems before entering the service.

    Unfortunately, these data are ignored. Our societal view of addiction is shaped by those who have the least success in dealing with it.

    In 1993 Robins wrote a follow-up paper entitled “Vietnam Veterans’ Rapid Recovery from Heroin Addiction: A fluke or normal expectation?” The clear answer, based on numerous studies: Natural recovery from heroin addiction is the general rule, and not an exception that cropped up in Vietnam.

    The significance of this finding is overwhelming. Unlike the widespread assumptions shared by media and the American medical establishment, natural recovery is, by far, the norm. Given a reasonable environment, time and the expectation that we can and will recover, almost all of us will.

    Compare and contrast the scientific-sounding fatalism of the following message from the medical body charged with treating addiction in the US, the American Board of Addiction Medicine:

    “Armed with that understanding [that addiction is a disease], the management of folks with addiction becomes very much like the management of other chronic diseases, such as asthma, hypertension or diabetes,’ said Dr. Daniel Alford, who oversees the program at Boston University Medical Center. It’s hard necessarily to cure people, but you can certainly manage the problem to the point where they are able to function through a combination of pharmaceuticals and therapy.’”

    William White, widely considered the most balanced and thoughtful among traditional addiction experts, analyzed 415 scientific reports of recovery in 2012. White (who is “in recovery” himself) confronted claims that addiction is a chronic disease that can get worse but never better. He found:

    “Recovery is not an aberration achieved by a small and morally enlightened minority of addicted people. If there is a natural developmental momentum within the course of these problems, it is toward remission and recovery.”

    A decisive demonstration of this truth was provided by a 2012-13 national study called NESARC (National Epidemiologic Survey on Alcohol and Related Conditions). The study involved over 43,000 people in face-to-face interviews about their lifetime substance use.

    This research found that people overwhelmingly overcome drug dependencies over the course of their lives: 84 percent in the case of nicotine, 91 percent for alcohol, 97 percent for cannabis and 99 percent for cocaine. People simply rarely spend their entire lives addicted.

    Unfortunately, these data are ignored. In place of this reality, our societal view of addiction is shaped by those who have the least success in dealing with it.

     

    Changing the “Addict” Narrative

    How is it possible that we hardly ever hear about this? Propaganda from vested interests in the American recovery industry is one factor. But another is that recovery is so normal, we don’t think anything about it.

    Many more 20-somethings misuse and become dependent on drugs and alcohol than 50-year-olds, who have usually grown up and gotten jobs, and are often supporting families. Everyone knows and accepts this, yet we rarely wonder what those 50-year-olds’ lives looked like when they were susceptible young people in their 20s (sometimes their 30s and later).

    For most people who formerly had a major drug or alcohol habit, their current absence of addiction has just become part of who they are, and they don’t see anything special about it. People grow up, settle down emotionally, concentrating on jobs and careers, responsibilities toward their families, or whatever other positive paths their lives take. This is the natural process of recovery, and we rarely give it a second thought.

    Most people who have had a drug or alcohol problem have never thought of themselves as “addicts.” And they were right not to do so.

    It is only thanks to the US-rooted recovery movement that people who previously had addictive habits refer to themselves as being “in recovery,” and are encouraged—indeed, admonished—to make that the focus of their identity forever.

    Similarly, most people who have had a drug or alcohol problem have never thought of themselves as “addicts.” And they were right not to do so, since this label is an anchor on their identities. Assigning people to that negative, self-fulfilling and self-defeating identity can never be justified.

    We can see the phenomenon of natural recovery in Zach’s own life, after he quit a considerable heroin addiction in his 20s. Zach, now in his 30s, withdrew from heroin gradually, on his own. His career and family responsibilities simultaneously developed. These days he drinks alcohol socially.

    Zach’s story of spontaneous recovery from heroin addiction is fairly typical, as NESARC demonstrated. Of course, some of those who quit an addictive drug habit take decades to do so, but we should look for chronically unfavorable life circumstances in most of these cases. Here, according to the government’s NESARC research, are the turning points by which half of the people who were addicted to each substance quit:

    * cigarettes = 24 years

    * alcohol =16 years

    * marijuana = 6 years

    * cocaine= 5 years

    NESARC did not analyze separately the Americans addicted to heroin (there weren’t enough of them), but Lee Robins found exactly the same pattern to hold for those addicted to heroin in Vietnam and elsewhere.  

    Most of the people in the NESARC study would have undergone considerable life changes in the time it took them to remit their dependencies. By the time they recovered, they had developed into very different people from when their addictions began. This is an ordinary developmental process, and the opposite of the disease theory.

     


    This article is an adapted excerpt from Chapter 1 of Stanton Peele and Zach Rhoads’ book, Outgrowing Addiction: With Common Sense Instead of “Disease” Therapy, published by Upper Access Press in May 2019.

    Top photo by Gregory Hamaker via Flickr/Creative Commons

    • Stanton Peele & Zach Rhoads

      Dr. Stanton Peele is a psychologist who has pioneered, among other things, the idea that addiction occurs with a range of experiences and recognition of natural recovery from addiction. He developed the Life Process Program for addiction and has authored many books since the 1975 publication of Love and Addiction (co-authored by Archie Brodsky).

       

      Zach Rhoads is an author and educational consultant working with families in Vermont. He is also an addiction coach in Dr. Stanton Peele’s Life Process Program. He hosts the podcast FSDP Presents on behalf of Families for Sensible Drug Policy.

      Their book Outgrowing Addiction: With Common Sense Instead of “Disease” Therapy was published by Upper Access Press in May 2019.

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