Chasing the Scream: The First and Last Days of the War on Drugs

In this chapter, Hari seeks answers to his questions about what addiction is and what causes it. He travels to Vancouver, Canada and visits a small group of scientists who have been finding the answers to his questions for several decades. One is Gabor Maté, a Jewish doctor who survived the Holocaust as an infant in Hungary and then left his family practice to work with addicts at the Portland Hotel Society. The Portland Hotel Society is a charity that houses and helps addicts on the Downtown Eastside of Vancouver, an area consisting of ten blocks that had “one of the highest death rates in the developed world” (156) during the 1990s due to drug overdose deaths. Hari interviews Maté about his findings, which directly contradict the common beliefs about what addiction is and what causes it. The universally accepted notion, as the “pharmaceutical” theory of addiction espouses, is that addiction is “the result of repeated exposure to certain very powerful chemicals” (155). In other words, drug users become addicted when the drug hijacks their brains because of repeated use.

Maté’s theory of addiction is quite different. It resulted from his work with the Portland Hotel Society, in which he meticulously listened to and studied his patient’s stories about their lives. His theory is that previous trauma is the real cause of addiction. Hari wonders “if the discovery of drugs wasn’t the earthquake in their life, but only one of the aftershocks” (159). Academic studies of patients who received opiates after surgery and do not become addicted lend validity to this theory. Maté argues that “nothing is addictive in itself. It’s always a combination of a potentially addictive substance or behavior and a susceptible individual” (159). One study by American scientists found that when children experience traumatic events, they are two to four times more likely to become addicts—and that nearly two-thirds of injection drug use results from childhood trauma. Maté, however, also explains that the picture is still incomplete. He argues that “it plainly cannot be the case that all addicts were treated appallingly as kids. It is an important factor in addiction—but it is not enough” (165). 

This chapter introduces Bruce Alexander, a psychologist and professor at Simon Fraser University in Canada. In the early 1970s, Alexander changed the way scientists understood addiction through a series of experiments that became known as Rat Park. For years before then, the scientific community had accepted the pharmaceutical theory of addiction, in part because of experiments in which rats placed alone in cages continued to choose the water that contained drugs. Alexander altered the experiment to include another set of cages, which Hari describes as “a paradise for rats” (172). These second cages contained multiple rats and included things such as toys and food. Both cages offered the rats one regular bottle of water and one spiked with morphine. The rats in the empty cages chose the morphine far more often. Hari explains that Alexander’s conclusion was that “it isn’t the drug that causes the harmful behavior—it’s the environment. An isolated rat will almost always become a junkie. A rat with a good life almost never will, no matter how many drugs you make available to him” (172).

Alexander’s theory alludes to what he calls dislocation, or “being cut off from meaning” (174). He examined periods in history when addiction soared and found that it always came after bonds were broken. For example, Native Americans turned to alcoholism when their land was taken; the English underclass turned to the “Gin Craze” of the 18th century when they were driven into the cities; and the inner-city crack epidemic began with the loss of American factory jobs in the 1980s. Alexander argues that “today’s flood of addiction is occurring because our hyperindividualistic, frantic, crisis-ridden society makes most people feel socially or culturally isolated” (175). Hari points to studies on the use of nicotine patches to quit smoking as proof that addiction stems more from social factors than from chemicals. An individual who uses nicotine patches receives the same amount of the chemical, yet “the Office of the Surgeon General has found that just 17.7 percent of nicotine patch wearers were able to quit smoking” (183). Hari explains that this discrepancy is attributable to the difference between physical dependence and addiction. The former, he argues, “occurs when your body has become hooked on a chemical” (184), but the latter “is the psychological state of feeling you need the drug to give you the sensation of feeling calmer, or manic, or numbed, or whatever it does for you” (184).