The Vietnam War Taught Us Much About Giving Up Addiction

2870348905_10a5b1d375_zMy father and I had many long and hard battles about the Vietnam War. Specifically we locked horns over the right of all of us to have the right to question everything being at war. Many years later, in 2015, I am learning that many of the Vietnam soldiers who were addicted to heroin during the war came home to America and simply gave up their addiction. They had no need for it here.

1.  From Business Insider: “This Vietnam Study About Heroin Reveals the Most Important Thing About Kicking Addictons”:

During the Vietnam War, around 20% of U.S. servicemen were addicted to heroin. It was an epidemic.

To figure out what was going on, the U.S. government started checking every soldier for addiction before sending them home — and those on drugs had to stay in the country until they were clean. Once they returned to the U.S., psychiatric researcher Lee Robins tracked their progress, reports Alix Spiegel at NPR.

Amazingly, only 5% relapsed on heroin use, according to Lee’s research. When addicts were treated in the U.S., 90% relapsed.

This finding supports the theory that when it comes to behavioral change, environment is a key factor.

A change in attitude is not enough. For example, when a smoker sees the outside of his office building, he’ll have a much stronger inclination to smoke than as if he were in a different environment, psychologist David Neal told NPR:

“People, when they perform a behavior a lot — especially in the same environment, same sort of physical setting — outsource the control of the behavior to the environment.”

Environment is especially important when it comes to changing repeated tasks or addictions. But if you’re trying to start new behaviors — like say, exercise more or increase your productivity at work— a change in attitude (more willpower) is still effective.

2. From TNW (thenextweb): “Breaking bad habits: What we can learn from Vietnam War veterans and their heroin addictions” by James Clear:

Here is what happened in Vietnam: soldiers spent all day surrounded by a certain environment. They were inundated with the stress of war. They built friendships with fellow soldiers who were heroin users.

The end result was that soldiers were surrounded by an environment that had multiple stimuli driving them toward heroin use. It’s not hard to imagine how living in a war zone with other heroin users could drive you to try it yourself.

Once each soldier returned to the United States, however, they found themselves in a completely different environment. Not only that, they found themselves in an environment devoid of the stimuli that triggered their heroin use in the first place. Without the stress, the fellow heroin users, and the environmental factors to trigger their addiction, many soldiers found it easier to quit.

Compare this situation to that of a typical drug user. The individual picks up a bad habit at home, goes to a clinic to get clean (i.e. somewhere devoid of all the external stimuli that drive their habit), then return to their old environment with all of their old triggers surrounding them, and somehow hope to quit their bad habit.

It’s no wonder 90 percent of typical heroin users became re-addicted once they return home—they are surrounded by all of the things that caused them to get addicted in the first place.

3.   From Jonathan Simon writing for The Berkeley Blog: “Vietnam and bad habits“:

Why did the good news that heroin addiction in veterans could be beaten (with fewer than five percent returning to heroine use) get so little cultural uptake (Spiegel suggests it was controversial but does that mean it was widely publicized?) May be the truth was just too far out of line with the cultural narrative about heroin to be convincing (which suggests just how unrealistic most “evidence based policy” aspirations may be). The result was disastrous. What might have been a just in time reminder that rehabilitation may be a realistic was to prevent crime, was lost on the eve of a shift in our penality toward exclusionary punishments.

Going back, briefly, to Spiegel’s story about behavior change, recent research seems to provide a satisfying explanation for why Robin’s 1970s study found such low recidivism rates. Vietnam soldiers were most people who were exposed to and got addicted to heroin in Vietnam. After being treated they returned to their communities in the US. While much our post Vietnam narrative is committed to describing that return as troubled, it appears to for the vast majority it was a world in which they no longer felt compelled to use heroin.

According to the behavioral psychologists interviewed by Spiegel, Wendy Wood of USC and David Neal, a great deal of our behavioral control is implemented through our spatial environment which routines are response so that we do not need to (or get to) think about much of what we do. For addicts this means that the routine spatial associations for use are a trigger that can and usually does overwhelm will based efforts to not use. The example given is smoking at the entry of an office building. For an addicted smoker, the approach to the building is a powerful signal to light up.

In the language of behavioral psychology we “outsource” behavioral control to the environment (something sociologists and anthropology also recognizes in Pierre Bourdieu’s concept of “habitus”) this suggest that self conscious efforts to change behavior, even if reinforced by a coercive state effort through police, courts, and corrections, face an up-hill battle unless they coincide with radical efforts to reshape the environment that a person is habitually acting in. This is likely not only to be true of classic addictive behaviors like drug use, but also other criminally relevant behaviors like aggression and theft.

Photo credit.



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