They open essential doors, but that means we clinicians, not just our patients, have to pass through those doors as well. Perhaps that is one reason we eschew the questions I offer above. I am not naïve about the complexities of human relationships and the fears and challenges they present. Please understand, I have been in practice for a long time. The science of medicine, with the exceptional value it attributes to symptoms, diagnoses, and evidence-based therapies, has had the unintended effect of eclipsing what we know and can do about the benefits of human interaction and attachment. These questions may lead to others, such as: Who can you call or spend time with in the next couple of days? What gives you pause in calling or making the kind of human contact needed to enable recovery? What do you imagine these people would think and feel if you did make contact? How might that encounter go-where it was not about asking for help, or money, but instead simply, and most importantly, about re-igniting their friendship, their attachment to you, and their wish for your life to go well? Their interest is one way to achieve the dignity, purpose, meaning, and life of contribution so critical to the hard work of recovery.Īnd so on, as the conversation may continue. How many of us, during clinical encounters with patients, focus on their families, their social communities, their sources of human contact and support?ĭo we ask questions like: Who do you care about in your life? Who cares about you? When was the last time you spent time with people who are good for you-instead of those who hurt you and foster your drug taking?
This is about as basic a psychological truth as exists, yet does it find application in clinicians’ offices? Humans, not just rats, need to be part of a community, encouraged to relate and experience the support of others. What we can do, a needed and effective approach, derives from what has Alexander taught us. 2 This article means to convey that there is a totally low-tech way of enabling people with addiction to (figuratively) prefer to ingest water rather than addicting drugs. In my earlier article, I described how prescribing clinicians can help people stay alive-until they enter an effective, individually shaped, recovery program. The rates of overdose deaths, especially but not only from opioids, in this country continue to climb. That is why we use them! It is also why campaigns of “just saying no” are naïve and ineffective, and why the dilemma of drug-taking, legal and illicit, has become one of the most dominant societal dilemmas we face in the 21st century. Or transport us away from loneliness and isolation.
In immediate and powerful ways, they change how we feel, think, relate, and behave. I believe that the biggest problem with the powerful, ubiquitous psychoactive drugs (meaning those that work on our brains and minds), is that they are so effective. A social community beat the power of drugs. Even when they did imbibe from the drug-filled bottle, they did so intermittently, not obsessively, and never overdosed. When inhabiting a “rat park,” they remarkably preferred the plain water. And they were given the same access to the same two types of drug laced bottles.
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Like pigeons pressing a pleasure lever, they were relentless, until their bodies and brains were overcome, and they died.īut Alexander wondered: is this about the drug or might it be related to the setting they were in? To test his hypothesis, he put rats in “rat parks,” where they were among others and free to roam and play, to socialize and to have sex. 1 Researchers had already proved that when rats were placed in a cage, all alone, with no other community of rats, and offered two water bottles-one filled with water and the other with heroin or cocaine-the rats would repetitively drink from the drug-laced bottles until they all overdosed and died. To stand a chance beating the opioid and other drug epidemics we have, we will be far better equipped if we follow his lead.Īlexander’s experiments, in the 1970s, have come to be called the “Rat Park. That a person, or animal in his studies, is an active ingredient in their interaction with a drug. We owe to American psychologist, Dr Bruce Alexander, the understanding that addiction is about far more than any drug. Dr Sederer is Adjunct Professor, Department of Epidemiology, Columbia University Mailman School of Public Health, Distinguished Psychiatrist Advisor to the New York State Office of Mental Health (OMH) and Director, Columbia Psychiatry Media.
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