Changing the Cage

white rat poking head out of cage

In public health we learn hard skills and strategies to guide us in assessing community health issues, developing programs/policies and evaluating their efficacy. And yet, each day our work is challenged by new frameworks, belief systems, politics, and systems of oppression. This week we ask: How does public health take on addiction—one of our most pressing social and health issues—creatively?

Johann Hari, British writer and journalist, released a HuffPo Politics article outlining his experience traveling the globe to research addiction science. His takeaway? To address addiction we have to look at more than behavior; we must change the context in which behavior exists. Specifically, Hari cites Dr. Bruce Alexander’s study of heroin use in rats. Rats who were caged alone, without resources or company, were more likely to overuse heroin until they died.

Conversely, rats housed in “Rat Park”— a cage with rat companions, adequate food, and toys— were less likely to use and didn’t die from heroin overdose. Perhaps most importantly, addicted rats who were transferred to Rat Park decreased their heroin use.

With cigarette smoking as the leading cause of preventable death in the United States and alcohol taking third place for the same trophy, we have to ask: Are we approaching addiction prevention/intervention in the most effective way possible? Do we need a paradigm shift? A little creative thinking?

I’m not an addictions expert by any means, but Dr. Alexander’s work gives me pause. Hari’s summation: that human connection is the opposite of sobriety is interesting—and limited.  I wonder how we move this thinking further. Taking into account rising wealth inequality, multigenerational racial discrimination, and ongoing gender injustice [among many (in)equity concerns], I’m compelled to suggest that the opposite of addiction is not human connection but human parity. If we all have social connection, adequate food, and toys—if we decrease social and economic inequities— can we change the cage and, ultimately, kick addiction?


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