Diseasing of America - 6. What Is Addiction, and How Do People Get It? - Who Becomes Addicted?

Written by Stanton Peele

Who Becomes Addicted?

Two questions then are "Why do some people become addicted at some times to some things?" and "Why do some of these people persevere at the addiction through all the facets of their lives?" The study we previewed of U.S. soldiers' drug use in Vietnam and after they returned home gives us good answers to both these questions. This study—based on the largest group of untreated heroin users ever identified—has such major ramifications for what we know about addiction that it could revolutionize our concepts and treatment for addiction—if only people, particularly scientists, could come to grips with its results. For example, Lee Robins and Richard Helzer, the principal investigators in this research, were shocked when they made the following discovery about veterans' drug use after leaving Asia: "Heroin purchased on the streets in the United States... did not lead [more] rapidly to daily or compulsive use... than did use of amphetamines or marijuana."[7]

What does it prove that people are no more likely to use heroin compulsively than marijuana? It tells us that the sources of addiction lie more in people than in drugs. To call certain drugs addictive misses the point entirely. Richard Clayton, a sociologist studying adolescent drug abuse, has pointed out that the best predictors of involvement with cocaine among high school students are, first, use of marijuana and, third, smoking cigarettes. Adolescents who smoke the most marijuana and cigarettes use the most cocaine. The second best predictor of which kids will become cocaine abusers does not involve drug use. This factor is truancy: adolescents who cut school frequently are more likely to become heavily involved with drugs.[8] Of course, truant kids have more time on their hands to use drugs. At the same time, psychologists Richard and Shirley Jessor found, adolescents who use drugs have a series of problem behaviors, place less value on achievement, and are more alienated from ordinary institutions such as school and organized recreational activities.[9]

Do some people have addictive personalities? What might make us think so is that some people do many, many things excessively. The carryover from one addiction to another for the same people is often substantial. Nearly every study has found that overwhelming majorities (90 percent and more) of alcoholics smoke.[10] When Robins and her colleagues examined Vietnam veterans who used heroin and other illicit drugs in American cities following the war, they found:

The typical pattern of the heroin user seems to be to use a wide variety of drugs plus alcohol. The stereotype of the heroin addict as someone with a monomaniacal craving for a single drug seems hardly to exist in this sample. Heroin addicts use many other drugs, and not only casually or in desperation.

In other words, people who become heroin addicts take a lot of drugs, just as kids who use cocaine are more likely to smoke cigarettes and use marijuana heavily.

Some people seem to behave excessively in all areas of life, including using drugs heavily. This even extends into legal drug use. For example, those who smoke also drink more coffee. But this tendency to do unhealthy or antisocial things extends beyond the simple use of drugs. Illicit drug users have more accidents even when not using drugs.[11] Those arrested for drunk driving frequently also have arrest records for traffic violations when they aren't drunk.[12] In other words, people who get drunk and go out on the road are frequently the same people who drive recklessly when they're sober. In the same way, smokers have the highest rates of car accidents and traffic violations, and are more likely to drink when they drive.[13] That people misuse many drugs at once and engage in other risky and antisocial behaviors at the same time suggests that these are people who don't especially value their bodies and health or the health of the people around them.

If, as Lee Robins makes clear, heroin addicts use a range of other drugs, then why do they use heroin? After all, heavy drug users are equally willing to abuse cocaine, amphetamines, barbiturates, and marijuana (and certainly alcohol). Who are these people who somehow settle on heroin as their favorite drug? The heroin users and addicts among the returned veterans Robins studied came from worse social backgrounds and had had more social problems before going to Vietnam and being introduced to the drug. In the words of Robins and her colleagues:

People who use heroin are highly disposed to having serious social problems even before they touch heroin. Heroin probably accounts for some of the problems they have if they use it regularly, but heroin is "worse" than amphetamines or barbiturates only because "worse" people use it.

The film Sid and Nancy describes the short life of Sid Vicious of the British punk rock group The Sex Pistols. All in this group came from the underclass of British society, a group for whom hopelessness was a way of life. Vicious was the most self-destructive and alcoholic of the group. When he first met his girlfriend, Nancy—an American without any moorings—her main appeal was that she could introduce Sid to heroin, which Nancy already used. Vicious took to the drug like a duck to water. It seemed the logical extension of all he was and all he was to become—which included his and Nancy's self- and mutual absorption, their loss of careers and contact with the outside world, and their ultimate deaths.

WHY DO SOME PEOPLE —AND THEIR FAMILIES AND EVERYONE THEY KNOW— DO SO MANY THINGS WRONG?

Lions' Rogers Out To Prove Himself

Reggie Rogers, the Detroit Lions' top draft pick last year, doesn't want to fan the flames of a disastrous rookie season. "I think I was just burnt out on football, to be honest with you."

[His football] problems paled in comparison to those off the gridiron. Two months after being selected first by the Lions, Rogers was devastated when his older brother, Don, a defensive back with the Cleveland Browns, died of a cocaine overdose. During the season, Reggie Rogers was charged with aggravated assault, he was sued by two former agents, and his sister disappeared for several days. (July 31, 1988.)[14]

Obituaries

A semicircle of caskets flanked a Berkeley minister Saturday as he looked out over a chapel of tearful mourners gathered for the funeral of three teens who were killed when their car was broadsided by Detroit Lions football player Reggie Rogers.

Rogers has been charged in warrants with three counts of manslaughter for driving under the influence of alcohol, speeding through a red light and colliding with the teens' car. (October 23, 1988.)[15]