Never Enough: The Neuroscience and Experience of Addiction

by Judith Grisel

This is to say that opiate addiction (like all addiction) is to some degree contextual. Such a point was made most strongly in recent history by a large group of U.S. veterans of the Vietnam War. Up to 20 percent of these troops sought escape by taking narcotics that were readily available in Southeast Asia. Congress had some warning of the pending problem as the troops were scheduled to return home at the end of the war, and national hearings were held by the Nixon administration to figure out what to do. It was decided that soldiers who tested positive would be detoxed overseas and carefully tracked upon their return. This strategy turned out to be fortuitous because the dramatically different context at home seemed to powerfully contribute to successful abstinence. In fact, only about 5 percent of the soldiers addicted in Vietnam ended up relapsing (compared with about 90 percent of people addicted and treated here). We can presume that exposure to a context similar to that experienced in Nam—such as dense, humid jungle or gunfire—might have produced a more typical rate of relapse.