A couple of weeks ago I heard a piece on NPR: “What Vietnam Taught Us About Breaking Bad Habits.”
It’s an interesting story. It tells how in 1971, researchers found that about 20% of the American soldiers in Vietnam were addicted to heroin. This was shocking news to the Pentagon and to President Nixon, who promptly created a new government department – the Special Action Office of Drug Abuse Prevention. This was the beginning of the so-called War on Drugs.
The story, however, takes an interesting turn. Those servicemen who were addicted to heroin were “dried out” in Vietnam, and then returned to the States. Then a year later they were examined again, and it was found that only 5% of them had resumed heroin use. Only 5%!
The conventional wisdom then (and now) was (and is) that heroin addiction is a disease, with very high rates of relapse (typically 90%). So how could the soldiers returning from Vietnam have such a low relapse rate? This result is simply inexplicable from a disease model of addiction, but is very readily explained from a behaviorist perspective.
To a behaviorist, context is a critical component in the formulation and shaping of behavior. For these soldiers, the Vietnam context had become so associated with heroin use that their use became addictive. Back in the States – in their homes – at their workplaces or classrooms – recreating in the company of their friends, etc. – the context no longer provided cues and opportunities for heroin use.
Heroin addiction is not a disease. It is a habit. And like all habits, it is best broken by avoiding people, places, and things that are associated with the habit, and by reinforcing behaviors that are incompatible with the habit.