One of Johann Hari’s earliest memories is trying to wake one of his relatives and not being able to. As a child, he didn’t know why, but as he grew up, Hari realised addiction was in his family.

The author of Chasing the Scream has had over seven million collective views of his TED Talk, ‘Everything you think you know about addiction is wrong’. His passionate and conscientious talk gives a personal insight into the extensive research that took place in the writing of his book.  

It’s now been over 100 years since drugs were banned and prohibited, a policy that was thrust upon the rest of the world primarily by the US through the enactment of the 1914 Harrison Act, federal law that sought to regulate and tax the production, importation, and distribution of opiates and coca products. From this seed, drug prohibition was sown with many other countries such as the UK following. When Richard Nixon held office, what we now term the ‘war on drugs’ began with the principle rationale being to deter addiction through punishment.

Addiction, drug use, and overdose rates are on the increase in many countries. The UK and US share the troubling statistic that more people die from drug overdose than road traffic accidents. Johann’s work has seen him question why we support a dusty model of drug prohibition when we know it doesn’t work in saving lives. In research for his book, Chasing the Scream, he travelled over 30,000 miles to talk to those who have lived with addiction to learn more about how it takes hold of people’s lives.

Like many of us, Johann believed in ‘chemical hooks’, the notion that drugs that are inherently addictive and can cause dependency with nominal usage. Using the example of diamorphine (medical heroin), which is given to patients who have receiving general hospital treatment, most patients do not exit hospital with an addiction to the drug. 

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This is because drug addiction is more than just the drug itself; many overarching factors play a part in our collective relationship with drugs. Johann draws upon the example of the Vietnam War where around 20 per cent of American troops were using heroin. News reports at the time feared that this would ultimately come back to America’s doorstep. Yet, Johann found that a detailed study conducted by The Archives of General Psychiatry reported that 95 per cent of soldiers stopped using heroin when they came back home, many without rehab or help.

Citing Bruce Alexander’s Rat Park experiment – which assessed the environmental conditions in addiction – Johann remarks that we will all bond with something that gives us relief. If you’re unable to form emotional connections or are lacking the resources to have a lifestyle that is conducive to happiness, then we may well bond with our own personal cages. Whether it’s gambling, drugs or violence, our very nature means we’ll seek something to fill the void.

It was in Arizona that Johann saw for himself an example of how badly people with drug addiction can be treated, spending time with a group of women who were made to wear t-shirts saying ‘I was an addict’ and put to work in chain gangs. This type of behaviour puts barriers between ‘us’ and ‘them’. We’re still pushing those who have suffered with drug addiction to the fringes of society in a form of social purgatory. 

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There is, however, hope; there is another way.

Portugal has done what Hari describes as the exact opposite of the subscribed model of punishment. At the turn of last the century, Portugal was suffering a heroin epidemic, with one in every 100 people addicted to the drug. A drastic new approach was needed. Far beyond legal reform, the work of Dr. João Goulão, currently serving as Portuguese National Drug Coordinator, set a precedent for a more humane approach to drug users. Working with a panel of scientists and doctors, Dr Goulão’s team recommended the immediate decriminalisation of all drugs. Crucially, they took the money spent on criminalisation and redirected it to series of measures designed to reconnect those with substance dependency. Portugal looked at job creation, wage subsidies, and microloans as ways to help those suffering from addiction get back on their feet.

Sixteen years on since the introduction of the legislation, the results speak for themselves. 

The British Journal of Criminology estimated that there was a 50 per cent reduction in injecting drug use and this was matched with a vast reduction in HIV infection and overdose rates. The latest EMCDDA report paints an even more vivid picture: drug overdose deaths in Portugal are the fifth-lowest in the European Union. As a result, Portugal’s system is so popular with its residents that there’s very little opposition to such a social-led approach. 

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Concluding, Johann recommends that in addition to talking about individual recovery, we also need to talk about a wider social recovery. As we become increasingly aware of mental health, we also need to overlap many of our conversations and attitudes with our view of society as a whole. Let’s see how drug addiction fits into mental health, and let’s also discuss how we’re accountable for community health.

The emotive position, as Johann readily admits through his own experiences, is to think in terms of “I wish you would just stop - I wish someone would stop you”. But after embarking on a journey around the globe in research, and with perhaps a far greater journey made in terms of reassessing his ingrained beliefs, Johann realises that he needs to give unconditional support to loved ones who suffer with addiction. He concludes, “The opposite of addiction is not sobriety; the opposite of addiction is connection.”

Chasing the Scream is available in paperback and audiobook.

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