Its definitely easier to beat addiction if you aren't living on the street, selling everything you have and are injecting one of the most horrible shit substances but instead you are using a clean, safe alternative that is provided by the state together with prevention programs (which is usually the model for this) - how is it a false dichotomy?
Or are you someone who assumes you just need to "use willpower" and "stop" being an addict?
I assure you its not so easy with opiates.
Hordes of American soldiers were doing heroin in the Vietnam war.
When they came back to America we were expecting a massive addiction epidemic. It never happened. Overall, all the soldiers who came back lost the addiction.
Little known phenomenon about addiction that can’t be fully explained yet. What you say is true, but the person you responded to, what he says has an aspect of the truth as well. Look into it.
> Despite initial fears, high substance abuse rates during the war did not entirely translate to enduring addiction issues post-war. A year after returning home, only 10% of Service members initially detected as drug positive reported using opiates after detoxification, and just 7% reported re-addiction
> VA initially found itself unprepared for the sudden increase in drug cases.
You’re wrong, and the “historical record” you’re citing is actually the same record the NPR piece is summarizing.
What that NPR piece is pointing at is the Lee Robins follow up result that became famous precisely because it violated the folk story of heroin addiction being inevitably chronic. A later review of Robins’ findings summarizes it bluntly:
In Vietnam, high heroin use and dependence. After return, only about 10% tried heroin, and only about 1% became re addicted in the first year.
Now compare that to the VA history page you linked as a “gotcha.” It says the same thing in slightly different numbers:
One year after return, 10% reported opiate use, and 7% reported re addiction.
So no, “not entirely” and “7%” are not a refutation. They are the punchline.
You can argue about whether it is 1% or 7%, depending on definitions and measurement, but the qualitative point survives trivially: it was nowhere near the relapse pattern people expected for heroin addiction, which is why NPR is telling the story in the first place.
Your OUP line about some vets shifting to other drugs is also not the contradiction you think it is. “Some people continued using substances” does not falsify “heroin dependence largely remitted when the environment changed.” Those are different claims. If anything, substitution strengthens the “context and cues matter” thesis, because it implies the Vietnam setting was uniquely good at sustaining heroin use, not that heroin had permanently rewired everyone’s brain.
Also, “VA was unprepared” is about bureaucracy, not epidemiology. The VA being behind the curve tells you the system wasn’t ready for the volume of cases showing up at the door, not that “everyone stayed addicted forever.”
If you want to be precise, the correct statement is:
Most soldiers who were using heroin in Vietnam did not remain heroin addicted after returning home, and relapse was low relative to expectations, which is exactly why this became a canonical example in the first place.
lol what? My dad was in Vietnam, came back with drug/alcohol problems that he never shook. Whatever study/phenom you are referring to, I imagine is inflated or misrepresented. Think about culture in the late 70s and 80s, that alone debunks this...
There is also very often a psychological aspect, which explains why some addicts are able to stop "cold turkey" if the psychological/contextual aspect of their addiction changes.
Oh for sure, I agree with that. Like smokers and the habit of touching something to the lips, inhaling. But at its core it's still a chemical dependency.
Or are you someone who assumes you just need to "use willpower" and "stop" being an addict? I assure you its not so easy with opiates.