Lance M. Dodes, M.D.

I have recently started reading Dodes' work, having found that as a mother of a heroin addict I experienced a period of several years where I could not read about this issue at all. Unusual response for an academic, I admit, but an indication of the level of pain parents experience as they live through this experience!

I have found what I have read so far to be very interesting and, together with Gene Heyman's work, has given me some reasonable explanation for very complex human behavior.

However, I wish to draw attention to one inconsistency in Dodes' arguments. He makes a good case that physical dependence and psychological dependence are independent issues, based on several different sources of evidence. However he then goes on to state that addiction 'resides in people'(Page 73 in The Heart of Addiction). But the same evidence that is used to support his earlier argument is ignored in this statement. In fact the evidence suggests that individuals who are 'addicts' in Vietnam are not necessarily 'addicts' in the USA, indicating that in fact the addiction does not reside in the individual but rather resides in an interaction of the individual and some other factor/s (context perhaps?). Put differently, the 'person' explains only a portion of the variance in the data that ties individuals, contexts, age, time and other factors to addiction or addictive behaviour.

Suggesting that the 'problem' of addiction resides within an individual and is thus a stable feature of that individual as he or she moves from one context to another, or one time to another, ignores the social-psychological factors/interactions that play a huge role and that can also be manipulated to reduce addictive behaviors.

My son says frequently "Drugs are not the problem, they are the solution". But the 'problem' is more complex than a stable characteristic or feature of one human being. It is the outcome of the interaction of that human being with his or her environment over time.

Thank you for your post. I believe you have misunderstood the argument arising from the Vietnam veterans' study. You wrote that "individuals who are addicts in Vietnam are not necessarily addicts in the USA" as evidence against the internal, psychological nature of addiction. But what I was saying is the opposite of that. The use of heroin by the soldiers in Vietnam was not addiction, and the soldiers were not “addicts”. They used heroin overseas because of the setting, much as anyone caught in a cave might pound on the rocks, but not need this as a compulsive behavior once out of the cave. Since the soldiers were never addicts, they also were not addicts when they came home.

This is what I get for writing before I had completed the reading!! Please understand it as the outcome of the significant excitement I felt in reading your book!

I will write more later but in the meantime thank you for your response.