ten years ago on a sunny Sunday in April
I found myself sitting in the light of
this window playing a game of Crazy
Eights with some teenagers a few months
prior I started working at this
addictions treatment center out in the
ghost wilderness only about 10
kilometers northeast of here I was just
starting to find my crew I looked over
at one of the young ladies on the couch
who up until that point have been
quietly reading her book and I noticed
tears streaming down her face
immediately shifting from card-playing
youth worker to concern there’s
something wrong youth worker I asked her
if she was okay with the look in her
eyes that was equal parts pain and
curiosity she asked me a question I’ll
never forget Jeff is this what happiness
feels like now aside from shaking me to
the core with the realization that
someone could make it to the age of 16
and first experience happiness at an
addictions treatment program this
question sent me on a journey of
interrogating some of the most basic
truths of addiction and the helping
profession central to this journey was
this question what is this thing called
addiction here I was spending half my
life out in the wilderness we were
taking kids rock climbing and doing
group psychotherapy treating their
addiction with casual conversations over
dishes and formal sessions with the
psychologist and no one that I talked to
was able to satisfactorily answer that
question and the logical questions that
start to follow what is addictions
treatment and why is the wilderness such
a powerful component I’m just out of
curiosity quick show of hands or nod
your heads who here would consider
addiction to be a problem in society and
maybe you’ve had a close encounter
yourself or a friend or a family maybe
read about fentanyl overdoses every day
for the past couple years it’s perfectly
reasonable for us to look at it
shouldn’t say that’s a problem we should
do something about it I’m here to
suggest that today addiction is not a
problem
addiction is actually a solution and we
need to start looking at it like that if
before we get to addiction being a
solution we need to understand some of
the different ways that we’ve
conceptualized addiction in society
first is the addiction as choice model
and that addicts are somehow morally
weak lack willpower and if they would
just pick up by their bootstraps
things would be better this conveniently
takes the burden and the blame and
places it squarely on the people
suffering the most the addicts
thankfully about 40 years ago
psychologists came out with a new
definition of addiction characterizing
it as a disease like tuberculosis or
Alzheimer’s this was certainly a move in
the right direction it reduced the
stigma and most more people would be
inclined to seek treatment
unfortunately widespread enthusiasm for
this disease model has caused us to
overlook the fact that addiction has
very little in common with diseases
there’s no infectious agent like in
tuberculosis there’s no pathological
biological process like in diabetes and
there’s no degenerative conditions like
in Alzheimer’s or arthritis in fact the
only thing that addiction has in common
with diseases that if you don’t do
something about it it tends to get worse
here’s the American Society for
addiction medicines definition of
addiction
don’t try and read it I shrunk it down
to six point font it still takes up more
than three slides it’s more than 2,000
words long which is longer than most the
essays I wrote in high school and
central to this definition is this term
bio psycho social spiritual like what is
that or what isn’t that isn’t that
everything addiction starts to look like
the everything in the kitchen sink
disease a convenient way to legitimize
and organize addictions treatment into
something that’s done by professionals
with advanced degrees in clinical
settings and more and more so with
medication and here we were treating
this so-called disease by carrying heavy
packs around the forest sitting around a
campfire talking about our feelings and
learning how to trust each other and
take the risks on a high ropes course
I’m not a doctor and I’m not gonna
pretend to be one here on the Ted stage
but this struck me is fairly unusual
treatment for a disease fast-forward a
couple of years in a mode on Vancouver
Island
doing a residency in a master’s program
and I pop into Monroe’s use book store
if you haven’t been it’s wonderful you
should check it out and I stumble across
this book by dr. Gao Marmont who spent a
lot of his career on the Downtown
Eastside and Cooper working with the
chronically homeless and addicted people
that that find their way there finally
something that started to explain
addiction not as choice or as disease
but as a completely irrational response
to someone’s context that they find
themselves in to the experiences that
they’ve had in their life that have led
them there in fact it’s a way to look at
addiction not as pathological but as a
completely logical response to the
distress and the pain that we find
ourselves in fact dr. Mattei says that
the question we should be asking
ourselves is not why the addiction but
why the pain turns out that most drugs
of abuse are actually painkillers from
fentanyl to heroin to alcohol and most
of the behaviors and habits that we
develop from workaholism to shopping to
compulsively checking our smartphones as
earnest would point out our attempts to
relieve distress relieve pain I started
to understand addiction and substance
use on a continuum not as black and
white as we thought not choice or
disease as existing in the in the gray
with addiction and substance use
disorders certainly on one end but
ceremonial uses recreational medicinal
should probably make the list lots of
different ways that we can understand
substance use and habits in society so
it’s at this point that I’ve developed a
fairly solid theoretical understanding
of addiction and what I thought was
addiction unbeknownst to me I was a few
short years away from taking this theory
and testing it in the real world
in early 2011 I found myself getting the
night to pee a lot thirsty all the time
rapidly losing weight and irritable yeah
you guessed it diabetes 28 years old
relatively fit and a pancreas that had
suddenly stopped producing the insulin
like it should now I could probably do
an entire TED talk on how to scare the
crap out of your healthcare professional
by ignoring their advice and eating lots
of bacon and butter to manage diabetes
but this is a talk on human nature not
being diagnosed with an actual disease
forced me to look this other disease
this idea of addiction squarely in the
face I realized that my tendency to open
up the freezer and reach for the ice
cream when I was stressed out about my
thesis was the exact same biological
mechanism that drags the alcoholic to
reach for the bottle the junkie to reach
for the needle and earnest to reach for
a smartphone addiction starts to look
like actually just a glitch in the human
operating system as a biological
mechanism left over from our
evolutionary past that at one point
served a really useful purpose and it
was now killing us
you see there’s essentially two things
that we do as humans unless lots of big
speakers have alluded to some of this
but we ease distress and we chase
eustress distress are those cortisol and
adrenaline those the fight flight
responses that distressing circumstances
bring bring about eustress is the other
side of that coin it’s the dope and the
oxytocin and the serotonin that Ernest
was talking about so these are the two
things that were constantly doing about
lots of different mechanisms for this
from taking a yoga class to a glass of
red wine both of those ease distress
going out climbing paddling skiing all
these things induce eustress so it is
eating a healthy meal and having sex and
doing lines of cocaine and just as
footsteps on a forest floor will
eventually wear down a path so to to our
habitual coping mechanisms create
pathways in the architecture and the
wiring of our brain when we find
something that works chances are high
we’re gonna do that again and again and
again and again it’s called learning
something that we’re particularly good
at it turns out there are two different
ways to ease distress and to chase
eustress functional and dysfunctional
glass of red wine on a Friday night to
deal with the stress of their week is a
pretty functional way to unwind it’s
when that glass turns into a bottle or
two and every Friday night becomes every
night we call it alcoholism and it’s not
actually alcoholism until you’ve got
hangovers and liver failure and broken
families
actually the substance is the problem
the substance alleviates distress it’s a
solution a temporary solution for the
distress that we’re under same thing
happens on the eustress side of the coin
in fact you can take something as
beautiful and abundant and natural as
sunshine and take it to the extreme and
it becomes tanorexia the addiction to
tanning beds all the things on that list
can be functional and they can become
dysfunctional we call these things below
addiction because of the consequences of
that repetitive behavior for maxing out
our credit cards from compulsive
shopping to checking our smartphone 100
times a day or touching it to 2600 times
a day to our more traditional ideas of
drug and alcohol abuse with this new
paradigm distress eustress we start to
see addiction everywhere and not as
choice or disease but as a logical
response to the context we find
ourselves in the context that we’ve
built around ourselves that is actually
just filled with distress we used to go
days in the wilderness without running
into big stressors and when we did they
were acute they were a bear or a
saber-toothed tiger or a storm something
we could fight or flee from now we’ve
built an environment around ourselves
that’s filled with chronic stress
traffic mortgage payments social media
in fact I often find myself looking out
into the crowd looking for the non
addicts and having trouble finding them
outside of very young children
mr. Howard yourself with enough distress
and the development of habitual coping
mechanism seems to become inevitable in
his book chasing The Scream author
Johann Harry spent two years going
around the world looking at addiction
and he writes about some of the early
research on addiction that involved
taking rats and putting them into cages
by themselves offering them water and
water laced with cocaine not
surprisingly the rats preferred the
cocaine
and wasn’t until a few years later that
a Canadian researcher dr. Bruce
Alexander replicated those studies with
an important twist that we began to see
the true nature of addiction he created
this place called rat Park where rats
were free to socialize and engage with
each other being true to their nature
and in that environment
none of the rats used the cocaine none
of them became addicted and none of them
died of overdoses turns out that
addiction has nothing to do with the
so whenever I invite you into a
challenge over the next couple of days
not today because your brains are gonna
be full but over the next couple of days
reflect on some of the habits behaviors
or substance use in your own life and
ask yourself how does this make sense in
the context that I and myself in how
does this make sense as a response to
distress chances are high that you’ve
been spending more time at your desk
doing this and sitting around the
campfire more time mindlessly going from
work to dance class to soccer practice
than purposefully going nowhere more
time feeling lost in this chaotic and
uncertain world instead of actually
being lost they pull me in your thoughts
and if only for a moment it’s only
recently that I begin to feel myself
getting closer to the answer for that
elusive question what is this thing
called addiction suddenly that
experience that I had on the couch ten
years ago with that young lady crying at
the discovery of happiness makes so much
sense she had opened the door to her
cage turns out that the opposite of
addiction is not sobriety the opposite
of addiction is connection connection to
ourselves connection to each other
connection to the world around us
connection to the true power of our
human nature the power to create habits
that will ultimately destroy us habits
that will call addiction are the power
to create habits that get us a little
bit closer to eustress a little more
suddenly the answer to that question
what is addictions treatment becomes
much more clear and it doesn’t surprise
me they’re taking kids out of their
cages and out into the wilderness
reconnecting them with nature and with
themselves and with other people would
have such tremendous effects doesn’t
surprise me that trading our cages for a
taste of the open air be such a powerful
way to heal what surprises me is that
most of us don’t do the same thank you
very much [Applause]