The “Lee Robins Study” and Its Legacy, Part Two

Editor’s Introduction: Earlier this week, Points began a look back at Dr. Lee Robins’ study of heroin use among returning Vietnam veterans, with an extended Introduction and some reflections from Dr. Dessa Bergen-Cico. Today, we’re posting the second and final part of Bergen-Cico’s reflections.  Readers interested to see more of her work, may wish to look for the appearance of her book, War and Drugs: The Role of Military Conflict in the Development of Substance Abuse, coming this June from Paradigm Press. 

Cover of War and DrugsReexamining the History and Experience of Heroin Addiction among Vietnam Veterans (Part Two)

Another thing the Robins study contributes to our understanding of substance use among veterans is awareness of the critical role that the environment plays in both the development of addiction and the potential for lasting recovery. The interplay of the drug (heroin), set (emotional state) and setting (environment) are significant factors in habitual behavior development and addiction relapse. It is important to recognize the unique environment in which the soldiers were using heroin in Vietnam. Service members were using extremely pure heroin (drug) in Vietnam, in a very different environment (setting), and under very stressful and different emotional situations (set) than they were presented with back in the U.S.  Moreover “use” does not equate to “addiction,” and the level of heroin use was somewhat controlled by the nature of military life. Soldiers could use heavily while on leave, but they could not use chronically like street addicts while on active duty; their drug use would become obvious and be readily brought to the attention of their superior officers due to heroin’s incapacitating effects. This early awareness would have precipitated early intervention, thereby partially mitigating the development of physiological addiction and the entrenchment of the brain’s reward reinforcement pathway, which is the key to physiological addiction and psychological habituation.

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