Lessons From Viet Vets

In the immediate postwar period, a subset of Vietnam veterans blew some people’s minds. This was half a century ago, and every few years the story gets recycled. Here is how it started. While the war was still going on, two American officials went over there and came back distraught about the number of active duty heroin users and addicts. What would happen when they returned to the States and to civilian life?

This anxiety seemed justified. At home, among standard American addicts who had received treatment, the relapse rate was around 90%. And this did not include the hard cases who had never even gone into any kind of treatment. With an expected tsunami of junkie vets, the future looked very dark.

In 2012, Alix Spiegel covered it retrospectively for NPR, relating how the government had hired psychiatric researcher Lee Robins to figure out what was going on. As personnel was scheduled for return to America, the military started testing everybody for heroin, and about one in five identified themselves as addicts. They were kept in-country to detox, but fears were great about what would happen once they were back on American soil. Robins kept track of them, and Spiegel wrote:

According to her research, the number of soldiers who continued their heroin addiction once they returned to the U.S. was shockingly low… [O]ne big theory about why the rates of heroin relapse were so low on return to the U.S. has to do with the fact that the soldiers, after being treated for their physical addiction in Vietnam, returned to a place radically different from the environment where their addiction took hold of them.

The writer also consulted psychologist David Neal, who shared with others the view that veteran addicts were different, because they had not become users in their own familiar environments. The fact that American troops in Southeast Asia caught a habit was a combination of crazy availability, and the unfamiliar, uncongenial environment. Neal said,

People, when they perform a behavior a lot — especially in the same environment, same sort of physical setting — outsource the control of the behavior to the environment.

To sum up, there are two kinds of risks, both having to do with geography:

— People who get hooked in their own environment, go somewhere else to recover, and then return home, are in danger of sliding back into addiction. They will probably do better in a new environment with none of the old associations.

— People who get hooked in a strange environment, recover, and then return home, are in danger of sliding back into addiction if they go to the strange place again. They will probably do better by not returning there, or anywhere like it.

The whole point here is to think about all these matters in the light of food addiction (FA), and what exactly that is agreed upon to mean, and by whom. So, here is the interesting part. Those two categories of people both can and do exist, under any definition of FA, and indeed any other addiction. It seems that the desire to fit into a scene can be universally dangerous. This may be what David Neal meant by saying that people “outsource the control of the behavior to the environment.”

Your responses and feedback are welcome!

Source: “What Vietnam Taught Us About Breaking Bad Habits,” NPR.org, 01/02/12
Image by Claudia Liebram/CC BY 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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