The Addiction Context: The addiction context consists of the environmental stimuli that were present when the drugs were taken (Uslaner, Crombag, & Robinson, 2007). It is well-known that drug-taking is more rapidly reinstated when the recovering addict is in the drug-taking context (Tsiang, and Janak, 2006). Rapid relapse to drug-taking may be provoked by the experience of abstinence, which may be particularly unpleasant in the presence of stimuli associated with the use of the drug. Heroin addicts, for example, when abstinent in the addiction context, report suffering intense dysphoria. Their bodies are wracked with intolerable pain. For heroin addicts treated in the United States and returned to their homes, relapse rates hover around 90%. Because of the presence of drug-paired contextual stimuli, heroin addicts in the United States typically suffer horrible withdrawal symptoms and this contributes greatly to their tendency to relapse over and over again. The prognosis for most heroin addicts is dismal. Most are doomed to suffer decades of recurring relapses.
A remarkable exception has been documented with United States Military personnel serving in Vietnam (Spiegel, 2015). Based on drug-testing results, approximately 20% of U.S. servicemen in Vietnam were actively addicted to heroin. Upon returning to the United States, these servicemen were expected to require drug rehabilitation services, but the number of soldiers who continued their heroin addiction after they returned to the United States was shockingly low. Over 95% of the soldiers who were addicted in Vietnam did not become re-addicted when they returned to the United States. They reported virtually none of the typical symptoms of heroin withdrawal that have been extensively documented in those who became addicted to heroin in the United States. The obvious suggestion is that heroin addiction and symptoms of withdrawal are specific to the context in which the effects of heroin were experienced.