Under the leadership of Mao Zedong, 45 million Chinese people were worked, starved or beaten to death during the four years from 1958 to 1962.[1] Mao’s Great Leap Forward, an attempt at a light-speed industrialization of China’s economy, enforced with staggering violence, was the cause of unimaginable human suffering. Mao rightly deserves his place alongside Stalin, Hitler and Pol Pot in the history of the 20th century.

There is, however, another period of China’s history and Mao’s leadership which, for positive reasons, deserves our attention. Another period of four years during which there was a rapid and widespread reduction in human suffering.

Between 1949 and 1953, despite ongoing mass poverty and following years of widespread addiction, Bruce Alexander writes, “Mao’s regime did not lead the world to utopia, but it did demonstrate that, under certain circumstances, addiction problems can be solved on a vast scale, quickly and with relatively little violence.”[2] It was not until the 1980s that a serious addiction problem returned to China. No comparable decrease in addiction at the societal level is to be found in modern history.

How did it happen?

In part through a series of inputs which are familiar to us from the policies adopted in the US – and elsewhere – since the advent of the War on Drugs. Incarceration, dramatic propaganda, intense policing, local surveillance and compulsory treatment.[3] Additionally, capital punishment was permitted for convicted drug traffickers. There were, however, far fewer executions than is often suggested and capital punishment was a continuation of the policies of the Chinese Nationalist governments which preceded Mao’s, not a deterrent distinct to his regime.

Whilst significant, none of the above explains the elimination of opioid addictions and the absence of a serious alcohol problem. The same policies, including capital punishment, have failed to have anything like the same impact elsewhere.

A better explanation is to be found in a set of social and economic policies which created conditions conducive to a turn away from addiction.

“After taking control in 1949, Mao’s new government immediately imposed its unique version of socialism throughout China… It entailed gaining and maintaining power by working through existing forms of social organization, as well as developing new social and political organizations particularly among poor peasants, industrial workers, and ethnic minorities, who together comprised the vast majority of China’s population.”[4]

Whilst all that sounds very dull the reality it ushered in transformed daily life for ordinary working people. From 1949 onwards the Chinese population engaged, together and wholeheartedly, in the creation of a new world of Mao’s design. It was a world which, at first, was demonstrably better than the old one.

“The great mass of the population… found it natural to work together in support of a regime that gave them real collective power, led by an icon of iron courage who idolized common people and expressed his grand designs in simple poetry and parables. Starvation was largely overcome; education flourished, barefoot doctors brought medicine to the poor for the first time; prostitution and domestic violence were greatly reduced; people were proud to be Chinese again.”[5]

Mao’s policies led to a dramatic improvement in quality of life. However, it seems improbable that those improvements explain the decrease in addiction. The very same improvements have tended to have the opposite effect in other contexts.

What was it then that did?

Three overlapping things.

Firstly, individuals found purpose. Whatever Mao’s true character, under his leadership the Chinese people worked together for him, for social justice, and for prosperity.

Secondly, individuals found community. They found one-another. The basic unit of government structure during these years was a group of just 100-200 people. Each of these communities was, in turn, part of a larger community of communities.[6]

Thirdly, individuals found identity. Mao’s reforms pulled people together in the pursuit of a collective purpose which, in turn, created a sense of shared identity. Individuals were proud to be Chinese, proud to be members of their local and vocational communities, proud to be turning Mao’s dream of a radically socialist nation into reality.

As we seek to understand both the ‘why’ of today’s addiction epidemic and the ‘how’ of recovery from addiction we find, in 1950s China, an unexpected source of insight. Those four years suggest that our approaches to prevention and treatment should focus on addressing our profound need for purpose, community and identity.


[2] Bruce Alexander, The Globalization of Addiction, 138.

[3] Alexander, Globalization, 141.

[4] “Of 10,000 addicts bought to public attention in China in the year preceding March 1951, 37 were executed. In Shanghai, the centre of the Chinese drug trade, only ten executions of major drug distributors took place between 1949 and 1951.” Alexander, Globalization, 140-141.

[5] Alexander, Globalization, 139.

[6] Alexander, Globalization, 140.

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