25 May 2006

The Myth of Addiction

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In the waning decades of the 19th century, Western societies experienced a wave of panic over the idea that various intoxicating substances offered pleasures so exquisite and seductive as to overcome the will and corrupt and enslave their users. One intoxicant after another became the target for prohibition efforts by ameliorist do-gooders.

All forms of prohibition make whatever is banned more desirable, and result in black markets. Black markets provide an opportunity for large profits by criminals, and typically lead to violence as rival gangsters fight over territories. The association of large profits with victimless forms of crime commonly results in the corruption of law enforcement.

Theodore Dalrymple draws on his medical experience as usual, in today’s Wall Street Journal, to debunk opiate addiction.

In 1822, Thomas De Quincey published a short book, “The Confessions of an English Opium Eater.” The nature of addiction to opiates has been misunderstood ever since.

De Quincey took opiates in the form of laudanum, which was tincture of opium in alcohol. He claimed that special philosophical insights and emotional states were available to opium-eaters, as they were then called, that were not available to abstainers; but he also claimed that the effort to stop taking opium involved a titanic struggle of almost superhuman misery. Thus, those who wanted to know the heights had also to plumb the depths.

This romantic nonsense has been accepted wholesale by doctors and litterateurs for nearly two centuries. It has given rise to an orthodoxy about opiate addiction, including heroin addiction, that the general public likewise takes for granted: To wit, a person takes a little of a drug, and is hooked; the drug renders him incapable of work, but since withdrawal from the drug is such a terrible experience, and since the drug is expensive, the addict is virtually forced into criminal activity to fund his habit. He cannot abandon the habit except under medical supervision, often by means of a substitute drug.

In each and every particular, this picture is not only mistaken, but obviously mistaken. It actually takes some considerable effort to addict oneself to opiates: The average heroin addict has been taking it for a year before he develops an addiction. Like many people who are able to take opiates intermittently, De Quincey took opium every week for several years before becoming habituated to it. William Burroughs, who lied about many things, admitted truthfully that you may take heroin many times, and for quite a long period, before becoming addicted…

Why has the orthodox view swept all before it? First, the literary tradition sustains it: Works that deal with the subject continue to disregard pharmacological reality, from De Quincey and Coleridge through Baudelaire, Aleister Crowley, Bulgakov, Cocteau, Nelson Algren, Burroughs and others. Second, addicts and therapists have a vested interest in the orthodox view. Addicts want to place the responsibility for their plight elsewhere, and the orthodox view is the very raison d’être of the therapists. Finally, as a society, we are always on the lookout for a category of victims upon whom to expend our virtuous, which is to say conspicuous, compassion.

The myth of addiction has a powerful appeal to the human imagination, and is enormously useful in exculpating personal misbehavior. But a society which holds more than a million people in prison for victimless crimes is paying a terrible price in order to cling to its illusions.

One Feedback on "The Myth of Addiction"


You do realize that Dalrymple is opposed to legalizing drugs?

Dalrymple is a wholehearted fool when it comes to his view on legalization.

But, I must commend your view — and his — that the whole disease metaphor for addiction is crap, particularly with the opiates.

A person taking an opiate everyday is not diseased. A disease is a state of impaired functioning. If a user takes an opiate everyday and functions well, as is the case with me, and was the case with Marcus Aurelius, and Benjamin Franklin, among many others, there is no disease. Simply taking a pill everyday is not a disease.

On the other hand, one might consider opiate withdrawal a disease.

But I am no sick man because I choose to take a chemical on a daily basis, just as a man who chooses to take vitamin C is not a sick man.

Neither the fact that my physiology differs from the norm, nor that it differs from the norm because of “unnatural” intervention, means I am “diseased” — is a tall man diseased because his physiology is different from the norm? Is a man with a plate in his head diseased because part of his physiology is “unnatural” (assuming he doesn’t feel dis-eased because he’s picking up radio stations — in which case schizophrenia, not possession-of-a-plate-in-the-head, is the likely problem).

I commend you greatly for recognizing the fact that drug use is indeed victimless, and that drug users are not victims (of disease) in all cases. Opiate users, in particular, may function at the highest level — not high relative to the diseased, a group to which they don’t belong, but relative to all of society.

In such cases, they are not diseased.

A disease is compromised functioning, not a physiological state.

The only reason some physiological states are “disease states” is because they are correlated on a 1:1 basis with impaired function.

Since taking an opiate on a daily basis results in a physiological state which — like large breasts — only sometimes is connected with impaired functioning, daily opiate use does not imply that the user is diseased.

I commend you again for seeing the simple truth that putting free adult human beings in cages for pursuing happiness is tantamount to murder as it robs people of a portion of their lives without justification. May the judges who go home and crack a beer after handing down a sentence find their way to the appropriate circle of hell ASAP.

–Your resident (at least near) genius, non-diseased, , opiate taking fan who now has mixed feelings about Dalrymple.



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